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I
THIRTY-FIRST ANNUAL REPORT
OF THB
State Department of Health
OF
NEW YORK
For THB Ybar Ending Dbcbmbbr 31, 1910
ALBANY
J. B. LYON OOKPANY. 8TATB PR1NTBRS
1911
I
is 1
k . .. A State of New York
\
s
No. 40.
IN SENATE
March 2, 1911.
THIRTT-FIRST ANNUAL REPORT
OF THB
STATE DEPARTMENT OF HEALTH
V STATE OF NEW YORK,
Executive Cuambeb,
.^ * Albany, March 2, 1911.
>
^ To ihe. Legislature:
I have the honor to transmit herewith the thirty-first annual
report of the State Department of Health.
(Signed) JOHN A. DIX
f
I
[
• • •
• • •
• • •
NEW YORK STATE DEPARTMENT OF HEALTH
Commissioner
EUGENE H. PORTER, MJL. M J).
Division of Administration
Deputy Commissioner William A. Howe, M.D.
Secretary Alec H. Seymour
Division of Sanitary Engineering
Chief Engineer Theodore Horton, C.E.
Principal Assistant Engineer H. B. Cleveland, C.E.
Special Assistant Engineer Prof. H. N. Ogden, C.E.
Ansietant Sanitary Engineer C. A. Hblmquist, C.E.
Assistant Engineer A. O. True, C.E.
Division of Laboratory Work
Director of State Laboratories William S. Magill, M.D.
Chief Sanitary Chemist L. M. Wachter
Water Analyst L. R. Milford
Assistant Water Analyst W. S. Davis
Bacteriologist William A. Bing, M.D.
Director Cancer Laboratory H. R. Gaylord, M.D.
Director of Bender Laboratory Thomas Ordway, M.D.
Division of Vital Statistics
Director F. D. Beagle
Division of Commnnicable Diseases
Director William B. May, M.D.
Division of Publicity and Education
Director Hills Cole, M.D.
Director of Tuberculosis Exhibition Edward G. Whipple, M.D.
Consulting Staff
Dermatologist Frederic C. Curtis, M.D.
Ophthalmologist Herbert D. Schenck, M.D.
Orthopedist Harlan P. Cole, M.D.
Laryngologist John B. Garrison, M.D.
SUtistician Prof. Walter F. Willcox, Ph.D.
Tuberculosis Advisory Board
Edward R. Baldwin, M.D Saranac Lake
Thomas Darlington, M.D New York City
Livingston Farrand, M.D New York city
Hon. Homer Folks, Esq New York city
Alfred Meyer, M.D New York city
Prof. Veranus A. Moore, M.D Utica
John H. Pryor, M.D Buffalo
William H. Watson, M.D Utica
John I*. Heffron, M.D Syracuse
[V]
89290
vi REroRT OF THE Statb Depabtment of Health
Medical Officers of the SUte Department of Health
F. W. Adbiancb, M.D., 306 Lake St., Elmira, N. Y.
W. D. Albeveb, M.D., 528 S. Salina St., Syracuse, N. Y.
F. D. Ain>BEW, M.D., Sodus, N. Y.
Chables E. Bibch, M.D., White Plains, N. Y.
M. Cavana, M.D., Sylvan Beach, N. Y.
•Edwabd CiABK, M.D., 571 Ellicott Sq.,* Buffalo, N. Y.
W. H. CoNNEiXT, M.D., 98 Fair St, Kingston, N. Y.
tH. H. Cbum, M.D., 116 E. State St., Ithaca, N. Y.
♦F. C. CxJBTis, M.D., Washington Av., Albany, N. Y.
$Z. F. Dunning, M.D., Philmont, N. Y.
*Fbanklin D. Eabl, M.D., 41 Hamilton St., Ogdensburff, N. Y.
H. A. Eajstman, M.D., 208 Lafayette St., Jamestown, N. Y.
*GKOBas M. FiSHEB, M.D., 230 Genesee St, Utica, N. Y.
W. S. Gabnset, M.D., 93 N. Main St., Gloversville, N. Y.
John B. Gabbison, M.D., 616 Madison Av., New York Gi^.
*:tWiLLiAH B. Gibson, M.D., Masonic Texnple, Huntington, N. Y.
JChablbs H. Glidden, M.D., 31 N. Ann St., Little Falls, N. Y.
iO, J. Hallenbeck, M.D., Canandaigua, N. Y.
Db Vebb M. Hibbabd, M.D., 128 S. Union St., Clean, N. Y.
John B. Hubes, M.D., 441 Park Ave., New York City.
Edwabd H. Hutton, M.D., 154 Pine St., Corning, N. Y.
tA. D. LiAKE. M.D., Gowanda, N. Y.
J. W. Le Seub, M.D., 207 K Main St., Batavia, N. Y.
Fbedebiok J. Mann, M.D., 262 Main St., Poughkeepsie, N. Y.
JPeblbt H. Mason, M.D., 734 South St., Peekskill, N. Y.
BuBT J. Mayoock, M.D., 560 Delaware Ave., Buffalo, N. Y.
H. E. Mebbiam, M.D., 224 E. State St., Ithaca, N. Y.
Geobge W. Miles, M.D., 11 Washington Ave., Oneida, N. Y.
Douglas C. Mobiabta, M.D., 511 Broadway, Saratoga Springs, N. Y.
C. F. Cbmes, M.D., 318 Main St., Jamestown, N. Y.
F. A. Palmeb, M.D., Mechanio.viUe, N. Y.
•O. W. Peck, M.D., 34 Watkins Ave., Oneonta, N. Y.
Joseph Roby, M.D., 52 S. Fitzhugh St., Rochester, N. Y.
B. W. Shebwood, M.D., 1117 S. Salina St., Syracuse, N. Y.
Geobgs E. Swift, M.D., 314 Warren St., Hudson, N. Y.
W. C. Thompson, M.D., 2 Brinkerhoff St., Plattsburgh, N. Y.
♦JD. M. ToTMAN, M.D., City Hall, Syracuse, N. Y.
♦Ja. G. Wilding, M.D., Malone, N. Y.
•tE. S. WiLLABD, M.D., 17 Paddock Arcade, Watertown, N. Y.
ijOHN S. Wilson, M.D., 22 S. Hamilton St., Poughkeepsie, N. Y.
E. H. Woloott, M.D., 57 S. Union St., Rochester, N. Y.
tH. L. Wheeleb, D.D.S., 12 W. 46th St., New York City.
tW. A, White, D.D.S., Phelps, N. Y.
*Smallpox experts.
tLecturers and consultants on oral hygiene.
iAiso health officers.
:ii:
:TY-FIRST ANNUAL REPORT OF THE STATE
DEPARTMENT OF HEALTH, 1910
To Hon. John A. Dix, Oovemor of the State of New York,
Albany, N. Y,:
Sib: — I have the honor to present herewith the thirty-first
arnual report of the State Department of Health, for the year
1910:
PUBLIC HEALTH WORK AND THE WELFARE OF
THE STATE
It cannot be doubted that the citizens of this State have at last
aroused themselves to the vital importance of public health work
and to a full realization of its possibilities. The educational
efforts of the Department, supplemented by local health oflBcers
and public-spirited citizens, have awakened a keen interest in
sanitary matters and aroused a public sentiment heartily in favor
of health reforms. It is realized that public health work is prac-
tical and that the State must play its part in its conduct and sup-
port. Where a few years ago hospital facilities were denied
those afflicted with tuberculosis, today seventeen counties have
built, or will soon construct, county hospitals. The demand now
is that epidemics of contagious disease shall be prevented, not
stamped out after they have assumed alarming proportions. The
social welfare of the State requires that the functions that should
properly be exercised by the State government in the prevention
of disease and the education of the masses in sanitary matters
shall be fully carried out.
This change of the attitude of the public is of recent develop-
ment and signifies the abandonment of old ideas and a new con-
ception of things. Now that contagious diseases may be pre-
vented, it is asked, why should not this be done? If it is possi-
ble, as Pasteur asserted, for the " world to rid itself of all con-
tagious diseases " a stricken community rises up to know what
progress we are making. Smallpox can be effectually checked by
vaccination. Then why not enforce it ? Typhoid can be largely
eradicated by proper hygienic measures. Why not establish
[11
2 State Depabtmkjst of Health
them? Tuberculosis is preventable. An aroused State is
determined to see this deadly menace to health properly con-
trolled. Diphtheria, formerly the scourge of childhood, can be
effectually checked by the use of antitoxin. Should the State
exercise as much care and spend as much money to save the lives
of children as it does to prevent diseases in cattle i These and
many other questions of similar import we are soon to be called
upon to answer. We must wage war against these enemies of
our State. A new civilization demands it. Xew York should
not be behind in so significant a movement as this.
The increasing demands upon the Department show that the
people believe in its efforts and that they are in thorough sym-
pathy with the fight for better sanitary conditions, more freedom
from disease and a stronger administration by the State in health
affairs. Proper education of the people in health matters, effi-
cient work by health authorities, and the co-operation of public
officials generally in the efforts for better housing and laboring
conditions, proper water supplies, parks and playing grounds,
and the other improvements that we know every municipality
should have, will eventually produce a condition which will fully
justify our pride in our citizenship.
The Conservation of Life in New York State
From an economic standpoint alone, it is entirely possible to
save millions of dollars and thousands of lives to the State. Gov-
ernmental agencies for the protection of the public health have
only begun the work in the vast field which they are destined to
eventually occupy. The average value of a life lost by preventable
disease has been estimated at $1,700. It is possible to reduce our
death rate by proper preventive measures and at this valuation
it would be necessary to save loss than one hundred lives annually
to equal the entire appropriation of $150,000 to the Department
of Health. From a business standpoint, how can a better invest-
ment be made ? — our mortality reduced, diseases prevented, un-
told suffering and sickness eliminated, and a better and happier
State in which to live. Are not these things worthy of our atten-
tion, appealing alike to humanitarian, economist, citizen and the
stranger within our gates ?
Our greatest uatural resource is tiie cliilcl. In tlie Hold of the
prevention of infant mortality alone, the JState could well afford
to spend more money than it now gives for our work and thereby
build a larger, healthier and better commonwealth for the future.
All the potential possibilities of the future of our State are in the
children of to-day. Would anyone argue that in providing so far
as lies in our power for a healthier race, the State is exceeding
its functions?
The PvJblic Health Laws
Our health law is in many respects inadequate. Much of it
wa5 enacted thirty years ago and is far behind the demands of
to-day, and has not kept abreast of our progress. While not ad-
vocating a large increase in the powers of the State Department
of Health, it cannot be* doubted that there should be sufficient
authority vested to improve many improper conditions, especially
where local authorities neglect or refuse to perform their duty.
The Department now has very little direct power. It can investi-
gate but it lacks authority to enforce necessary changes. Our
efforts to secure proper legislation in the past have met with but
little success. I desire to point out that unless we can make the
proper changes in our statutes strengthening the authority of he
Health Department where needed, the State of ?^ew York will
not occupy the position in health work which it should. It should
be clearly pointed out that rapid progress is being made in other
States and that our situation will soon be a reproach to us unless
we move more rapidly. T, therefore, earnestly request that the
JvCgislature seriously consider ray previous recommendations
covering this matter.
A pproprtations
For a number of years the very limited appropriations for the
work of this Department have been pointed out. The amount
of money expended by the State for public health work is insignifi-
cant when compared with many other lines of activity. Those
who are most interested in this subject cannot but feel that it has
not received the attention that it should.
It is realized that the demands on the State government far
exceed the income, and for this reason the Department is asking
4 State DhrAUTMEAX of Ukaetii
for verj' few new iteiiib, and only t^ucli as are al>?olu(e]^' iieee^ary
to make its work efficient.
Our fund for the investigation and euntnd ut communicable dis-
eases is $7,500. There should be a sufficient amount appropriated
to enable the Department to exercise a wider control and make
more thorough and careful investigations of epidemics.
The demands on the Department for other investigations and
for assistance from municipalities require an increase in our
fund for general investigations.
The facilities of our antitoxin laboratory are too limited, the
buildings are overcrowded, residents of the city of Albany com-
plain of its location, and the manufacture of antitoxin which re-
quires the keeping of a considerable number of horses, should not
be conducted where the laboratory is now situated but should be
moved outside of the city. The State owns the property and it
has increased in value. A farm should be purchased outside of
the city, where the antitoxin work should be moved at once, and
where eventually the State should build and equip a State Lab-
oratory adequate for its needs.
Tuberculous
The success attained in our educational efforts with this dis-
ease has been very marked. The Department's large traveling
tuberculosis exhibition which has been shown in most of the cities
of the State, has Ix^en continued and for the season 1010-11 its
itinerary is as follows:
Saratoga
Little Falls
Hat a via
Platt.sbnrgh
(ihfversville
irornell
Malono
Johns (own
Oneonta
Ogdensburg
Water town
Ithaca
IFudson
The attendance has l>een large. The interest which has been
aroused is very apparent and no single educational effort on the
part of the Department has met with as much enthusiasm. In
addition to this joint campaign and pursuing the plan of co-opera-
tion with the State Charities Aid Association which has l>een
conducted in the past, the Department has also sent out six smaller
Commissionek's Kei'okt 5
i>
<'xlnl>iU for the conduct of county campjiignti. The increased
ilcniaiids for hospital facilities for iLiberculosis patients is owing
largely to the educational work which has been done and the es-
tablishment of county hospitals, laboratories, dispensaries and
other efforts to combat this disease are all in large part owing to
tlio work that has l)een jnir^ued.
Heavimjs on Tuberculosis Hospitals
I'nder the amendment to the Public Health Law of 10O9, re-
fjuiring tlie approval of the State Department of Health and tlio
hx»al health officer for the establishment of a hospital for tuber-
culosis, ten applications were filed upon which hearings were held,
and during the past 'year nine applications were submitted.
These were as follows :
The Independent Order of Brith Abraham, of Liberty, filed
an application for permission to establish a tuberculosis hospital
in the town of Liberty, Sullivan county, and hearing was held on
^farch 11th. The desired permission was denied April 7th,
1010.
The Independent Order of Foresters filed an application for
]>ormissinn to establish a tuberculosis hospital in the town of
I>righton, Franklin county. The hearing was held at Albany,
May 5th, and the application granted the same day.
Application was filed by the Utica Tuberculosis Camp Commit-
tf^ of the State Charities Aid Association for permission to es-
tablish a tuberculosis haspital in the town of New Hartford,
Oneida countv, but was withdrawn.
Application was also filed by the Metropolitan Life Insurance
Company for permission to establish a tuberculosis hospital in the
town of Somers, Westchester county, and hearing was held in
White Plains May Hth and adjourned to May 20th, and the ap-
plication was withdrawn. A new application was filed by this
company for permission to establish a tuberculosis hospital in
the town of Moreau, Saratoga county. The hearing was held at
Albany, December 2nd, and application granted December 21st,
lf>10.
Tlie county of Schenectady filed an application for permission
to establish a tul>erculosis hospital in the town of Olenville, Sche-
G State i)Ei»AUTME:<T of IIeajltu
iKH'tady county, and hearinj^' was held in Albany, August 18tli.
The application was granted September IGth, 1010.
Jefferson county filed an application for permission to estal>-
lisli a tu'berculosis hospital in the town of Wilna, Jefferson county.
Hearing was held at Watertown, September 12th, and the applica-
tion granted September 23rd, 1910.
The Ked Cross Committee of Newburgh filed an application for
permission to establish a camp for the treatment of tuberculosis
in the town of Kew Windsor, Orange county, but the application
was withdrawn.
The Tupper Lake Sanatorium' Company filed an application
for permission to establish a tuberculosis hospital in the town of
Altamont, Franklin county, and hearing was held at Tupper
Lake, November 28th. The application was granted December
6th, 1910.
The application of the Metropolitan Life Insurance Company
is noteworthy as showing a determination on the part of a large
corporation to care for its employees afilicted with this disease.
The increased hospital provision not only provides the means
of cure, but removes the danger of infection from the home and
workshop and is one of the first great steps in the solution of this
problem. I wish to call attention to my recommendation of last
year in regard to needed amendment to the statute requiring my
approval of sites for these hospitals.
For the Future
Every effort cjliouM 1x3 exerted to see that our municipalities
provide h(>sj)ital facilities and that these institutions are properly
conducted. The law requires the State Department of Health to
approve plans for county tuberculosis hospitals and these will be
required to \)0 constructed on modern lines. Special attention
should be paid to the tuberculosis law, complete registration of
cases should be insisted upon, and localities that have not as yet
seen fit to appropriate funds for its enforcement should be shown
its importance. We can proceed in tins work with the absolute
confidence that in a comparutively sliort space of time the results
will l)e so apparent that they will fully justify our expectations.
Commissiojnek's ItKroiiT 7
Cancer Laboratory
Tliu iucrea^o each year iu the deaths from cancer, despite tu'i
fact that the death rate from many other diseases is decrea^iing,
furnishes the saddest chapter in medicine to-day. The establish-
ment of a cancer laboratory by the State some years ago marked a
point in our civilization and its research work has been devoted
to determining the causes and methods of control of this great
afBiction.
It is greatly to the credit of the State that this laboratory has
been maintained, but the point has now been reached where pro-
vision should be made for a hospital in connection with the labora-
tory. The proposed plan for such an institution provides for con-
veying to the State the valuable land and laboratory building at
present used by the State, and furnished for such use through the
generosity of Mrs. William H. Gratwick of Buffalo, N. Y., and
constructing necessary buildings for such a hospital, which shall
be under the control of a board of trustees.
It is to be hoped that the State will not fail to avail itself of
this opportunity and that this next great step may be taken with-
out delay.
Oral Hygiene
Proper hygiene care of the teeth is being rapidly recognized as
•»iie of the most important adjuncts to good health. A good dental
equipment, which means good teeth and a clean mouth, is one of
the best physical assets which a person can possess, and materially
contributes to his health and happiness.
As in most matters pertaining to the conservation of the health
of the people, this special line of preventive medicine finds its
greatest possibilities for effective work among the millions of
school children of the State. It is proposed as far as time and
funds at our disposal will permit, to conduct a campaign of educa-
tion throughout the State, by means of illustrated lectures, largely
among the children of our schools. These lectures will be pre-
pared by two of the most eminent dentists in the State, who have
recently been appointed lecturers and consultants to the State
Department of Health. Arrangements will then be made to illus-
trate these lectures and to utilize them for educational purposes
throughout the State.
8 State Depaktment of HEAi/ru
DEPARTAIENT DIVISIONS
Division ok Sanitary Engineeking
The nature and scope of the duties which a ])r()perly equipped
division of engineering should be ready to perform was briefly
outlined in my annual report for 1905. At that time it could
hardly have been considered as organized, although the nature of
the work which would devolve upon it had in a measure been
correctly foreseen. It remained, therefore, largely a matter of
time and experience as to the rapidity with which this newly-
created division would have to be developed in order to meet the
demands upon it.
The history of this division has from its beginning been one of
rapid and progressive development. An awakening public inter-
est in matters relating to public and personal hygiene, a realiza-
tion of the importance and necessity for changes in the sanitary
conditions and customs of public and private living, have resulted
in demands for advice and assistance which have constantly taxed
our resources to the limit
A high standard of efficiency of an engineering organization of
this nature in what may still be considered a comparatively new
field of practical science, and with a public eager to take advantage
of all of the resources which may be legitimately demanded of it,
can only 'be accomplished by a constant adjustment of its engineer-
ing force and facilities to these increasing demands. The work
and duties of an engineering division cannot stop with or be re-
stricted to merely the duties prescribed by the Public Health
Law. If the Department stopped here the health work of the
State would surely retrograde. There is now an aroused interest
in health work among the citizens of this State, brought about
largely through a stimulus resulting from an educational cam-
paign and an accession or response to voluntary appeals for advice
or assistance.
If, then, the work of this important division is to be con-
tinued efficiently, progressively and with combined facilities and
resources to satisfy a justly aroused public sentiment toward bet-
ter sanitary living, it must be accomplished on the one hand by a
continued careful study and continued readjustment of the forces
iuu] resources of the enc^ineering staff to the work to be performed.
Coaimissionek's Kepout 0
The work of the engineering division for li>10 holds the record
for what has been accomplished by it since its organization some
tive yeara ago. Thid will be briefly described under general head-
ings adopted in my previous annual reports, as follows:
Protection of PuhlU Water Supplies
The protection of public water supplies will probably always
bead the list of important duties devolving upon the Sanitary En-
gineering Division since a pure supply of water has always been
accepted among sanitarians as one of the greatest conservers of
public health. Indeed, the record of past epidemics of disease
traceable to infected water supplies has lost none of its force in
the present day in causing the public to realize that whatever
else is lacking in the way of municipal cleanliness, a clean and
un{>olluted water supply should be procured and maintained at
almost any cost.
Unfortunately the lay mind does not dwell as often or as con-
scientiously as it should upon these grave questions and for this
reason it becomes incumbent upon the State Department of
Health, in addition to the regular duties required of it under the
Public Health Law, to perform also a large amount of voluntary
work in this field.
These activities may, in general, be classified under the head-
ings of
(a) Protection of public water supplies subject to rules and
regulations enacted ^by the State Commissioner of Health.
(b) Protection of public water supplies not subject to any such
rules and regulations.
The work for 1910 under these two headings will now be briefly
<1 escribed.
fa) Protection of water supplier protected by rules and regula-
tions.
Perhaps the most important provision of the Public Health Law
relating to water supplies is the enactment by the State Commis-
sioner of Health of rules and regulations for the protection from
oontaraination of public water supplies when application has been
duly made by the proper authorities having control of these sup-
plies, and during 1910 applications wore received and rules and
10 State Department of Health
regulations prepared for enactment in tlie cases of the following
municipalities:
East Syracuse Deansboro C'ooperstown
DvXhi Cortland West Haverstraw
West Carthage
These applications were received in the latter part of the year,
and since it is necessary in each case to carefully inspect the water-
sheds, and customary to submit drafts of these rules for considera-
tion and comment of local authorities, these rules and regulations
were at the close of the year enacted only in the cases oi East
Syracuse and West Haverstraw, the remaining ones being at this
time in the hands of the local authorities for consideration.
Attention was called in my last report to the lack of clear under-
standing on the part of many water boards and companies as to
the methods of procedure to follow in removing violations under
these rules and regulations, and to the responsibility both legally
and financially in causing these rules to be rigidly complied with.
It was also pointed out that, owing to these responsibilities and es-
pecially the burden of expense entailed by the enforcement of
rules, there appeared to be some hesitation on the part of many
municipalities and wat-er companies in enforcing the rules and
regulations, and, further, a reluctance on the part of many mu-
nicipalities where their supplies were not protected by rules but
the sanitary quality of which was unquestionably subject to sus-
picion to apply for enactment of these rules.
Realizing this hesitancy on the part of local authorities to meet
their full responsibility in this matter, and with a purpose of
counteracting to some degree at least this undesirable, and at
times dangerous, consequence, a special investigation was made of
the watersheds of a considerable number of public supplies which
were protected by rules and regulations. These inspections proved
clearly that the fears entertained regarding the enforcement of
rules and regulations were in a measure well founded; for in a
number of cases violations were found to exist on the watershed
and in a few cases the conditions revealed a shocking disregard of
the moral and legal responsibility which undoubtedly rests upon
water boards and water companies.
Commissioner's Report
11
The municipalities, the watersheds of which were inspected dur-
ing this investigation, are as follows :
Avon and Qeneseo Elmira
Canastota
Chester
Cobleskill
Cold Spring
Corinih
Cornwall-on-the-
Iludson
Coxsackie
Dolgeville
Fredonia
lUion
Little Falls
Livonia
Mechanicville
Monticello
Middletown
Middleville
Newburgh
Elmira (State Re- Norwich
formatory)
Oneonta
OssiniDg
Penn Yan
Pleasantville
Port Jervis
Rome
Sherburne
Tarrytown
Troy
West Point
Walton
Waverly
Nyack
It is not to be inferred that any considerable number of water
boards and companies are delinquent in maintaining a proper sani-
tary patrol over the watersheds of their supplies. On the contrary,
the water supplies of this State which are protected by rules are
mostly very carefully and conscientiously patrolled and the boards
and companies are very prompt in reporting any violations of these
roles and regulations to the State Department of Health, as re-
quired of them by law. These cases are always promptly inspected
for verification following which the customary notices are issued
and action by the State or local authorities in accordance with the
procedure required by these rules is taken.
During the year 1910, violations of water rules were voluntarily
reported to this Department, examined into, and necessary orders
to local boards of health issued in connection with the water sup-
plies of the following municipalities :
Auburn
New Rochelle
Utica
Kingston
New York Citv
V
Yonkers
Mt. Vernon
Saugertics
»
(b) Protection of ^Vater Supplies not Protected hy Rules and
Regulations
By far the larger proportion of public water supplies in the
State are not protected by rules and regulations enacted by the
State Department of Health, ^fany of those are, however, verj^
12 State Dkpautmknt ok Hkalth
eflSciently patrolled, but at the same time it has been found that a
considerable number of them receive practically no regular or
even occasional inspection for the purpose of ascertaining and
removing sources of pollution.
There may be a number of reasons to account for the relatively
few public water supplies in the State that are protected by water
rules and undoubtedly the question of expense of abatement is,
as pointed out above, a very important, if not the principal one.
At any rate it has been found that the number of such supplies
improperly patrolled is a serious question, one which might well
deserve the consideration of some change in the laws relating to
the control of waters of the State used for water supply. In order,
however, that the dangerous conditions which do exist in connec-
tion with many of them may be brought more forcibly to the at-
tention of the local authorities responsible, as well as to the peo-
ple themselves, the special investigation of these unprotected sup-
plies, begun in 1908 and extended during 1909, was continued
during the present year.
It is noteworthy to find that many more applications were made
by municipalities in the State for these examinations and reports
during 1910 than in either of the two preceding y^ars, which can
only be accounted for by a more general knowledge throughout
the State of the activities and successful results accomplished by
the Department through these investigations in improving the
condition of many supplies not protected by rules. A list of the
municipalities where such investigations were made during 1910,
and where reports setting forth the findings and recommendations
were duly transmitted to the local authorities, is as follows :
East Worcester North Tarrytown Houses Point
Fonda Oxford (Woman's Seneoa Falls
Glens Falls Eclief Corps Sonyoa
Kingston Home) Whitehall
Lyons IRound Lake
In addition to the special investigations outlined above, con-
siderable work of the Engineering Division has been devoted to
examinations into, and reports upon, special features or prob-
lems which have arisen in connection with water supplies not
protected by rules and regulations. These have usually been in
response to jjarticular requests and in these cases field examina-
tions have usually been made and advice freely given.
Municipalities where examinations into special problems or
features have been asked for during 1910 and where advice has
been furnished, are as follows:
lU-lmont Delhi Niagara Falls
Hlauvelt (State Rifle Dobbs Ferry Ogdensburg
Range) Letchworth Village Skaneateles
Cold Spring Monticello Waterloo
Coming
Typhoid Fever Investigations
Although typhoid fever through the State during 1910 was on
the average less prevalent than for the past decade or semi-decade,
it appears that the number of outbreaks or cases of undue preva-
lence of this disease in cities and villages were nevertheless more
numerous. In most, but not all, of these cases the Department
was appealed to for aid in searching out the sources of infection
and in giving recommendations for remedial measures.
Since the sources of infection responsible for such outbreaks
are in general most frequently found in conditions associated
with infected water supplies, infected foods and insanitary con-
ditions of living or premises, and involve frequently many ques-
tions of a strictly engineering nature associated with water sup-
plies and sewage disposal, this epidemiological work devolved
largely upon the Sanitary Engineering Division. In every in-
stance a careful study was made of the infected territory and a
searching investigation made to determine the source of infection.
This investigation work was not always simple but was neverthe-
less ultimately successful, for the sources of infection were dis-
covered and measures promptly recommended to suppress them.
The list of places where the prevalence or epidemics of typhoid
fever were thus investigated and reported upon by the Engineei^
ing Division during 1910, is as follows:
Hobart Syracuse Willard State IIos-
Long Lake and Webb Syracuse (State In- pita!
(towns) stitution for Yonkers
Moravia Feeble -Minded
Quarryville Children)
Rouses Point
14 State Department of Health
Sewerage and Sewage Disposal
If the streams of this State used as sources of water supplies
are to be protected against the dangers of sewage contamination,
and if the remaining ones are to be maintained in a satisfactory
degree of cleanliness, it is essential that some adequate control
over the discharge of sewage into these waters be vested in the
central authority of the State, having jurisdiction broader than
those possessed by local authorities which if left to decide these
questions might be swayed by local interest or prejudice. Such
control is in part granted the State Commissioner of Health under
certain sections of the Public Health Law, which provides that
all plans for systems of sewerage and sewage disposal of munici-
palities must first be submitted to and approved by him, before
they may be constructed or put in operation ; and that in all such
cases the Commissioner shall stipulate the conditions under which
sewage and wastes from these factories or sewer systems may be
discharged.
Under these sections of the Public Health Law, which have
been in effect since 1903, the date of the passage of the act, there
is required of the Engineering Division the larger part of its rou-
tine work, comprising the examination of plans for original sys-
tems of sewerage and sewage disposal and of extensions or
modifications thereof, and the preparation of permits containing
the conditions as to degree and extent of purification required and
to the location and manner of discharge of the effluent from the
sewage disposal works.
During 1910 plans for sewerage or sewage disposal works were
examined, reported upon and approved in the cases of the follow-
ing municipalities:
Auburn Bronxville and Tuck- Clarence (T.) (Buf-
Auburn (State ahoe falo Auto Club)
Prison) Chappaqna (Conva- Clifton Springs
Bingham ton lescents' Home of (Clifton Springs
Blauvelt (New York New York City Sanitarium)
State Rifle Range) Children's Aid So- Comstock (Great
Bronxville ciety) Meadow Prison)
Commissioner's Report
15
Dahnemora (Clinton
Prison)
Depew
Elka Park (T. Hun-
ter)
Fulton
FultonviUe
Hastings-on-Hudson
Hempstead
Dion
Johnstown
Lestershire
Letchworth Village
Long Beach -
Medina
Monroe County
Tuberculosis Hos-
pital.
Monticello
New Eochelle
North Tonawanda
Ogdensburg
Oneonta
Oswego
Pelham
Pelham (T.)
Poughkeepsie
Rochester
Rockaway Beach
Rome
Sonyea (Craig Col-
ony for Epilep-
tics)
Spring Valley (Sal-
vation Army Or-
phanage)
Stamford
Ticonderoga
Tuckahoe
Utica
Watertown
Westfield
Yorkville
The following is a list of places where permits were issued
during 1910 for the discharge of wastes from factories and indi-
vidual properties into streams of the State under suitable restric-
tions:
Brasher Falls Earlville
Chautauqua Lake Gilbertsville
(11 permits is- Harford Mills
sued) Hermon
Clarkstown (T.) Java (T.)
Downsville Pittsford (T.)
Poughkeepsie
Rensselaer
Scriba Center
Shaverton
Sherburne (T.)
Wolcott
In addition to the routine of examining au<l reporting upon
plans for sewerage systems and extensions, time-consuming as this
work must necessarily be, there is still much work of an educa-
tional and advisory nature to be done in connection with it. This
educational work is considerable in amount and varied in its
nature, and includes numerous conferences with local boards or
committees, lectures and talks in connection with sewerage sys-
tems and sewage disposal plants, and advice and reports concern-
ing specific local problems. The municipalities where work of
IG
State Depabtment of Health
this nature has been performed by the Engineering Division dur-
ing 1910, are as follows:
Akron
(Vntral Islip (State
Hospital)
Cheektowaga
Cornwall-on-Huds<.»n
East Syracuse
Geneva
Glen Cove
Hamburg
Hastings-on-Hudson
Lancaster
Long Beach
Martvillo
Morristown
Newark
New Paltz
Nyack
Phelps
Port Jefferson
Ravena
Ray Brook
Riverhead
Rome
Theresa
Victor
Warwick
Yonkers
Torktown Heights
Investigations of Stream Pollution
If there is any one subject or topic, excepting perhaps that of
tuberculosis, over which the people of this State have become
thoroughly aroused during the past few years, it is the pollution
and defilement of our streams. It is a subject which cannot be
discussed too frequently, nor can its importance be too often
impressed. Much has been done within recent years, it is true,
not only in curtailing but actually eliminating some of the wan-
ton defilement which has up to this time been permitted with
many of the streams of our State. A vast amount of work still
remains to be done, however, before these streams have been re-
claimed to a degree of cleanliness which public decency demands.
It is indeed fortunate that the people of this State have through
the educational campaign which has been waged during the past
five years, been awakened to a sense of appreciation on the one
hand of the healthfulness and comforts derived from preserving
our streams in a state of natural purity, and on the other hand
of the dangers and annoyance in allowing tHem to become defiled
with sewage pollution.
DiflScult as a crusade must be against these practices of sewage
pollution, and made more difficult by the lack of adequate laws to
enforce its removal, it must be continued energetically until these
streams, once pure, have been reclaimed to a reasonable degree of
purity. The work of the Department in this field devolves neces-
garily upon this Division, which is called upon almost daily to in-
Commissioj^ek'b Eeport
17
vestigate and report upon complaints of nuisances arising from
fetream pollution in different sections of the State.
These nuisances are usually of a public nature, frequently far-
reaching in their effect and not infrequently require considerable
time to thoroughly investigate and report.
The municipalities where the more important of these nui-
sances have arisen and received the attention of the Department
are the following:
Allegheny River
Amenia
Andes (T.)
Andover
Augur Lake
Babylon
Banksville
Bath
Bethel
Big Moose
Binghamton
Brant Lake
Bronx River
Camillus
Chateaugay
Chautauqua Lake
Cortland
Esperance
Fairport
Findley Lake
Fishkill-on-lIu(lMMi
Franklin
Gowanda
Greenfield Center
Greenwood Lake
Harriman
Hunter
Huron
Islip
Jamestown
Lake Placid
Lakewood
LaSalle
Malone
Margaretville
Mt. Pleasant
North Pelham
Oneida
Oneonta
Oxford
Patchogue
Perinton
Phelps
Philjnont
Phoenicia
Piermont
Plattekill
Plattsburg
Prattsville
Plymouth
Rensselaer
Scarsdale
Scriba Center
Sharon Springs
Skaneateles
Smithtown
Spring Valley
Stony Point
Tonawanda
Victor
Warren
Warwick
Waterloo
Wilton
Windham
Wolcott
Yonkers
Public Nuisances Not Arising from Stream Pollution
Although the pollution of streams is, generally speaking, re-
sponsible for the larger number of what may be considered serious
nuisances, there are on the other hand a great many nuisances
arising from other sources which must be investigated. Many
of them are of minor importance, many are of a more private
18
State Department of Health
than public nature, and most of them are directly or indirectly
cases of appeal from the action, or more often inaction, of the
local board of health.
Frequently these cases can be satisfactorily dealt with through
correspondence and the assistance of the local board of health or
its representative, the local health officer. These local boards have
full jurisdiction to deal with nearly all nuisances in this class
and it seems to be generally overlooked or ignored that nearly all
of these cases should be dealt with by the local boards and not
referred to this Department. When referred to the Department,
however, these complaints are always investigated and if sustained
are either referred to the local board of health for action if the
case falls within its jurisdiction or authority, or they are taken
up indirectly by the Department with the party complained of
through the local board of health if the case falls partly outside
its jurisdiction.
The municipalities of the State where the more important of
these nuisances have arisen and have been referred to this De-
partment for investigation and action during 1910, are as follows:
Akin
Coxsackie
Hudson Falls
Albion
E. Syracuse
Huntington
Athens
Euclid
Hyde Park
Aurelius
Fair Haven
Islip
Aurora
Fa vet to
Jordan
Baldwinsville
Fayetteville
Lewiston
Ballston
Fishkill Landing
Lyndonville
Batavia
Franklinville
Malone
r» roc ton
Freeport
Mamaroneck
Brooklyn
Friendship
!Marcellu8
Callicoon
Fulton
Matteawan
Canaseraga
Geneva
Milford
Cato
Greece
^Montour Falls
Catskill
Greenport
Mt. View
Cheektowaga
Harrison
Newburgh
Clarks Mills
Hensonville
New City
Clarksville
Hermon
Newfane
Clifton
Highland Falls
New Rochelle
Cohoes
Homell
Niskaynna
Commissionek's Report
10
North Salem
Oneonta
Oriskanj
Ossining
Peekskill
Penn Yan
Port Chester
Port Henry
Port Jervis
Red Hook
Rensselaer
Rhinebeck
Ripley
Rockland Lake
Rome
Rosendale
Schenectady
Schuylerville
Seneca Falls
Sharon Springs
Sheridan
Silver Springs
South Nyack
Somers Center
Stillwater
Stony Ridge
Syracuse
Tarrytown
Troy
Tuckahoe
Tupper Lake
Variek
Vestal
Walton
Watervliet
Wheatfield
Whitehall
Yonkers
Investigations hy Order of the Governor
Section 6 of article I of the Public Health Law provides that
whenever required by the Governor of the State the Commissioner
shall have the power and shall make an examination into nuisances
or questions affecting the security of life and health in any locality
of the State. Although, strictly, no executive orders were issued
under this provision of the law, two investigations and reports
were made at the request of the Chief Executive, one in relation
to the prevalence of typhoid fever in the State and one in rofrr-
once to the reconstruction of the Bird Island pier outfall sewor in
citv of Buffalo.
The first of those investigations and reports was roquesto<l by
Cfovemor Wliite during the month of October, aufl since at this
season of the year typhoid fever is normally most prevalent this
investigation afforded an opportunity of emphasizing the fact well
understood by sanitarians hut not hy the public at large, that
there is normally a very marked seasonal variation in the preva-
lence of typhoid fever during the year. That this fact is not
generally understood or appreciated was evident from the ay>-
parent feeling of anxiety entertained by the public and freely
circulated through the press that typhoid fever was unduly preva-
lent throughout the State, and in certain localities or munieipali-
ties this feeling reached a state of real alarm. The results of thi«
investigation showed very clearly, however, that through the State
20 State Depaktmkkt of llEAi/ni
as II whole, tjj>hoid fever during i\)Uf was .^oiue 10 per ceut. Ieii8
pix^vali'iit than the average for the ten-year periixl imniediatelv
preceding, notwithstanding that in some di&triets of the State its
prevak»nee was in excess of the normal. Incidentally the results
alx) illustrate the false anxiety or alarm frequently evidenced by
the puhlic concerning a strictly scientific niattervvhen important
facts and a knowledge of the subject are lacking.
Special Investigations
If real and continued progress is to be made in public health
work through the officers of a State Department of Health, it is
essential that the work be not limited to merely the requirements
and duties imposed by the Public Health Laws. Important as
these duties mav be under the law% and etticient as the work of
the Department may be in carrying them out, there is a consider-
able amount of work of an educational character that must be
performed in order to make the public understand and appreciate
the rationality or the necessity of the enforcement of these laws.
Furthermore, there is a considerable amount of information con-
cerning statistics of health and sanitary conditions in different
localities of the State which must be considered a prerequisite to
suitable and appropriate action by the Department in many
matters pertaining more especially to water supply and sewage
disposal. This information can only be secured through special
work and investigations outside of the routine or regular duties
imposed by the Public Health Law.
It is hardly ])racticablo in this brief report to describe fully the
many investigations of a special nature, or to give detailed account
<yf the different educational activities, devolving upon the Krigi-
neering Division nnder this heading. The inore inij)ortanl of
these, however, may be considered the special inv(»stigations of the
sanitary conditions of summer resr>rtv<?, sanitary conditions of cities
and villages, sanitary conditions of State institutions reporting to
the Fiscal Supervisor of State Charities, illegal construction of
sewers and violations of permits issued for the discharge of sew-
age, and the work of preparation of the engineering exhibit for
the State fair.
The work in all these branches is a continuation and develop-
Commissioner's JiEroirr .'2{
ment of the work instituted and carried on during previous years
and, except in the case of the State Fair Exhibit, has in a large
measure been fully described in my previous annual reports. A
brief outline, however, will be given of the work during 1910
under the headings and in the order above referred to.
(1) Sanitary Conditions of Summer Resorts
The work of inspecting the sanitary condition of summer re-
sorts, first commenced by this Department in 1906, has been ex-
tended each year since that time. During the season of 1910
three inspectors were engaged almost continuously on this work
for a period of three months.
The work accomplished in 1910 includes the reinspection of
2yj reports previously inspected, to the proprietors of which re-
sorts letters had been addressed requesting that improvements in
sanitary arrangements at their resorts be made, together with
original inspections of some 170 additional resorts not previously
inspected, a total of 429 resorts, many of them accommodating
several hundred guests, having been visited and inspected by
representatives of the Department.
As noted in my report of last year, the State has been divided
into thirteen districts in order to systematize the investigation
and to facilitate the work of inspection. These districts are as
follows :
1. Thousand Islands — St. Lawrence district.
2. Fulton Chain — Big Moose district.
3. Raquette, Tupper and Long Lake district.
4. Saranac — St. Regis district.
5. Lake Champlain district,
6. Lake George district.
7. Lake Pleasant — Saratoga Springs district.
8. Western district.
9. Central — Finger lakes district.
10. Otsego Lake — Richfield Springs district.
11. Catskill — Albany district.
12. Southern district.
13. Long Island district.
The work of reinspection in 1910 of the 259 resorts referred to
22 State Dj£pabtmekt of Health
above was carried on in districts 2, 3, 4, 9, 11 and 12. Original
inspections were made of resorts in districts 1, 3, 4, 5, 11 and 12.
With the completion of these inspections the Department now has
full information concerning the sanitary condition of practically
all of the summer resorts in these districts having guest capacities
of twenty-five or more persons.
As has been my custom in the past, it is my intention to give
publicity in the Department's Monthly Bulletin or the press to
those resorts where the proprietors, after repeated notices from
this Department, have failed to make the improvements recom-
mended to safeguard the health of their guests.
In this connection it may be stated that many requests are re-
ceived during the summer season from prospective summer
visitors, for information relative to the sanitary condition at
hotels and summer resorts which they are planning to visit. From
the records of recent inspection of summer resorts on file in the
Department, it has been possible to answer many of these in-
quiries and it is expected that eventually complete records will be
available at this Department of the sanitary condition of all
summer resorts in the State.
(2) Investigation of Sanitary Conditions of Cities and Villages
These investigations and studies of the sanitary conditions of
certain cities and villages in the State were begun some three
years ago with the object, primarily, of determining what munici-
palities were apparently experiencing or suffering an unduly high
rate of mortality from communicable diseases and, secondarily, of
determining the causes and influences responsible for these high
rates in order that they may be removed and thq mortality rates
lowered. These investigations have covered a considerable num-
ber of the cities and villages of the State, have proved of in-
estimable value to the respective localities, and have in most cases
•resulted in the undertaking of extensive improvements which will
unquestionably lead to a lessening of death rates from infectious
diseases in these places.
Since these investigations have in previous years covered the
more important places where improvement seemed potential,
leaving thus a smaller number of places for consideration, and
Commissioner's Report 23
owing to the necessity for important lines of investigation in
other directions, there were investigated during 1910 the sanitary
conditions of only three municipalities, namely Lockport, Kings-
ton and Oneonta. These investigations were started late in the
year and although only the field inspections and studies have been
made at the close of the year it is expected that the reports will
be completed at an early date.
(3) Illegal Sewer Construction and Violations of Sewer Permits
The handicap placed upon an eflfective campaign against illegal
practices in sewer construction and the discharge of sewage into
the waters of the State resulting from a lack of adequate powers
granted the Commissioner of Health for the enforcement of cer-
tain sections of the Public Health Law, and of the failure of the
passage of bills amending this law, has however not lessened the
efforts of the Department in this direction. This campaign, if
such it may be called, has been carried on along two general lines ;
first a special investigation to determine as to what municipalities
were constructing sewers without the approval of the Department
or were violating any of the conditions of any permit issued for
discharge of sewage into streams; and secondly, the holding of
conferences with local authorities when violations of the law
occurred to enlist their co-operation and compliance with the pro-
visions of these statutes.
Unfortunately there are many cities and villages still openly
violating the Public Health Law in regard to both the construction
of sewers and the discharge of sewage from them into the waters
of the State. The large number of these cases and the serious
conditions of pollution of some of our streams incident to them,
makes the matter an important one, so much so that it was referred
to the Attorney-General a year ago for his opinion as to the scope
and powers of the Health Commissioner under Article V of the
Public Health Law with reference to sewerage and sewage dis-
charge, and to his authority in dealing with municipalities which
persisted in violating the law.
This decision had not been rendered at the time my last report
was transmitted but was received earlv in 1910. The decision is a
very important one and disappointing in so far as it defines clearly
2\: State Uepaktaiknt of Health
the narrow limitation of authority and powers of the Health
Commissioner in enforcement of the provisions of Article V and
the relatively greater authority and power of local boards of health
in correcting and removing violations of these provisions. Inci-
dentally, it emphasized the pressing need for a complete revision
of these sections of the Public Health Law.
As stated above, however, the eiforts of the Department havo
not been relaxed in this direction, nor will they be, notwithstand-
ing the present number of continued violations of the law and
the greater difficulties resulting from the recent decision of the
Attorney-General. It should be stated, however, and with no
little credit to the people and local authorities in the State, that
throughout our work in this direction there has been generally
sho\vTi a spirit of co-operation in this movement to correct abuses
of stream pollution and to comply with the provisions of the
Public Health Law.
(4) Engineering Exhibit at Slate Fair
Perhaps nothing can better or more graphically illustrate the
character and diversity of the work of the Engineering Division
than the display of maps, records and models exhibited as part
of the Department's general exhibit at the State Fair at Syra-
cuse; and for this reason and because a considerable amount of
work was devoted to the preparation and arrangement of these
engineering records and models, mention should be made of it.
This exhibit was essentially an educational one and comprised
largely a wall display of plans, charts, profiles, photographs and
other graphical illustrations representing the work of the division
in connection with public water supplies, sewerage and stream
pollution; and a series of working models, in operation, repre-
senting various methods and types of sewage purification works.
Interest centered largely around these working models, and in
connection with the operation of them a member of the engineer-
ing staif was detailed to give brief descriptive talks upon their
constructive and operating features.
It may be well to mention in connection with these models that
they were made from actual detailed plans, requiring consider-
C'ouMissrosKn'a HKi'ttitT :ij
able time in their construction, and that so far as known thny
represent the first working models of sewage purification works
that have ever been e.ihibited, at least in this country.
(5) Investigation of State hislilutions Beportlng to Fiscal Su-
pervisor of Stale Charities
At the last session of the Legislature, section 14 of the Public
Health Law was amended by chapter 03 of the Laws of 1910, to
provide for examinations and reports on the sanitary condition
of such institutions as report to the Fiscal Supervisor of State
Charities whenever requested by him, and for regular analyses
of water supplies of these institutions. A request was accordingly
received from the Fiscal Supervisor on May 18, 1910, for exami-
nations and reports of all of these institutions, and since that date
the work of inspection has been in progress jointly by the Divis-
ions of Engineering and Laboratory Work. Tliere are seventeen
of these State institutions, -is follows:
Western House of Refuge for Women, Albion.
Jfew York State School for the Blind, Batavia.
Xew York State Soldiers and Sailors' Home, Bath.
New York State Reformatory for Women, Bedford.
New York State Reformatory, Elmira.
Xew York State Training School for Girls, Hudson.
Agricultural and Industrial School, Industry.
Thomas Indian School, Iroquois.
2(5 Statk Depaktment of Health
Although no provisions for increased funds were made to cover
the work thus added to the reguFar duties of these two divisions,
this work has l)een actively prosecuted and at the close of tlie
year the examinations and inspections of all of the institutions
listed above have been made and the reports when completed are
transmitted to the State Fiscal Supervisor and to the Board of
Managers of these institutions.
Labobatoby Division
For reporting the work of this division last year, it was found
advantageous to group its services under five headings :
A. Educational.
B. Routine investigations for purposes of sanitary control of
potable waters and foods.
C. Diagnostic examinations for the detection of infectious dis-
ease and control of quarantine.
D. Special investigations of complaints of epidemics or unsatis-
factory sanitary matters in various communities and institutions
of this State.
E. Preparation and distribution of bacterial products, sera and
therapeutic material.
Oroup A
A further expansion of the educational work of the Laboratory
Division was made during the year. After the completion of
fifteen short courses described in the preceding yearns report, it
was found practicable to offer every week in the year a course, for
the first four days of each week, in bacteriology ; a course for the
last four days of each week in chemical and bacteriological exami-
nations of water and milk, and quarterly, a course of four days'
duration on the purification of water and sewage, with demon-
strations made by members of the staff and of the Engineering
Division of this Department of large plants of water filtration
and sewage purification in the vicinity of Albany.
The auxiliary laboratory at Ithaca for water analyses and in-
struction of health officers and students of sanitary science in that
vicinity, has been continued with increasing activity throughout
the year. Members of the laborntorv staff have also ffiven in-
CUMMISSIONKU'S llKrOKT 27
struction in this auxiliary laboratory at Ithaca in methods of
sanitary water analysis for ten day periods last year and will re-
peat this course this year.
About fifty students taking courses at Cornell Univei*sity have
also utilized the courses of this Department in sanitary water
analyses oflFered at its laboratory there.
Twice during the year courses have been offered at the labora-
tory in Albany for the medical officers of the Department during
their meetings there and such courses have been greatly appre-
ciated and seemed to be of great advantage in the training of
these men for the particular activity for which they are designed.
In addition to the educational services aforementioned, one or
more members of the laboratory staff have lectured at Cornell
University in the course of lectures in sanitary science maintained
there throughout the year. One of the staff has delivered a public
lecture on rabies at a special meeting and invitation of the County
Medical Society at Amsterdam, and members of the staff have
appeared in conjunction with county medical societies to aid such
societies in a special effort to secure a county laboratory for their
district, and the Department in assisting such effort, through a
member of the Laboratory Division, has appeared before the
boards of supervisors of the counties of Allegany, Warren and
Westchester to make the public plea that such supervisors should
provide a County Laboratory and a well equipped and organized
service for their respective counties.
Members of the laboratory staff have also taken active educa-
tional part at the Annual Sanitary Conference of Health Officers
at Buffalo last November and have contributed very largely to the
matter of the special number of the Bulletin distributed to every
physician in the State (August number of 1910), and a consider-
able portion of each number of the Bulletin throughout the year.
A special effort of the Laboratory Division to instruct the
physicians using the State antitoxins, in the necessity of making
prompt and complete reports, has been made this year by corre-
spondence with those delinquent in furnishing a satisfactory re-
port and as a result of this education of the physician to a realiza-
tion of his duty in the matter of reporting his use of antitoxin, a
far greater percentage of reported cases is available for the anti-
2S State Depaktmknt of Hkaltu
tx)xin statistical service this year. Continued and more rigorous
efforts in this direction, however, must manifestly be made.
Group B
Extending and systematizing the function of the Laboratory
Division hero chissitied, which comprises the examination of the
potable waters of the State; the control of filtration plants and
protection from sewage pollution: 2,6G2 sanitary water analyses
were made during the year 1010, an increase of 32 per cent over
the work of the preceding year. Of this total number of analy-
ses 1,564 were bacteriological examinations (an increase of 25
per cent, over that of the preceding year) and 1,097 were chemi-
cal analyses (an increase of 44 per cent, over that of the preceding
year).
During the year 1010, 31 G public water supplies were exam-
ined, and of these various supplies 98 were examined once; 75,
twice; 55, three times; 28, four times; 24, five times; 19, six
times; 10, seven times; 3, eight times; 3, nine times; and 1, ten
times.
The bacteriological examination of spring waters described in
the report of the preceding year was repeated this year as a mat-
ter of control and these results w^re supplied to the State Com-
mission in charge of such springs.
It will be noted that in my report of the preceding year it was
pointed out that the capacity of the present laboratory facilities
was already close to its maximum. It will be noted that a very
decided increase in every line of laboratory activity has been ac-
complished this year, but particular attention is draw^n to the
fact that this increase has been accomplished only by the most ex-
acting personal effort of members of the staff, working at great
disadvantage in unsuitable surroundings and inconvenient fa-
cilities.
It is gratifying to find an increased and better systematic
laboratory control of our public water supplies, but it is by no
means to be concluded tliat the activity of this closing year real-
izes in any proper proportion the amount of such work necessarily
to be undertaken for any adequate control of the waters of this
State.
('(IMMlSSlUNKll's IiliftJliT li'.i
Group C
The reorganization of tLis group, undertaken at the beginning
o£ ]aat jear, has proved most advantageous. The bringing to-
gether of all of the laboratory services under one personal direc-
tion has practically abolished any foundation of complaint as to
the promptitude and exactitude of the diagnostic service under-
taken by the Laboratory Division during the past year. Possibly
because of this improvement and also because of the educational
policy- of the Department in pointing out the utility of laboratory
services to the health officers and practicing physicians of the
State, it is found that this work is increasing very rapidly,
whereas the total number of specimens examined in this aervice
in 1»08 was 2,938; in 190i», 3,Gi)5; that in IfllO, 8,895 such
specimens were examined, showing an increase over the work of
the preceding year of 141 per cent.
Additional duty imposed upon this Department by the legisla-
tion of last year involves the sanitary control of all of the institu-
tions of the State now grouped under the authority of the Fiscal
Supervisor, seventeen in number.
The utilization by this Department of laboratory service in
connection with this sanitary control, involves a still greater de-
mand upon the bacteriological diagnostic service than heretofore.
It is anticipated that the gradual development of county labora-
tories will relieve the State Laboratory of a portion of the diag-
30 SxATJi: Depaktmk.nt of Health
breadth and depth at Cape Viuceiit, Clayton and an intermediary
point.
Special investigations of filtration plants at Yonkers, Pocanticc
Lake, Peekskill, Albany and Rensselaer have been made and spe-
cial investigations of water supplies at l\ew Paltz and Watervliet
have been made bv members of the Lalx)ratorv staff, and the
medical inspections of the seventeen State institutions referred to
have been made by members of this staff.
The laboratory examinations involved in determining the
quality of a number of waters proposed for future public supply-
have been undertaken bv the Laboratory IMvision at the request
of the State Water Supply Commission and the results of all such
examinations have ])een communicated to that commission.
The special investigation undertaken by the Division of Lab-
oratories, at the request of the Saratoga Reservation Commission,
has been continued, completed and reported to that commission,
and in addition to the technical work inv^olved, the expert service
of various members of the staff has been utilized by the latter
commission in determining their action upon the technical prob-
lems involved.
Group E
The activity of the Antitoxin Laboratory shows a most remark-
able development. Throughout the year 1910, 36,916 packages
of diphtheria antitoxin of 1,500 units each were prepared and dis-
tributed, an increase of 51 per cent, over the output of the pre-
ceding year.
The Department has made considerable effort during the year
to secure a better use of its antitoxins by physicians and particu-
larly it pointed out in its annual report of the preceding year, and
'in various issues of the Monthly Bulletin of this year that suffi-
ciently large doses of antitoxin were not being used by attending
physicians in the State. The very gratifying increase in the
number of complete reports of the use of State antitoxins fur-
nished by the physicians is supplying sufficient data tg indicate
that the physicians of the State are utilizing antitoxin to a some-
what better degree and the reports thus far received would indi-
cate a very decided decrease in the mortality from diphtheria in
all cases where State antitoxin has been used, and a complete
CoMMlSSlO.NKu'b liEl'OlCT 31
Study of the development and directly consequent immediate
results in mortality statistics will be made and included in the
body of the annual report of this year.
The insufficient resources of the Antitoxin Laboratory have
been repeatedly reported and the strain involved to meet the ex-
actions of this service with those resources has become so great as
to require a special communication on this matter, which has
been made elsewhere.
The educational efforts of the Department to increase the use
of its antitoxins and to make known more widely among the
medical professioji, not only the curative but the prophylactic
advantage of antitoxin use, are quite manifest in the increased de-
Hiand for tetanus antitoxin.
In my report of the preceding year the stationary demand for
tetanus antitoxin, which was noted as 4,313 packages of tetanus
antitoxin of 1,500 units each, representing the total distribution of
1909, did not differ markedly from the distribution of preceding
years. It is gratifying, however, to find that the distribution of
this year, 1910, shows 9,655 packages of 1,500 units each of tet-
anus antitoxin, an increase over the distribution of the preceding
year of 102 per cent, and it is hoped, as a result of the educational
efforts of the Department and the increased distribution of this
antitoxin, that the number of deaths from tetanus, which
amounted to over 100 in 1909, may be very decidedly decreased
in our future annual statistics.
Throughout the year the Antitoxin Laboratory has distributed
solely the concentrated and purified antitoxin and the reports of
its use confirm very decidedly the advantage of antitoxin of this
form, as well as the advantage of the syringe package, in which
package all the diphtheria antitoxin for therapeutic use is now
supplied.
The year 1910 was the first full year of the distribution of tlie
special outfits provided by the Department for the prophylactic
treatment of ophthalmia neonatorum. A larger number was dis-
tributed throughout the year than was made for the initial distri-
bution reported for the year previous.
It is manifest that extensive educational efforts must be made
by the Department to secure the utilization of these outfits to their
best advantage.
o'2 Statk Dkpautmknt of JIkaltii
The limited resources of the laboratory and the increased de-
mand for antitoxin have made it impossible to begin the distribu-
tion of the material for the treatment of rabies. The laboratory is
prepared to undertake this as soon as the resources are provided,
as pointed out last year. The expense would be comparatively
slight and the benefit obvious.
Division of Communicable Diseases
During the past year an unusual amount of effective work has
been done by this division in conducting an energetic campaign
against the prevalence of communicable diseases and in personal
investigation at numerous places in which such assistance has
been needed.
In contagious and epidemic diseases this portion of the Depart-
ment comes into more direct contact with the people and more
effectually meets their needs than perhaps any other part of the
Department.
The thousands of report cards which are received each month
by this division are carefully analyzed and studied by the director
of this division, and put to such practical advantage as is found
possible. This division is now daily utilizing reports received
from the 1,400 health ofiicers of the State, and is constantly in
touch with such officers and rendering to them every possible
assistance in both the prevention of communicable disease and the
suppression of any outbreak of the same.
Special investigations are now in progress concerning epidemic
poliomyelitis and ophtlialmia of the new-born, while much investi-
gative work is contemplated concerning the prevalence of other
diseases.
Tuberculosis
Of the 35,000 cases reported of pulmonary tuberculosis,. 31,731
came from New York city. As less than one-tenth were from the
rest of the State it is clear that far from full record of the cases
is being made. In this third year of reporting, the law requiring
it having passed in 1908, about two thousand more cases have been
returned than in 1909 ; compared to reported deaths there were
2.5 casos to one death, against 2.4 as in 1909. The number of
reported casos to deaths in 1910 in Now York oity was 3.5. At
Commissioner's Report 33
this rate the number of eases in the State outside the citv would
have lx?en three times the number reported and there would have
been about 50,000 cases in the State. Whether the average
longevity of pulmonary tuberculosis is more than three and one-
half years we have no means of knowing, but as not a few cases
recover it is probably well within the bounds. It is at any rate
quite unlikely that the duration of the disease in the country is
less than in the city.
As tuberculosis is a communicable disease and one in which
death is more certain to those deprived of fresh air, it would be
anticipated that in the crowded parts of a city it would abound
most, and this is true. In New York city there were, in the
twelve months, 165 deaths from tuberculosis of the lungs and air
passages to each 100,000 population ; in the rest of the cities taken
together the rate was just the same ; in the rural part of the State
there were 130 deaths to 100,000 population.
In Xew York city there were 300 more deaths than in 1909,
«nd the consequent death rate, 165 then against 190 this year, is
less as the increase is less than that of population. In the other
cities there have been on the other hand 300 fewer deaths from
tulterculosis in this year than in 1909 and in the rural part of the
State there were a few less deaths than in 1909. There is about
the same mortality this j^ear as in 1909 for the entire State, but
the rate to population, which was. 160 last year, is this year 157,
which represents a saving of about 300 lives.
The strenuous fight against the White Plague, in which volun-
tary, civic and national organizations are engaged along with the
established health workers, has gone on with unabated effort
during the year and it is quite certain is already bringing forth
fmit.
Smallpox
There has been a material decrease in the number of cases
of smallpox reported during the past year. Since 1898 it
has been widespread throughout the country, in a mild form
which made its control difficult. The number of cases in
1908 was nearly 1,000; in 1909 it was reduced to 461;
thi? year only 355 cases have been reported. This number
of cases is, however, largely to be credited to two areas of
2
34 State Depabtment of Health
prevalence; one in and about Tonawanda and adjoining towns
in Niagara and Erie counties; the other in the northern part
of the State, over three-fourths of the cases occurring in these
two areas. In the fall of 1909 one sick with smallpox came to
North Tonawanda from Canada and the end of this outbreak
which ensued was not reached till July, sixty cases occurring
there, and as many more in Tonawanda and Niagara Falls, with a
few in BuflFalo. This outbreak should have been controlled ear-
lier, but there was considerable opposition to vaccination which
this Department and the local health officers did all that was possi*
ble to counteract. In the northern part of Herkimer county small*
pox started in lumber camps in January, remote from observation
and oversight, and it was very difficult to control it, for being
mostly mild the men ignored it and scattered it to many adjoining
towns where it became a source of cost and trouble. It was carried
to twenty diflFerent towns, not remote, in Jefferson, Lewis and St,
Lawrence counties, and in some of them continued \mtil July —
137 cases having been accounted for. In this indifferent and un-
controlled population of sparsely settled communities the difficul-
ties of the case are magnified. These two outbreaks illustrate the
obstacles to the control of a disease which, of minor importance
now, has become so only through the operation of vaccination. One
of them was prolonged by misguided opposition to this and the
other by ignorant indifference to it. When everyone is vaccinated
there will be no smallpox, and vaccination is the only means by
which an outbreak can be promptly suppressed.
There were 355 cases of smallpox, seldom more than one case
being reported save in the places above noted, in twenty-eight
counties during the year, including Greater New York, where
there were sixteen cases. There were seven deaths in the State
from this cause, one in Buffalo, one in Walden and five in New
York.
Typhoid Fever
With the exception of a few short, spontaneous outbreaks of this
disease . throughout the State, typhoid fever has prevailed much
the same as during the past few years. Much detailed work is
contemplated for the coming year, with a view of more effectually
preventing the prevalence of this communicable disease. With
Commissioner's Report 35
this aim in view, it is proposed to daily locate the prevalence of
every case of typhoid fever reported to this Department, in its
relation to the watersheds of the water supplies of the several
municipalities of this State. Having done so, we propose to com-
municate this information to the health authorities of such
municipality that proper prophylactic measures may be taken to
prevent the pollution of the water supply of such municipality.
The typhoid bacillus is not disseminated through the air. It
may be transmitted by contact with the sick, by attendants,
through infected milk or other food, through the agency of the
house fly or by carriers for an indefinite period, but drinking
water is undoubtedly one of the chief media for its dissemination.
The protection of the water supplies of our State is therefore one
of the most important parts of our work in the suppression of
typhoid fever.
While the department has laid special emphasis on investigation
into the sources of all cases of this preventable disease, it proposes
to institute even a more active campaign against its suppression.
The causes are sometimes obscure, but they should be traced and
removed. There have been no prolonged epidemics during the
year 1910. There have been 8,536 cases of typhoid fever reported,
of which 3,735 were for Greater New York, while 4,801 were
scattered throughout the State. There was an increase in both the
number of cases reported and in the mortality during 1910, as
compared with 1909. There were 1,374 deaths charged to this
disease, which is a slight increase over the mortality of 1909.
Death occurred in one of the seven reported cases. The bulk of the
cases occurred in the months of August, September and October
f 3,953), almost one-half of the entire number reported during the
year. Whether the diagnosis is more frequently made in the
cities or not, it is a noticeable fact that the disease appears to be
more prevalent in large centers of population, and the deaths of
the year have been more largely urban than rural.
Scarlet Fever
There are periods of two or three years of higher prevalence,
succeeded bv one of lower with scarlet fever. This year is the
third of a high period, with a mortality for this State of 1,600.
36 State Depabtme:^t of Health
The anticipation in the report for 1909 that it was on a decline
has not been realized, for the deaths are more for this year. It is
a cold weather disease; two-thirds of the deaths in 1909 occurred
in the first six months of the vear, and this vear three-fourths,
with 450 more deaths than of the vear before. Scarlet fever is
much less fatal than it was two decades ago, which is true of all
the eruptive fevers. The mortality of this year has not been ex-
ceeded in fifteen years ; prior to^ that the deaths sometimes ex-
ceeded 2,000 in the year. This is because of the milder type of
later times, for many cases occur ; it is seldom that the disease oc-
curs in the severe and fatal form once not infrequent. There have
been reported more than 30,000 cases this year from all parts of
the State, and without doubt not a few have failed of report. The
mortality has been less than five per cent.
Measles
In 1909 there were more deaths from measles than from scarlet
fever. This is not infrequent. The disease is regarded lightly
by the people, but on the average it causes yearly in this State
1,100 deaths, while the number from scarlet fever is 1,300. Both
have series of years of greater prevalence and mortality, succeeded
by years of less. Now for five years measles has had a mortality
of from 1,000 to 1,300, and this year as well as last approaches
this high range. There were some 50,000 cases reported in 1909 ;
this year the number is near to 70,000. It is, like scarlet fever, a
cold weather disease; 1,000 of the deaths this year come in the
first six months, or four times as many as in the last half of the
year. It has had a lethality of 2 per cent., half that of scarlet
fever. More ill conditions follow in its train, however, and it is
far from being a disease to hold in light regard. Much has been
done this year to instruct the people as to its prevention. As
with all the communicable diseases, leaflets of instruction to the
I)eople are issued in large numbers in affected localities. Measles
is especially a disease to be controlled in good degree by intelli-
gence about it on the part of the people.
Commissioner's Report 37
Whooping Cough
There were half as many deaths from this minor disease as
from measles. But it is not to be held in light esteem, for some
years have a mortality in excess of measles and the average
yearly for the past twenty-five years has approached 1,000. A
measure of control is being imposed, and a leaflet of instruction
for this disease has been prepared this year and is placed in the
Manual, and used for general distribution where this disease
prevails.
Diphtheria
This is a disease of the cities. In 1909 of the 2,300 deaths
nearly 2,100 were urban, of w^hich 1,700 were in Xew York city.
This year there were 2,431 deaths, of which 2,190 were urban and
241 rural, the rural population being about one-third the urban
two-thirds. Xew York city reported 17,22G cases, and the rest
of the State 5,404. In Xew York city there were 9 deaths per
100 reported, but as the number of deaths in the rest of the State
to reported cases was double this lethality, the inference is that
the reports of cases are generally imperfect. Tl^e urban mortality
is three times that of the rural part of the State, there having
been 33 deaths per 100,000 population during the year in the
cities, while there were 11 to the same population in the rest of
the State. There was no notable epidemic of diphtheria preva-
lent during the year and the mortality is not materially different
from that of recent vears. Xow for thirteen vears, since 1897,
the disease has been causing less than one-half the number of
deaths that were occurring prior to that time. Indeed the num-
l)er of actual deaths now, with a greatly increased population, is
hardly one-third the number that were occurring twenty-five
years ago. Xo doubt this in part is due to the lessened severity
in all the epidemic diseases, in w^hich this disease participates,
but since nothing like this decrease is observed in others, such as
scarlet fever and measles, it is certainly mainly because of the
present day use of diphtheria antitoxin, which is freely made and
supplied by this Department. The abrupt diminution in its
death rate since this came into use is one of the notable facts in
medicire. There has been a decrease from nearlv 100 deaths
per 100,000 population to one of 25, and a saving of between
38 State Department of Health
3,000 and 4,000 lives a year, mostly through this beneficent
agency, certainly a notable triumph for modern sanitary medi-
cine, and one of the assets of the work of this department is the
contribution made in the saving of life thus effected.
Epideynic Poliomyelitis
This is not a new disease, but it has of late taken on qualities
which make it in effect a new disease, to the sanitarian at least,
for it has become, as an evidently infectious and epidemic disease,
and almost within the current year, so extensively prevalent as to
be pandemic. Prior to 1907 it was in this State of rare occur-
rence and sporadic. In 1908 a considerable epidemic occurred
in and near New York citv, while at the same time there was
another in Boston, which appears to have been brought by immi-
grants from Scandinavia where it had become prevalent. From
the same source it soon after appeared in Minnesota and other
western states. In 1909 there was a single epidemic in this State,
in St. Lawrence county. In 1910 it became more general and
there have been 227 cases reported from 4G counties. It is a dis-
ease of warm weather, and these epidemics began at midsummer
and ended at mid-autumn. It occurred in 46 counties, in all parts
of the State. Children have been its chief subjects. The num-
ber of deaths credited to it for the year is 52, but many, most in-
deed, of those in whom it has not been fatal have been left with
some degree of paralysis. The resources of investigation are be-
ing called upon to determine its conditions and prevention.
Epidemiological studies are being made by many State Boards of
Health. In this State it has been placed among the communi-
cable diseases and a report of the surroundings of each case is
called for. Such studies thus far made are to a degree convincing
that it is spread by direct contact with the sick and that it may
be carried by those who have been attendant on the sick, young
children being its chief subjects. It is required, therefore, to be
quarantined. Laboratory investigation shows it to be a germ
disease, an infectious fever with inflammation of the nervous
centres. It has clinical characteristics which define it. Its mor-
tality IS not preat, its principal effect being a permanent disa-
bility which often results in a lifetime of dependence. There is
Commissioneb'i^ Kepobt 39
evidently a low degree of susceptibility to it even among the
young who are its chief subjects. It aflFects a limited epidemic
area and is not apparently a disease which becomes implanted in
a locality so as to occur in succeeding seasons where it has once
been epidemic. It is not conveyed by food or water, but directly
by the sick, nor is it a disease of institutions or tenement house
districts nor of unhygienic conditions. It appears likely to be-
come a permanent feature of medical work.
Cerebrospinal Meningitis
This is a disease of the cities, as the mortality to population in
the cities is double that of the country, or as 6 to 3 per 100,000
population for this year. For recent years it has been a minor
disease, causing less than 400 deaths in the twelve months. It
is a disease of the colder months, whereas poliomyelitis is one of
the warm months.
Pellagra
While in recent years pellagra has arrested attention from its
prevalence in some of the southern states and in Illinois in an
asylum for the incurably insane, it has not been known to exist
in this State during the year save the discovery of one or two
sporadic cases among sailors or others coming from abroad. It is
a chronic disease marked by nervous disorders and skin lesions
and dependent to some degree on impoverishment of surround-
ings and food. It is most likely to find its way to the hospitals
for the insane on account of its effect on the nervous system. The
disease has this year been placed among those that are report-
able, although thei:e is doubt as to the exact manner of its com-
munication.
Ophthalmia Neonatorum
This disease of the eyes of the new-bom whereby they generally
become blind, is more important than the number of reported
cai«es indicates. Its report is required as of scarlet fever and
other infectious diseases. The Department has joined the cur-
rent work by voluntary organization of a crusade for its control.
Its prevention can be assured by the use of a prophylactic fluid
dropped into the eyes and such simple procedures as are not only
familiar to physicians but are easily employed by midwives or a
40 State Department of Health
helping neighbor. Such a prophylactic fluid is sent out for free
distribution everywhere in the State, along with instructions for
use, and leaflets are being extensively distributed to inform all
as to the nature, dangers and means for preventing this unhappy-
ailment. All birth certificates contain a reminder as to the pro-
phylactic. The work of the Department this year has the uni-
versal commendation of the medical profession. There have been
but 40 cases reported during 1910.
Infant Mortality
While the death rate under five years of age is somewhat ap-
palling when we look at the figures, 38,278 deaths in the year
1910, we can congratulate ourselves and the medical profession
in general throughout the State of New York when we compare
this mortality rate with that of the year 1900, which was 39,204,
a saving of 1,000 this year from the deaths on every life of ten
years ago. At the same time the mortality at all ages was in-
creased by over 11,000 in 1910 as compared with 1900, and the
percentage of deaths under five years to the total death rate in
1900, was 30.50 while that of the ye«ar 1910 was 27.35, a marked
decrease in the percentage of deaths under five years.
The causes of infant mortality are complex and present some
of the most important features of the conservation of the health
of the children. Milk being the staple food of the babies, it be-
hooves us to exercise great care wuth this product. In municipali-
ties where the greatest care is taken in the purity of the milk sup-
ply, we find the lowest infant mortality. There is an essential
feature in the milk industry which properly falls within the
*
province of the health officers throughout the Sts^te, viz. : the pre-
vention of the spread of contagious diseases such as typhoid fever,
scarlet fever, diphtheria, etc., through the milk supply.
The diarrheal mortality of midsummer and early autumn is
largely of young children. Conditions of the weather, crowded
habitations and sociological conditions contribute to the sickness
and death among these susceptible subjects. While these are not
all within the controllable authority of boards of health, there
are many things that can be remedied by their efforts and they
have already accomplished a decreasing mortality rate of infancy
and early childhood.
Commissionee's Eeport 41
Health Officers
The health officers of the different towns, villages and cities
for the most part are careful and conscientious men, and are do-
ing excellent work in the suppression of communicable diseases,,
but they are often hampered not only by lack of funds but also
by the fact that in many cases they antagonize their friends and
neighbors, who resent their interference, while frequently out-
side advice and counsel is hailed with delight and meets with
hearty approval. The most cordial relations are enjoyed between
the 1,400 health officers of the State and the Department of
Health. Mutual assistance is daily extended and an increasing
efficiency is apparent to those who watch the results being ob-
tained.
During September, Medical Officers of Health made an inves-
tigation as to the prompt reporting of communicable diseases,
also regarding quarantine and other efforts put forth by the health
boards to prevent the needless spread of preventable diseases. In
the majority of cases the Medical Officers met with hearty co-
operation from the health officers and health boards throughout
the State.
Some of the rural districts do not observe the provisions of the
tul»erculosis law as fully as could be desired. This will probably
be remedied in the near future, as the tuberculosis exhibit now
on the road is rousing not only the physicians, but the laity as
well, to a sense of their duty to co-operate fully in the effort to
suppress the " White Plague."
Division of Publicity and Education
Monthly Bulletin
The Monthly Bulletin continues to prove a useful medium be-
tween the Department and the health officers, and to exercise an
educative influence upon the wide circle of general readers which
it reaches.
During the year we have issued two special numbers, one deal-
ing with the " Pollution of Streams," and the other addressed
particularly to the medical profession of the State. A copy of
this issue was mailed to every physician outside of Greater New
42 State Department of Health
York. Among the special articles it contained was one outlining
the work of the several divisions of the Department, and there
were others pointing out various ways in which physicians can
co-operate with the Department and the Department with phy-
sicians, for the protection of the health of individuals and of the
community.
Circulars
The demand for the various circulars on Communicable Dis-
eases, etc., issued by this division, has been steadily maintained
during the past year. A number of them have been recently re-
vised preparatory to the printing of further supplies.
Puhlic Tlealth Manual
Considerable effort has been put into the preparation of a com-
plete Public Health Manual which can constitute a working guide
for our health officers. In this volume we have incorporated the
Public Health Law, and such parts of other statutes which lay
duties upon local boards of health or the health officers. A model
set of sanitary regulations is given for the guidance of local boards
of health. The procedure governing the protection of public
water supplies and the installation or extension of sewerage sys-
tems and sewage disposal plants is set forth. The requirements
of the Department in the control of cases of communicable dis-
eases are gone into at some length. The use of the State Hy-
gienic Laboratory and of the antitoxins and sera made by the
Department is discussed.
A chapter is devoted to a general survey of the work devolving
upon the health officer. A special section is devoted to vital sta-
tistics, and other phases of work and matters of interest to the
health officers are discussed.
Annual Sanitary Conference
The Tenth Annual Conference of the Sanitary Officers of the
State of New York was held in the auditorium of the Y. M. C. A.
in Buffalo on November 16, 17 and 18, 1910.
The attendance was good, but the Department looks forward
to the (lay when every health officer, instead of one out of two or
three, shall be present at this " school of instruction." In order
Commissioner's Eeport 43
to bring this about it will l>e necessary for an '* enlightened '* >^elf-
interest in each community U not onlv defray th(» expenses of the
health officer, but to grant him a reasonable per diem allowance
as partial compensation for the loss of income o<*ca-ioned by his
being awav from the practice from which, as a phy-jician, he de-
rives his means of existence.
The program presented at the Buffalo Conference was a*^ fol-
lows:
First Session — Wednesday, November i6, ii:oo A. M. to i:oo P. M.
Address of Welcome. Hon. T>oiii9 P. Fubrniann, Mayor of Buffalo; Francis
K. Fionezrtk, M.U., Health Commissioner, Buffalo.
T. PrBi.ir Health a:vd the School
(a) As an Aid to Public Health Work. John S. Wilson, M.D., Med-
ical Officer, State Department of Health. Pour'hkeeps'e.
(6) Follow-up Work. Franklin W. Barrows, M.D.. Medical Inspertor
of Schools, Buffalo,
(r) School Hygiene and School Disease. Edward Clark, M.D., Medical
Officer. State Department of Health. BuH'alo.
id) From Standpoint of Educationalist, Tlios. E. Finegan. Assi-tunt
Commissioner of Education.
DiscUhsion by John L. Hazen, M.D., Brockport: .John L. }\\i}x\ oa,
M.D., Mt. Vernon.
II. Pi^Bi.ic Health and the Dextal Profession.
William O. Ebersole. M.D.. D.D.S.. Cleveland. (H io.
Discussion by W. A. White, D.D.S.. Phelps; W. W. Belcher, D.D.S.,
Rochester.
III, PrBLir Health and the Mfdical Profkssiov.
(a) The Difficulties of Health Officers as Seen by the Physician. A.
I). L«ake, M.D., Medical Officer. State Depanment of Health,
Oowan da
(6) The Spirit of Mutual Helpfuljie^s. Wm. I). Alsever, M.D., Medi-
cal Officer. State Department of Health. Syrin-use.
Di&cu^8ion bv Charles S. Clowe, M.D., Schenectady: (). W. Burhyto,
M.D..'Brookfleld.
Second Session — Wednesday, November i6, 3:00 P. M. to 5' 00 P. M.
IV. PrBLir Health and the Press.
iO) From tlie Health Officer's Standpoint. Join B. Huber. M.D.,
Medical Officer. State Department of Health. New Vo'-k.
(6) From the Newspaper Man's St.indpoint. Mr. F. P. Hall. Jjuncs-
town.
Dii^cussion by Hon. Charles F. Milliken. Canarduiirna : William If.
Snyder, M.D.. Xewbur^^h.
V. Public Health and Municipal Authorities.
(a) What a Health Department Expects From Mnnicipal Authoriti^M.
Eugene H. Porter. M.D.. State Commis«ii<«iier of Health.
(6) From the Standpoint of the ^Innicipal Offircr. Mayor Charb^a
C. Durvee, .Schenectady.
Third Session —Wednesday, November 16, 8:00 P. M. Public Meeting.
I. Public Health and the Conskkvation Movemknt.
C. A. Hodgetts. M.D., Medical Adviser, Commis-ion of Conservation,
Ottawa.
11. Public Health and the Publk Pi rsk.
Col. Francis G. Ward. Commissioner of Public Worki. BiifTalo.
44 State Department of Health
Fourth Session — Thursday, November 17, 10:00 A. M. to 12:00 noon. Sec-
tional Meetings.
(a) For City Health Officers, phairman Francis E. Fronczak, M.D.,
Health Commissioner, Buffalo.
1. Garbage Disposal. P. M. Hall, M.D.. Health Officer, Minneapolis.
Discussion by William D. Peckham, M.D., Utica; John J. Mahoney,
M.D., Jamestown.
2. City Sanitation. Prof. Charles Baskerville, College of the City
of Xew York.
Discussion bv William S. Coons, M.D., Yonkers; George E. Ellis,
M.D., Dunkirk.
3. Milk and Foods, F. E. Fronczak. M.D., Health Commissioner,
liuflfalo.
Discus.sion by D. M. Totman, ^I.D., Syracuse: F. B. Parke, M.D.,
Elmira.
(6) For Rural Health Oflieers. Chairman Wm. A. Howe, M.D., Dep-
uty, State Commissioner of Health.
1. Rural Hygiene. Allen W. Freeman. M.D., Assistant State Com-
missioner of Health. Richmond. Va.
Discussion by Charles S. Butler, M.D., Harpursville ; B. F. Chase.
M.D.. East Syracuse; G. Scott Towne, M.D., Saratoga Springs,
2. Brief Talks l)y Heads of Divisions.
(c) For Medical Officers of Health.
Afternoon
Xo formal J-et-^ion held this afternoon. Health Officers had the choice of
attending a Demonstration at the Cancer Laboratory; a Tuberculosis Clinic:
of making a Trip through the Buffalo Stockyards, through the courtesy of
Dr. Wm. H. Heath. C'hief Inspector of Foods and Drugs, Buffalo Department
of Health; or a Trip to Niagara Falls.
Social Evening
Smoker at Hotel Iroquois, 9 P. M.
Fifth Session — Friday, November 18, 10:00 A. M. to 12:00 noon.
I. TiiK Laboratory as an Aid xo Diagnosis.
Dr. John A. Amyot, Director Laboratories. Provincial Board of
Health, Toronto.
Discussion by 0. J. Hallenbeck. ^[.D.. Canandaigua : W. W. Waite,
M.D., Syracuse.
11. Rfportino CoMMUNicAm.E Diseases.
Dr. E. C. I^vy. Health Officer. Richmond, Va.
Discui-sion by John Diigan, M.D., Albion; E. S. Willard, M.D., Water-
town.
III. Quarantine, Isolation and Disinfection.
William A. Howe, M.D., Deputy State Commissioner of Health. .
Discussion by Harry S. Tuthill, iM.D., Penn Yan; Frank S. Overton,
M.D., Patchouue.
IV. The Control of Typhoid Fever.
H. W. Hill. IM.D., Director Epidemiological Division, Minnesota State
Board of Health, ^linneapolis. Minn.
Discussion bv Joseph Roby, M.D.. Rochester; F. X. C. Jerauld, M.D.,
Niagara Falls.
Sixth Session — Friday, November 18, 2:00 P. M. to 4:00 P. M.
I. rXATTACKEI) COMMX' NIC ABLE DISEASES.
Gardner T. ^warts, M.D., Secretary State Board of Health, Provi-
dence. R. T.
Discission bv J. W. Le Seur, M.D.. Batavia: 0. W, Goler, M.D.,
IvOchoster.
Commissionek's Report 45
II. Epidemic Antebior Poliomyelitis.
Surgeon W. H. Frost, U. S. Public Health and Marine Hospital Serv-
ice, Washington, D. C.
IMscussion by Irving M. Snow, M.D., Buffalo.
HI. The Tuberculosis Campaign as Conducted by the State Department.
Mr. Charles W. Fetlierolf, Director Tuberculosis. Exhibits.
School of Sanitary Science at Cornell University
The Department has again cooperated with the authorities of
Cornell University by providing for one-half of the lectures given
in that university in Sanitary Science and Public Health. This
course continues to be popular with the students and there can be
no question of the value of the interest it is arousing among our
educated citizens in public health work and the prevention of
disease. A work so meritorious desei-ves to be put upon a perma-
nent basis ; at present it is largely a voluntary effort, no remuner-
ation being available for the lecturers who give of their valuable
time and to whom the cause of sanitation is greatly indebted.
The success of this course has amply justified my assertion last
year that our colleges should have instruction in sanitary science,
and that this work at Cornell should be on a firm basis. It is mv
earnest desire that the Legislature will recognize the value of this
school, and place it on a stable foundation.
The list of lecturers and lectures for 1910-1911 is as follows:
First Term
October 4. Introductory lecture, outlining field and subject-matter of the
coarse. President J. G. Schurman, Cornell University.
October 6. Tlje History of Therapeutics, Dr. G. W. Goler, Health Officer,
Rochester, N. Y.
October 11. Public Health Administration, E. H. Porter, M. D., State Com-
missioner of Health, Albany, N. Y.
October 13. State Control of Certain Insanitary Conditions, E. H. Porter,
H.D., State Commissioner of Health, Albany, N. Y.
October 18. The Application of the Laws of Heredity to Public Health, S.
H. Gage, B.H., Professor Emeritus of Hi&tology and Embryology, Cornell Uni-
▼errity.
October 20. Infant Mortality, Albert Sudekum, M.D., Member of Reichstag,
Xoremberg, Germany.
October 25. Prolongation of Human Life, W. F. Willcox, LL. D., Professor
of Political Economy and Statistics, Cornell University.
October 27. Marriage and Divorce, W. F. Willcox, LL. D., Professor of Po-
litical Economy and Statistics, Cornell University.
November 1. The Birth Rate, \V. F. Willcox, LL. D., Professor of Political
Economy and Statistics, Cornell University.
November 3. The Conservation of Hiunan Life, L. L. Seaman, M.D., Sur-
geon, Xew York city.
November 8. European Problems of Public Health, F. A. Fetter, Ph. D.,
ProfeMor of Political Economy and Finance, Cornell University.
46 State Department of Health-
November 10. American Philanthropy and the Public Health, F. A. Fetter,
Ph. D., Professor of Political Economy and Finance, Cornell University.
November 15. Ibe Nature of Disease, \'. A. Moore, M.D., Director* of the
New Vork State Veterinary CcJl)ej*o, Cornell I nivcrt^ity.
November 17. Micro-Organisms and Iheir Kelation to Disease, V. A. Moore,
M.D.. Director of the New Vork State Veti*rinary t'ollege, Cornell University.
November 22. Di»'ea>es of Animals Transmissible to Man, V. A. Moore, M.JJ.,
Director of the New ^ ork State Veterinary Colle;je, Cornell I'niversity.
November 21). 1 he Development of Public Health l^w. A. H. Seymour, E»q.,
Secretary' State Department of Health, Albany, N. V.
December 1. A])plieation8 of Public Health I>aw to Specific Rejjulations. A.
11. Seymour, Kscj.. Secietary State Department of Health. Albany, N. V.
December ti. Inlir.ence of A^Lrrifulturul Pr< <lncts on Public Health, Hon. R.
A. Pearson, State Coniniihsioiur of Ajiriculture. Albany, N. V.
December 8. Sc''ool Hygiene, (i. M. Whipple. Ph. D., Assistant Professor of
the Science and Art of Education. C orr.ell U^iver^itv.
December 13. Probh-nis of Life and Health in 'Industry. Frederick L. IIolT'
man, Statistician, Prudential Life Insurance Co., Newark, N. .1.
December 15. insanity and Public Health, \V. L. Hussell, M.D., formerly
Inspector New York State Commission in Ltmacy, Albany, N. V.
December 20. Health in Agricultural Communities, L. H. Bailey, LL.D.,
Director of New York State College of Agriculture, C'ornell University.
January 6. Voluntary Organizations in Public Health Work. Hon. Homer
Folks, Secretary State Charities Aid Association, New York citv.
January 10. Transmi^sion and Prevention of Some Infectious Diseases, Dr.
V. E. Sorapure, Professor of Pathology. Fordham College, New York city.
January- 12. Immunity. Dr. V. E. Sorapure, Professor of Pathohjgy, Ford-
liam College, New ^ork city.
January 17. Preparr.tion of Antitoxins, W. S. Magill, M.D., Director of
State Hygienic LaljMoratory, Albany, N. Y.
January 19. The Value of Antitoxins in Certain Infectious Diseases, W. S.
Magill, M.D., Director of State Hygienic Laboratory, Albany. N. Y.
January 24. The Campaign Against the Hookworm, \V. H. Glasson, Acting
Professor of Economics and Politics. Cornell University.
Januar}^ 26. Health Ciinditions Among the American Negroes, W. H. Glasson,
Acting Professor of Economics and Politics, Cornell University.
t^ccond Term
February 14. Cancer and Its Relation to Public Health, James Ewing, M.D.,
Professor of Pathology-, Cornell University Medical College, New York city.
February 16. The Occupatidiial Diseases of Modern Life, W. G. Thompson,
M.D., Professor of Medicine, Cornell University Medical College. New York
city.
February 21. Insects and the Transmission of Disease, A. D. MacGillivray,
Ph. D., Assistant Professor of Entomology' and Invertebrate Zoology, Cornell
University.
February 23. Inj^ects and the Transmission of Disease, A. D. MacGillivray,
Ph. D., Assistant Professor of Entomology and Invertebrate Zoology, Cornell
University.
February 28. The Correspondence of Mental and Physical Conditions, W. A.
White, M.D., Superintendent of the Hospital for the Insane, Washington, D. C.
March 2. Health Conditirms in the Philippines, E. W. Kemmerer, Ph. D.,
Assistant Professor of Political Economy, Cornell University.
March 7, Tuberculosis. Its Nature and Causes, John B. Huber. M.D., Lec-
turer, Fordham College. New York city.
March 9. Tuberculosi.s, Its Prevention and Cure, John B. Huber, M.D.. Lec-
turer, Fordham College. New York city.
March 14. Some Facts and Fallacies Concerning Tuberculosis. J. H. Pryor,
M.D., Member of Tuberculosis Advisorj' Board, New York Sta^te Department
of Health, Buffalo. N. Y.
March 16. Early Diagnosis of Tuberculosis, Lawrason Brown, M.D., Trudeau
Sanitarium, Saranac Lake. N. Y.
im I
Commissioner's Report 47
March 21. Local Quarantine Measures, L. E. Cofer, M.D., U. S. Public
Health Service, Washington, D. C.
March 23. Ihe Supervision of Infectious Diseases, H. H. Crum, M.D., Health
Officer, Ithaca, N. Y.
March 28. Food Adulteration and Its Effects, H. W. Wiley, Department ot
Agriculture, Washington, D. C.
March 30. The Detection of Food Adulteration, E. M. Chamot, Ph. D., Pro-
fessor of Sanitary Chemistry and Toxicology, Cornell University.
April 4. Ihe Detection of Food Adulteration, E. M. Chamot, Ph. D., Profes-
ror of Sanitary Chemistry and Toxicologj% Cornell University.
April 11. The Dangers of Impure Milk, W. A. Stocking, M. S., Assistant
I^ofesaor Dairy Bacteriology, Cornell University.
April 13. Dairy Hygiene, W. A. Stocking, M. S., Assistant Professor of
Dairy Bacteriology, Cornell University.
April 18. Animal Wastes and ITieir Dis{K>8aI, G. W. Cavanaugli, B. S., As-
sistant Professor of Chemistry, Cornell University.
April 20. The Law of Nuisances, Alfred Hayes, Jr., LL. B., Professor of
Law, Cornell University.
April 25. The Purification of Drinking Water, J. L. Leal, M.D., Sanitary
Adviser of the -East Jersey Water Co., Paterson, N. J.
April 27. Principles of Water Purification, G. C. Whipple, Consulting
Enjfineer. New York city.
May 2. Water Purification Plants, Theodore Horton, Chief Engineer, State
Department of Health, Albany, K. Y.
May 4. The Problem of Sewerage, H. X. Ogden, C. E., Professor of Sanitary
Engineering, Cornell University.
May 9. Sewage Disposal Plants, H. B. Cleveland, Principal Assistant Engi-
neer, State Department of Health, Albany, N. Y.
May 11. Ihe Sewage Disposal of a Large City, E. B. Whitman, C. E.,
Engineer in charge of Sewage Disposal, Baltimore, Md.
May 16. Street Cleaning, William H. Edwards, Esq., Commissioner of Street
Cleaning, Xew York city.
May 18. House Planning with Reference to Public Health, Professor C. A.
Martin, Director of the College of Architecture, Cornell University.
Maj' 23. The Healthful House, Professor C. A. Martin, Director of the
College of Architecture, Cornell University.
May 26. The Principles of Ventilation, R. C. Carpenter, M. S., C. E., Pro-
fessor of Experimental Engineering, Cornell University.
May 30. The Applications and Results of Ventilation, R. C. Carpenter,
M. S., C. E., Professor of Experimental Engineering, Cornell University.
June 1. Health in Rural Communities, G. N. Lauman, B. S. A., Assistant
Professor of Rural Economy, Cornell University.
The Service of the Press
The press of the State has shown an increasing interest in
health matters and has been of immense assistance in the publica-
tion of material pertaining to the subject.
The educational effect has been marked and the assistance thus
rendered is appreciated.
Instruction for Health Officers
In addition to the laboratory courses open to health officers and
other meetings designed for their benefit, the Department has been
jrt)le, through the courtesy of Dr. Alvah H. Doty, health officer
48 State Depabtment of Health
of the Port of New York, to offer an opportunity for study there,
of the methods of inspection, diagnosis, disinfection smi quaran-
tine used in guarding our great seaport
Many of the health oflScers in the State availed themselves of
this, and all have been enthusiastic over the instruction gained.
The health service of the State owes Dr. Doty much for his in-
terest and willingness to co-operate in this way and the knowl-
edge gained cannot fail to be of value to the people.
Publicity at the State Fair
For the second time the Department was represented at the
State Fair at Syracuse. In the space allotted to the Department
were shown maps denoting the prevalence of various communicable
diseases ; diagrams and tables to demonstrate in a popular way the
value of vital statistics ; plans and pictures of filtration and sew-
age disposal plants, etc. One feature that proved very attractive
was a working model of a sewage disposal plant. Another model
graphically called attention to the small sum appropriated by the
State to its Public Health Department, as compared with the
money devoted to the protection of the health of plants and ani-
mals. A large amount of literature was distributed during the
week the fair was open, one piece being a special four-page cir-
cular giving a brief but comprehensive account of the work done
by the Department for the citizens of the State.
Public Leclures
For some time past there has been in course of preparation a '
series of illustrated public lectures on various phrases of public
health work. The lectures above mentioned have been prepared
with a view to their being put in such form that they can be sent
with a set of slides to a health officer in any part of the State
who may be called upon or have the opportunity to use the lecture
platform to reach the people of his community and interest them
in hygienic living and the preservation of health, which can easily
be demonstrated to be the most valuable phase of the increasingly
popular conservation movement.
Commission£b's Bepobt 49
Division of Vital Statistics
It is gratifying to note that the earnest effort of the Depart-
ment to bring about a more complete and satisfactory registration
of births and deaths occurring in the State* during the past year
has resulted in obtaining the active co-operation of the local boards
of health in enforcing compliance with the provisions of section
22 of the Public Health Law.
With but few exceptions the local board3 are awake to the im-
portance of all births and deaths being promptly reported, and
the returns now being received at the Department are more com-
plete and satisfactory than at any time since the enactment of the
State registration laws in 1880.
The living births reported .to the Department for the past year
numbered 213,235, which is 10,579 ijiore than were reported in
1909, and showing a birth rate of 23.3. The number of still-
births reported in 1910 was 9,952.
Of the living births 210,315 were white and 2,920 colored.
The latter were classified as follows: Xegro, 2,874; Indian, 28;
Mongolian, 18. Of these 213,235 living births, 109,214 were
male, 103,992 female, and sex of 29 not reported.
The average city birth rate was 25.3, and the rural 16.1. The
cities having the highest birth rate were : Dunkirk, 32,7 ; Rome
27.7 ; Xorth Tonawanda, 27.6 ; Little Falls, 27.2 ; Greater New
York, 26.9; Lackawanna, 26.7; Niagara Falls, 26.5, and New
Kochelle, 25.8.
The lowest birth rate is shown in the following cities, due to
incomplete registration: Troy, 12.4; Albany, 13.6; Watervliet,
13.9 ; and Eensselaer, 15.6. Troy reports 641 more deaths than
births; Albany, 576; Watervliet, 51, and Rensselaer, 9. Other
cities reporting less births than deaths were Cohoes, Cortland,
Ithaca, Kingston, Lackawanna, Middletown and Port Jervis.
The total number of deaths reported for 1910 was 147,629,
and the death rate for the year was 16.1. The urban death rate
was 16.1 ; the rural 16.3. The relative mortality in early child-
hood is low. For fifteen years prior to 1900 there were 32.2 per
cent, occurring under five years of age; for the next ten years,
27,5, and last year 27.0 per cent. ; 18.5 per cent, of the deaths
were under oAe year and 31.0 per cent, at sixty years and over.
50 State Department op Health
The deaths past sixty years of age were more than for any prior
year, increasing somewhat in proportion to increase in deaths from
acute respiratory diseases.
The cities having the highest death rates were: Lackawanna,
27.3; Troy, 20.8; Hudson, 20.6; Cohoes, 20.6, and Rome, 19.9,
Xew Rochelle has the lowest death rate, 11.7; and the follow-
ing cities show a reported death rate of 14.0 and under:
liochester and Geneva, 14.0; Mt. Vernon, 13.9; Johnstown, 13.7;
North Tonawanda, 13.3; Olean, 12.7; Jamestown, Hornell and
Tonawanda, 12.8; Xew Rochelle, 11.7.
Of the largest cities in the State, Rochester shows the lowest
death rate, 14.0. Of the smaller cities Genevia has a like rate.
The total reported mortality from pulmonary tuberculosis was
14,059, or 9.5 per cent, of all deaths. There were 153 deaths per
100,000 population. Ten years ago, with a census population less
by 2,000,000, there were 13,600 deaths, or but 275 less than now,
and 187 deaths per 100,000 population. In 1890, with a popula-
tion of 6,000,000, there were 12,400 deaths, a rate of 205 deaths
per 100,000 population. The urban rate is 165 deaths per 100,-
000 population; the rural, 135. There were lOO more deaths than
in 1909, but it is less than in the five years preceding. For the
entire period of twenty-five years 11.0 per cent, of the deaths have
been from consumption; last year 10.0 per cent., this year 9.5 per
cent. From tuberculosis other than pulmonary there were 2,278
deaths, the lai'gest number, one-half being from tubercular menin-
gitis, and the next numerically abdominal tuberculosis, 385.
Pneumonia caused 9,867 deaths, 444 more than in 1909, 1,200
more than in 1908, but fewer than in the years preceding; 109
deaths per 100,000 population in the cities, and 10^ in the rural
population alike. From broneho-pneumonia there were 7,248
• deaths, and from acute bronchitis 1,598. These were chiefly fatal
in March, and during the annually recurring epidemic of in-
fluenza, which is given as the direct cause of 1,452 deaths.
Cancer, showing in each succeeding year an increase, has this
year caused 7,522 deaths; in 1900 there were 4,871; in 1890,
2,868. In the cities there were 80 deaths per 100,000 popula-
tion; the rural rate was 99. Compared with tuberculosis, its
• • • • •
• • • < • • » »
Commissionee's Eepobt 51
urban mortality was less than half, its niraj considerably more
than half- the number from that cau^e.
Typhoid fever has caused during the year 1,374 deaths. This
is about the mortality for the last two years, while the average
yearly for twenty years prior was 1,600 deaths, and most of the
years were close to the average. The rate of mortality, 15 per
100,000 population, is the same as that of 1909, and the lowest
ever recorded for the State. The urban mortality from typhoid
fever was 14.9 per 100,000 population; the rural was 15.2; in the
cities .93 per cent, of the deaths were from typhoid fever, in the
country .94 per cent.
Diphtheria caused 2,433 deaths, 120 more than in 1909, 40
less than in 1908, 350 less than the yearly average of the past
twelve years of low mortality, and 3,000 less than the average of
the twelve years prior to that. In the urban population there
were 32 deaths per 100,000 during the year; in the rural 10 from
diphtheria. Sixty-four per cent, of the deaths occurred in the
winter and spring months.
Scarlet fever was more prevalent than last year, and the deaths
were 1,617 to 1,205 in 1909. There were 21 deaths per 100,000
population in the cities, and 8 in the rural population. New
York city shared in the increase of mortality over last year to a
less extent than the rest of the State.
Measles which last year had a mortality in excess of that from
scarlet fever, has now 1,285 deaths, or 332 less. In eleven years
of the last twenty-five, the deaths from measles have exceeded
those from scarlet fever and their average mortality has been an-
nually 1,100 to 1,350. Taking account of its remote effects,
measles is probably fully as large a contributor to mortality as
scarlet fever. The urban mortality has decreased but the rural
is nearly double that of 1909. Six-sevenths of the cases and four-
fifths of the deaths occurred during the first six months of the
year.
Whooping cough, which has had an average yearly mortality
for twenty-five years of 900, has now 727 deaths. In August the
largest number, as heretofore noted, occurred, with July nearly
as many, the smallest mortality having been in the winter months.
The relative urban and rural mortality was the same.
62 State Department of Health
Cerebrospinal meningitis caused 452 deaths, an increase over
the two years preceding, but one-half that of the three prior years.
Cases were reported from thirty-five counties, two-thirds of the
deaths occurring in New York city.
There were fifty-eight deaths from epidemic poliomyelitis.
Smallpox caused 7 deaths ; — 1 at Buffalo, 1 at Walden, and 5
in New York city.
Violence was the cause of 9,846 deaths — 614 more than in
1909. There were 1,479 by suicide, 420 homicides and 7,695
accidental.
Complete returns of marriages occurring in the State during
1910 are still lacking at the Department, but reports received
from the county clerks indicate that there were about 85,500. The
total number reported in 1909 was 80,090.
• _
Respectfully submitted,
EUGENE H. PORTER, M.D.,
State Commissioner of Health
February 6, 1911
APPENDIX
THIRTY-FIRST ANNUAL REPORT
OF THE
STATE DEPARTMENT OF HEALTH
[53]
FINANCIAL STATEMENT
Disbursements for the Fiscal Year Endrag September 30, 1910
Salaries
Division of Administration
Eugene II. Porter, M.D., Commissioner $5,000 00
Alec H. Seymour, secretarj- 3,125 00
Feninioro D. Beagle, chief clerk and registrar. . . . 2,475 00
Edward C. Kenny, stenographer 1,800 00
Marion L. Peters, stenographer 1,080 00
Harry Crotty, page 480 00
Total $13,900 00
Temporary Services
Helen L. MacQuide, telephone operator $440 00
Eleanor M. Roosa, stenographer 300 00
Grace McCollom, stenographer 18 26
Minnie S. Warner, clerk 05 60
Katherine C. Judd, laborer 347 0^
Total $1,200 95
Division of Engineering
The^ dore Horton, chief engineer $4,500 00
H. B. Cleveland, principal assistant engineer 2,400 00
Henry X. Ogden, special assistant engineer 860 00
C. A. Holraquist assistant engineer 1,500 00
Charles F. Breitzke, assistant engineer 125 00
O. A. True, assistant engineer 592 66
Homer L. Higley, stenographer 558 00
A. Dudley Mills, stenographer 286 00
Total $10,821 66
[55]
56
State Department of Health
Division of Vital Statistics
Charles E. Thompson, clerk $375 00
A. K. Cole, clerk 1,575 00
William A. Wallace, clerk 1,500 00
Jeremiah Grogan, Jr., clerk 1,500 00
Ella H. Porter, clerk '. 1,125 00
Kae Samuels, clerk 720 00
Meta E. Mills, clerk 855 OO
Anna B. Byrne, clerk 900 00
Eleanore C. Gibb, junior clerk 690 00
*Estelle Jarvis, junior clerk 50 00
Emma H. Kelly, junior clerk 3C8 38
Euth Van Noy, stenographer 288 00
Total $9,946 38
Division of Communicable Diseases
Wm. A. Howe, director $1,187 50
Cora Partridge, clerk 600 00
Alice M. Fuller, stenographer 90O' 00
Eleanor M. Roosa, stenographer 250 00
Total ; $2,937 50
Antitoxin Laboratory
William S. Magill, M.D., director $2,833 32
I. H. Lindsay, clerk 1,500 00
Mary C. Cuthbert, stenographer 455 00
"^Grace McCollum, stenographer 50 00
Mrs. J. Cruickshank, cleaner 630 00
Mrs. Fannie Mainster, cleaner 480 00
Mrs. Charles Schadler, cleaner 82 50
Margaret Hill, cleaner 480 00
Elizabeth R. Lampman, cleaner 212 00
Margaret Bott, cleaner 80 00
•Transferred to Labor Department,
^ Granted leave of absence November 1, 1909.
FixANciAL Stateme^^t 57
Bessie ^cComb, cleaner $60 00
Charles Schadler, stableman 720 00
Walter Reynolds, assistant stableman 525 00
Total ' $8,107 84
Hygienic Laboratory
Lef^nard M. Wachter, chemist $2,100 00
W. G. Fellows, assistant bacteriologist 630 00
Herbert Ant, water analyst 465 16
W. S. Davis, water analyst 143 22
Leslie R. Milford, water analyst 150 00
Wm. A. Bing, M.D., assistant bacteriologist 009 07
Blanche C. Vose, cleaner 600 00
T. G. Conklin, laborer 600 00
Jno. C. Reynolds, laborer 100 00
F. B. Pedrick, laborer '. . . 150 00
$5,638 35
Cancer Laboratory
H. R. Gaylord, M.D., director $3,583 26
G. H. A. Clowes, chemist 1,749 99
Burton G. Simpson, M.D., clinical pathologist... 624 99
F. W. Baeslack, assistant biologist 800 00
C. A. Maclay, secretary 975 00
D. Averill, assistant in photo-chemistry 975 00
F. A. Payne, janitor 360 00
Jesse McCarney, laborer 435 00
Guv Owen, laborer 675 00
Fred West, laborer 246 00
Ed. Sears, laborer 46 00
John Coburg, laborer GOO 00
Chas. Stephan, laborer 32 00
Chas. Gerlach, laborer 40 00
* Arthur Johnson, laborer 5 40
• Temporary.
68 State Department of Health
Anna Grerlach, laborer $35 00
* Thomas Woodcock, laborer 12 00
$11,194 64
Tvherculosis Exhibition
Chas. W. Fetherolf, director $1,875 00
Paul Bernhardt, laborer 540 00
* Dr. George W. Beach, lecturer 60 00
* Dr. John H. Prjor, lecturer 20 00
* Dr. H. B. Doust, lecturer 20 OO
^ Dr. M. E. Leary, lecturer • 20 00
$2,535 00
* Temporary Employees
Services investigating outbreaks of communicable diseases,
registration of vital statistics, sewage disposal, stream pollution,
public nuisances and general local sanitary conditions.
Dr. F. C. Curtis, medical expert $1,485 00
Dr. Wm. A. Howe, medical expert 310 00
Dr. Hills Cole, medical expert 930 00
Dr. Edward Clark, medical expert 215 00
Dr. John B. Huber, medical expert 940 00
Dr. D. C. Moriarta, medical expert. • 90 00
Dr. E. E. Larkin, medical expert 30 00
Dr. Geo. E. Swift, medical expert 60 00
Dr. W. S. Gamsey, medical expert 70 00
Dr. G. W. Miles, medical expert 70 00
Dr. S. A. Russell, medical expert . 20 OO
Dr. E. S. Willard, medical expert 225 00
Dr. F. J. Mann, medical expert 30 00
Dr. D. M. Hibbard, medical expert 60 00
Dr. O. W. Peck, medical expert 120 00
Dr. O. J. Hallenbeck, medical expert 80 00
* Paid out of appropriation for suppression of communicable diseases, and
investigations.
Financial Statement
59
Dr. C. H. Gildden, medical expert
Dr. Jos. Roby, medical expert
Dr. F. W. Adriance, medical expert
Dr. B. J. Maycock, medical expert
Dr. C. E. Birch, medical expert
Dr. G. M. Fisher, medical expert
Dr. n. H. Crimi, medical expert
Dr. F. D. Andrew, medical expert
Dr. D. M. Totman, medical expert
Dr. E. H. Wolcott, medical expert
Dr. R. A. DeKay, medical expert
Dr. A. D. Lake, medical expert
Dr. J. W. LeSeur, medical expert
Dr. W. H. Connelly, medical expert
Dr. W. O. Alsever, medical expert
Dr. E. H. Hutton, medical expert
Dr. F. D. Earl, medical expert
Dr John S. Wilson, medical expert
Dr. John B. Garrison medical expert
Dr. W. B. Gibson, medical expert
Dr. H. S. Shenvood, medical expert
Dr. A. G. Wilding, medical expert
Dr. (\ F. OrmeSy medical expert
Dr. W. W. Thompson, medical expert
Dr. Z. F. Dunning, medical expert
Dr. Wm. T. Sedgwick, lecturer
E. Hoffman, lecturer
Jas. C. Marriott, stenographic services, tuberculosis
hospital hearings
X. H. Goodnough, civil engineer, examination of
sewage disposal plans and reported same
T. Herbert Snow, civil engineer, examination of
eewage disposal plans and report on same
Hazel & Whipple, civil engineers, examination of
sewage disposal plans, and report on same
Dr. Thos. S. Carrington, examination of and report
on plans for county tuberculosis hospitals
Albert F. Forthmiller, stenographic services in in-
vestigation of mineral springs at Saratoga
$20 00
80 00
20 00
10 00
60 00
80 00
80 €0
80 00
50 00
20 00
40' 00
90 00
130 00
60 00
20 00
80 00
180 00
90 00
70 00
70 00
20 00
30 00
20 00
80 00
30 00
75 00
330 00
910 40
20O 00
20O 00
200 00
loO 00
62 00
60
State Department op Health
Prof. W. F. WiUcox, consulting statistician
Charles F. Breitzke, inspecting engineer
Prof. H. N. Ogden, special sanitary engineer. . .
Hiram G. Conger, sanitary inspector
Carl Crandall, sanitary inspector
E. M. Chamot, sanitary inspector
Fritz M. Arnolt, sanitary inspector
M. W. Brower, sanitary inspector
Geo. T. Palmer, sanitary inspector
T. G. George, sanitary inspector
John M. Sill, sanitary inspector
W. B. Clift, sanitary inspector
Robt. L. Tate, sanitary inspector
W. J. McKee, sanitary inspector
Theo. B. Whittemore, sanitary inspector
Harmon B. Smith, draftsman
$350
00
880
00
100
00
20
00
to
00
10
00
276
00
85
00
80
oo
45
oo
90
00
243
00
216
00
12
50
204
00
98
00
$11,175
00
The following were employed in the preparation, packing and
shipment of prophylactic solution for the prevention of ophthalmia
neonatorum, and paid out of appropriation for that purpose:
John C. Reynolds $500 00
Margaret Bott 217 OO
Ellen Slingerland 180 00
Bessie McComb 101 00
Grace McCoUum 125 00
$1,123 00
Detailed Statement of Expenditures from Funds Appro-
priated FOR THE Following:
Investigations
Expenses in connection Avith Annual Conference
1909, and printing proceedings of same
Investigations of watersheds and public water sup-
plies
$1,S60 '27
2,607 22
Financial Statement 61
Investigating registration of vital statistics, com-
municable diseases, etc $2,382 68
Investigating public nuisances, etc 1,982 45
Expenses in connection with public hearings, steno-
graphic services, etc., relating to establishment of
profK>sed hospitals for tuberculosis patients. . . . 1,411 04
Investigating sanitary conditions of summer re-
sorts 756 31
Investigations in connection with sewage disposal,
etc 610 00
Investigations in connection with eyesight and
hearing of school children 559 96
Investigating efficiency of municipal water purifi-
cation plants 42 60
$12,221 53
Office Expenses
Printing:
Publication of Monthly Bulletin $3,693 00
Envelopes for same 251 73
Blank forms for registration of births
and deaths 308 05
General office printing 1,988 85
$6,241 63
Office supplies 859 35
Furniture and office furnishings 650 45
Telephone service 689 99
Telegraph and messenger service 324 47
Books and subscriptions 384 92
$9,150 81
^
Office Expenses and Equipment Division of Engineering
Oak rack $15 00
Book cases 25 75
Costumer 315
62 State Department of Health
Curtains
Microscope and micrometer
Typewriters
Steel tape measures
Map tubes
Sewage disposal model
Lithoprints and blueprints
Atlas
Other books and subscriptions
Office supplies
$5
45
37
54
156
00
14
00
5
00
352
15
20
4 t
32
50
77
60
113
22
$858 13
Antitoxin Laboratory
Microscope, glassware, etc $1,446 65
Centrifuge 454 20
Refrigerating plant 1,145 00
Antitoxin syringes 297 50
Needles 221 57
Boxes 54 40
Camera, slides, etc 224 90
Mailing cases 374 78
General laboratory supplies 353 23
Envelopes 109 68
Printing 523 38
Postage - 100 00
Books and subscriptions 57 55
Telephone service 67 08
Office supplies 29 60
Gas 46 20
Lumber 125 44
Painting and varnishing 607 25
Plumbing 136 63
Excavating and concrete work 84 55
Work on drain 15 40
Whitewashing 88 93
Oilcloth 10 00
Window shades 6 00
Financial Statement 63
Repairs to wagon $24 15
Kepairs to sterilizer 7 50
Labor in stable 96 00
Cleaning laboratory 38 00
Brooms and brushes 9 23
Laundry work 18 94
Hay, straw and oats 2,394 33
Horses 125 00
Horse blankets 30 00
Guinea pigs 18 00
Meats and vegetables 352 48
Coal 240 50
Ice and water 54 45
$9,888 50
Salaries 8,107 84
$17,996 34
Hygienic Laboratory
Services of Bender Laboratory $1,650 00
Constructing addition to laboratory 485 00
Extra lumber 8 18
Painting 52 00
Plumbing 77 99
Water bath 46 50
Labor and material fixing up branch laboratory
at Ithaca 25 65
Ventilator, etc 28 00
Platinum and petri disLes, water bottles, test tubes,
etc 707 95
Boxes for water bottles 234 00
General laboratory supplies , 287 25
Expenses collecting samples of water 89 07
Water rent 49 25
Ice and water 90 30
Meat and vegetables 45 09
Gas 121 70
64 State Depabtmzxt of Health
TelejAone service $21 67
^Isiiiiiig crises 15 15
Tag envelopes 16 28
Printing 150 64
VloUjs 11 74
Laandrv 4 88
Kxpre^?, freight and cartage 33 40
(Jthoe expenses 5 10
Insurance on lal»ratory buildings 102 00
$4-358 ,79
Salaries 5,638 35
$9,997 14
Cancer Lahoratory
Lalx;ratory supplies $1,823 67
Postage, express, freight, cartage, etc, (Sundry ac-
counts rendered bv Secretary) 548 07
General repairs — material and labor 594 35
Lumber 29 70
Painting 214 50
Kefrigerating plant 1,650 00
Addition to ice machine 136 13
Tank for gas 30 00
Desk 75 00
Carpet 75 00
Matting 31 25
Mirror 2 00
Window screens 25 50
Shades 5 53
Safe 65 00
Kent of animal house 480 00
Guinea pigs and rabbits 21 87
Mice and rats 681 57
Water rent 68 50
Electric light 482 17
Gas 66 90
Financial Statement
66
Coal $856 42
Ice 10 56
Laundry 193 00
Telephone service 131 44
Telegraph service 11 63
Books and subscriptions 401 63
Prinring 301 11
Traveling expenses 198 70
$9,191 34
Salaries 11,194 64
$20,385 98
Ophthalmia Neonatorum
Equipment — glass vials, droppers, nipples and
other materials used in preparation of ophthalmia
neonatorum outfits $1,729 04
Services of employees engaged in making the
prophylactic solution, bottling and packing same
for shipment 1,123 00
Postage 950 00
Printing 272 74
Coal 136 50
Gas ; Ill 60
Water rental 58 63
Telephone and telegraph 30 76
$4,412 27
Postage
Transportation
Postage and Transportation
$2,900 00
2,083 48
$4,983 48
8
66 State Depabtment of Health
Suppression of Communicable Diseases
Services of medical experts investigating outbreaks
of communicable diseases, etc $5,130 00
Traveling expenses and printing — report cards,
red cross shields, circulars of instructions to
health officers, and for general household distri-
bution 1,710 85
$6,840 85
Marriage Licenses
Printing blank affidavits, marriage licenses, certifi-
cates of marriages, registers, index books, etc. . . $3,000 00
Traveling Expenses
Monthly expenses of the Department investigating public water
supplies, sewage disposal, public nuisances, registration of vital
statistics, sanitary condition of summer resorts, etc., as follows:
October, 1909 $512 31
November, 1909 244 55
December, 1909 578 65
January, 1910 ; 341 36
February, 1910 438 57
March, 1910 644 06
April, 1910 567 60
May, 1910 437 66
June, 1910 458 91
July, 1910 416 46
August, 1910 738 12
September, 1910 1,284 52
$6,662 77
Commissioner 1,246 05
$7,908 82
Financial Statement 67
Tuberculosis Exhibition
Salaries of director, lecturers and laborers con-
nected with the exhibition $2,535 00
Traveling expenses of 2,059 38
Banners, mottoes, lumber and othei necessary
material for equipment 1,254 23
Express, freight and cartage 251 51
Kent of rooms for exhibition 156 50
Printing and advertising 140 70
$6,397 32
Recapitulation
Total Expenditures During the Year oui of Appropriations made
for the Department
Division of administration, salaries $13,960 00
Division of engineering:
Salaries $10,821 66
Office expenses 858 13
11,679 79
Division of vital statistics, salaries 9,946 38
Division of communicable diseases,
salaries 2,9-37 50
Antitoxin laboratory:
Salaries $8,107 84
Sundries 9,888 50
17,996 34
Hygienic laboratory :
Salaries $5,638 35
Sundries 4,358 79
9,997 14
Cancer laboratory :
Salaries $11,194 64
Sundries 9,191 34
20,385 98
68 Stats Depa&tm£nt of Health
Investdgatioiis :
Salaries $6,045 90
Miscellaneous 6,175 63
$12,221 53
Marriage license blanks 3,000 00
Office expenses 9,150 81
Postage and transportation 4,983 48
Prevention of ophthalmia neonatorum :
Salaries $1,123 00
MisceUaneous 3,289 27
Suppression of smaUpox and other com-
municable diseases:
' Salaries $5,130 00
Miscellaneous 1,710 85
Traveling expenses :
General $6,662 77
Commissioner 1,246 05
4,412 27
6,840 85
7,908 82
Tuberculosis exhibition:
Salaries $2,535 00
Miscellaneous 3,862 32
6,397 32
Unexpended balances for temporary employees. . . 1,200 95
$143,019 16
DIVISION
or
VITAL STATISTICS
[69]
DIVISION OF VITAL STATISTICS
Albany, N. Y., April 15, 1911.
Dr. Eugene H. Pobteb, State Commissioner of Health, Albany,
N. Y.:
Sib: — I have the honor to transmit herewith the Annual Re-
port of the Division of Vital Statistics for the year 1910.
During the year the Department has kept the local registrars
well supplied with registration blanks, and rendered all possible
adsi&tance in aiding the local boards in the enforcement of the
registration laws.
Copies of sanitary regulations approved by the Department re-
quiring compliance with the provisions of sections 22 and 23 of
the Public Health Law were mailed to each of the local boards
of health, together with an urgent request that the boards adopt
and enforce the same.
Returns received from the local registrars have been checked up
each month, and wherever it has come to the notice of the De-
partment that defects existed in the local registration steps have
been taken to correct such defects.
While this Department was obliged to serve formal notice upon
fifty-two local boards of health to amend known defects in the
local registration, as required by section 5 of the Public Health
Law, but in three instances only was the Department compelled
to take charge of the registration town of Bombay, Franklin
county; village of Marlboro, Dutchess county and village of
Avoca, Steuben county.
The living births reported to the Department for 1910 wf^re
213,235 — 10,579 more than reported in 1909. There wore
147,629 deaths reported, which is 7,308 more than reported in
1909.
The United States Census Bureau gives the population of the
State, for July 1, 1910, 9,158,328, and the birth rate per 1,000
population is shown to be 23.3. while the death rate was 16.1.
The urban death rate was lfi.1 : the rural 10 3. The urban birth
rate was 25.3; the rural 17.4.
During 1910 there were 85,490 marriages reported in the State
— about 5,400 more than occurred in 1909.
1711
72
State Department of Health
TABLE I
Total Registraiinn in State Since 18&5
The following table shows the total registration of births, deaths
and marriages occurring in the State since 1885.
YEAR
18^5
ISSft
18^7
1S88
1889
1800
1801
1892
1893
189t
189i
1N90
1897
1^98
1<99
1000
roi
19; »2
1003
1904
1905
1906
1907
1908
19;)0
1910
Population
5.609.910
6.719.866
5.831.947
5,946.246
6.062.764
6.182.600
6.316.333
6.438.283
6,537,716
6.638.696
6.741.246
6,845.375
6.951,111
7.058.459
7.167.491
7.281.533
7.434,896
7.. 591, 491
7.751.375
7.914.636
8.081.333
8.251.538
8.425.333
8.646.356
8.699.643
9.158,328
•Birthn
Deaths
Marriages
Birth
rate
Death
rate
63.536
80.407
24.409
11.3
14.3
89.828
86.801
36,764
15.7
15.2
102.038
108,269
44.438
17.6
18.6
103.089
114,584
43,683
17 3
19.3
114.804
113.156
60.960
18.8
18.6
112.672
128.648
41.195
18.2
20.8
125.909
129.850
61.458
19.9
20.6
130,143
131.388
52.725
20.2
20.3
136,297
129.659
62.805
20.8
19.7
141.827
123.423
52.539
21.4
18.6
142.311
128.834
50.059
21.1
19.1
147.327
126.253
68.990
21.5
18.4
144.631
118.526
57,630
20.8
17.1
138.702
122,584
57.392
19.7
17.4
136.778
121.831
61 , 167
19.1
17.0
143.156
132.089
63.225
19.7
18.1
140.639
131.335
65.216
18.9
17.7
146.740
124.830
68.903
19.3
16.4
158.343
127.498
73,011
20.4
16.4
166.014
142.217
74,677
20.8
18.0
172.259
137.435
78,261
21.3
17.0
183.012
141.099
87.870
22.2
17.1
196.020
147.130
92.421
23 3
17.6
203.159
138.912
73.644
23.8
16.3
202.656
140.261
80.090
23.3
16.1
213.235
147.629
85,490
23.3
16.1
Marriage
rate
4.4
6.4
7.6
7.8
8.4
6.7
8 1
8.1
8.1
7.9
8.7
8.6
8.3
8.1
8.5
8.7
8.S
9.1
9.4
9.4
9.7
10.7
11.0
8.6
9.2
9.3
* Still births excluded.
Registration of Deaths
WTiile the registration of deaths has been more satisfactory
during the past year than at any time previous in the history of
the Department, we are still in receipt of delayed returns each
month, and compelled to return a large number of certificates for
the purpose of ascertaining a more satisfactory statement as to
cause of death. During the year 2,021 defective death certificates
were returned for correction.
The Department has recently mailed to each of the physicians
practicing in the State outside of Greater New York a pamphlet
pointing out defects in the registration of vital statistics, which,
together with the '^ Pocket reference to the International List of
Causes of Death " issued by the United States Census Bureau,
and mailed to all of the physicians in the State would result in
correcting existing defects if the physicians would familiarize
DIAGRAM SHOWING
FLUCTUATIONS
OF THE DEATH RATE
PER THOUSAND^
IN THE STATE \
OF NEW YORK \
SINCE 1890
21
20
19
18
17
16
15
lA
1890 "92 '9+ '96 'SS 1900 '02 '04 "06 "08 '10
Division op Vital Statistics 73
themselves with the nature and purpoaes of the International list,
and co-operate with the registration officials in giving the neces-
sarv information so that returns can be properly be classified.
The delayed certificates of death filed with the Department are
from the rural districts, and in most instances the delay in making
prompt reports is due to the local board of health failing to en-
force the provisions of section 23 of the Public Health Law re-
quiring undertakers to obtain burial permits before remo^^ing a
corpse for burial. Occasionally it comes to the notice of the De-
partment that such delays are due to the undertakers insisting
upon the physicians filling out the complete record of death, in-
stead of obtaining the family history of deceased themselves,
which necessitates the physician driving several miles to obtain
the information, and they abide their time in making such visits.
I believe that existing defects in the registration may be rem-
edied by having section 2^2 of the Public Health Law amended
requiring the attending physician to promptly fill out the medical
certificate of death and deliver same to the undertaker or other
person having charge of a corpse, and that they be required to ob-
tain the family history and file the completed record of death with
the local registrar of vital statistics within 24 hours after receiving
same from the physician.
Undertakers could then be held to strict accountability for the
filing of prompt returns of deaths, and can be more effectively
dealt with than the many physicians practicing in the State.
Registration of Births
Daring the past year there has been a noticeable improvement
m the registration of births, due to the short interval of registra-
tion and general attention given to the registration of births.
The amendment to section 22 of the Public Health Law requit-
ing births to be reported within thirty-six hours after they rc-
cnr at first met with considerable opposition on the part of the
practicing physicians, not so much that it was impossible to report
the cases within the time prescribed, but that it was a hardship
*tid unreasonable to demand such exacting services of a physician.
Of course in some of the rural districts it is difficult to strictlv
•
comply with the law, but most of the rural physicians are making
74 State Depaktmeno? op Hbai^th
returns as quickly as possible. In the cities the law can be com-
plied with, but there is some difficulty in getting the local boards
of health to enforce the law, the belief being that a physician
should be allowed a more reasonable time in which to file a com-
plete record of the birth.
However upon looking over the certificates filed with the De-
partment I find a great majority of the birth certificates are filled
out on the day the birth occurred or the day following. Ap-
parently it is not a question of time so much as it is lack of will-
ingness on the part of certain physicians to file certificates within
any reasonable time after a birth occurs, as I notice that most of
the physicians who fail to promptly report births attended by
them delay tiling the records until weeks after the births occurred,
when undoubtedly the local registrar has brought the matter to
their attention.
*
I believe that should the law be amended allowing the phy-
sicians five days within which to file the complete record of
birth, local boards of health failing to enforce strict compliance
with the law as it now stands, would heartily co-operate with the
State Department of Health in correcting existing defects in the
registration.
A postal notification card could be prescribed by the Depart-
ment to be furnished by the local boards of health in supplying
physicians for use in making prompt reports of births as now re-
quired by law, thus retaining the thirty-six hour clause, and mak-
ing it possible for the local boards of health to see that proper
measures had been taken to prevent ophthalmia neonatorum by
the use of a prophylactic solution, and allow the physician five
days in which to file the complete record of the birth on the form
prescribed by the State Department of Health. Such an amend-
ment would at least leave the local boards of health without a
reasonable excuse for failure to enforce the law.
The following shows the number of births occurring in I&IO re-
ported to the Department, classified by months in which the
births occurred :
Division of Vital Statistics
75
TABLE II
MONTH
18.589
16.108
18,711
kpni ; 17.343
JnauMiy.
FcbroMy
M*rrh.
Total
living
births
May.
Joae
July
Attfost.. .
Seplaiiber.
October. . .
NoTODMr .
December.
Total.
17.590
17.596
18.893
18.123
17.910
17.679
17,363
•17.340
213.235
White
Colored
Total
Male
Female
Not
stated
18.355
15.889
18.402
17.104
17,343
17.384
18.664
17.906
17,675
17.458
17.101
17,034
234
219
309
239
247
212
229
217
235
221
252
306
9.620
8.200
9.592
8.845
9.046
9.055
9.699
9.143
9.243
8,998
8.869
8.904
8.969
7.906
9.116
8.495
8.541
8.538
9.194
8.975
8.665
8.677
8.483
8.433
2
3
3
3
3
5
2
4
1
3
210.315
2.920
109.214
103.992
29
StiU
iMrihi
856
806
925
828
847
840
816
818
794
786
803
834
9.952
The 2,920 colored births were classified as follows: Negro,
2,874; Indian, 28; Mongolian, 18. Of the 213,235 living births
1,W5 were premature.
Registration of Marriages
While the local registration of marriages under the marriage
license law is satisfactory, the law should be amended so as to
provide for the original records to be filed with the State De-
partment of Health, instead of copies of the records filed with
the county clerks.
Previous to the enactment of this law the Department received
the original returns from all of the registration districts in the
State, excepting the cities of Albany, Buffalo, Greater New York
and Yonkers. The filing of returns from these cities with the
Department has more than doubled the work formerly required in
indexing the marriage certificates filed with the Department under
the old law, and put the Department to the expense of providing
additional steel filing eases to provide for copies of the original
records.
The Department is not only required to furnish the town and
city clerks with the necessary printed blanks to carry out the pro-
visions of the .marriage license law, but also required to furnish
toe comity clerks with the necessary blanks for transcripts of
••ine to be filed with the Department.
If the law could be amended so as to provide that the original
76
State Depabtmsnt of Hsai^th
records outside of Greater New York should be filed with the
State Department of Health, the State would save more than one-
half of the expenses now incurred, and the counties the expense
of providing the clerical help now necessary to make copies of the
original records for filing with the Department, as well as the
expense incurred in providing filing cases for the original records.
If the Department is to continue receiving the returns from
the whole State it will be necessary for the Legislature to pro-
vide for the employment of two additional clerks in the division
of vital statistics.
The following table shows the number of marriages reported in
the State since 1907 — the year previous to the enactment of the
marriage license law :
TABLE III
Marriages in New York State
COUNTY
Albany
AUegany. . . .
Broome
Cattaraugus.
Cayuga
Chautauqua.
Chemung . . .
Chenango.. .
Clinton
Columbia . . .
Cortland....
Delaware. . .
Dutchess. . . .
Erie
Essex
Franklin
Fulton
Genesee ....
Greene
Hamilton . . .
Herkimer. . .
Jefferson... .
Kin^
Lewis
Livin^ton. .
Madison. . . .
Monroe
Montgomery
Nassau
New York..
Nisf^ra
Oneida
1910
1909
1.386
1.301
325
333
859
726
618
580
511
524
1.181
1.156
538
555
290
255
408
419
315
288
230
215
378
371
575
640
4,728
4.330
281
255
358
371
387
386
254
272
210
231
28
34
514
515
620
629
12.451
12,714
175
195
235
258
282
319
2.647
2.393
596
563
628
559
•34.647
31,596
941
848
1.416
1,293
1908
1907
1.209
1.331
317
469
691
1.461
594
1.021
485
632
980
2.147
472
910
226
296
350
499
254
195
355
538
3.917
216
299
341
272
220
34
391
571
11.664
152
225
274
2.058
532
472
29.550
750
1.186
371
231
395
782
5,375
300
436
411
271
250
34
399
891
12.916
178
302
315
2.529
606
474
36.097
1,100
996
COUNTY
Onondaga
Ontario
Orange
Orieans
Oswego
Otsego
Putnam
Queens
Rensselaer . . .
Richmond. . . .
Rockland
St. Lawrence.
Saratoga
Schenectady. .
Schoharie
Schuyler
Seneca
Steuben
Suffolk
Sullivan
Tioga
Tompkins
Ulster
Warren
Washington . .
Wayne
Westchester. .
Wyoming. . . .
Yates
ToUl
1910
1909
1.586
1.419
391
352
889
783
223
240
532
551
349
338
110
97
2.077
1.647
985
904
526
450
211
265
682
685
412
399
705
677
152
147
83
113
180
162
632
686
604
544
274
218
249
239
274
240
616
581
276
275
400
360
387
375
2.369
2.055
230
228
125
136
85.490
80.090
•
1908
1907
1.296
329
727
192
471
324
114
1.292
916
425
281
584
369
674
155
95
158!
608
553
242
238
233
555
264
387
336
1.848
226
122
1.423
419
1.008
327
571
438
145
1.490
998
504
308
884
553
775
106
178
1«7
963
628
270
502
310
716
358
445
458
2.650
298
124
73.644
92.421
* Licenses issued.
Division of Vital Statistics
77
RegiHration of Births, DecUhs and Marriages
The following table shows the number of births, deaths and
marriages reported in the State during 1910, by counties:
TABLE IV
COUNTY
Population
Births
Deaths
Marriacea
Albany ...
173.797
41.341
79.043
66.919
07.138
106.492
64.761
36.623
48.221
43.092
29.244
46.632
87.816
631.338
33.601
46.668
44.636
37.690
30.181
4.350
66.472
80.392
1.646.286
24.777
38.068
39.281
286.079
67.902
84.664
2,779,103
92.362
164.741
201.243
62.280
116.303
32.026
71.746
47.182
14.689
287.725
122.296
86.626
46.967
88.903
61.900
88.966
23,797
13.961
26.952
83.382
2.439
769
1.389
1.208
1.121
2.242
862
611
1.129
729
668
782
1.640
12.177
690
1.061
800
686
642
70
1.209
1.486
42.708
446
664
725
6.136
1.107
1.780
77.263
2.092
3.426
3.782
942
2.074
662
1.336
779
214
7.119
1.616
1.991
797
1.716
1.131
2.103
329
216
412
1.367
3.228
622
1.331
901
999
1.644
866
698
676
768
628
726
1.480
8.546
643
822
673
690
627
66
867
1.362
26.676
374
641
619
3.963
991
1.133
46.636
1.402
2.662
3.067
781
2.023
500
1,123
847
267
3.971
2.283
1.467
668
1.351
1.081
1.249
395
215
412
1.221
1.386
ADcf^y i
325
869
CittantigiM
618
CanMB
511
(Tiawtanqty^ , , , t ,
1.181
ChfnDUBtf
638
^""•"■'^^ i*-i.*.... >
Chmftncn
290
OmUm
406
Cohtmbift
316
CortluMl
230
TMftvan
378
D«tche«
676
Em
4,728
F«M1 .
281
368
FoHoQ
387
264
^JTvVOO ^ 114,4 4a&«>*>>a*«*««'**">**'****
210
Haoiilton
28
ttCflllflttiCf , «•• • •#•
614
*-^ --
620
ITniM , ,
12,461
uSS:::::::::':::::::::::::::
175
TJ^rfufiioii . .
236
283
MoQItM . .
2.647
696
iVMMa
628
♦34,647
941
oSdi....;: ■ ";;
1.416
1,586
OnUno' . .
391
Orutt .
889
OrttwM.
223
'-'■•Nro X , , ■
632
S5o .. :
349
rtitinm
110
Qoett..:::
2,077
985
RKhmoBd,.
626
211
8l. Ltwreme
682
8M»toe»....'.'
412
705
gcbobwie.^: ::::::::::::::::::::;:::
163
jdwykr..... :::.::..
88
Swept
180
8*wb«,..
632
78
State Department of Health
TABLE IV — (Concluded)
county
Suffolk...
Sullivan. .
Tioga
Tompkins ,
Ulster...,
Warren ....
Washington.
Wayne
Westchester
Wyoming . .
Yates
State Institutions.
Totols
Population
96.489
33,773
25.576
33,633
91.989
32.241
47,802
50.233
285.350
31.907
18.614
9.158.328
Births
1,676
615
387
554
1.516
538
853
884
6.559
514
268
213.290
Deaths ^ Marriages
1,403
671 i
404
548
1.459
456
796
766
4.335
468
280
1.992
147.629
604
224
249
274
616
275
400
387
2.369
230
125
85.490
Deaths in State Institviions
NAME OF INSTITUTION AND
LOCATION
Auburn State Prison, Auburn
Binghamton State Hospital, Binghamton.
Bloomingdale Asylum, White Plains
Craig C^ony Sonyea*
Dannemora State Hospital, Dannemora. .
Elmira State Reformatory, Elmira
Gowanda State Hospital, Gowanda
Hudson River State Hospital, Pough-
Iceepsie
Long Island State Hospital, Kings Park. .
Manhattan State Hospital, Central Islip. .
Matteawan State Hospital, Matteawan . .
Middletown State Hospital, Middletown .
State Soldiers and Sailors' Home, Bath. .
Rochester State Hospital, Rochester
Rome Custodial Asylum. Rome
St. Lawrence State Hospital, Ogdcnsburg.
Sing Sing Prison, Ossining
Utica State Hospital, Utica
Willard State Hospital:
Romulus
Ovid
Total
3
3
9
2
10
1
1
4
26
26
25
12
12
17
3
12
2
8
24
13
11
197
Xi
U4
1
15
i4
1
20
21
26
2
7
21
14
5
12
3
7
16
6
10
09
11
4
11
1
9
30
25
30
i7
28
16
4
16
1
15
21
mm
4
14
188 239
<
1
9
28
18
38
1
9
24
8
11
11
is
10
7
3
200
(0
8
22
23
37
3
9
21
10
3
14
1
13
9
8
1
a
3
21
4
1
197
21
27
41
6
1
12
6
3
9
■ • •
3
19
11
8
177
2
12
2
4
3
<
18
32
48
1
8
29
12
1
10
2
8
12
9
3
210
1
13
3
9
1
1
6
13
21
41
1
6
21
13
2
8
2
8
19
12
7
I
189
21
22
29
1
8
14
14
1
3
152
O
10
2
3
2
1
3
26
25
36
1
4
17
8
8
11
o
1
10
3
7
3
13
3
12
2
6 8
10
17
9
8
184
23
27
46
2
10
18
13
6
9
6
16
7
9
206
34
39
45
1
7
Oi
lOl
2<
121
12
21
11
10
10
139
25
97
21
4
60
282
306
442
18
98
226
141
49
127
11
111
193
102
91
230it2,369
* Town oC Groveland.
t This total is greater than that given in th? classification of causes of death, p. . for the
reason that previous to March these deaths were classified for the Bulletin under the county id
which institution is located.
City Registration
The following table shows the total registration of births and
deaths in cities of the State; births and death rates for 1910, and
the average rates for the previous five years based upon the United
States Census Bureau estimated populations:
Division of Vital Statistics
79
TABLE V
CITY
Population
1910
Census
City of New York
BoroQch Manhattan.
Borough Bronx
Bocoush Brooklyn . .
Borouch Queens. . . .
Borough Richmond.
Buffalo
Rochester
Srracoae. . . .
Albany. .. .
Yoaken. . . .
Troy
Utica
Hcbmectady.
Biochamton. .
Elmira
Auburn
Amsterdam. .
iamestown.. .
Mt. Vernon. .
Niagara Falla .
N*w Kochelle
Pottghkeapsie .
Nefn>urgh . . . ,
Watertown. . .
Kingston ....
Cohoea
(ISNego
Glorenville. .
Rome
Lockport
Hunkirk
Oifdensburg
Middletown
Olena Falls
Wftterrliet
Ithaca
Otean
Lackawanna
Gomiog
HoroeU.
Geneva
UttJe Falls
North Tonawanda .
Cortland
Hudson
patlaburgh
nennelaer
Folton
Johnstown
Oneonta
Port Jervis
Oneida
Tottawanda
Total urban.
Rural
4.799.639
2.341.312
437.791
1.646.285
287.725
86.526
425.715
219.693
138.087
100,358
80.589
76.836
74.879
73.450
48.671
37.238
34.760
31.586
31.523
31.175
30.617
29,229
28.055
27.868
26.792
25.929
24.737
23.410
20.730
20.632
17.993
17.308
15.981
15.297
15.268
15,099
14.815
14.814
14.549
13.742
13,637
12.438
12,326
12.033
11.517
11.462
1 1 . 182
10,712
10.550
10.476
9.552
9.304
8.316
8.308
6.768.877
2.389,451
Births
129.081
66.358
10.905
42.708
7.119
1.991
10.008
4,999
2,797
1.369
2,064
956
1,902
1,817
908
594
645
695
659
706
811
753
570
536
620
431
438
488
401
571
342
566
348
266
290
210
237
328
389
268
233
235
335
332
264
254
284
167
242
177
190
166
157
168
171.267
41.968
Deaths
76.750
38.668
6.968
26.676
3.971
1.467
6,877
3,084
2.124
1.943
1.226
1.597
1.297
1.070
765
554
522
540
404
433
551
342
466
510
468
475
509
385
321
411
299
279
268
275
241
261
244
188
397
200
174
175
194
160
219
236
195
158
155
143
181
170
118
106
108.660
38.969
Rate per 1. 000
Population
Births
26.9
28.3
24.9
25.1
24.8
23.0
23.5
22.8
20.3
13.6
25.6
12 4
25.4
24.7
18.7
16.0
18.0
22.0
20.9
22.6
26.5
25.8
20.3
19.2
23.1
16.6
17.7
20.8
19.3
27.7
19.0
32.7
21.8
17.3
19.0
13.9
16.0
22.1
26.7
19.5
17.1
18.9
27 2
27.6
22.9
22.2
25.4
15.6
22 9
16.9
19 9
17.8
18.9
20 2
25 3
17.6
Deaths
16.0
16.1
15.9
15.6
13.8
17.0
16.2
14.0
15.4
19.4
15 2
20.8
17 3
14.6
15.7
14.9
15.0
17.1
12.8
13.9
18.0
11.7
16.6
18.3
17.5
18.3
20.6
16.4
15.5
19.9
16.6
16.6
16.8
18.0
15.7
17 3
16 5
12.7
27.3
14.6
12.8
14.0
15.7
13.3
19.0
20.6
17.4
14.7
14.7
13.7
18 9
18 3
14 2
12 8
16 1
16.3
AvERAOR Rate
Past 5 Yrarr
Births
27.5
28.7
27.4
26.0
25.6
25.5
22.4
21.4
18.9
11.5
24.9
12.1
23.6
25.6
18.5
16.0
19.6
22.8
20.5
24.3
20.3
28.6
21.1
18.3
18.5
21.6
18.9
19.3
18 0
23.3
18.5
33.9
22.8
15.2
15.7
14.0
15 6
20 8
i7.9
19.2
19.4
20 1
27.0
16.3
17.2
20.9
14.0
19 9
16 6
17 I
17 5
17 5
19 4
25 5
Deaths
15 9
17.7
17.7
20.4
17.1
16.5
19.9
15.7
15.0
15.8
18.1
16.1
20.4
18.2
13.0
16.0
15.5
15 8
16.5
11.4
14 5
15.6
13 0
18 4
18.3
16.3
18.5
19.9
16.4
n 6
19 9
14.6
n.2
18.4
10.4
It. 9
17.4
14 8
12.9
is 9
14 I
13 6
13 7
13 9
12.8
17.8
14.5
14.4
14.9
14 3
17 5
17 9
14 7
12.8
17.3
15.4
The above table includes deaths of nonresidents occurring in
the cities, except in the following cities, where deaths occurring
^ State institutions are excluded : Auburn, State Prison, Bing-
80
State Depajeltmbnt of Hsai^th
hamton, State Hospital, Elmira, Reformatory, Middletown, State
Hospital, Ogdeiisburg, St Lawrence State Hospital, Borne, Stato
Custodial Asylum, Utica, State Hospital.
Average city death rate, 1910 15.3
Average city birth rate 20. 3
The average city birth rate was 25.3, and the rural 16.1, The
cities having the highest birth rate were: Dunkirk, 32.7; Rome,
27.7; North Tonawanda, 27.6; Little Falls, 27.2; Greater New
York, 26.9; Lackawanna, 26.7; Niagara Falls, 26.5 and New
Rochelle, 25.8.
The lowest birth rate is shown in the following cities, due to
incomplete registration: Troy, 12.4; Albany, 13.6; Watervliet,
13.9 and Rensselaer, 15.6. Troy reports 641 more deaths than
births; Albany, 576; Watervliet, 51 and Rensselaer, 9. Other
cities reporting less births than deaths were Cohoes, 71 ; Cortland,
45; Ithaca, 7; Kingston, 44; Lackawanna, 8; Middletown, 9 and
Port Jervis 4.
The cities having the highest death rate were Lackawanna,
27.3; Troy, 20.8; Hudson, 20.6; Cohoes, 20.6 and Rome, 19.9.
New Rochelle has the lowest death rate, 11.7; and the follow-
ing cities show a reported death rate of 14.0 and under; Rochester
and Geneva, 14.0; Mt. Vernon, 13.9; Johnstown, 13.7; North
Tonawanda, 13.3; Olean, 12.7; Jamestown, Homell and Tona-
wanda, 12.8; New Rochelle, 11.7.
Of the largest cities in the State, Rochester shows the lowest
d<*ath rate, 14.0. Of the smaller cities, Geneva has a like rate.
The following tables shows the total registration in each of the
registration districts in the State:
Albany County
Albany, city
AUamont. village. . . .
Berne, town
Bethlehem, town. . . .
Coeyman^. town
Cohoes, rity
Polonie. town
Green Island, town*.
Green Island, village.
Guilderland, town . . .
Birth?
Deaths.
Mar-
•
1910
1910
riages,
1910
1.369
1.943
824
11
14
24
34
is
47
64
13
89
65
21
413
508
231
82
118
49
33
76
72
20
34
16
Knox, town
1 10
New Scotland, town. .
40
Hensaelaerville. town.
25
Voorheesville. village.
5
Watervliet. city
209
Westerlo, town
1 19
Delayed returns
1 9
Total
2.448
Births.
Deaths,
1910
1910
10
13
40
43
25
23
5
10
209
260
19
28
9
2
2.448
3.221
Mar-
riages,
1910
17
17
11
131
8
6
1.392
*^Bm
* Town and village have same boundaries.
Division of Vital Statistics
81
Allegany County
Alfred, town
Alfred, village
AOen, town
Alma, town
Almond, town
Amity, town
Andovrr. town ....
Aodover, village . . .
Angelica, town ....
Angelica, village . . .
Belfast, town
Belfast, village ....
Befanoot, village . . .
BinbaU. town
Bolivar, town
Bolivar, village ....
Bam. town
Caaaseraga, village
Gaoeadea. town . . .
Onterville. town. .
Clarksville. town . .
Cuba, town
Births.
1910
18
13
10
20
22
26
21
18
15
14
29
18
9
27
14
9
10
22
21
23
17
Deaths,
1910
11
20
11
10
27
10
15
14
15
23
27
24
7
11
11
12
18
21
9
8
16
Mar-
riages,
1910
12
3
5
10
19
18
9
15
3
22
6
6
5
20
Births,
1910
Deaths,
1910
Mar-
riages,
1910
Cuba, village
43
18
11
9
13
16
36
23
17
5
30
21
6
24
76
6
13
26
3
33
23
27
9
13
3
19
14
13
1
17
20
3
12
65
7
11
8
1
Friendship, town
Friendship, village
Genesee, town
Granger, town
Grove, town
17
U
2
1
Hume, town
10
Independence, town. . .
New Hudson, town . . .
Richburg, village
Rushfora, town
Scto. town
11
7
i
Wand, town
2
Wellsville, town
WellsviUe. village
West Almond, town. . .
Willing, town
Wirt, town
63
7
8
8
Delayed returns
Total
3
772
619
.')28
Broome County
Births,
1910
Deaths,
1910
Mar-
riages,
1910
Barker, town
20
12
905
13
26
20
12
12
765
15
38
19
13
3
536
9
15
3
9
'■■j
7
"is
Binghamton. city
Okenangn. town
CoWwrifie. town
Conklin. town
Deporil, village
Dickinson, town
EndJcott. village
ronton, town
25 43
7 44
53 27
19 19
Kirkifood. town
Lestmhire. village
liiie, town
9 ,
49
19
4
12
62
17
9
Lidei village
Mar-
riages,
1910
Maine, town
Nanticoke, town
Port Dickinson, village
Sanford, town
Triangle, town
Union, town
Union, village
Vestal, town
Whitney's Point, vil.
Windsor, town
Windsor, village
Delayed returns
Total
23
14
4
34
14
28
33
18
9
26
5
10
1.399
20
17
7
6
8
27
24
12
9
23
92
39
30
13
13
24
29
7
1.304
807
Cattaraugus Cownty
ADegany. town
Afljpnv. Tillage
Asoford. town
Csrrolltoa, town
O^ranguft. village . .
CoW Spring, town . .
gwe»»ngo. town
^r^on, town
B«st Otto, town
|S« Rsadolph, viUage
^».town
^wttviDe, town ....
Births,
1910
52
20
38
4
16
11
11
2\
25
6
8
16
Deaths.!
1910
28
20
22
8
20
9
14
18
9
22
6
11
Mar-
riages,
1910
31
15
43
5
6
15
7
4
16
Ellicottville. village.
Farmersville. town. .
Franklinville, town.
Franklinville, village
Freedom, town
Gowanda, viUage. . .
Great Valley, town .
Hinsdale, town
Humphrey, town . . .
Ischua, town
Leon, town
limestone, villacQ .
Births.
Deaths,
1910
1910
10
16
14
11
33
14
32
28
21
13
27
21
25
29
19
20
15
9
13
11
12
10
19
7
Mar-
riage?,
1910
5
28
11
3
7
4
5
82
State Depabtmknt of Health
Cattaraugus County — C!ontiniied
Births,
1910
Litt4e Valley, town. .
UtUe Valley, villace
Lyndon, (own
Machias. (own
Maiufield, town ....
Napoli, town
New Albion, (own . .
Olean, town
Olean, city
Otto, town
Penysburg. town. . .
Persia, town
4
16
5
25
10
15
14
7
328
15
18
6
Deaths.
Mar-
1910
riages.
1910
4
29
18
5
3
35
7
10
4
11
2
11
17
11
5
188
174
13
6
12
8
4
16
1
1
1
Births.
1910
I>eatha.
1910
Mar-
riaciea,
1010
, Portville, town
1 Portville, villase
1 Randolph, town
1 Randolph, villace
Red House, town
Salamanca, town
Salamanca, villaxe. . . .
South Valley, town. . .
West Salamanca, vil . .
Yorkshire, town
Delayed returns
Total
35
7
12
23
9
3
142
10
6
25
3
19
8
16
14
4
9
85
8
18
32
2
26
19
io
62
8
17
1.211
913
618
Cayuga County
Auburn, city
Aurelius, town. . . .
Aurora, village ....
Brutus, town
Cato, town
Cato, village
Cayuga, village. . . .
Conquest, town. . .
Fair Haven, village
Fleming, town
Genoa, town
Ira, town
Ledvard, town. . . .
Locke, town
Ments, town
Meridian, village . .
Montesuma. town .
Moravia, town ....
Births.
Deaths,
Mar-
1910
1910
riages,
1910
646
521
302
11
10
10
3
2
24
17
14
18
10
11
2
5
• . • • •
5
7
16
26
9
9
7
17
10
4
19
25
0
' 9
13
9
26
19
15
10
18
8
19
11
13
4
6
18
11
8
22
8
14
•
Births.
1910
Deaths.
1910
Mar-
riagea,
1910
Moravia, village
Niles. town
19
21
17
16
23
10
24
9
25
13
11
5
11
21
18
9
19
14
9
16
20
14
31
6
40
5
6
20
19
21
29
6
Owasoo, town
Port^ Byron, village . . .
Scipio. town
10
4
Sempronius. town
Sennett, town
Springport. town
Sterling, town
Summer Hill, town . . .
Throop, town
Union Springs, village .
Venice, town
10
9
3
20
2
3
6
Victory, town
1 Weedsport, village. . . .
1 Delayed returns
1
13
•
Total
1.130
995 1 504
1
ChaiUauqua County
Arkwright. town
Brocton, village
Busti, town
Carroll, town
Celoron, village
Charlotte, town
Chautauqua, town
Chautauqua Lake Asso-
ciation, village*
Cherry creek, town ....
Cherry creek, village. . .
djrmer , town
Dunkirk, town
Dunkirk, city
£31ery, town
Deaths,
1910
i
12
24
29
12
9
59
Mar-
riages,
1910
7
12
13
4
15
9
10
19
26
i6
11
7
553
272
i86
33
19
10
6
8
10
8
78
EUicott, town
Ellington, town ...
• Falconer, village . . .
Forestville, village.
Fredonia, village . . .
French creek, town ,
Gerry, town
Hanover, town ....
Harmony, town. . .
Jamestown, city. . .
Kiantone. town. . .
Lakewood, village . .
MayviUe, village.. .
Mina, town
Panama, village . . .
Deaths.
1910
Mar-
riages,
1910
25
48
19
7
19
15
78
10
7
16
45
51
35
4
404
492
4
15
11
8
6
8
* P<q;>iiIation included in ihat of the town of Chautauqua.
Division of Vital Statistics
83
Chaviauqua County — Continued
PoImmI. town.
Pomf ret, town.
PortUnd, town
Riplev. town
Sheridmn* town
Sherman, town
SbenoAn. villa^
SUrar Creek, viUage. .
Births,
Deaths,
Mar-
•
1910
1910
nates,
1910
29
15
7
38
22
47
42
25
13
43
28
58
24
27
9
25
16
10
n
6
52
34
Sinclainrille, village
Stockton, town. . . .
Villenova, town. . .
Westfield, town . . .
Weatfield, villace . .
Delayed returns. . .
Total
Births.
Deaths.
1910
1910
8
11
29
35
28
14
15
22
44
64
55
3
2.297
1.536
Mar-
1910
6
8
71
2
1.183
Chemung County
town
BeJdmn. town
Bi( Flats, town.
Catiin. town
Cbemunt, town
Ehnira. town
Elmira, city
Elmira Heichts. village*
Erin, town
Births.
I>eaths.
Mar-
•
1910
1910
nages,
1910
3
1
8
5
10
5
20
19
18
17
10
5
24
27
16
12
39
6
593
554
388
49
41
15
18
\2
Horseheads, town. .
Horsehoads, village
Southport, town. . .
Van Etten, town . .
VanEtten. village.
Veteran, town
Wellsburg. village. .
ToUl
Births,
Deaths.
1910
1910
21
44
24
25
24
27
18
7
8
6
18
30
11
8
862
866
Mar-
riages.
1910
39
17
9
15
538
* Part of village in town of Horseheads.
Chenango County
Afton, town
Af ton, village
Baiobridge. town
Bainbridge. village
Cohunbus, town
Coventry, town
Oetman, town
Grerne, town
Greene, village
Otntford. town
Uneklarn, town
McDonou^, town
^f*w Berlin, town. ...
New Berlin, village . .
North Norwich, town
Norwich, town
Births.
Deaths,
Mar-
1910
1910
riages,
1910
26
18
11
1 11
12
12
7
2i
24
24
17
14
6
7
16
4
10
2
2
33
28
30
20
18
h
31
37
18
13
4
3
16
17
4
9
18
19
' 16
22
12
14
2
10
11
68
1
Norwich, village. .
Otselic, town
Oxford, town
Oxford, village . . .
Pharsalia, town. .
Pitcher, town. . . .
Plymouth, town. .
Preston, town. . . .
Sherburne, town. .
Sherburne, village
Smithville, town . .
Smyrna, town
Smyrna, village . .
Delayed returns . .
ToUl
Births,
1910
153
12
30
35
9
18
7
10
19
15
17
15
4
I
612
Deaths.
1910
122
17
43
32
9
12
9
17
25
16
11
11
7
593
Mar-
riages.
1910
10
20
4
4
6
6
23
6
9
280
84
State Department of Health
Clinton County
Altona, town
Ausable, town
Beekmantown, town
Black Brook, town. .
Champlain, town . . .
Champlain. village. .
Chasy, town
Clinton, town
Dannemora. town . .
Dannemora, village .
EUenburgh. town. . .
Births.
Deaths,
Mar-
•
1910
1910
nages,
1910
46
21
10
18
12
22
25
39
11
30
23
15
76
37
55
27
19
109
37
is
49
24
7
63
20
18
25
9
72
14
19
Mooers, town
Mooera, village
Peru, town
Plattsburgh, town. . .
Plattsburgh, citjr ....
Rouse's Point, village
Saranac, town
Schuyler Falls, town.
Delayed returns
ToUl
Births,
Deaths,
1910
1910
67
64
9
7
48
27
51
50
284
192
5
7
91
46
45
22
11
3
1.140
663
Mar-
riages.
1910
30
16
18
134
28
7
408
Columbia County
Ancram, town
Austerlits, town. . . .
Canaan, town
Chatham, town ....
Chatham, village . . .
Clavcrack. town. . . .
Clermont, town ....
Copake. town
Gallatin, town
Germantown, town .
Ghent, town
Greenport. town
Hillsdale, town
Births.
Deaths.
Mar-
•
1910
1910
nages.
1910
31
17
9
10
10
8
11
14
12
23
38
31
44
37
30
38
32
14
20
6
20
25
6
6
8
5
21
22
7
15
47
17
30
15
5
11
22
7
Hudson, city
Kinderhook, town. .
Kinderhook, village.
Livingston, town . . .
New Lebanon, town.
Philmont. village . . .
Stockport, town. . . .
Stuyvcsant, town. . .
Taghkanic. town. . .
Valatie. village
Delayed returns. . . .
ToUl
Births.
1910
254
8
19
22
17
32
42
33
12
24
3
732
Deaths.
1910
236
21
17
20
19
32
47
25
11
27
2
770
Mar-
nages,
1910
66
23
io
8
ih
18
6
290
Cortlwnd County
Cincinnatus. town. .
Cortland, city ,
Cortlandville. town . ,
Cuyler, town
Freetown, town
Harford, town
Homer, town
Homer, village
Lapeer, town.
McGrawville. village.
Marathon, town
Births.
Deaths.
Mar-
1910
1910
riages.
1910
1 18
14
5
1 264
218
95
26
40
26
15
16
6
' 7
7
4
1 8
11
3
1 22
25
25
42
47
11
8
0
10
20
10
4
11
Marathon, village
Preble, town
Scott, town
Solon, town
Taylor, town
Tnixton, town . . .
Virgil, town
Willet, town
Delayed returns . .
ToUl
Births.
Deaths.
1910
1910
22
19
14
11
17
15
10
11
17
10
22
18
18
22
6
12
1
559
528
Mar-
riages,
1910
1
4
3
6
10
8
6
1
214
Division of Vital Statistics
Delaware County
"SS
IBIO
■si-
Binhi
1910
^5fS^
'*
i
0
S2
21
26
1
15
13
"19
19
56
4J
60
12
27
Bsn£^^::'::::
S
wsZn.T;™"".*.;::;
WBlton, villme
DtlBy.d relurai
Toll!
Fnnkliai viOue'. '.'.'.'.'-'.
Btararlc. vmtB.'.V.'.'.'.
'ss
793
720
3*7
Dvichess County
Birtts,
Deiths.
M.r-
Birthg
1910
Deatlii.
1910
S
IS
1
es
43
1
20
21
1
i
122
20
e
3
B
24
s
105
is
■ 8
Pleuant Valley, town.
Ple^nl V,ll,y. viUw
Poughkeepaie, town...
Bed Hook, town
Rod Hook. vilUce
Rliinebeck, town
Stanlord. town...!!:!
Tivoli. vUlace
Union VaC^wn
wgSTril-Xvii:
1
34
i
2S
20
1
29
is
48
gl*»»«^™
*"'24
^arrSi.-".:::
Fiilikill, viUuB
11
■2?
NjJ^jBuJ^wn
Delaj^retufo.
14
^^"Jj^jJUj*^
1.553
1.429
Erie County
.Mar. 1
"l^l^'
30
21
18
7
86
Statb Depabtmewt of Heai^th
Erie County — Continued
Kenmore, villa^ . . . .
Lackawanna, city. . . .
Lancaster, town
Lancaster, village
MariUa, town
Newstead, town
North Collins, town. .
Sardinia, town ......
Sloan, village
Births,
Deaths,
Mar-
•
1910
1910
nages,
1910
18
6
389
395
134
46
34
95
100
62
28
23
8
41
30
27
47
28
15
38
21
12
21
7
SpringviUe. village. .
Tonawanda, town. .
Tonawanda, city . . .
Wales, town
West Seneca, town. .
Williams viUe, village
Delasred returns ....
Total
Births.
Deaths,
1910
1910
32
32
8
21
164
106
14
14
97
65
16
18
13
12,190
8,534
Mar-
riages.
1910
37
09
7
34
152
4.745
Essex CowrUy
Bloomingdale, village. . .
Chesterfield, town
Crown Point, town. . . .
Eliaabethtown, town. . .
Eliaabethtown, village..
Essex, town
Jay, town
Keene, town
Keeseville, village
Lake Placid, village
Lewis, town
Minerva, town
Moriah, town
Newcomb, town
Births,
Deaths.
Mar-
•
1910
1910
nages,
1910
2
1
25
18
is
19
35
9
13
11
16
10
8
11
25
4
46
31
15
12
13
13
25
34
32
21
14
17
9
13
11
3
151
108
78
6
2
2
North Elba. town. . .
North Hudson, town
Port Henry, village .
St. Armand, town . .
Schroon, town
Ticonderoga, town..
Ticonderoga, village.
Westport, town
WiUsboro, town ....
Wilmington, town. .
Delayed returns ....
ToUl
Births. I Deaths,
1910 1910
14
6
74
2
19
75
37
43
28
13
6
17
8
35
9
15
46
17
32
24
18
2
Mar-
riages.
1910
34
1
6
9
46
11
6
696
558
277
Franklin County
Altamont, town
Bangor, town
Belmont, town
Bombay, town
Brandon, town
Brighton, town
Burke, town
Chateaugay, town
Chateaugay, village. . . .
Constable, town
Dickinson, town
Diiane, town
Fort Covington, town. .
Fort Covington, village
Births,
Deaths.
Mar-
•
1910
1910
nages,
1910
42
20
39
40
31
11
65
26
15
28
35
12
27
9
9
22
16
6
44
23
5
56
25
23
10
24
30
32
is
39
24
8
11
3
38
18
25
13
14
Franklin, town
Harrietstown. town. .
Malone, town
Malone, village
Moira, town
Santa Clara, town . . .
Saranac Lake, village.
Tupper Lake, village.
Waverly. town
Westville. town
Delayed returns
Total
Births,
1910
25
10
64
141
45
10
tll2
85
64
30
42
Deaths.
1910
Mar-
riages.
1910
22
13
74
108
44
2
141
50
39
18
1
8
56
90
"is
0
i5
5
1,093
1
812
358
t Part of village in E^ssez county.
Division of Vital Statistics
87
Fulton County
Bleetker. town . .
Bro«daU)in, town
C«roca. town. . .
EphimtAh. town .
GlorereviUe, city ,
Johnstown, town.
Johnstown, city.
Hayfieid. town..
Msyfiekl. village .
Births.
Deaths.
Mar-
1910
1910
riages,
1910
12
6
0
25
29
12
13
11
1
15
29
8
401
321
217
38
39
16
188
153
110
1 28
23
13
1 6
11
Northampton, town
Northville, village
Oppenheim. town.
Perth, town
Stratford, town. . .
Delayed returns . .
Total
Births,
1910
21
21
6
14
12
12
812
Deaths,
1910
15
9
14
8
13
681
Mar-
riages.
1910
7
2
1
4
391
Genesee Cownty
Alabnma. town. . .
Alexander, town. .
Alexander, village
Ratavia, town
B«t»Tia, village. .
Bergen, town
Bonpen. village. . .
Bethany, town . . .
Byron, town
Corfu, village. . . .
Darien. town.. . . .
Elba. town.
Births,
Deaths,
Mar-
1910
1910
riages,
1910
41
31
14
16
22
7
3
6
18
30
iu
232
206
17
13
7
12
21
18
30
14
24
22
11
10
7
30
19
ii
16
6
4
Elba, village ...
Le Roy, town . .
Le Roy, village.
Oakfield, town. .
Oakfield, village
Pavilion, town. .
Pembroke, town
Stafford, town. .
Delayed returns
Total
Births,
1910
9
34
77
25
42
31
25
6
13
699
*«*" 1910
5
24
45
8
9
26
35
22
587
36
U
10
10
2
1
255
Greene Coimty
Births,
1910
Ashhind. town. . .
Athem. town
Athens, village . . .
Cairo, town
Catalan, town... .
Cataidll. village. . .
Coxaaclue, town . .
Coxaarkie. village
Durbam, town. . .
Grvraville, town. .
HaSoott, town
8
11
31
31
61
93
33
63
16
30
7
Deaths. M*'
1910 nages.
***" 1910
32
24
4
8
0
15
15
26
39
8
68
76
96
17
27
56
9
13
4
Himter, town
Himter, village
Jewett, town
Lexington, town
New Baltimore, town
Prattsville, town. . . .
Tannersville, village. .
Windham, town
Delayed returns
ToUl
Births,
Deaths,
1910
1910
35
28
8
8
12
7
8
11
31
33
21
14
15
10
28
29
3
545
525
Mar-
riages,
1910
18
6
7
9
6
12
210
Hamilton Cotmty
Arietta, town
Braaon. town
Hoof. town
Iikdian Lake. town. .
Inlet, town
Lake Pleasant, town
Births.! Deaths,' ^^
1910 1910 I ™^
4
4
4
24
5
4
4
3
1
8
5
11
1
0
5
8
0
0
Long Lake, town
Morehouse, town
Wells, town
Total
Births.
1910
Deaths,
1910
70
57
13
10
0
0
12
15
Mar-
riages.
1910
7
0
7
28
88
State Department of Health
Herkimer County
Cold Brook, village . .
Columbia, town
Danube, town
Dolgeville, village
Fairfield, town
Frankfort, town
Frankfort, village
German Flata, town..
Herkimer, town
Herkimer, village. . . .
liion, village
Litchfield, town
Little Falls, town
Little Falls, city
Manheim, town
Middlevilie, village . .
Mohawk, village
Newport, town
Births,
1010
4
20
16
63
10
30
119
18
18
195
131
9
4
336
5
5
30
9
Deaths,
1910
5
26
8
19
6
25
57
18
34
121
87
11
9
188
4
11
36
6
Mar-
riages,
1910
4
6
6
41
67
81
1
3
200
25
15
Newport, village
Norway, town
Ohio, town
Old Forge, village. . .
Poland, village
Russia, town
Salisbury, town
Schuyler, town
Stark, town
Warren, town
Webb, town
West Winfield, village
Wilmurt, town
Winfield, town
Delayed returns
Total
Births,
Deaths.
1910
1910
10
10
7
9
3
4
16
10
11
18
27
38
25
14
10
13
19
6
17
19
8
16
14
7
7
14
13
9
2
1,218
857
Mar-
riages.
1910
10
18
11
4
4
8
6
5
5
519
Jefferson County
Adams, town
Adams, village
Alexandria, town
Alexandria, Bay, village
Antwerp, town
Antwerp, village
Belleville, village
Black River, village
Brownville, town
Brownville, village
Cape Vincent, town ....
Cape Vincent, village .
Carthage, village
Champion, town
Chaumont, village
Clayton, town
Clayton, village
Dexter, village
EUisburg, town
Ellisburg. village
Glen Park, village
Henderson, town
Henderson, village
Births,
1910
22
16
46
44
44
15
6
18
19
18
19
22
90
15
4
35
39
19
65
5
8
22
5
Deaths,
1910
Mar-
riages,
1910
39
25
30
39
30
29
27
i9
13
8
11
18
30
10
22
22
15
57
11
16
9
30
33
27
11
52
18
5
12
16
io
6
Hounsfield, town
Le Ray, town
Lorraine, town
Lyme, town
Mannsville, village
Orleans, town
Pamelia, town
Philadelphia, town
Philadelphia, village. . .
Rodman, town
Rutland, town
Sacketts Harbor, vil . .
Theresa, town
Theresa, village
Watertown, town
Watertown, city
West Carthage, village
Wilna, town
Worth, town
Delayed returns
Total
Births,
I>eatha.
1910
1910
23
21
23
44
19
18
10
20
1
9
48
34
7
25
15
12
9
23
28
18
13
21
11
17
29
15
9
24
14
11
583
467
15
25
20
46
12
5
25
1
1,510
1.353
Mar-
riages,
1910
31
10
8
8
ie
8
6
■ 6
16
"i?
"7
231
49
4
1
621
Lewis County
Constableville, village.
Copenhagen, village . . .
Croghan, town
Croghan, village
Denmark, town
Diana, town
Greig. town
Harrisburg, town
4
4
47
16
21
24
12
6
Deaths.
1910
5
22
23
13
18
25
8
9
Mar-
riages,
1910
26
15
13
7
3
Harrisville, village
Highmarket, town
Lewis, town
Leyden, town . .
Lowville, town .
Ixjwville, village
Lyonsdale, town.
Lyons Falls, village
Births,
Deaths.
1910
1910
10
14
7
4
17
12
28
14
18
21
37
47
22
13
15
6
Mar-r
riages,
1910
1
6
13
34
a
Division of Vital Statistics
89
Lewis Gowrdy — Continued
MartinsburK, town. .
Montague, town
Xew Bremen* town .
Oaeeola. town
Pinokney, town ....
Port Leyden. villace
Ttfrin, town
Births.
1910
Deaths,
1910
Mar-
riages,
1910
28
8
30
11
11
22
14
26
5
15
3
8
18
7
14
1
6
'■5
■'9
Turin, village . . . .
Watson, town. . . .
West Turin, town
Delayed returns. .
Total
Births.
1910
Deaths,
1910
2
17
15
11
3
22
12
457
373
Mar-
riages,
1910
10
9
175
Livingston County
Avon, town
Avtm, Tillage
Caledonia, town. .
Caledonia, village
Concsus. town . . .
DaofTille. village.
Oensaeo. town . . .
Geneseo. village . .
Grovdand, town.
l«ioester, town. . .
Lima, town
Uma. village
Uvoma. town. . . .
Uvonia, village...
Moaoow. village . .
Birtha,
1910
22
41
20
18
22
59
17
41
27
42
25
11
41
13
8
Deaths,
1910
19
32
18
21
13
76
20
22
12
15
13
19
15
16
2
Mar-
riages,
1910
19
id
ii
23
15
2
12
16
Births.
1910
Deaths,
1910
Mar-
riages,
1910
Mount Morris, town. .
Mount Morris, village.
North Dansville, town.
Nunda, town
23
62
5
21
12
12
23
5
26
20
48
7
13
65
6
22
20
6
9
7
16
9
40
3
18
■ "38
12
Nunda, village
Ossian, town
3
Portage, town
Snarta. town
8
9
Springwater, town ....
West Sparta, town. . . .
York, town
17
3
13
Delayed returns
Total
16
671
528
251
Madison Cotmty
Brookfieki. town
Brookfiekl, viDage . .
Canastota, viOage . .
Caienovia, town. . . .
Casenovia. village. .
Chittenango, village
De Ruyter. town . . .
De Ruyter, village. .
EariviUe. village....
Eaton, town
Fenner. town
Oeorgetown. town. .
Hamilton, town . . . .
Hamilton, village. . .
W»non, town
Births.
Deaths,
Mar-
1910
1910
riages,
1910
39
30
14
8
5
81
62
36
35
21
23
30
11
14
15
14
9
1
10
15
10
23
46
21
13
8
10
20
18
7 >
32
28
1 ^
34
23
20
15
6
Lenox, town
Lincoln, town
Madison, town
Madison, village
Morrisville, village. .
Nelson, town
Oneida, city
Smithfield, town
•Stockbridge, town. .
Sullivan, town
Wampsville. village.
Delayed returns . . . .
Total
Births,
1910
23
17
26
' • ■ •
8
20
157
15
26
60
2
1
726
Deaths,
1910
18
10
20
4
8
16
118
11
20
44
4
621
Mar-
riages,
1910
39
6
14
13
78
4
13
26
283
90
Statb Depa&tment of "EizAurK
Monroe County
Brighton, town
Brockport, village ....
Chariotte, village
Chili, town
Churchville, village . . .
Clarkaon, town
East Rochester, village
Fairport, village
Gates, town
Greece, town
Hamlin, town
Henrietta, town
Hilton, villue
Honeoye Falls, village.
Irondequoit, town ....
Mendon, town
Ogden, town
BiHhs.
Deaths,
Mar-
•
1910
1910
nages,
1910
62
43
20
66
49
15
31
26
16
13
9
9
28
23
9
69
32
48
49
68
49
21
23
94
45
38
16
18
18
28
15
11
9
16
20
76
40
16
31
21
18
33
33
30
Parma, town
Penfield, town
Perinton. town. . . .
Pittsford, town. . . .
Pittsford, village . .
Riga, town
Rochester, city. . . .
Rush, town
Spencerix>rt. village
Sweden, town
Webster, town ....
Webster, village . . .
Wheatland, town. .
Delayed returns. . .
Total
Births,
1910
49
59
41
25
30
22
5,092
30
17
28
51
13
52
35
6,171
Deaths,
1910
25
27
32
20
16
18
3.072
20
15
21
36
. 16
33
2
3,915
Mar-
riages.
1910
Id
37
20
18
2,265
7
38
25
16
2,647
Montgomery County
Akin, village
Amsterdam, town. . .
Amsterdam, city ....
Canajoharie, town. . .
Canajoharie, village. .
Charlestown, town. . .
Florida, town
Fonda, village
Fort Plain, village . . .
Fultonville, village. . .
Glen, town
Hagaman, village. . . .
Births,
1910
12
18
695
27
32
11
23
15
47
14
10
18
Deaths,
1910
Mar-
riages,
1910
9
35
16
541
394
18
37
41
10
9
17
10
24
60
18
23
14
9
Minden, town
Mohawk, town
Nelliston, village
Palatine, town
Palatine Bridge, village
Root, town
St. Johnsville, town. . .
St. Johnsville. village.
Delayed returns
ToUl
Births,
1910
Deaths,
1910
31
29
20
22
11
13
32
33
13
6
16
28
1
6
61
45
10
1
1.117
988
Mar-
riagoa,
1910
38
23
19
5
28
596
Nassau County
East Rockaway, village
Farmixigdale, village
Floral Park, village .
Freeport, village
Hempstead, town. . .
Hempstead, village.
Lawrence, village. . .
Mineola, village ....
Births,
Deaths,
Mar-
•
1910
1910
nages,
1910
9
16
31
20
24
12
88
46
637
338
320
76
89
• ■ ■ ■ •
7
3
70
105
North Hempstead,
town
Oyster Bay, town
Rockville Center, vil-
lage
Sea Cliff, village
Delayed returns
Total
Births,
Deaths,
1910
1910
414
173
337
258
65
41
22
33
20
2
1,800
1.136
Mar-
riage*.
1910
132
175
628
DiviBiow OF Vital Statistics
New York
(tJrea^er)
Birthi,
D«tlui.
Birthi,
IS 10
Dnths,
1910
Mar-
QtrriNgw York:
M,36S
as.Btts
B.ses
•M.647
ls;s;S"'5™srcb:
7,119
1.991
8.971
1,407
a.on
Toua
129,081
78,760
Bontich of Brook-
Niagara County
»»
"silr
1
■»
"tsr
S
i
«9
340
,1
2S
H
S3
1
■'649
"17
■'"is
140
436
SS.£-,S^::::
337
24
VI
1
13
1
n.
!i3S;,-SS..:;:::
tegSSS-,..;:::
!S
SSnS^'
Niacum.lowIi
NiMnFaU^eHy
■ji
3.130
1.403
Oneida County
BMh*.
°!j.r
AUr-
'St'
D»tlu.
1910
Mh-
US?
33
39
i
33
1
i
99
17
i
1
16
';
37
13
34
3
1|
" i
s
1
i
3i
1. 800
30
IS
M
38
3.431
31
J
i
1.390
i
JarSir".-.:-.:::::
RSST-^tV"^
i^Sa::::::
SUuben. town
avlrtaB-K*. TJllM*.
TnotoS; !XU' ■. : :: !
6
■"■■«
llll
il
17
W.(,rvUl..Till.p..-..
Whitsiboro, TilUn...
D.l.y«l ™tulir
J
sISSi;
Ori.kuTFUk.TiUw>.
92
State Dbpabtmsnt ov Health
Onondaga County
Baldwinffville, villace. .
Cumilhm, town. ......
CamilluB, yilUge
Cicero, town
Clay, town
De Witt, town
East Sjmtctue, village.
Eastwood, Tiliice
Eibridge, town
Elbridge. villace
Fabius, town
Fabitia, village
Fayetteville, village. . .
Geddes, town
Jordan, village
La Fayette, town
Liverpool, village
Lyaander, town
ManUuB, town
Birtba.
Deaths.
Mar-
1910
1910
nages,
1910
45
51
85
25
9
13
11
51
28
12
43
29
19
40
43
47
94
47
7
5
13
26
24
8
7
35
20
i5
2
5
18
23
8
10
53
3
16
25
14
9
22
20
28
44
30
54
50
40
Manliua, village . . .
Maroellua. town . . .
Marcellua. village. .
Onondaga, town. . .
Otiaoo. town
Pompey. town. . . .
Salina. town
Skaneatelee, town.
Skaneatelfa, village
Solvay. village ....
Spafford, town ....
Svracuae, city
TuUy, town
TuUy, village
Van Buren. town . .
Delayed returns. . .
Total
Births.
Deaths,
1910
1910
29
12
25
20
7
9
62
132
19
17
39
33
26
25
46
25
20
28
100
77
17
11
2,796
2,124
23
10
6
14
23
33
51
2
3,833
3,046
Mar-
riages,
1910
23
35
3
10
23
31
7
1.144
9
16
14
1,572
Ontario County
Bristol, town
Canadioe, town
Canandaigua, town . . . .
Canandaigua. village. . .
Clifton Springs, village .
East Bloomfield, town. .
Farmington, town
Geneva, town
Geneva, city
Oorham, town
Hopewell, town
Manchester, town
Manchester, village
Naples, town
Births,
Deaths.
Mar-
1910
1910
nages,
1910
22
15
7
18
11
6
35
16
81
182
157
23
64
14
26
14
30
24
10
14
7
3
241
175
122
27
14
6
23
31
6
29
21
26
23
17
21
8
22
Naples, village
Phelps, town
Phelps, village
Richmond, town
Seneca, town
Shortsville, village. . . .
South Bristol, town. . .
Victor, town
Victor, village
West Bloomfield, town
Delayed returns
Total
Births.
Deaths,
1910
1910
4
8
50
37
17
17
21
17
52
32
27
12
10
10
30
10
15
19
8
20
9
2
951
779
Mar-
riages,
1910
15
9
18
10
360
Orange County
Blooming Grove, town.
Chester, town
Chester, village
Cornwall, town
Cornwall, village
Crawford, town
Deerpark, town
Goshen, town
Goshen^ village
Greenville, town
Hamptonburah, town . .
Highland FaUs, village .
Hijihlands, town
Middletown, city
Minisink, town
Monroe, town
Monroe, village
Montgomery, town ....
Births,
1910
18
39
15
49
46
17
16
30
38
10
22
93
36
268
7
18
29
36
Deaths,
1910
22
18
15
52
37
27
34
49
76
10
22
49
13
274
16
22
27
34
Mar-
riages.
1910
Births,
1910
Deaths.
1910
Mar-
riages,
1910
13
16
Montgomery, village. .
Mount Hope
17
24
81
541
76
167
54
5
70
36
90
47
10
32
37
31
13
37
76
509
62
180
60
9
49
41
79
41
8
25
39
3
ii
''4i
19
33
6
56
147
4
12
Newburgh, town
Newburph. city
New Winosor. town . .
Port Jervis, city
Tuxedo, town
Unionville, village ....
Walden, village
I Wallkill, town
1 Warwick, town
Warwick, village
i Washington, village. . .
' Wawayanda. town. . . .
Woodbury, town
Delayed returns
Total
25
238
15
83
13
......
50
"12
13
60
2,105
2,017
889
J
Division of Vital Statistics
93
Orleans Cownty
Albion, town
Albion. Tillage
Barre, town
Cazltoo, town
Claraodon, town. . .
Gsines, town
HoUey. village ....
KmHall. town
Lyndoorille, village
Births.
Deaths,
Mar-
1910
1910
riages,
1910
15
36
46
67
85
30
26
11
42
37
15
26
25
6
29
27
12
38
36
31
19
11
15
8
Medina, village.
Murray, town..
Ridseway, town
Shelby, town...
Yates, town
Delayed returns
Total
Births.
Deaths,
1910
1910
91
101
74
26
39
23
31
28
34
20
16
578
497
Mar-
riages,
1910
29
53
24
16
223
Oswego County
Albion, town
Altmar, village
Amboy, town
Bo^ston. town
Oentral Square, village
Clevelaoa. village
Cooatentia, town
Fulton, city
Granbv. town
Hannihal, town
Hannibal, village
Haattngs, town
I^awwia. village
Mexico, town
Mexico, village
New Haven, town ....
OrwcD, town
Oswego, town
Births.
Deaths,
Mar-
1910
1910
riages,
1910
19
17
18
6
4
4
11
7
19
10
5
6
12
8
25
245
31
36
7
32
7
31
15
22
19
45
11
16
155
21
23
7
29
7
46
27
19
7
47
0
96
18
19
i7
ie
8
7
14
Oswego, city
Palermo, town
Parish, town
Parish; village
Phoenix, vilUge ....
Pulaski, village
Redfield, town
Richland, town
Sandy Creek, town .
Sandy Creek, village
Schroeppel, town . . .
Scriba, town
Volney, town
West Monroe, town.
Williamstown, town.
Delayed returns
Total
Births,
Deaths,
1910
1910
488
385
24
18
10
13
5
12
23
26
14
25
8
9
35
35
20
15
5
17
25
17
34
23
41
36
16
12
11
10
2
1.338
1,122
Mar-
riages,
1910
184
8
14
0
28
12
23
13
13
7
5
1
533
Otsego County
Boriington. town
Bntmnuta. town
Cbafry VaUeyi town.. .
Cherry Valley, village.
Coofmtown, village..
Deeatur, town
Edmeaton, town
Eaetar. town
Oilbertaville, village. . .
Haitwick, town
Laurena, town
Laurent, village
Maryland, town
Middletown, town
Milford. town
Mitford« village
Morria, town
Morris, village
New lirfMm. town. . . .
Oneonta. town
Births.
Deaths.
Mar-
•
1910
1910
nagea.
1910
7
15
2
22
17
8
15
14
5
9
14
50
58
■ • • • •
11
6
3
25
23
16
14
18
9
6
15
30
24
i6
16
17
8
3
2
22
25
ii
28
50
8
22
16
10
13
15
17
10
14
5
12
19
12
9
16
12
1
Oneonta, dty
Otego. town
Otego, village
Otsego, town
Pittafield. town
Plainfield, town
Richfield, town
Richfield brings, vil-
lage
Roseboom, town
Sohenevus, village ....
Sprin|:field, town
Unadilla, town
UnadlUa, village
Westford, town
Worcester, town
Delayed returns
Total
1
Births,
Deaths.
1910
1910
190
182
20
17
11
15
27
27
11
9
9
13
9
17
20
27
6
20
6
6
16
28
24
24
12
24
17
9
51
49
13
5
792
847
Mar-
riages,
1910
100
4
30
8
10
25
1
22
3
19
349
94
State Dbpabtmbnt of "ELzautk
Ptdnam GourUy
Brewster, yillace. . .
Carxnel. town
Cold Sprints, yilUge
Kent, town
NelsonviUe, villsc^. .
Patterson, town ....
Births,
1910
18
29
74
7
5
18
Deaths,
1910
29
47
47
18
18
16
Mar-
riages,
1910
Births,
1910
Deaths,
1910
Mar-
ria«ea,
1910
" "8
niillipstown, town
Putnam Valley, town..
South East, town
Delayed returns
Total
23
13
27
21
48
16
30
2
35
6
32
1
j
235
271
105
Rensselaer Coxmty
Beriin, town
Brunswick, town
Castleton, yillace
East Qreenbush, town. .
Grafton, town
Hooeiok, town
Hoosick Falls, yillace. . .
Nassau, town
Nassau, village
North Greenbush, town.
Petersburgt town
Pittstown, town
37
37
28
17
11
25
129
21
3
10
25
31
Deaths.
Mar-
•
1910
naces,
1910
23
6
32
10
24
27
4
12
13
35
83
86
26
12
10
15
6 1
13
6 '
34
H
Poestenkill, town
Rensselaer, city
Sand Lake, town
Schaghticoke, town . . .
Schaghticoke, village. .
Schodack, town
Stephentown, town. . .
Troy, city
Valley FaUs. village. . .
Delajred returns
Total
Births,
Deaths,
1910
1910
20
18
168
160
22
27
18
42
12
18
43
52
26
24
924
1.597-
9
7
52
1
1.667
2,283
Mar-
riages,
1910
8
97
15
9
28
16
658
989
Rockland County
Clarkstown, town
Grand View-on-Hudson.
village
Haverstraw, town
Haverstraw. village
Hillbum. village
Nyack, village
Orangetown^ town
Piermont, village
Ramapo, town
Births.
Deaths.
Mar-
•
1910
1910
nages.
1910
109
93
32
4
10
9
3
5
104
67
19
13
10)
96
1
'I
55
35
80
• • • ■ •
99
107
72
South Nvaok. village. .
Spring Valley, village. .
Stony Point, town ....
Suffem, village
Upper N3rack, village. .
West Haverstraw, vil-
lage
Delayed returns
Total
Births,
Deaths,
1910
1910
27
34
65
26
89
54
46
47
7
7
34
26
32
3
829
676
Mar-
riages.
1910
^
212
8t. Lawrence County
Brasher, town.
Canton, town.
Canton, village
dare, town. . .
Clifton, town. .
Cdton, town. .
DeKalb, town
Births,
1910
Deaths,
1910
Mar-
riages,
1910
37
29
17
69
54
38
38
52
9
6
6
53
23
4
32
25
9
88
23
11
De Peyster, town
Edwaras, town
Edwards, village
Fine, town
Fowler, town
Gouvemeur, town ....
Gomremeur, vfllage. . .
Births,
Deaths.
1910
1910
18
14
26
19
8
6
48
26
24
IS
84
16
77
79
Mar-
riages,
1910
3
11
17
14
64
Division of Vital Statistics
95
St. Lawrence County — Continued
Hammond, town. .
Hatnmnnd, viUagc.
Hennoa. town ....
Hermon, Tillage . . .
Hopkinkon, town . .
LawnBAce, town . . .
LiBboii. town
LouiaviUe. town . . .
Macomb, town
Mafdrid, town
Mwawina. town
Mifpini. village...
Morratown, town.
Morriatown, Tillage
Nocfolk, town
Norwood, Tillage. .
city. .
Births,
Deaths,
I
Mar- 1
•
1910
1910
nagee,
1910
23
15
13
10
9
26
13
16
12
12
23
23
io
22
23
17
27
30
18
28
22
9
22
14
10
25
24
6
37
15
51
72
50
21
28
12
10
12
80
36
22
45
31
343
264
ios
Births,
1910
Deaths,
1910
Mar-
riages,
1910
Oswegatchie, town. . . .
PariahTille, town
Piercefield, town
! Pierrepont, town
• Pitoairn, town
Potadam, town
Potsdam, village
Richyille, village
Rossie. town
15
39
23
27
20
48
72
5
16
30
54
16
5
6
41
24
17
21
7
30
76
3
14
22
36
11
12
3
49
18
8
9
5
66
9
Russell, town
Stockholm, town
Waddington, town. . . .
Waddington, village. . .
Delayea returns
Total
13
18
11
3
1,722
1.325
685
Swratoga CownJty
BaDatoo, town
BaBatonSp*. village. .
CbaiHoit, town
CUftoB Park, town
Coffiath, town
Coriath, Tillage
THj, town
Edu^barg. town
Oalwajr, town
Gahray. Tillage
Gfeenfidd. town
Hadtor, town
Half Moon, town
Maha. town
MecfaanieTille, village.
Miitoo. town.
Mocean, town
NorthumbertaiMl. town
Births.
Deaths.
Mar-
•
1910
1910
nagee,
1910
19
32
12
85
75
18
11
4
37
40
10
32
11
18
63
35
10
9
5
10
12
7
18
18
9
0
4
23
32
9
18
6
7
9
31
35
10
25
7
218
117
36
40
48
21
13
33
17
18
8
Providence, town
Saratoga, town
Saratoga Springs, town
Saratoga Springs, vil-
lage
Schuylerville, village. .
South Glens Falls, vil-
lage
Stillwater, town
Stillwater, village
Victory, village
Wateriord, town
Waterford, village ....
Wilton, town
Delayed returns
Total
10
26
12
218
42
32
26
14
8
46
37
16
9
1,140
1,083
Mar-
riages,
1910
9
2
22
25
17
78
253
26
27
45
37
22
5
57
54
52
18
4
1
3
415
Schenectady Covnty
Births,
1910
Deaths.
1910
Mar-
riage*.
1910
Buths,
1910
Deaths,
1910
Mar-
riages,
1910
Oleoville. town
Niskayuna, town
I^saeMown, town
RoCterdain. town .... r -
83
15
39
7
86
26
24
30
6
60
18
15
12
1
33
Schenectady, dty
Scotia, village
Delayed returns
Total
1.865
58
71
1.070
25
626
i
2.174 1 2JVI i 7nA
• v»#
96
State Defa&tment of TTkat.th
Schoharie County
Blenheim, town
Broome, town
Carlisle, town
Cobleskili, town
Cobleskill, village
Conesville, town
Esperance. town
Elsperance, village . . . .
Fulton, town
Gilboa, town
Jefferson, town
Middleburgh, town . . .
Middleburgh, village. .
Births.
Deaths.
Mar- '
1910
1910
nages,
1910
1
16
13
5 1
12
17
3 :
6
13
7
25
23
26
22
33
8
8
7
6
13
7
0
4
30
29
9
22
25
8
24
18
7
21
29
17
9
14
Richmondville, town. .
Richmondville, village,
Schoharie, town
Schoharie, village
Seward, town
Sharon, town
Sharon Springs, village.
Summit, town
Wright, town
Delayed returns
Total
Births,
Deaths,
1910
1910
11
11
6
16
18
27
11
21
26
17
21
21
3
9
15
14
17
19
7
336
394
Mar-
riages.
1910
10
is
7
5
8
8
152
Schuyler Cormty
Burdette, village
Catherine, town
Cayuta, town
Dix, town
Hector, town
Montour, town
Montour Falls, village.
Odessa, village
Births,
Deaths,
Mar-
•
1910
1910
nages,
1910
3
7
18
13
8
7
8
3
15
14
34
49
52
17
3
3
2
10
14
• * • « •
8
7
Oran^, town . . .
Readmg, town. .
Tyrone, town . . .
WatkinB, village.
Delayed returns .
Total
Births,
Deaths,
1910
1910
24
13
14
14
19
16
46
52
3
2
219
215
Mar-
riages,
1910
10
4
5
84
Seneca County
Covert, town
Fayette, town
Interlaken, village .
Junius, town
Lodi, town
Ovid, town
Ovid, village
Romulus, town
Seneca Falls, town
Births,
Deaths,
Mar-
•
1910
1910
nages.
1910
19
20
29
34
26
14
4
8
19
17
9
30
22
19
9
20
13
5
9
24
29
9
10
12
38
Seneca Falls, village. .
Tyre, town
Variok, town
Waterloo, town
Waterloo, village ....
Delayed returns
Total
Births,
Deaths,
1910
1910
128
112
32
5
21
20
15
20
62
52
2
414
872
Mar-
riages,
1910
4
8
37
181
Steuben Cormty
Addison, town .
Addison, village
Avoca, town . . .
Avoca, village. .
Bath, town ....
Bath, village. . .
Bradford, town.
Cameron, town.
Births,
1910
Deaths,
1910
Mar-
riages,
1910
15
22
19
13
39
58
8
14
6
52
24
15
48
67
15
15
29
***i4
'"67
* '6
13
Campbell, town .
Camsteo, town . .
Canisteo, village.
Caton, town . . . . .
Cohocton, town.
Cohocton, village
Coming, town. . .
Coming, city
Births.
Deaths,
1910
1910
13
21
16
14
27
30
23
13
38
20
10
12
34
41
209
200
Mar-
riages,
1910
4
37
■ •
11
16
14
120
Division of Vital Statistics
97
Steuben County — Continued
Duasville. town
Erwin. town
Fremont, town
Greeuwuod, town
RAnuDoadqport. village.
HartwiUe, town
Horabv, town
HoraeO. ^ty
Horoelkriue. town
Howard, town
Juper. town
Lisidley. town
Painted Post, village. . .
Pnttsbtirg, town
Prmttsburg. villacc
Pulteoey. town
Deaths.
Mar-
1910
riages,
1910
10
9
13
19
12
6
15
11
17
9
5
8
3
173
113
31
i
27
14
18
9
25
7
17
9
ii
10
10
8
Rathbone, town. .
Savona, village. . .
Thurston, town . .
Troopebing, town
Tuscarora, town. .
Urbana, town ....
Wayland, town. . ,
Wayland, village .
Wayne, town. . . .
West Union, town
Wheeler, town
Woodhull, town . .
Woodhnll, village.
Delayed returns . .
Total
Births,
Deaths,
1910
1910
13
12
9
17
5
15
28
25
11
9
14
18
22
22
37
20
9
12
27
16
12
13
23
12
2
6
4
5
1.371
1.199
Mar-
riages,
1910
6
14
5
20
18
i
6
8
10
628
Suffolk County
Births.
1910
Deaths.
1910
Mar-
riages,
1910
Births,
1910
Deaths,
1710
Mar-
riages.
1910
AaiityviUe. village
BabTloa. town
Babylon, village
BeOport. village
Brookhaven, town
Eut Hampton, town. . .
Greenport, village
Huntixigton. town
Iriio. town
39
95
48
3
184
86
106
205
318
31
72
66
72
39
'i94
56
51
147
190
20
50
""7i
"5
97
38
"n
79
Riverhead. town
Sag Harbor, village . . .
Shelter Island, town. . .
Smithtown. town
Southampton, town . . .
Southampton, village. .
Southold, town
Delayed returns
Total . . . . :
52
49
25
77
123
39
124
50
74
53
9
56
106
33
74
9
54
6
27
70
' "9i
3
". V» •V^l*.
Northport. village
1,726
1.304
607
PMcfaogue. village
Sullivan County
B»-hrl, town
C'aliiroon. town. . .
Cocherton. town . .
Driawtre. town . .
Fsliiburgh. town
Forwtbur]^, town
rremoot. town . . .
™«WaiKl. town . .
Libmr, town. . . .
I4beny. village...
Lumberbnd, town
Births,
Deaths,
1910
1910
35
32
37
30
17
15
35
22
101
65
9
4
34
27
16
26
68
97
40
101
16
11
Mar-
riages,
1910
10
12
5
14
29
1
12
35
Mamakating, town .
Montioello. village. .
Neveraink, town ....
Rockland, town ....
Thompson, town...
Tusten, town
Wurtsboro, village . .
Delayed returns ....
Total
Births,
1910
26
58
19
60
26
14
4
7
622
Deaths,
1910
670
Mar-
riages.
1910
35
13
58
32
9
49
39
41
34
17
7
7
1
224
98
State Dsfabtment of Health
Tioga
County
Births,
1010
Deaths,
1010
Mar-
riaces,
1010
1
1
1
Births. De h s.
1010 1010
Mar-
naiies.
1010
Barton, town
22
8
38
8
10
23
4
2
55
26
12
23
14
17
11
12
8
68
80
5
21
*i2
■*'i2
"86
1 Oweco. village
Richiord, town
1 Spencer, town
Spencer, villace
Tioaa. town
62
54
Berkshire, town
Oandor. to«ni . - - r , - . - ,
14 < l\
18 1 15
5
16
Candor, villace
Newark Valley, town. . .
Newark Valley, villace..
Nichols, town
10
27
77
1
0
31
83
" ii
Waverlv, villace
' Delayea returns
' Total
Nichols, village
Oweso. town
388
300
249
1
Tompkins County
Caroline, town . .
Danby, town
Dryden, town. . .
Dryden, village.
Enfield, town. . .
Freeville. village
Groton, town, . ,
Groton, village . .
Ithaca, town. . . ,
Births.
1010
37
24
35
10
24
1
43
22
18
Deaths.
1010
27
10
33
14
13
7
38
23
17
Mar-
riages,
1010
1
Births.
1010
Deaths.
1010
Mar-
riages.
1010
13
Ithaca, city
234
50
15
6
13
22
1
238
32
10
8
23
30
2
146
7 1
23 ;
.....
""28 I
Lansing, town
Newfield, town
1 Newfie d. village
Truman^urg, village. .
Ulysses, town
Delayed returns
20
4
• 23
• • • • . 1
3
1
1 Total
555
543
374
Ulster County
Denning, town
EUenvilTe, village
Esopus. town
Gardiner, town
Hardenburgh, town. . .
Hurley, town
Kingston, town
Kingston, city
Lloyd, town
Marbletown, town. . . .
Marlborough, town . ., .
Marlborough, village..
New Palts, town
New Palts, village
Olive^town
Pine Hill, village
Births,
Deaths,
Mar-
•
1010
1010
nages,
1010
11
6
4
38
47
■ • • • •
82
54
21
41
47
12
7
4
3
22
30
8
0
6
4
433
475
233
58
38
10
75
57
28
50
45
24
18
11
22
30
34
17
23
56
56
27
1
7
Plattekillj town. . . .
Rifton. village
Rochester, town. . .
Rosendale, town . . .
Rosendale, village .
Saugertira. town . . .
Saugerties. village.
Shandaken, town . .
Shawangunk, town
Ulster, town
Wawarsing. town. .
Woodstock, town. .
Delayed returns. . .
Total
1,623
Births,
Deaths.
1010
1010
23
22
10
3
41
34
47
41
15
15
123
02
61
64
44
41
53
33
37
30
02
80
30
40
107
Mar-
riages.
1010
1.440
13
2
17
56
16
18
18
53
7
1
617
L
Division of Vital Statistics
99
Warren Cownty
Boltoa. town
CaJdwsU, town
Chester, town
GknuFUls, city
Hacoe. town
HonooQ. town
Johnaburg. town. . . .
I^Ake Qeorce, viUace
Births.
Deaths,
Mar-
1910
1010
nages.
1910
26
18
8
13
14
14
25
28
•
« • • • •
200
238
154
13
10
16
11
18
0
27
28
16
0
10
.....
Luieme, town
Queensbury. town. .
Stony Creek, town. .
Thurman, town. . . .
Warrensburgh, town
Delayed returns ....
Total
Births,
Deaths,
1010
1010
15
13
41
36
17
13
16
3
35
36
2
• • ^ • •
540
464
Mar-
riages.
1010
11
0
11
27
32
307
Washington County
Argyle, town
Argyle. village
Cambridge, town . . . .
Cambridge, village . . .
Dresden, town
Easton, town
Fort Ann. town
Fort Ann. village . . . .
Fort Edward, town . .
Fort Edward, village.
Oraaville, town
Gnnville, village . . . .
Greenwich, town. . . .
Greenwich, village. . .
Hampton, town
Births.
1010
25
1
9
11
11
26
40
7
31
78
51
82
43
34
17
Deaths.
1910
30
7
20
31
7
25
27
0
31
00
49
36
43
44
14
Mar-
riages.
1910
10
i2
17
16
40
78
33
3
Hartford, town
Hebron, town
Jackson, town
Kingsbury, town . . . .
Putnam, town
Salem, town ....;...
Salem, village
Hudson Falls, village.
White Creek, town. . .
Whitehall, town
Whitehall, village....
Delayed rotums
Total
Births,
Deaths.
1910
1910
25
30
13
16
16
9
28
24
9
9
17
28
22
16
100
74
19
26
9
8
129
96
5
1
858
788
Mar-
riages,
1910
12
7
3
56
2
21
21
63
1
395
Wayne County
Arcadia, town. . .
Bntkr, town
Clyde, viUago...
Galen, town ....
Huron, town. . . .
Lyooa. town
[fOML village. . .
Maoedon. town..
Maeedon, village .
Marion, town. . .
Newark, village . .
Ontario, town
Pftlmyrm, town . .
Births,
1910
47
28
55
29
28
22
72
38
11
56
82
53
38
Deaths,
1910
31
30
37
24
17
30
75
25
10
32
85
36
27
Mar-
riages,
1010
75
10
34
13
46
14
14
IS
33
Births,
1910
Deaths'.
1010
Mar-
riages,
1010
Palmyra, village
Red Creek, village. . . .
Rose, town
37
8
35
10
5
73
38
74
28
8
3
30
0
35
16
6
64
32
44
25
20
0
"io
Savannah, town
Savannah, village
Sodus, town
10
35
Walworth, town
Williamson, town
Wolcott. town
Wolcott, village
Delayed returns
10
32
33
i
Total
. 887
758 1
^AH,
• ^" 1
100
State Depabtment of Health
Westchester Cotmty
Ardsley, villace. .
Bedfonl, town...
Briarcliff Manor,
Bronrville, village.
Cortlandt, town . . .
CrotonH>n-Hudflon, vil-
lase
DobM Ferry, villace
Eastcheeter, town. . .
ESmaford, village . . .
Greenburgh. town . .
Harrison, town
Hastinge-on-H u d ■ o n,
village
Hillside, village
Irvington. village
Larchmont, village
Lewiaboro. town
Mamaroneck,- town ....
Mamaroneck, village. . .
Mt. Kiaeo. village
Mounts Pleasant, town..
Mount Vernon, city. . . .
New Castle, town
New Rochelle, city
North Castle, town . . . .
Births,
Deaths.
Mar-
•
1910
1910
nagee,
1910
15
8
95
54
47
20
11
23
42
118
87
ieo
35
23
79
71
33
12
32
14
3
• • • « •
50
69
136
77
56
20
96
57
8
55
41
23
16
8
13
20
4
6
10
66
141
71
59
42
56
174
113
700
434
245
43
33
18
782
342
230
23
26
6
North Pelham. village
North Salem, town . . .
North Tarrytown, vil-
lage
Oasining, town
Oaaining. village
Peekakul, village
Pelham, town
Pelham, village
Pelham Manor, village
Pleaaantville, village . .
Port Cheater, village . .
Poundridge, town
Rye, town
Rye, village
Scaradale, town
Somera, town
Tarrytown, village
Tuckahoe, village
White Plaina, town . . .
White Plaina, village. .
Yonkera, city
Yorktown, town
Delasred retuma
Total
31
14
151
> • ■ •
186
330
2
7
15
43
445
11
4
54
Deatha,
1910
13
19
80
6
166
280
1
4
8
28
207
15
4
45
22
10
27
17
89
85
125
38
5
362
279
2.064
1,226
34
51
108
1
6,667
4,317
Mar-
riages,
1910
9
si
is
9
246
14
118
797
14
1
2.370
Wyoming County
Arcade, town
Arcade, village
Attica, town
Attica, village
Bennington, town. .
Caatile, town
Gaotile, village
Corington, town. . . .
Esfle. town
OamesvUle. town . . .
Oaineaville. village.
Geneaee Falls, town
Java, town
Middlebury. town. .
Birtha.
Deatha.
Mar-
•
1910
1910
nagea,
1910
13
15
22
40
23
18
10
• • • • •
32
22
• • • • •
20
22
14
11
15
15
15
27
19
12
3
21
12
12
23
15
15
5
7
18
9
4
21
23
13
19
28
6
Orangeville, town
Perry, town
Perry, village
Pike, town
Pike, village
Sheldon, town
Silver Springs, village
Warsaw, town
Warsaw, village
Wethersfield, town. . .
Delayed returns
Total
Birtha,
Deatha.
1910
1910
13
28
18
22
61
58
12
11
3
7
33
27
19
10
20
12
34
39
26
13
1
2
515
469
Mar-
riages.
1910
5
52
11
9
39
3
1
224
Yates County
Barringtbn, town
Benton, town . . .
Dresden, village.
Dundee, village .
Italy, town
Jerusalem, town.
Middlesex, town.
Milo, town
Births.
Deaths.
Mar-
1910
1910
riages,
1910
19
18
3
22
25
6
6
2
7
26
14
11
4
43
40
21
21
19
8
24
21
37
Penn Yan, village .
Potter, town
Rushville, village.
Starkey, town
Torrey, town
Delayed returns. .
Total
Births.
Deaths,
1910
1910
67
70
16
14
5
10
14
15
10
8
268
279
Mar-
riages,
1910
10
24
0
1
114
Division of Vital Statistios 101
Summary of Mortality for the Year- 1^10
Pulmonary tuberculosis caused 14,059 or 9.5 per cent, of the
147,629 deaths occurring in the State during the year 1910.
There were 153 deaths per 100,000 population.
From tuberculosis other than pulmonary there were 2,278
deaths, the largest number, one-half being from tubercular menin-
gitia, and the next numerically abdominal tuberculosis, 385.
Pneumonia caused 9,867 deaths, 444 more than in 1909, 1,200
more than in 1908, but fewer than in the years preceding; 109
deaths per 100,000 population in the cities, and 103 in the rural
population. From broncho-pneumonia there were 7,248 deaths,
and from acute bronchitis 1,598. These were chiefly fatal in
March, and during the annually recurring epidemic of influenza,
which is given as the direct cause of 1,452 deaths.
Cancer showing in each succeeding year an increase, has this
year caused 7,522 deaths; in 1900 there were 4,871; in 1890,
2,868. In the cities there were 80 deaths per 100,000 popula-
tion; the rural rate was 99. Compared with tuberculosis its
urban mortality was less than half, its rural considerably more
than half the number from that cause.
Typhoid fever has caused during the year 1,374 deaths. This
is about the mortality for the last two years, while the average
yearly for twenty years prior was 1,600 deaths and most of the
years were close to the average. The rate of mortality, 15 per
100,000 population, is the same as that of 1909, and the lowest
ever recorded for the State. The urban mortality from typhoid
fever was 14.9 per 100,000 population; the rural was 15.2; in
the cities .93 per cent of the deaths were from typhoid fever, in
the country .94 per cent.
Diphtheria caused 2,438 deaths, 120 more than in 1909, 40 less
than in 1908, 350 less than the yearly average of the past twelve
years of low mortality, and 3,000 less than the average of the
twelve years prior to that. In the urban population there were
32 deaths per 100,000 during the year; in the rural 10 from
diphtheria. Sixty-four per cent of the deaths occurred in the
winter and spring months.
102 State Depabtment of Health
Scarlet fever was more prevalent than last year, and the deaths
were 1,617 to 1,205 in 190^. There were 21 deaths per 100,000
population in the cities, and 8 in the rural population. New
York City shared in the increase of mortality over last year to a
less extent than the rest of the State.
Measles which last year had a mortality in excess of that from
scarlet fever, has now 1,285 deaths or 332 less. In 11 years of
the last 25 the deaths from measles have exceeded those from
scarlet fever and their average mortality has been annually 1,100
to 1,350. Taking account of its remote effects, measles is prob-
ably fully as large a contributor to mortality as scarlet fever.
The urban mortality has decreased but the rural is nearly double
that of 1909. • Six-sevenths of the cases and four-fifths of the
deaths occurred during the first six months of the year.
Whooping cough, which has had an average yearly mortality
for twenty-five years of 900, has now 727 deaths. In August the
largest nimiber, as heretofore noted, occurred, with July nearly as
many, the smallest mortality having been in the winter months.
The relative urban and rural mortality. was the same.
Cerebrospinal meningitis caused 452 deaths, an increase over
the two years preceding but one-half that of the three prior years.
Cases were reported from thirty-five counties, two-thirds of the
deaths occurring in New York City.
There were 58 deaths from epidemic poliomyelitis.
Smallpox caused 7 deaths — one at Buffalo, one at Walden, and
five in New York City.
Violence was the cause of 9,846 deaths — 614 more than in
1909. There were 1,479 by suicide, 420 homicides and 7,695 ac-
cidental.
The following shows the urban and rural death rates per
100,000 population :
J
Division of Vital Statistics 103
Urban and rural death rates per 100,000 population from dif-
ferent causes:
Dia eases Cities Rural
All causes 1,606.9 1,627.1
Typhoid fever 14.9 15.2
Malaria 0.5 1.1
Measles 15.2 0,82
Scarlet fever 20.7 8.3
Whooping cough 7.8 8.2
Diphtheria and croup 32 . 1 10 . 0
Influenza 9.4 34.9
Erysipelas 6.1 4.7
Cerebrospinal meningitis 5.5 3.3
Pulmonary tuberculosis 164.0 122 . 3
Other forms of tuberculosis 27.1 18.4
Cancer and other malignant tumors 79.5 89.8
Diabetes 16.0 17.5
Other general diseases 55.2 55.0
Diseases of nervous system 91.0 223 . 9
Diseases of circulatory system 212.3 214.5
Pneumonia 109.2 103.3
Other disease of respiratory system 138 . 7 93 . 5
Diarrhea and enteritis 127 .0 85 . 8
Under 2 years 111.9 59.3
Over 2 vears 15.2 26.5
9
Other diseases of digestive system 82 .6 88.0
Bright's disease and nephritis; 103.0 115.2
Other diseases of genito-urinary system ... 32.9 36.6
The puerperal state 16.9 12.6
Congenital debility (under 3 mos.) 59.0 24.2
Accidents 81.3 91.9
Suicides 15.6 17.6
Homicides 5.1 2.8
Til-defined diseases 29.0 51.8
All other causes 47.9 67.3
104
State Depabtment of Health
The total urban population (cities and viUagee of 8,000 popu-
lation and over) is 6,849,203, or 74.7 per cent, of the entire popu-
lation of the State.
The following table shows the mortality in the State by age
periods, sex, color, nationality, etc., outside of the cities of Buffalo
and Greater New York.
AGE
Total
Whitb
Negro
Other Colored
Native
Male
Female
Male
Female
Male
Female
IVUle
Femfile
Male
Female
Under 1....
1-4
5- 9
10-14
15-19
20-29
30-39
40-49
50-59
60-69
70-79
80 and over.
Unknown . .
5.545
1,785
539
400
660
2,218
2,543
2,939
3,712
4,903
5,340
3,455
115
4.228
1.689
552
379
•601
1,761
1.871
2.226
2,872
4,389
5.246
3.987
47
5,426
1,739
527
386
644
2,167
2,464
2.868
3,647
4,852
5,290
3.435
108
4,153
1,647
538
364
578
1,709
1,827
2,183
2,818
4,352
5,210
3,958
43
116
43
8
13
16
48
75
67
59
45
45
18
6
74
40
12
13
23
47
44
41
53
37
35
29
4
3
3
4
1
" "3
4
4
6
6
5
2
1
I
2
2
' ■ 5
■ "2
1
j
5.521
1.739
524
361
548
1.580
1,827
1.983
2.640
3.309
3.625
2.326
27
4,213
1.635
523
355
531
1.411
1.480
1.622
2,120
2.895
3.509
2.787
34
Total
34.154
29,848
33.553
29,380
559
452
42
16
26.010
23. 124
•
AGE
Foreign Born
Natiyitt
Unknown
Single
Married
Widowed and
Divorced
Male
Female
Male
Female
Male
Female
1 ■ 1
Male
Female
Male
Female
Under 1....
1- 4
5- 9
10-14
15-19
20-29
30-39
40-49
50-59
60-69
70-79
80 and over.
Unknown . .
23
43
14
35
103
586
627
857
984
1.520
1.662
1,094
24
15
49
27
24
67
343
368
582
730
1.446
1,676
1.159
13
1
3
1
4
9
52
89
99
88
74
53
35
64
5
2
""3
7
14
22
22
48
61
41
5,545
1,786
539
400
652
1.610
985
728
593
538
360
156
28
4,228
1,689
552
378
520
692
420
388
349
440
448
283
8
"■5
521
1.377
1,892
2.534
3.223
2,944
1.321
18
j
81
1.032
1.323
1,539
1.793
1.922
1.348
390
18
■ 35
96
204
477
1.043
1.933
1,911
11
• ■...■
27
118
279
699
1.978
3.385
3.272
16
0
ToUl....
7,572
6,499
572
225
13,919
10,395
13.835
9.447
5.710
9.774
MariUl condition unknown, 922; Males, 690; Females, 232
Division of Vital Statistics
105
The mortality statistics of Buffalo and Greater Ifew York as
classified by the city departments of health, are as follows:
The City op New York
Total Nxxniber of Deaths, hy the Principal Causes, in 1910
BOROUGH
Tvphoid
farer
Malarial
fever
SmaU-
POK
Meaelea
*
Scarlet
fever
Whoop-
cough
Diph-
theria
and
croup
In-
fluenia
Tb* Bronx
Brooldjm
269
41
198
39
II
7
4
13
3
4
i
271
56
422
30
6
448
76
385
33
12
154
23
92
21
4
898
136
658
104
19
162
26
144
QUMM
24
^iehjBond
10
City
568
27
5
785
953
294
1,715
366
The City of Xew York — (Continued)
BOROUGH
The Bronx
BrDokl>-n. .
Qowoa
Eirhmood.
Oty
Other
epidemic
oueaiea
Tubcr-
cukwis
of the
lungs
Tuber-
culous
menin-
gitb
Other
forms of
tuber-
culosis
Cancer
and
other
malig-
nant
tumors
Simple
menm-
gitis
Of which
cerebro-
spinal
memn-
gitis
292
24
132
13
6
3.975
1.781
2,430
358
148
485
84
198
24
10
329
31
186
24
11
1.915
323
1,212
185
75
380
53
136
31
8
177
29
72
12
4
467
8,692
801
581
3.710
608
294
Conges-
tion,
henoor-
rhage
and
soften-
ing of
the Drain
389
254
245
55
36
979
The City of Xew York — (Continued)
m
Organic
diseases
of the
heart
Acute
bron-
chitis
Chronic
bron-
chitis
Pneu^
monia
(not in-
cluding
bron-
cho-
pneu-
monia)
Bron-
cho-
pneu-
moma
Other
respira-
tory
diseases
Diseases
of the
stomach
Diar-
rhea
and
en-
teritis
(under
five
years of
age)
Manhattan
The Bronx
Brooktrn
Qum&s
Richmond . .....
3.071
706 ,
2.540 ^
405
148
406
51
405
59
7
103
10
278
?
2.666
462
2.001
305
106
2,725
312
1.644
221
77
501
57
220
27
15
251
38
Ittrt
25
21
3.021
342
2.092
359
1C4
CUy
6.870
928
' 407
1
5.540
4.979
820
501
5.918
106
State Depabtmbnt of Health
The City of New Yoek — (Contimied)
BOROUGH
Manhattan
The Bronx .
Brookl3rn. . ,
Queens. . . ,
Richmond.
aty..
Api)en-
dicitis
and
typhili-
tis
Hernia
and
intee-
tinal
obstruc-
tion
Cir-
rhosis
of the
Uver
Ne-
phritis
and
Bright's
disease
Non-can-
cerous
tumors
and
othir
diseases
of the
female
genital
organs
Puer-
peral
septi-
cemia
Other
puer-
peral
disease
340
43
223
20
13
308
45
198
27
9
545
75
445
47
28
2.627
411
2.160
317
123
200
21
120
6
2
138
31
74
11
1
249
28
194
20
15
639
687
1.140
5.638
349
255
506
Congen-
ital de-
biUtv
and
malfor-
mations
2.396
262
1.311
254
90
4.313
The City of New York — (Continued)
BOROUGH
Manhattan
The Bronx.
Brooklyn. .
Queens. . . .
Richmond .
aty..
Senile
debility
Violent
deaths
Acci-
dents
Homi-
cides
Suicides
Other
diseases
235
68
274
73
33
2,101
280
1,101
245
86
1.919
270
1,023
231
84
182
10
78
14
2
459
64
246
40
16
5.818
664
• 3.610
605
174
683
3.813
3.527
286
825
10.771
Ill-de-
fined
causes
522
87
22
52
36
719
The City of New York — ( Continued)
Deaths According to Age and Color
BOROUGH
Manhattan
The Bronx .
Brooklyn . .
Queens. . . ,
Richmond.
aty..,
Under
1 year
1
2
3
4
Total
under 5
5
10
15
8,953
2.283
935
563
323
13.047
831
467
775
1.051
271
149
90
65
.1.626
159
91
209
5.059
1.535
710
387
256
7,947
707
373
544
869
201
92
69
41
1.282
110
56
78
282
61
19
11
12
385
27
23
30
16,214
4.351
1.905
1.100
697
24.267
1.834
1.010
1,636
20
1.303
342
845
152
50
2.692
Division of Vital Statistics
107
The City of New York — ( Continued)
BOROUGH
Minhattan
Tbe Bronx.
Brooklyn. .
Queena. . . .
Richmond.
City. .
25
30
35
40
45
50
55
60
1.630
398
1.032
137
55
1.916
445
1.135
169
47
2.110
463
1.372
207
93
2.267
589
1,349
191
62
2,305
459
1.355
204
67
2.316
421
1.481
248
85
2.0S6
239
1.377
194
90
2,080
378
1.526
237
87
3.262
3.712
4.245
4.458
4.390
4.551
3.9S6
4,308
65
1.863
345
1,432
230
105
3.975
The City of New York — (Continued)
borough
Maahattan
The Bronx.
Brooklyn . .
Qoeeiu. . . .
Richmond.
City. .
70
75
80
85
Total
Colored
•
Chinese
Death
rate
1,500
1.046
650
468
38.660
1.401
83
16.51
337
231
134
102
6.968
203
3
15 85
1.259
919
598
425
25,676
582
12
15.59
185
173
72
66
3.971
84
1
13 77
114
M
59
34
1.467
33
16.94
3.395
2.423
1.513
1,095
76.742
2,303
99
15.98
Cor-
rected
inter-
bor-
ough
death-
rate*
16.72
13.95
15.75
14.30
16.18
^ Corrected interborough death rate means that the death rate of each borough is corrected by
the exdusion of the d»&tha of residenta of the other boroughs occurring within its limits and the
indoaion of the deaths of residents of that borough occurring in other boroughs.
The City of New York — (Concluded)
Births, Marriages and Still Births Reported
BOROUGH
Manhattan
The Bronx.
Brooklyn..
Queeoa. . . .
KiehmoDd.
City..
Estimated
population
2.341.383
439.567
1.647.294
288.440
86.580
4.803.264
Births
66,357
10.905
42.708
7.119
1.991
129.080
Marriages
28.883
2.308
12.881
1.839
506
46.417
Still
births
3.541
553
2.221
347
93
6.755
108
State Department of Health
City of Buffalo
Summaries of Deaths for 1910
totals 1910
I. General diseases
II. Diseases of nervous system. . .
III. Diseases of circulatory system
IV. Diseases of respiratory sjrstem,
V. Diseases of dicestive system . .
VI. Diseases of genito-urinary
system
VII. ChUdbirtli
VIII. Diseases of the skin
IX. Diseases of locomotor system .
X. Malformations
XI. Early infancy
XII. Old age
XIII. Violence
XIV. Ill-defined diseases
Total
Total
Age bt
Yeara
Under 1
lto2
2to3
3to4
4to5
1.081
191
135
88
79
49
626
36
11
7
4
4
912
14
2
955
335
95
30
22
11
915
487
87
8
6
3
417
27
4
1
2
2
132
80
12
2
69
3
"*57
.....
3S9
334
3
I
53
*
468
\A
8
6
2
6
69
63
4
1
6.940
1.641
348
142
117
75
Total
under
Syrs.
542
62
16
493
501
36
80
3
""58
338
"36
68
2,323
City of Buffalo — {Continued)
totals, 1910
1
Age bt Years
5 to 10
10 to 15
15 to 20
20 to 30
30 to 40
40 to 50
50 to 60
I.
General diseases
120
7
5
9
16
5
39
9
13
6
13
5
j
.....
79
8
17
9
12
4
1
■"27
247
20
31
34
26
21
22
2
"83
■ • • • ■
244
35
59
49
43
37
23
3
"83
217
76
91
62
61
57
6
.....
• • • • •
• • • • •
"80
1
219
II.
III.
IV.
V.
VI.
Diseases of nervous system . . .
Diseases of circulatory system.
Diseases of respirator^' system .
Diseases of digestive system . . .
Diseases of genito-urinary
system
102
173
61
60
67
VII.
Childbirth
VIII.
Diseases of the skin
1
.....
1
1
IX.
X.
Diseases of locomotor system . .
Malformations
XI.
Early infancy
XII.
Old age
XIII.
Violence
27
55
XIV.
Ill..defined diseases
Total
192
97
157
486
576
652
738
Division of Vitai. Statistics
109
City of Buffalo — (Continued)
TOTALS. 1910
AOB BT
Years
Color
60 to 70
70 to 80
80 to 90
Over 90
White
Colored
I. General diocMBo
163
126
196
72
47
86
88
115
191
96
29
66
2
" "ie
23
20
62
108
55
14
30
■ "27
4
3
4
12
0
3
3
9
3
1,950
623
003
045
Oil
413
132
13
2
59
338
53
463
69
22
II. DiMase of nervous system
m. Diaeaaee of circulatoiy system. .
rv. DIaeaaee of respiratory system . .
V. Dieeaoes of digestive system
▼1. Diseaees of genito-urinaiy system
VII. Childfairtb
3
9
10
4
4
VIII. Diseaeea of the nkin
IX. Diseases of locomotor system . . .
X. Malformation
]
XII. OMace '
1
36
Xin. Violence
5
XIV. Ill-defined diseases
Total
727
626
320
46
6.882
58
City of Buffalo — (Concluded)
8bx
Social Rblationb
TOTAL. 1010
Male
Female
Single
Married
Widowed
Divorced
I. General dineaees
1,007
327
490
512
479
221
48
6
2
31
195
20
389
40
074
299
422
443
436
196
84
6
""*28
144
33
79
29
1,111
167
161
587
670
121
82
6
1
59
339
4
221
68
666
252
415
aio
163
184
50
5
1
6
198
104
202
333
157
71
110
i
43
48
1
10
II. Diseases of nervous tystem
m. Discltees of circttlatory system. .
IV. Diseases of respiratory system..
V. Diseases of digestive system . . .
VI. Diseases of genito-urinary sys-
tem. . . . ,
5
3
1
2
2
VII. Childbirth
VnL Diseases of the skin
IX. Diseases of locomotor system. .
XI. Karlv infancv
XII. Old age
XIII. Violeaoe
1
XIV. Ill-defined diseases
Total
3.767
3.173
3,606
2.15Q
1,160
24
The following shows the total number of deaths occurring in the
State during the year, and the sex, color, social relations and
nationality :
Males 79,643
Females 67.986
Unknown
Total 147.629
White 144.102
Negro 3,370
Mongolian ... 99
Indian 58
Total
147.620
Social relations
Married. . . .
. 49,668
Widowed. . .
. 29,204
Single
. 67,261
Divorced* . .
103
Unknown . . .
. 1.393
Total 147,629
Nativities
United States 101.341
Foreign 46.117
Unknown 1,171
Total 147,629
* Of New York City only — Buffalo's and rest of State being included under title " widowed."
110
State Depabtment of Health
The death rate and per cent, of deaths at different age periods
were as follows:
•AGE period
Under one year
One year to four years
Five to nine years ,
Ten to nineteen years
Twenty to thirty-nine years.
Forty to fifty-nine years
Sixty to seventy-nine years.
Over eighty years
Unknown
Total deaths at all ages
Number
of deaths
27,457
12.233
3.127
4.942
23.340
30,567
34.745
11.054
174
147.620
Death rate
per 1.000
living at
aU
2.0
1.3
0.3
0.5
2.5
3.3
3.8
1.2
0.2
16.1
Per oent.
of total
mortality
18.7
8.3
2.1
3.4
15.8
ao.7
23.5
7.5
0.2
100.0
The following shows the death rate and per cent, of deaths from
different causes:
Death Rate and Per Cent, of Deaths from Different Causes
1 . General diseases
2. Diseases of nervous system
3. Diseases of circulatory system . . . .
4. Diseases of respiratory system . . . .
5. Diseases of digestive system
6. Diseases of genito-urinary system .
7. The puerperal state
8. Diseases of skin and cellular tissue
0. Diseases of organs of locomotion . .
10. Malformations
11. Early infancy
12. Old age
13. External causes
14. Ill-defined causes
Total deaths {rom all causes .
Nimiber
of deaths
30,000
11.856
10,407
21.520
18.374
12.811
1.452
654
272
1,310
6,037
1,051
0,846
1.231
147.6^
Death rate
per 1.000
living
4.35
1.20
2.12
2.35
2.00
1.30
0.15
0.71
0.03
0.14
0.75
0.21
1.07
0.13
16.1
Per oent.
of total
noortality
27.1
8.0
13.2
14.5
12.4
8.6
0.98
0.44
0.18
0.00
4.7
1.3
6.6
0.83
100.0
DEATH RATE &
PER CENT OF DEATHS
DIFFERENT AGE PERIODS
1910
A6E PERIOD
Ns OF DEATHS
DEATH RATE
PER WOO UVMG
AT ALL AGES
PER CENT
OF TOTAL
MORTAUTY
UNDER I YEAR
lYEARTO 4YEAR8
10
»»
n
SO *•
40 "
60
19
39
69
79
OVER 80
UNKNOWN
27.467
12.233
3.127
4.942
23.340
30.5 67
34.745
I 1.064
.174 I
TITAL DEATHS AT AIL AGES 147.629
2.9
1.3
0.3
0.6
2.6
3.3
3.8
1.2
0.2
18.7
8.3
2.1
3.4
15.8
20.7
23.5
T.5
0.2
16.1
100.-
DEATH RATE &
PER CENT OF DEATHS
FICH
DIFFERENT CAUSES
NEW YORK STATE ISrO
f.« FaCEMTIFniAlMnAUIT
DEATHS
1 imui mum
39.900
II DISEASES OE lEIiyDUS STSTEI
1 IIBSe
III - CIIICaLITDIIT "
19.497
n RESPIUTDIY "
21.629
V DISESTIVE ••
18.374
«i " eEiiTD-gmitiii -
I2SII
HI TIE PUEIPERAL STATE
I.4S2
m nSUSESOFSKINlIELLUlAITISSIE
.684
IX " imUIISOFLOEOWTIOII
.272
X atLFOIIIIATIIIIII
1.319
XI EIRLT INFtllCy
6.937
n 0L> taE
1.961
XII EXTEIIIAL CAUSES
9M6
Xlt ILL lEFIIED CAUSES
1.231
TOTAL lEATIS FROM ALL CAUSES 147.629
J
CHART SHOWING TOTAL
DEATHS BY MONTHS
DURING 1910 IN NEW YORK STATE
FIIM TIE
CHIEF CAUSES OF DEATH
rca MAR. APIt MAY JUNE JULY AUQ. SEPT OCT. NOV. P£a DEATHS
TYFHODFEVEIU-
-J
Division of Vital Statistics
111
The following table shows the seasonal fatality from the chief
causes of death :
Seasonal Fatality, Etc.
January
February
March
April
May
June
Tuberculoflia of the lungs.
Pnwunonia
1.204
1.249
809
891
627
276
226
92
170
1,156
1.058
619
796
584
248
221
90
173
1.427
1.429
710
947
652
271
253
96
219
1.311
1.149
750
874
622
275
223
72
195
1,242
867
795
834
623
238
177
63
134
1.068
524
VioleDoe
887
Bright'v ditrafff
766
C^nwr
595
Diphtheri*
198
S^irlet fever
138
Typhoid ferer
71
Meaalee
138
Total mortality in
the SUte from all
causes
13.158
12.109
14.397
13.085
12.099
11.066
Seasonal Fatality, Etc, — (Concluded)
Tuberculosis of the lungs ....
Pneumonia
Viotenc«
Bright's disease
Cancer
Diphtheria
Scarlet fever
Tjrphmd fever
Measles
Total mortalitv in the
State from all causes. .
July
August
Se^m-.
October
Novem-
ber
Decem-
ber
1.180
1.085
1.078
1.055
1.060
1.193
321
286
333
553
761
1.347
1.253
917
812
824
765
705
740
718
696
718
830
901
601
642
670
639
637
630
159
131
108
131
209
189
73
36
41
53
83
93
97
135
191
172
163
132
83
47
36
12
31
47
13.098
12.238
11,441
11.108
10.938
12.892
Total
14.059
9,867
9.846
9.711
7.522
2.433
1,617
1.374
1.285
147.629
112
State Depabtmext op Health
The following table shows the deaths and death rate from the
principal causes of death in the counties of the State:
COUNTY
An>any
Allegany
Broome
CattaraugUB
Cayuga
Chautauqua. . . .
Chemung
Chenango
Clinton
Columbia
Cortland
Delaware
Dutchess
Erie
Essex
Franklin
Fulton
Genesee
Greene
Hamilton
Herkimer
Jefferson
Lewis
Livingston
Madison
Monroe
Montgomery. . .
Nassau
New York city..
Niagara
Oneida
Onondaga
Ontario
Orange
Orleans
Oswego
Otsego
Putnam
Rensselaer
Rockland
St. Lawrence . . .
Su^toga
Schenectady. . . .
Schoharie
Schuyler
Seneca
Steuben
Suffolk
Sullivan
Tioga
Tompkins
Ulster
Warren
Washington ....
Wajme
Westchester
Wyt)ming
Yates
State institutions
Total
PULMONAKT
TCBBBCUXXMn
Number
deaths
344
17
93
40
67
66
64
25
61
62
13
28
126
612
57
177
40
26
64
6
56
67
28
28
26
322
60
70
8.690
85
192
187
36
167
35
65
32
18
229
65
69
74
83
22
9
29
45
102
189
16
29
130
. 35
52
33
403
15
16
272
Rate per
100.000
population
14,059
197.8
41.1
117.6
60.7
99.7
62.6
98.6
70.3
126.3
141.9
44.4
61.5
143.5
115.1
170.0
388.0
89.6
69.0
202.0
137.9
99.2
83.3
113.0
73.5
66.2
112.9
103.6
82.7
180.8
92.0
124.1
92.9
68.9
143.6
109.3
90.6
67.8
122.5
187.2
138.4
77.6
119.5
93.2
92.4
64.5
107.6
54.0
105.7
559.6
62.6
86.2
141.3
108.6
108.8
65.7
141.2
47.0
8.6
Ttpboio FavEM
Number
44
7
U
7
19
15
14
3
7
12
12
17
13
86
6
10
4
8
11
3
2
39
2
5
5
39
11
6
558
42
16
54
9
27
3
17
4
0
26
5
20
13
5
2
1
1
18
13
9
2
7
17
6
6
8
39
10
5
13
153 5
1.374
Rate
5
5
1
1
,7
25.3
16.9
13.9
10.7
28.2
14.2
25.6
8.4
14.5
27.5
41.0
37.3
14.8
16.4
17.9
21 9
9.0
21.2
36.4
69.0
3
48
8
13
12
13.7
19.0
7 1
11.6
45.5
10.3
26 8
17
23
9
23
8.5
0
21.3
11.1
22 5
21.0
5 6
8.4
7.2
3.7
21.6
13.5
26.6
7.8
20.8
18 5
18.6
12.6
15 9
13.7
31.3
26.9
2
2
4
7
DlPBTHBBlA
Number
34
1
13
9
8
22
9
4
6
3
3
4
13
183
12
11
3
3
1
0
5
5
1
1
1
43
15
14
1,715
22
30
36
2
23
2
5
2
1
18
4
9
7
18
2
0
1
1
11
2
0
0
25
1
1
1
65
2
0
0
Rate
19.6
2 4
16 4
13.7
11 9
20 9
16
11
12
4
2
4
6.9
10 2
8.8
14.8
34 4
35 8
24.1
6*7
8.0
3.3
0
8.9
6.2
4.0
2.6
2 5
15.1
25.9
16.5
35 7
23.8
19.4
17 9
3.8
19.8
6 3
7.0
4.2
6.8
14.7
8 9
10.1
11 3
20 2
8.4
0
3 7
12
1U4
5.9
0
0
27 2
3.1
2.1
2.0
22.8
6.3
0
0
15.0
2.433
26.5
Division of Vital Statistics
113
COUNTY
CMttermucus.
Qiyuf«
Cluiotauqua.
CSBtOO^
Cohnnbia
Gortland.
Erie
FHnkUn
FtaHoo..
OrsBoe.. .
Hamilton
Lirinsstoo. . . .
lUdiMa
Monroe
MootcDBiery. .
Nmmu
Wew York city.
ODondaga.
Ontario. . .
Otaeco.
Putnam.
Roddand. .
St. LawTen<«
Saratoca ....
Scbeneetady.
SdMharie . .
Schuyler
Steuben.. .
SoffoUc...
SoOiTan...
Tioga
Tompldtta.
Ubter . . .
Waobington
Weatcheeter
Wjroming. .
State inatitutions .
Total
DfABmncA (Umdxb
2 Yeabs)
Number
142
12
49
31
47
68
21
16
35
32
7
15
60
435
25
40
26
25
13
3
34
43
11
24
20
276
100
92
5.655
86
162
200
22
84
10
42
23
11
82
38
63
49
130
3
4
8
27
64
28
13
9
39
7
31
26
383
18
7
1
Rate
7
0
0
0
0
4
3
0
81
29
62
47
70
64
38
45
72.5
73.2
23.9
32.9
68.3
81.8
74.6
87.7
58.2
66.3
43.1
69.0
60.2
53.5
44.4
63.0
50.9
96.8
172.7
108.7
1.175.3
153.1
104.7
99.4
42.1
72.2
59.3
" 68.5
48.7
74.9
67.0
84.8
70.9
79.1
146.1
12.6
28.7
29.7
32.4
66.3
82.9
50.8
26.8
42.4
21.7
64.8
51.8
184.2
56.4
37.6
IlfrLUBNSA
Number
46
17
16
18
15
36
21
24
18
17
9
21
13
42
18
19
14
12
5
1
15
24
14
9
19
29
8
9
366
14
35
31
16
31
11
17
29
6
42
7
38
26
6
10
9
10
22
29
17
9
18
36
9
25
21
29
8
9
7
9.036
98 6
1.452
Rate
26.6
41.1
20.2
27.3
22.3
34 1
38.3
67.6
37.3
38.9
30 8
46.1
14.8
7 9
53.7
41.7
31.4
31.8
16 6
23.0
26.6
30.0
56.5
23.6
48.4
10.2
13.8
10 6
7.6
15.2
22.6
15.4
30.6
26.7
34.3
23.7
61.5
40.8
34.3
15.5
42.7
42.0
6.7
42.0
64.5
37.1
26.4
30.1
50.3
11.7
53.5
39 1
27 9
52.3
41.8
10.2
25.1
48.3
Cancbb
Number
191
34
77
69
69
91
54
34
26
41
32
48
80
380
24
33
42
39
31
2
40
76
26
29
40
266
38
62
3.709
58
148
176
65
99
35
63
52
18
125
34
66
66
52
25
13
26
73
69
13
20
47
70
35
36
37
243
24
13
38
Rate
109 8
82.2
97 4
104.7
102.7
86.2
98.6
95
53.
7
.8
93 8
4
4
0
4
15.8
7.522
109
105
91
71
71.6
72 3
94.1
103.5
102.7
46.0
70.8
94.5
104.9
76 1
101.8
93 3
45.6
73 3
77 1
62.8
95.6
87 5
124.3
85 1
109.3
87.8
110
122
92
75
74
106.6
. 58.4
105 0
93 1
96 5
87.5
71 5
38 5
78.2
139.7
76 1
108 6
75 3
73 7
85.1
7.S 2
69 8
82 1
2
5
2
5
2
lU
State Depabtment op Health
Mortality from Principal
CITY
LMkftwanna
Troy
CoboM
Hudson
Rome
Albany
Cortland
OneonU
Newburg
Kingston
Port Jervk
NiannFaUs
MkMletown
Watertown
Plattaburg
Utica
Watervliet
Amaterdam
Ogdensburg
Poughkeepsie
LockpoH
Ithaca
Oswego
Buffalo
Dunkirk
New York (Gr.)..
Manhattan
Bronx
Brooklyn
Queens
Richmond
Binghamton
Glens Falls
Uttle Falls
Gloverwille
Syracuse
Yonken
Auburn
Elmira
Rensselaer
Fulton
Schenectady
Corning
Oneida
Rochester
Genera
Mt Vernon
Johnstown
North Tonawanda
Olean
Jamestown
Homell
Tonawanda
New Rochelle
Population
14.540
70.830
24.737
11.402
20.032
100.358
11.517
0.552
27.808
25.020
0.304
30.017
15.207
20.702
11.182
74.870
15.000
31.580
15.081
28.055
17.003
14.815
23,410
425.715
17.308
4.700.030
2.341.312
437.701
1.640.285
287,725
80.520
48,071
15.208
12.320
20,730
138.087
.80.580
34.760
37.238
10,712
10.550
73,450
13.742
8,310
210.003
12.458
31.175
10.476
12.033
14,814
31,523
13,637
8,308
29.229
Total DiAin
AD
307
1,507
500
230
411
1.043
210
181
510
475
170
551
275
408
105
1,207
201
540
208
406
200
244
385
6.877
270
70.750
38.008
0.008
25.070
3.071
1.407
705
241
104
321
2.124
1,220
522
554
158
155
1,070
200
118
3.084
175
433
143
100
188
404
174
106
342
Rate
per
1.000
er,;
27.3
20.8
20.0
20.0
10.0
104
10.0
18.0
18.3
18.3
18.3
18.0
18.0
17.5
17.4
17.3
17.3
17.1
10 8
10.0
10
10
10
10.2
10.1
10.0
10.1
15.0
15.0
13.8
17.0
15.7
15.7
15.7
15.5
15.4
15.2
15.0
14.0
14.7
14 7
14.0
14.0
14.2
14.0
14.0
13.0
13.7
13.3
12.7
12 8
12.8
12.8
11 7
Ttfboid
Deaths
1
15
10
0
4
15
0
2
12
5
0
80
4
24
3
5
7
7
0
5
2
5
12
78
4
558
200
41
108
30
11
0
2
1
2
38
15
3
10
3
1
5
8
4
30
3
3
1
5
0
0
5
3
1
Rate
100,000
7.0
10.5
70.8
52.3
10.3
14.0
78.1
20.0
43.1
10.2
04.5
07.0
20.1
80.0
20.8
0.7
40.4
22.1
37 5
17.8
11.1
33.7
51.2
18.3
23.1
11.0
11.0
0.4
12.0
13.5
12.7
12.4
13.1
8.1
0.0
27 5
18.0
8.0
20.0
28.0
0 5
0.8
58.2
48 1
13.7
24.1
0.0
0.
41
0
.5
.0
28 5
36 6
36 1
3 4
PULMONART
TUBncUX<0BI8
Deathf
18
175
40
20
20
230
3
0
50
40
11
32
27
21
23
04
21
32
17
35
25
15
17
510
11
8,000
3.070
1.770
2.420
358
148
58
18
10
10
123
120
41
10
15
13
72
7
3
277
13
34
11
8
7
23
5
7
21
Rate
100.000
123 7
227,8
108.0
220.8
120.0
238.1
20.0
02.8
170.4
177.4
118
104
170
78.
207
125.5
130.1
101.3
100 4
124.8
138.0
101.2
72.0
110.8
03.4
181.1
171.0
400.4
147.4
124.2
170.2
110.2
117.0
81.1
77.2
80 1
148 0
118.0
51 0
140.0
123 2
08.0
50.0
36 1
126.1
104.4
100 1
106.0
66.5
47 2
73 0
36 7
84 3
83 1
Cancbb
Deaths
3
83
14
0
23
135
14
13
25
21
le
14
16
23
0
65
8
15
14
27
12
16
20
305
13
8.700
1,015
323
1.212
185
74
41
12
5
15
125
50
30
38
14
7
41
6
0
213
11
20
13
6
17
21
0
5
23
Rate
100,000
ktlOD
20.6
107.0
50.6
78.5
111.8
134.5
121.5
130.5
80.5
80.9
107.4
45.0
104.5
85.8
80.5
87.1
53.0
47.4
87.5
00.1
00.0
108.0
80.0
71.7
75.1
77.3
82.4
73.8
73.6
04 2
85.1
84 1
70.2
40 5
72.3
00.5
73.2
112.3
101.8
130.0
60 4
55.
43
108.2
00.0
I
88.2
04 2
124.0
40.0
114.8
00 0
06 0
6) 2
73.7
a
Division of Vital Statistics
115
Causes in Cities of State
Dvmum ow m
CntcajLTomr
Simof
PmTIMOlIU
Onss RwpiBA-
TOBT DUBAUS
CHBomc BaioBT's
Dbbabi
DURBHSA
Emtuutib
(Under 3 yeam)
ViOLSNca
(Aocidenti, sui-
cides, ete.)
Rate
Rate
Rate
Rate
Rate
Rate
De»tbs
100^
DefttlM
ioJ!ooo
DeatiM
loS^
Deaths
lOOAK)
Deaths
100.000
Deaths
100.000
ponibb-
popula-
popuhp
popula-
popuhp
popula-
tioa
tion
txm
tion
tion
tion
16
109.9
30
206.1
19
130.5
3
20.6
98
673.3
41
281.7
2»
288.6
115
149.5
109
141.7
113
146.9
67
87.1
79
102.7
35
141.4
34
137.4
45
181.8
23
92.9
54
318.2
21
84.8
S
244.2
10
87.2
17
148.3
21
183.1
17
148.2
23
200.6
»
280.7
19
92.0'
18
87.1
35
169.4
27
130.7
26
125.8
379
277.9
126
125.5
97
96.6
139
138.4
56
55.8
96
95.6
SS
217.0
21
182.3
10
86.8
24
206.3
4
34.7
17
147.6
31
220.5
17
178.5
5
52.5
10
105.0
9
94.5
30
315.0
51
182.6
60
179.0
36
93.1
48
171.8
25
89 5
36
128.9
71
273.4
26
100.1
17
65.5
24
92.4
12
46.2
33
127.1
12
128.9
10
107.4
4
43.0
7
75.2
5
53.7
19
161.1
40
130.4
37
120.6
29-
94.5
24
78.2
45
146 7
70
228.2
34
222.0
18
117.5
16
104.5
23
150.2
1
6.5
31
202.4
54
201.4
29
108.3
24
89.5
24
89.5
20
74.6
37
138.0
19
169.9
11
98.3
11
98.3
2
17.9
7
62.6
7
62.6
142
190.3
101
135.3
79
105.9
77
103.2
100
131 0
75
100.5
26
172.1
23
162.3
23
145.6
17
112.6
11
72.8
11
• 72.8
39
123.2
54
170.6
32
101.1
34
107.4
89
281.2
36
113.8
34
212.5
8
50.0
25
156.3
19
118.8
16
100.0
12
75.0
67
238.5
31
110.4
23
81.9
39
138.8
21
74.8
34
121.0
49
272.0
20
111.1
20
111.1
15
83.8
11
61.1
24
133.2
29
193.8
11
74.3
10
67.5
26
175.5
6
405
19
126.3
43
184.9
19
81.7
11
47.3
36
154.8
18
87.4
31
133.3
899
211 3
110
25.9
761
178.8
277
66.3
264
62.0
345
81.1
18
104.0
25
144.5
9
52.2
21
131.4
23
132.9
29
167.6
lO^SlS
218.7
6;546
115.4
7.182
148.3
4.893
101.8
5.655
117 6
4.863
101.2
4,8&5
206.8
2,686
115.5
3,719
159.9
2.353
101.3
2.904
124 9
2,727
117.3
896
204.6
462
105.5
431
98.4
356
81.3
316
72 2
346
79.0
3.966
240.7
2.002.
131.5
2.546
154.5
1.793
108.8
l/«96
121.2
1.393
84.6
S83
202.3
296
102.7
325
112.8.
279
96.8
335
116 2
298
103.4
215
247.3
100
115 0
111
127.7
112
128.8
101
119.2
99
113.9
81
166.1
62
127.1
39
80.0
65
133.3
39
80.0
54
110.7
41
270.6
16
105.0
14
02.4
12
79.3
7
46 2
10
66.0
31
251.1
19
153.9
10
81.0
13
105.3
11
89.1
16
129.6
30
144.6
16
77.1
10
91.6
30
144.6
14
67.5
17
81.9
383
212.1
144
104.3
121
87.6
160
115.8
166
120.2
162
117.3
175
217.0
75
93.0
85
106.4
65
80.0
180
233.2
56
69.4
63
181.4
40
115.2
39
83.5
34
97.9
36
103.6
28
80.6
63
168.8
33
88.4
30
80.4
89
338.5
14
37.5
45
120.6
30
186.6
9
84.0
11
102.6
6
56.0
2
18.6
15
140.0
14
132.7
9
85.3
6
56.9
7
66.4
7
66.4
14
132.7
84
114.2
108
146.9
74
100.6
63
85.7
115
156.4
74
100.6
20
145.4
18
130.9
9
65.4
10
72 7
4
29.1
17
123.6
U
168.3
7
84.1
7
84.1
4
48 1
5
60.1
10
130.3
415
188.8
153
69.6
254
115.6
351
114.3
303
92.4
180
81.9
37
216.5
12
96.2
11
88.3
13
104.3
4
33.1
14
113.3
61
195.8
31
99.6
34
109.1
42
134 8
36
115.6
22
70.6
12
114.5
18
171.7
6
57.3
10
95.4
7
66 8
5
47.7
7
58.2
8
66.5
18
140.6
4
33 2
21
174 5
13
108.0
22
148.5
16
106.0
6
40.5
8
54.0
9
60.8
18
121.5
47
149.0
30
96.1
33
73.9
43
•136 3
8
35.4
22
69.7
36
190.6
14
103.6
3
22 0
9
66 0
4
29.3
15
110 0
11
133.4
7
• 84.3
6
72.3
3
36.1
5
60 2
14
168 6
35
86.5
22
75.3
35
85.5
33
112 9
23
78.7
34
116.3
116
State Department of Health
Toted Mortality by Motiihs
Azmual
death
rate per
1.000
lation
January. . ,
Februarj'-
March . . . .
April
\iay
June
July
August. . .
September
October. . .
November
December.
Total.
14.4
13.2
15 7
14.3
13.2
12.1
14.3
13.4
12.5
12.1
11.0
14.0
16.1
Total
deaths
13.158
12.109
14,397
13.085
12.009
11.066
13.098
12.238
11.441
11.108
10.038
12.892
147.629
Deaths
under
1 year
2.055
1.851
2.192
2,051
1.960
2.027
3.512
3,414
2.781
2.312
1.537
1.765
27,457
Aocs
Deaths
1 to4
srears
1.155
1.144
1,296
1.172
1.111
953
1,206
1.090
900
713
700
794
12.233
Deaths
5 to 19
years
Deaths
20 to 30
years
604
681
760
783
730
683
702
652
5ol
566
557
611
8.060
Deaths
40 to 50
yean
2.053
1,876
2.250
2.131
2.048
1.876
1.065
1.710
1,760
1.832
1.826
2.004
23.340
2.835
2.590
2.903
2.734
2.519
2.240
2.360
2.252
2.207
2.325
2,487
2.007
30.557
Deaths
at 60
years
and over
4.352
3.935
4.899
4.205
3.704
3,274
3.243
3.100
3,214
3.347
3.820
4.706
45,790
Total Mortality by Months — (Continued)
Epidemic Diseasbs
Ty-
phoid
fever
January. . .
February . . ,
March
April
May
June
July
August ....
September. .
October
November . .
December . . .
Total..
02
90
96
72
63
71
97
135
191
172
163
132
1.374
Ma-
laria
7
4
3
5
6
5
6
8
5
10
2
4
65
Small-
pox
Measles
Scar-
let
fever
Whoop-
ing
cough
Diph-
theria
and
croup
•
■ • • •
170
226
46
276
1
173
221
40
248
• • • *
219
253
56
271
2
195
223
60
276
1
134
177
68
238
2
138
138
54
198
1
83
73
97
159
47
36
103
131
36
41
57
108
12
53
48
131
31
83
45
209
47
93
53
189
7
1.285
1,617
727
2.433
Influ-
ensa
153-
204
418
260
109
43
15
8
12
30
44
156
1,452
Ery-
sipelas
51
71
87
52
50
46
33
19
11
23
31
43
526
Cercbro-
sinnal
menin-
gitis
35
37
45
49
49
41
37
37
38
39
22
33
452
Division of Vital Statistics
117
Total Mortality by Months ^ — (Continued)
Pul-
tobcr-
Total
1.204
1.156
1,427
1.311
1.242
1.068
1.180
1.085
1.078
1.065
1.060
1.193
14.059
Other
forms
of
tuber-
coloois
Cancer
and
other
iwmltg-
nant
tumoiB
Dia-
betes
Other
dkeaaes
Diseases
of the
nervous
system
Diseases
of the
circula-
tory
qrstem
1S4
181
214
216
216
217
226
167
166
171
163
157
627
584
652
622
623
595
601
642
670
639
637
630
145
127
143
130
110
129
100
118
117
117
116
146
386
367
462
'434
423
366
448
528
460
416
370
897
1.002
926
1.099
969
987
8n
938
810
879
913
944
1.060
1.867
1,736
1.854
1,720
1,670
1,454
1.405
1.284
1.357
1.473
1.656
2,021
2.278
7.522
1.498
5.057
11.404
19.497
Pneu-
1.249
1.058
1.429
1.149
857
524
321
286
333
553
761
1.347
9,867
Other
Diar-
diseases
rhea
of the
and en-
tmfxnr
teritis
tory
(under
system
2 yean)
1,373
223
1.199
200
1,406
224.
1,277
260
990
337
743
620
641
2,237
524
2.071
623
1,430
731
885
873
320
1,282
211
11.662
9.036
Diar-
rhea
anden^
teritis
(over
2 years)
59
80
69
98
75
112
283
331
241
125
91
83
1,647
Total Mortality by Months — (Concluded)
Other
Other
db-
Con-
BtRTHB
db-
Bright's
The
PUCT-
peral
state
genital
ni-<ie-
fined
dis-
eases
All
otha
causes
di^estr-
ive
system
and
ne-
phritis
ofthe
genito-
urin-
ary
system
de-
bUity
(under
3
months)
Acci-
dents
Sui-
cides
Homi-
cides
ToUl
births
StiU
births
J.,^
627
891
276
132
416
647
112
42
261
379
18.589
856
FArsary
618
796
266
141
342
487
101
26
248
381
16,108
805
Msnk.
661
947
306
166
468
530
132
31
291
438
18,711
925
iC?-:;;. :
616
874
312
132
397
574
128
30
230
404
17,343
828
609
834
256
131
302
591
140
34
247
521
17.590
847
629
766
246
142
362
686
148
34
236
376
17.596
840
«y
662
740
279
116
370
1.025
153
42
315
415
18,893
816
794
718
229
99
420
750
108
42
329
379
18,123
818
S^l^^iv
659
696
218
93
422
624
131
36
301
409
17.910
794
Oilobe
629
718
211
99
428
641
113
31
269
373
17,679
786
%mm»bK
538
.830
226
93
316
593
111
46
232
332
17,353
803
l>^ngakm
649
901
275
108
356
547
102
26
223
428
17.340
834
Total
7.691
9.711
3.100
1.452
4.599
7.695
1.479
420
3,182
4.835
213,235
9.952
118
State Department of Health
Detailed Statement as to Causes of Deaths
9
Jan.
Feb.
Mar.
April
May
June
July
1.
All cftuses
13,158
3,567
1.028
92
12.109
3,467
1.060
90
14.397
4.301
1.415
96
13.085
3.857
1,155
72
12,099
3.469
865
63
11,066
3.070
707
71
13.098
?.
T. Oftfiftml diw!!*iiw^
3.119
3.
(A) Koidennio diseases
617
4.
Tvnhoid fever
97
R
Tvnhiifl fftver
6.
RelaDsins fever
1
1
6
2
138
138
54
190
8
43
7,
Malaria
7
4
1
173
221
40
239
9
204
3
' 2i9
263
56
264
7
418
5
2
195
223
60
271
4
260
6
1
134
177
68
236
2
109
6
8
BniallDOX
1
9.
IVfeasles
170
226
46
262
14
153
83
10.
Roarlet fever
73
11.
Whoooine couiEh
07
12.
(a^ Diohtheria
168
13..
(h) CrouD
1
14.
Tnfliiensa . t
15
15
\f iliftrv fever
16
Afliiitir cholera
17.
Dvsenterv
6
7
10
9
• 8
7
53
IH
PlAfMie
10
Yellow fever
20
T ^enron V
?1.
Krvsioelas
51
1
2.539
25
71
1
2.407
25
87
2
2.886
46
1
52
2
2.702
34
1
59
2
2.604
36
46
4
2.363
16
33
72.
Otner eDidemic diseases
23.
(B) Other iceneral diseases
2.602
24.
25
Purulent infection and septicemia . .
Glanders
30
26
AntHrax
3
27.
Ttabiea
1
6
1
9
2
9
ii
1
28.
Tetanus
8
9
17
20
T^AllairrA
30.
Tuberculosis of lunss
i;264
7
109
27
12
6
17
6
2
50
5
19
253
91
16
56
92
102
9
48
54
5
1
145
13
2
14
37
82
3
1.156
15
91
33
10
5
13
14
14
36
1
35
219
78
15
68
84
85
11
68
47
6
1
127
11
2
10
■ 33
68
i.'427
27
93
35
16
3
18
22
4
61
1
25
247
95
16
76
84
109
11
84
42
11
2
143
14
1
17
40
97
5
1.311
30
91
32
14
6
32
11
6
48
3
20
246
102
15
58
98
83
6
81
20
37
1
130
U
4
18
47
80
2
i.242
16
117
28
13
5
25
12
6
69
1
18
253
97
19
55
83
98
5
63
13
33
"iio
10
2
14
48
87
1
1.068
14
108
4«
15
2
24
8
8
65
214
101
13
62
109
85
8
69
14
20
1
129
10
4
8
44
61
10
3
11
1,180
31
Acute miliarv tuberculosis
24
32.
Tuberculous meniniritis
119
33.
Abdominal tuberculosis
33
34.
Pott's disease
10
35.
white swelling
4
36.
37.
Tuberculosis of other organff
Disseminated tuberculoma
27
9
38.
Rickets
12
39.
Svohilis
65
40.
GonococcuB infections
41.
Cancer of mouth
25
42.
43.
Cancer of stomach and liver
Cancer of peritoneum, intestines and
rectum
238
84
44.
Cancer of skin
15
45.
Cancer of breast
51
46.
47.
48.
Cancer of female genital organs
Cancer of other or unspecified organs
Tumor (noncancerous)
87
101
20
49.
60.
51.
52.
Acute articular rheumatism
Chronic articular rheumatism
Chronic rheumatism and gout
Scurvy
17
26
18
63,
Diabetes
100
54.
ExoDhthalmic goiter
10
56.
Addison's disease
3
56.
Leukemia
8
67.
Anemia, chlorosis*
37
68.
Alcoholism
92
69.
Chronic lead Doisoninic
4
60.
Other chronic occupational poison-
infffl
10
61.
Other chronic noisoninirs
3
15
"is
4
13
"\l
1
24
5
62.
Other general diseases
20
• Not separately
Comparative Mortality
TWELVE PROMINENT CAUSES
OF DEATH
NEW YORK STATE lOlO
MM tooo iooo 4000 6000 0000 Tooo 8000 0000 10000 iiooo itooo laooo wooo
TUBERCULOSIS]
PNEUMONIA
VIOLENCE
BRIGHrS DfSEAt
CANCER
DIPHTHERIA
OLD AGE
SCARLET FEVi
TYPHOID FEVER
MEASLES
WHOOPING 0
CCffeUfO'SMMAL
M£NIM9m$
Division of Vital Statistics
119
Occurring in the State During 1910
K All causes.
3.
4.
5.
6.
7.
8.
9.
10.
IL
12.
13.
14.
15.
10.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
30.
40.
41.
42.
43.
44.
45.
46,
47.
48.
40.
80.
51.
52.
33.
54.'
55.
55.
57.
58.
».
ao.
51.
82.
2. I. Generml diseases.
(A) Epidemic diseases.
Typooid fever
Typhus fever
Befapmng fever
Malaria
Snudlpox
Measles
Scarlet fever
Whoopmg cough
(a) Diphtheria. . .
(b) Croup
Ii&fluensa
Miliary fever
Asiatic cholera
Dysentery
Aug.
12.238
3,027
611
135
8
Sept.
11.441
2.052
561
191
Oct.
11.108
2,877
524
172
Nov.
Yellow fever,
Lepro«y
Enrsipelas
Other epidemic diseases .
(B) Other general diseases
Purulent infection and septicemia
Glanders
Anthrax
Rabies
Tetanus
Pellagra
Tuberculosis of lungs
Acute miliary tuberculosis
Tuberculous meningitis
Abdominal tuberculosis
Pott's disease
White swelling
Tuberculosis of other origans
Disseminated tuberculosis
Rickets
Syphilis
Gronoooccus infections
Cancer of mouth
Cancer of stomach and liver
Cancer of peritoneum, intestines and
rectum
Cancer of skin
Cancer of breast
Cancer of female genital organs
Cancer of other or unspecified or-
gans*
Tumor (noncancerous)*
Acute articular rheumatism
Chronic articular rheumatism
Chronic rheumatism and gout
Scurvy ,
Diabetes
Exophthalmic goiter
Addison's disease
Leukemia
Anemia, chlorosis*
Aloobolum
Choronio lead poisoning
Other chronic occupational poison
ings
Other chronic poisonings
Other general ois
47
36
103
129
2
8
123
19
2.416
13
2
16
useases.
1.085
18
78
33
6
1
22
9
17
64
1
26
272
03
14
59
00
08
12
40
16
20f
2
118
7
3
11
20
72
1
36
41
57
103
5
12
09
11
1
2,391
16
1
10
12
53
38
123
8
30
45
23
2.353
22
11
16
39
1,078
22
76
32
7
2
22
5
8
48
7
24
265
108
17
74
85
97
10
41
25
17
5
1
1,055
16
86
33
4
10,938
2.954
627
163
31
83
45
195
14
44
18
31
- 1
2.327
13
1
Dec.
12,892
3.240
729
132
47
93
53
180
9
156
10
43
2
2.511
21
117
8
5
15
36
77
2
11
22
26
6
6
50
3
25
243
99
16
60
98
98
14
23
17
38
3
117
6
1
11
42
87
4
1.060
19
82
23
6
2
36
22
11
4
40
2
19
241
97
20
58
100
102
9
35
19
25
7
I
1.193
20
75
30
12
ToUl
147.629
39.900
9.899
1.374
1
65
7
1,285
1.617
727
2.350
83
1.452
395
116
13
4
8
33
95
3
16
4
7
59
5
28
242
86
17
66
86
105
6
52
21
27
146
14
1
13
34
92
1
1
42
13
10
526
17
30.001
301
4
4
7
111
2
14.059
228
1.125
385
125
' 34
264
117
93
625
31
285
2.933
1.121
192
732
1.096
1.163
121
630
314
265
11
1.498
127
32
147
460
990
26
20
61
262
tiUJuly.
120
State Department of Health
Detailed Statement as to Causes of Deaths Occurring
63.
64.
05.
66.
67.
68.
69.
70.
71.
72.
73.
74.
76.
76.
77.
78.
79.
KO.
«1.
82.
83.
84.
85.
86.
87.
oo.
89.
90.
91.
92.
93.
94.
95.
96.
97.
98.
99.
100.
101.
102.
103.
104.
105.
106.
107.
108.
109.
110.
111.
112.
113.
114.
115.
116.
117.
118.
119.
120.
121.
122.
123.
124.
125.
IT. Dticaaes of nervoua system
Ebu»phalitia*
Simple meningitis
Cerebrospinal fever
Locomotor ataxia
Other diseases of spinal cord
Apoplexy, cerebral hemorrhage . . .
Softening of brain
Paralsrsis without specified cause . .
General paralysis oi inaane
Other forms of mental alienation. .
Other diseases of brain
Epilepsy
Conrulsions fnonouemeral)*
Convulsions of infants*
Chorea
Other diseases of nervous system . .
Diseases of the eye and its adnexa.
Diseases of the ear
Anterior poliomyelitis
III. Diseases of circulatory system. . . ,
Pericarditis
Acute endocahditis
Organic disease of the heart
Angina pectoris
Diseases of the arteries
Embolism and thrombosis
Diseases of the veins
Diseases of the Ijrmphatic system . . .
Hemorrhages (except of lungs)*. . . . .
Other diseases of circulatory system .
IV. Diseases of respiratory ssratem
Diseases of nasal fossae*
Diseases of the larynx
Diseases of the thjrroid body
Acute bronchitis
Chronic bronchitis
Broncho-pneumonia
Pneumoma
Pleurisy
Pulmonary congestion
Gangrene of lungs
Asthma
Pulmonary emphysema
Other diseases of the respiratory sys-
tem
V. Disease of digestive system
Diseases of the mouth and its adnexa.
Diseases of pharj'nx
Diseases of the esophagus
Ulcer of stomach
Other disease? of the stomach (cancer
excepted)
Diarrhea and enteritis (under 2 years)
Diarrhea and enteritis (2 years and
over)
Intestinal parasites
Hernia . .'
Obstruction of intestines
Appendicitis and t>'pbiliti8
Other diseases of intestines
Acute yellow atrophy of liver
Hydatid tumor of liver
Cirrhosis of liver
Biliary calculi ,
Other di<«ease.«) of liver
Jan.
1.037
4
64
35
20
39
511
13
104
39
12
31
2
89
1
48
25
1.867
12
262
M03
61
326
63
6
5
15
14
2,622
13
3
204
107
879
1.249
58
34
6
22
11
36
909
13
3
25
104
223
59
69
23
81
30
7
3
182
IR
29
Feb.
963
1
78
37
17
32
488
14
76
34
11
31
4
70
1
60
14
1.736
6
249
1.041
64
300
42
8
5
12
9
2.257
8
3
176
106
787
1.058
45
23
"22
2
27
898
5
12
2
39
92
200
80
71
34
76
18
4
3
1.51'
ISi
3<V
Mar.
1.144
5
99
45
20
39
632
16
119
48
17
5
27
1
97
4
48
22
1.854
13
320
1.037
49
329
41
8
2
16
39
2.835
14
1
203
99
897
1.429
69
39
7
29
9
39
054
4
19
6
29
123
224
69
76
59
72
18
4
April
1,018
4
87
49
10
47
450
16
105
42
16
1
34
2
74
1
66
1
24
1,720
12
258
982
71
306
48
8
2
18
20
2,426
8
6
178
106
796
1,149
60
32
2
28
13
48
983
8
20
3
34
88
269
98
58
32
85
2
147
IS'
41i
149
2'?
25
May
1.036
4
83
49
13
34
490
28
101
42
18
2
82
3
83
3
39
17
1,670
10
227
1.009
72
266
41
4
6
9
26
1.847
13
2
118
90
598
857
65
18
3
13
8
62
1.021
5
20
2
34
103
337
75
1
47
40
68
14
8
1
146
17
331
June
918
2
60
41
17
34
443
14
84
61
7
6
18
3
61
3
41
1
22
1.454
12
185
912
5S
217
88
8
3
6
20
1.267
14
1
100
40
461
524
65
16
3
17
7
19
1.361
7
11
2
25
89
620
112
1
66
49
88
21
2
1
138
12
36*
July
975
9
86
37
14
51
400
13
106
80
17
II
1
89
4
66
8
6
1*
1.405
13
186
823
48
84
7
2
6
8
962
6
2
68
48
387
321
84
31
16
9
40
3,182
2
11
2
36
87
2.237
4
78
34
125
30
3
4
123
16
29
* Not separately
Division of Vital Statistics
121
m the State During 1910 — (Continued)
Aug.
63. II.
64.
65.
66.
67.
68.
69.
70.
71.
72.
78.
74.
76.
76.
77.
78.
79.
80.
81.
82.
83. III.
84.
86.
88.
87.
88.
80.
90.
91.
93.
93.
Diaeaaes of nervous Bystem
Encenhaliiis*
Simple meningitis
Cerebrospinal fever
Looomotor ataxia
Other diseases of n>tnal cord
Apoplexy, oerebral hemorrhage . . .
Softening of brain
Paralysis without specified cause*. .
G«neral paralysis of insane
Other forms of mental alienation. . .
Other diseases of brain
Epilqjsy
Convulsions (nonpuerperal)*
Convulsions of Wants*
Chorea
Other diaeasea of nervous system . .
Diseases of the eye and its adneza .
Diseases of the ear
Anterior poliomyelitis.
Diseases of drculatoiy system
Pericarditis
Acute endocarditis
Organic diseases of the heart
Angina pectoris
DtBeaees of the arteries
Embolism and thrombosiB
DtBeaees of the veins. :
Diseases of the Isrmphatic system. . .
Hemonhages (except of lungs)*
Other diseases of circulatory system .
M. IV. Diseases of respiratory system
95.
96.
97.
98.
99.
100.
101.
102.
103.
104.
106.
106.
107,
108. V.
109.
110.
111.
112.
iia.
114.
115.
U6.
117.
118.
119.
120.
UL
122.
123.
,24.
;25.
Diseases of nasal fossae
Diseases of the larynx
Diseases of the thyroid body
Acute bronchitis
Chronic bronchitis
Broncho pneumonia
Paeumoma
Pleurisy
Pulmonary congestion
Gangrene of lungs
Asthma
Pulmonary emphysema
Other diseases of the respiratory
QTstem
Diseases of digestive system
Diseases of the moilth and its adnexa
Diseases of pharsmx
Dtseases of the esophagtu
Ulcer of stomach
Other dieeasea of the stomach (can-
oer excepted)
Diarrhea and enteritis (under 2
years). .
Diarrhea and enteritis (2 years and
over)
Intestinal parasites
Hernia
Obstruction of intestines
Appendicitis and typhilitis
Other diseases of intestines
Acute valknr atrophy of liver
Hydatid tumor of liver
Curhoois of Uver
Biliary calculi. .*
Other diaessee of liver
847
8
83
37
17
56
380
77
32
13
5
80
62
1
37
1.284
5
136
801
43
263
25
4
3
3
11
810
7
2
75
35
319
286
34
18
2
7
7
18
3.196
7
9
2
38
116
2.071
331
24
66
59
102
35
24
178
11
28
Sept.
907
2
64
28
22
34
402
24
98
40
17
7
24
3
58
5
43
1
14
21
1,357
7
109
867
53
264
31
3
3
6
14
956
1
7
1
92
38
376
333
30
21
2
21
10
24
2.339
5
7
6
19
. 113
1,439
241
40
23
46
74
25
4
1
146
19
38
Oct.
952
4
61
39
26
52
464
7
77
44
13
3
32
4
52
45
2
16
21
1.473
9
108
1.020
40
238
33
7
1
6
11
1.284
7
1
101
64
442
553
42
28
2
10
6
28
1.630
5
14
46
103
885
125
1
39
45
83
27
2
1
126
11
40
Nov.
966
8
43
22
10
39
485
21
88
56 f
14
O
37
2
49
1
50
1
16
11
1.656
11
104
1,107
55
319
31
2
1
5
21
1,634
11
2
113
71
509
761
41
35
2
23
9
57
949
4
12
35
73
320
91
10
70
66
15
2
2
143
20
31
Dec.
Total
1.093
11.856
7
58
82
889
33
452
16
211
50
507
526
5.556
20
191
109
1.144
50
538
18
173
14
59
44
368
2
27
65
839
1
25
38
561
9
14
191
4
58
2.021
19.497
10
120
121
2.265
1.413
12.115
64
673
317
3.363
51
523
10
75
3
36
2
104
30
223
2.629
21.529
1
13
121
2
26
170
1,598
114
918
797
7.248
1.347
9.867
44
587
38
333
4
33
29
237
18
109
53
451
943
18.374
1
53
15
163
2
30
36
396
99
1.190
211
9.036
83
1,647
2
51
84
687
46
537
68
988
13
270
2
42
16
172
1.801
23
203
29
395
clsasified till July.
122
State Depabtment of Health
Detailed Statement as to Canises of Deaths Occurring
V. Diaeaaes of diseotive aystem — {Con,)
126. DiseaseB of tBe spleen
127. Simple peritonitis (nonpuerperal)
128. Other diseases of digestive ssrstem
(cancer and tuberculosis excepted)..
Jan.
129.
130.
131.
132.
133.
134.
136.
136.
137.
138.
139.
140.
141.
142.
143.
144.
146.
146.
147.
148.
149.
150.
151.
152.
153.
154.
155.
156.
157.
VI. Diseases of genito-urinary system,
mtui
Acute nephri
Bright's disease
Other dia^ises of kidneys and adnexa.
Calculi of urinarv passage
Diaeaaes of bladder
Other diaeaaea of urethra, urinary
abscess, etc
Diseases of prostate
Nonvenereal diseases of the male
genital organs
Metritis
Uterine hemorrhage (nonpuerperal).. .
Uterine tumor (noncanceroua)
Other diaeaaes of uterus
Cyata and other tumors of the ovary. .
Salpingitia and other diaeaaea of feinale
gepital organs
Nonpuerperal diaeaaes of the breast
(cancer excepted)
VII. ChUdbirth *. . . .
Accidents of pregnancy
Puerperal hemorrhage
Other accidents of labor.
Puerperal septicemia
Puerperal albuminuria and convul-
sions
Puerperal phlegmasia alba dolens,
emDolus following childbirth (not
otherwise defined)
Puerperal diseaaea of the breaat
VIII. Diaeaaea of the akin. .
Gangrene
Furuncle
Acute abaceaa
Other diseaaea of the skin .
158. IX. Diaeaaes of locomotor aystem
159. Diaeaaes of bones (tuberculosis ex-
cepted)
160. Diseases of joints (tuberculosis and
rheumatism excepted)
161. Amputation
162. Other diseases of organs of locomotion
163. X. Congenital malformations (still births
not included)
164. XI. Diseaaea of early infancy
165. Premature birth
166. Congenital debility, ic tenia and
sclerema
167. Other diseases of early infancy
168. Lack of care
169. Xn. Old age senility.
170. XIII. Violence
171. Suicide by poison
172. Suicide by asphyxia
173. Suicide by hanging or strangulation .
174. Suicide by drowning
175. Suicide by firearms
176. Suicide by cutting instruments
80
10
1,167
139
891
23
3
40
26
2
2
10
6
3
22
132
29
6
14
53
26
3
1
60
33
'1
21
5
29
27
1
1
115
583
148
416
19
195
809
29
20
14
5
33
6
Feb.
2
33
22
1,062
148
796
11
7
41
2
18
1
3
2
9
3
4
17
141
30
11
12
55
24
9
56
32
5
13
6
17
16
126
519
147
342
29
1
178
619
28
22
11
1
28
5
Mar.
3
29
13
1,253
161
947
26
10
41
6
19
3
2
12
4
4
18
166
35
9
13
68
24
17
75
37
5
27
6
43
40
124
647
136
468
40
3
201
710
29
20
22
11
37
10
AprU
38
28
1,186
152
874
18
4
46
3
1
18
5
8
22
132
36
0
11
56
18
55
28
8
13
6
42
41
96
590
168
397
24
1
156
750
20
19
23
10
39
12
May
2
32
36
1.090
116
834
23
13
21
7
14
1
1
2
17
9
15
16
1
131
32
11
16
43
22
53
29
3
16
5
14
10
1
3
114
612
274
302
36
165
795
27
22
27
8
35
13
June
1
51
20
1,012
113
766
17
9
28
4
19
2
1
16
9
6
22
142
28
18
6
49
28
13
55
35
3
6
11
19
17
1
i
107
538
135
362
40
1
149
887
18
30
28
7
42
9
July
10
25
43
1.019
121
740
22
5
42
1
22
1
1
18
11
0
29
116
22
18
10
24
26
16
57
82
6
10
no
21
21
98
576
153
370
46
7
148
1.253
31
21
29
11
40
7
* Not separately classified
Division of Vital Statistics
123
in ihe State During 1910 — (Continued)
Aug.
Sept.
Oct.
Nov.
Dec.
Total
*
V Diaruea of digestive system — [Con.)
|M r>Mr>*flnn nf thfi imleen ,
1
35
19
1,056
100
830
16
3
36
6
18
1
30
27
1,176
155
•901
22
3
30
2
20
2
2
21
127. Simple peritonitis (nonpuerperal) . .
128. Other dueases of diaestive system
(csneer and tuberculosis excepted)
139. VI. Diseases of ^ni to-urinary system. .
130. Amte nenhnti* t
38
101
947
112
718
15
6
31
3
17
1
23
70
914
89
696
16
8
34
2
24
39
47
929
100
718
17
2
23
2
23
403
445
12.811
1.506
\%\. Bricht's disease
9.711
132. Other diseases of kidnesrs and adnexa
131. CslcuU of urinary rinnnsfl.r
226
73
IS4. Dimases of bladder
413
lis. Other diseases of urethra, urinary
sbsoess, etc r
39
110. Disease of orostate
250
117. Nonvenereal diseases of the male
14
138. Metritis
1
3
12
6
9
13
1
93
14
10
10
26
27
6
1
1
14
11
4
13
17
IK T^terine hemorrhage (nonDuemeral) .
2
13
10
5
14
11
110. Uterine tumor (noncancerous)
^^1 . Other diseases of uterus
12
7
8
20
20
3
6
10
171
84
142. Cysu and other tumors of the ovary
141 Salpingitis and other diseases of fe-
male genital organs
78
216
144 Nonpuerperal dis^wes of the breast
2
145. 111. Childbirth
99
15
10
6
37
25
6
99
29
16
7
24
18
6
93
26
8
4
32
17
6
108
13
10
11
31
29
9
5
49
28
7
8
6
18
16
1
1
1,452
144. Accidents of Dreimancy
309
147. Puerperal hemorrhage
136
148. Other accidents of labor
120
Itf. PtMSperal septicemia
498
UO- Puerperal albuminuria and convul-
tions, ...
284
IM. Punpcral phlegmasia alba dolens,
embolus following childbuth (not
otherwise defined)
99
^^ Puerperal diseases of the breast ...
6
Ua. Tin. Diseases of the skin
46
22
7
12
6
22
21
1
43
20
5
11
7
19
18
41
20
5
6
10
9
8
1
64
32
3
24
5
19
16
3
654
1^ Gangrene
348
lis. FWuncle
57
'^ Acute abscews
167
^' Other disrasffl of the nkin
- 82
j% IX Diseases of locomotor system
Ul. Diseases of bones (tuberculosis ex-
cepted)
272
251
^ Diseases of joints (tuberculosis and
liieumatism excepted)
13
•*!• Antmitation ...
1
*^ OtMr diseases of organs of locomotion
92
622
150
420
51
1
147
917
21
17
20
6
33
5
1
122
626
162
422
39
3
142
812
33
25
12
8
30
11
7
1^ X Omgeaital malformations (still
births not included)
105
607
126
428
50
3
138
824
20
24
22
6
30
7
89
461
107
316
37
1
163
765
19
23
17
9
29
8
131
556
145
356
53
2
169
705
15
24
13
35
11
4
1,319
^ XI. Dieeases of early infancy
6.937
'**• P^mature birln
1.851
W Congenital debility, icterus and
4,599
J2 Other diseases of eariy infancy
iw. Ladt of care
464
23
*. XII. Old age— senility
1,951
l^ Xm. Violence
9.846
171. Suicide by poison
290
*!?• Suicide by asphyxia
267
\t*' ftiieide by hanging or strangulation.
\i!t' duieide by drowning
238
117
!l*- 8aieide by firearms
387
i««. Suicide by cutting instruments
97
^^. tMyeosis.
124
State Department of Health
Detailed Statement aa to Cavses of Deaths Occurring
Jan.
Feb.
Mar.
April
May
*
June
July
177.
178
XIII. Violence — (C<m<»ntt«<0
Suicide by jumping from high places. .
8ui<?ide by mwninff
3
3
3
4
1
5
2
1
3
9
16
49
34
38
103
•
11
2
1
5
10
6
38
18
65
129
3
30
13
1
179
Other suicides .
2
3
1
16
10
52
50
48
13
3
180
Poisonimi bv food
4
13
5
53
31
61
40
1
8
16
6
58
42
62
65
3
181
Other acute Doisoninirs
23
5
90
65
55
14
2
13
182
ConflaffTfitioD
6
183.
184.
185
Bums (conflagration excepted)
Inhalation of poisonous gases
Fractures
57
13
60
186
Accidental drownimr
272
187
Dislocations
3
188.
Heat and sunstroke
136
189
Cold and freesing
19
13
4
1
190
Lishtnins
I
9
1
13
5
191.
192
Electricity (lif^htning excepted)
Starvation, privation, etc
6
1
5
11
3
76
35
177
6
54
35
6
1
8
66
1
2
6
3
2
60
8
134
21
46
22
4
5
70
3
3
2
3
18
2
91
26
121
6
46
15
3
13
17
1
8
14
2
193
Accidental gunshot wounds
6
9
1
86
39
117
7
43
18
8
4
18
74
3
2
11
5
16
16
194.
Injuries by machinery
16
195
Injuries in mines and quarries
Railroad accidents and injuries
Injuries by horses and vehicles
Other accidential traumatisms
Suffocation
196.
197.
198.
199
147
23
99
6
41
16
4
14
30
82
3
3
9
2
106
47
141
5
46
16
5
13
19
87
3
2
1
157
54
158
4
200
Injuries at birth
37
201
Homicide by firearms
24
202.
Homicide by cutting and piercing
instruments
5
203
Homicide by other means
13
204.
Other external violence .*
33
205
XIV. Ill-defined diseases
167
206
Dropsy
2
207.
Sudden death
10
208.
Heart failure
5
8
6
2
12
4
7
6
1
50
12
209.
InapiMon
2
210.
Debility (over 3 months)
211,
Marasmus
41
11
67
1
i
58
80
97
212.
Fever
1
213.
Other ill-defined diseases
9
2
47
1
4
3
6
1
i
39
214.
Unknown
4
«
• Not separately
Division of Vital Statistics
125
in the State During 1910 — (Continued)
XIII. Violence — {Contin%itd)
177. Suicide by jumping from high places
178. Suicide by cnuoing
179. Other auicides
180. Poisoning by food
181. Other acute poisoningB
1S2. Conflagration
183. . Bums (conflagration excepted) . . .
184. Inhalation of posionous gaaes
185. Fractures
184. Accidental drowning
1H7. Dislocationa
188. Heat and sunstroke
VA. Cold and freeiing
190 Li^tning
191. Electricity (U|Jitning excepted) . . .
192. Starvation, privation, etc
193. Accidental gunshot wounds
194. Injuries by machinery
195. Injuries in mines and quarries
196. Railroad accidents and injuries. . . .
197. Injuries b^ horses and vehicles ....
19S. Other accidental traumatisnls
199. SufFooation
200. Injuries at birth
201. Homicide by firearms
20*2. Homicide by cutting and piercing
instruments
203. Homicide by other means
204. Other external violence
Aug.
205. XIV. Ill-defined diseases
206. Dropsy*
207. Sadden death
208. Heart failure
209. Inanition
210. Debility (o\'er 3 months)
211. Marasmus
212. Fever
213. Other ill-defined diseases.
214. Unknown
2
15
13
2
39
18
76
142
17
7
14
6
0
4
167
34
131
6
60
23
7
12
17
182
1
2
12
Sept.
155
2
4
6
• 7
1
4
7
10
4
22
22
61
97
2
0
7
11
4
173
36
106
1
43
17
6
13
21
159
3
II
6
127
U
1
Oct.
8
17
12
73
32
67
84
3
7
1
15
11
4
133
29
98
4
42
16
7
8
39
131
3
Nov.
100
2
9
2
2
3
16
14
65
50
71
31
7
13
5
146
15
110
5
30
26
8
12
15
Dec.
8
3
49
"6
2
3
16
13
69
50
52
27
9
4
12
i26
6
107
9
40
16
4
6
30
54
1
1
9
2
31
io
Total
61
7
15
60
172
99
666
425
716
1,017
16
192
47
16
90
6
81
140
25
1,470
352
1.499
80
527
244
63
113
252
1.231
30
16
102
42
1
866
6
144
. 24
elsssified tiU July.
State Depahtment op Health
Total Mortality for the Vrar
SANITARY DfSTRfCTS
MARITIME DISTRICT:
CilyofNrwlok:
Bat noH □ MnauiTi
BoR noH <
Totel
ToUlitiirllMiliitrHt. ..
H0D80N VALLEY DiaTRICT:
AlbmyfAlUiiyCo,)
Cobw (Albmy Co.) -. -.
Onm Uud, vUli«« (Albuqr Co.)
W«toT»lirt (AJUny Co.)
FUikiU. lowD (Duicboi Co.)
FifiiVili f^p4j*r TiUifv fDulehflii C<
MiitU*wu,Tilb«« (DuUluB Co.) . .
CaUdil, villiga lOrtsnt Co.)
Cowsku. Man (Onne Co.)
RgrtatmiDlr
G«ha. Uon (Oiufc Co.) . .
MiddltUum (Orufi Co.) .
17.S88
II, UT
S.710
i.SM
2.810
j!io7
Divisios OF Vital Statistics 137
1910 in the Sanilart/ Districts — (Continued)
State Depabtmest of Health
Total Mortality for the Year 1910 In
I)lVISU»N 0\ VlJ'AL S'JAriSlKs
120
//le Sanitary DiMricls — (Continueil)
SANITARY DISTRICT?
MARITIME DISTRICT:
Citjr of New York:
BoiuMJOB or Manbattam
BoKOUQB ow TBI Bronx.
BoM»iTeH or BaooiaTN . .
BoROfTOB or OcnN*
BosoroH or Ricbmi.nd. .
Toteb
Frwport. rUli^e (Nmbm Co.)
HempstciMl, town (Nunu Co.).. . .
North Hflmpiteftd, town (Nmmu Co.)
Offtm Bay. town (Nmmu Co.).. . .
Roekrille Center. Tilkn (Nunu Co.)
AmHyrille, Tillage (Suffolk Co.)
Babrloa, rillaxe (Suffolk Co.)
BrookhaTOL. town (Suffolk CTo.)
Greeoron. riOace (Suffolk Co.)
Rontincloo. town (Suffolk Co.)
PklchoKUtt. Tillaee (Suffolk Co.)
Sac Harbor. rUlaoe (Suffolk Co.) ... .
HoothoM. town (Suffolk Co.)
Reat of county
Dobfaa Fmy. riUage (West. Co.). . . .
Oreeobur^ town (Weitehester Co ) .
Haatmca-OQ-Hudaon, Til. (West. Co.).
Irrioffton. riOafe (Wfetctwster C^.). .
Mamnronedc. town (Weatehester Co.)
Mount VaiaoD (Wertebester Co.). . . .
New RoehtUe (Weatckeeter Co.)
North Tanrtown. Tillafte CWeat Co ).
Oaiininc, Tillage (Westchester Co.).. .
PUkrtim. TtUage (Westrhesfr Co.) .
Port Cheater, villace (^est. Co.). . . .
Rye. town (Westchctter Co.)
Tarrytown. Tillace (Weetcbeiter Co.)
White Plaim, Tifla^ (Weat Co.). .
Yooken. (Weatehester Co.)
Rest of oounty
ToUh for the District.
HUDSON VALLEY DISTRICT:
Albany (Albany Co.)
Cohoea (Albany Co.)
Qretn Uuand. village (Albaoy Co.). .
Wfttenrliet (Albany Co.)
Rest of county «,
Hwbon (Cohunbia Co.)
Restof eounty
Fahkin, town (Duteheas Ck>.)
FahkJl iMod'um, Tillan (Dutch. Co.)
Matteawan. riUbge (Dutchess Co.)..
Pbughkeepair (Dutchess Co.)
Wappivtert Falla. Tilk«e (Dutch. Co.
Htri of oounty
Catakill rihace (Greeoe Co.)
CovsacLie, town (Greene Ca)
Rest of oounty
Gosbco, town (Orange Co.)
Middletown. (Orange Co.)
Montgomery, town (Orange Co.) . . .
Newburgh (Orange Co.)
Port Jenris (Oranxe Co.)
H
4
5
6
69
7
3
2
• • •
33I
6,
18
21
U
ri
28'
65'
62
1
13
3
1
1
1
2
7
8
1
4
7
7
4
1
6
41
11
4291,578
139
23
3
17
38
21
57
1
6!
9
39
3
43
7
4!
30;
3,
23,
3
48
7
3
5
1
2
5
4
1
1
4
16
7
839
72!
8'
2
7'
8
2
11
11
"7
10,
2,
17|
1
2,.
'•
CO
"S
e
o
U
5
a
:2
<
2.148 2,147
175 272
902 1.091
223 242
69 81
1.517 3.833
2
15
6
0
37
38
21
2
7
7
3;
2
8
5
1
6
I
12'
3
13
2
9
2
3
8
33,
I2I
4;
3
t
19
26
3
6
13
10
5
11
34
46
5%
1.614 1.271
15
4;
2.
i'
2i
1
1
70
10
3
2
9
1
12
2'
2
2
6
10
1
10
4!
7
1
4
5
5
79
14
4
11
33
21
46
7
5
9
31
1
43
5
4
15
5
24
4
27
16
0
QQ
1
11
2
6
S
o
180
10
76
16
2
284
761
156
296
125
68
1.416
1
8
5
7
• 1
2
1
8
1
1
1
• 2
10
2
1
2
I
750
14S
604
4-
33
1'
2
1
1
1
1
5
818
30S
14
3
'
1
9
1
2
4
4
3
4
2
1
1
3
6
• 1
1
6
3
3
2
1
3
1
2
10
2
3
12
18
30S' 1.513 1.9r)0
1.58.T
1
35
15
12
2
2
4
6
7
18
1
3
1
34
5
2
2
3
23
23
5
14
11
7
1
3
18
76
33
38
7
2
5
12
3
21
i
2
6
1
10
6
1
3
6
3
1
3
6
43
24
16
15
II
23
3
4
5
2S
3
36
4
6
17
3
5
4
22
0
Births
o
66.358
10.905
42.708
7.119
1.991
CO
3.526
549
2.206
XiA
OV3
93
i29.O8r5.722
76, 6
717, 31
473 «
378' 15
61 2
39; 2
60 0
174; 1
97, 2
234 16
64 1
49i 3
103; 0
80
63
97
36
145
706
75 i
14^
171
33)
440
61
90
351
2.064
2
5
6
2
6
28
35
6
6
13
26
4
8
26
100
1.369.
43rt.
75
210
76
26
4
8
254 10
84
94
105
570
46
2
2
3
25
0
91
95
3
4
6^
266!
53 1
536
166.
5
9
3
20
7
130
Statk Dkpartmk.nt ok Hkai.th
Total MoHality for (he Year 11)10 ///
SANITARY DISTRICTS
HUDSON VALLEY DISTRICT-iCcm/rf)
Waklen. village (Onnge Co.)
Warwick, town (Orange Co.) |
Rot of county i
Cold Spring. viTage (Putnam Co.)
Rest of county • ;, :
Hoosick Falb. village (Rcnwdaw Co.)
Rennelaer (Renaselaer Co.)
Troy (Renaelaer Co.)
Rert of county
Haventraw. town (Rockland Co.)
N/ack. village (Rockland Co.)
Ramapo, town (Rockland Co.)
Spring Valley, village (Rockland Co.)
Suffcrn, village (Rockland Co.)
Rest of county
Ellenville,villaKe (Ulster Co.)
E^pua. town (Ubter Co.)
Kingston agister Co.)
Marbletown. town (Ulster Co.)
Roaendale, town (Ulster Co.)
Saugertiea. village (Ulster Co.)
Rest of county
Totals for the District.
ADIRONDACK AND NORTHERN DIS-
TRICT:
Plattsburg* (Clinton Co.)
Rest of county
Essex county
Mak>ne. village (Franklin Co.)
Haranac Lake, village (Franklin Co.)
Tupper Lake, village (Franklin C^).)
Rest of county
Hamilton county
Carthage, village (Jefferson Co.)
Clayton, town (Jefferson Co.)
EUbburg, town (Jefferson Co.)
Watcrtown (Jefferson Co.)
Rest dr county
liowville, town (Lewis Co.)
Rest of county
Canton, town (St. Lawrence Co.)
Gouvemeur. town (St. Lawrence Co.) —
Maasena. village (St. Lawrence Co.)
Ogdensburg (St. Lawrence Co.)
PotKlam, village (St. Lawrence Co.)
Rest <rf county
GkiiM Falb (Warren Co.)
Rest of county
Fort Edward, town (Washington Co.)
Granville, town (Washington Co.)
Greenwich, town (Washington Co.)
Sandy Hill, village (Washington Co.)
WhitehaU. vUlage (Washington Co.)
Rest of county -
Totals for the District
MOHAWK VALLEY DISTRICT:
JohiMtown (Fulton Co.)
Oloversville (Fulton Co.)
Rest of county
4.015
7.161
44,048
2.557
12.132
5.544
10.712
76.83A
29.203
9.288
4.626
6.588
2.344
2.663
21.448
3.124
4.731
25.929
4.787
3.678
3,933
45.807
727.719
11.182
37.03P
33.501!
6.4671
5.032.
3.079'
31.090|
4.350
3.569
4.026
3,631
26.792
42.374
3.872
20.905
6.123
5.998
2.968
15.981
4.031
53.802
15,268
16.973
5.759
6,433
4.224
5.184
4,949
21.253
406,855
I
S
o
49
121
727
50
217
87
158
1.597
441
97
97
122
21
47
284
47
58
475
57
56
63
703
12,703
195
481
543
108
150
50
514
56
57
59
73
468
695
08
306
104
95
50
268
78
756
241
215
100
87
89
74
96
350
6,426
10,476
20.730,
13.430|
143
321
209
t
a
9
I
I
8
23
140
9
22
12
32
224
43
18
16
23
4
7
58
5
5
71
7
2
9
87
1.867
53
93
88
22
13
21
102
9
12
4
11
87
86
7
36
9
21
11
55
8
107
32
16
13
18
10
10
21
36
l.OU
20
60
28
I
i
0
14
53
3
7
5
5
103
17
5
3
8
1
16
3
5
25
3
2
7
35
705
14
48
34
6
8
7
56
4
5
0
2
27
34
2
11
2
4
7
15
9
42
8
2
3
5
4
1
1
10
371
4
14
4
AOBS
§ §
a
i
2
8
35
2
12
8
10
82
17
7
4
5
2
3
14
2
1
26'
6
6
2'
41i
30
39 1
a:
3'
38
4
?
1
?
26
33
2,
14.
4
7
2'
12
2
46
12
9
5
6
3
4
7
10
348
3
5
P
95
6
20
14
22
2621
47l
17
19i
13
3'
10)
41
6|
lOl
66!
Ill
io'
7
98
6771 1.774
261
84)
201
67
10
75
16:
9
7
7
85
52
10
36
10
14
4
S'i
'•3
5-
i
131
23,
19;
30 !
374 «
72|
21 (
18
2.'»i
5
J'
5
12,
93 >
.11
1341
21
44
289
20
98
29
59
550
244
27
87
50
5
19
102
26
25
194
22
29
24
314
2.551' 6.087
28
52
89
i
69'
8(
.1,
12'
80
104
8.
42
17
16
7
4
12
8
33
54
9
6
83
97
35
48
24
44
16
22
2
11
4
18
10
14
14
15
36
46
849
989
12
32
31
71
21
33
60
207
208
40
14
4
174
15
22
33
39
163
385
39
166
62
33
18
98
43
375
106
120
40
45
50
35
38
210
2.842
71
132
115
Division ov Vitat, Statisths
ini
the Sanitary Disfricls — (Coiitiimed)
SANITARY DISTRICTS
HUDSON VALLEY DlffT .—iContd)
WaMea. villBiie (Onnge Co.)
Wanrksk, town (Onoge Co.)
Rest of eoanty
Cold Saiiag, vUlace (Putnam Co.) . .
Reai ot county
Hoooiek FaUb. villMce (Rcuselaer Co.)
RcoflKber (Rconeber Co.)
Troy (Rcn«eber Co.)
Rot of county
HaTcntnw, town (Rockland Co.) . . .
Nyaek. TUlage (Rockland Co.) ....
Ramapo. town (Rockland Co.) ....
Spring Vallv. villace (Rockland Co.)
Saffcrn« TiOaKe (Rockland Co.)
Rest of county
EOenTiOe, ▼Ulan agister Co.)
Enpua, town (Ulster Co.)
KittotcMi (Ulster Co.)
Marbletown. town (Vbter Co.)
Roseodale. town agister Co.)
SauieertieB. village (Ulster Co.)
Rest of county
Totals for the District
Epidemic DukAvSrs
ADIRONDACK AND NORTHERN
DISTRICT
Flattrtnirg. (Clinton Co.)
Rett of eounty
FmrT county
Makme. Tillage (Franklin Co.)
Saranae Lake, village (Franklin Co.)
Tupper Lake, vUlage rFranklin Co.).
Rest of county
Hamilton county
Carthage, village (Jeffefvon Co.)
ClaytMi. town (Jeffenon Co.)
EOi^iirg. town fJeffeiaon Co.)
Watcrtown (Jefferson Co.)
Rest of county
LowviOe, town (Lewis Co.)
Rest of MMinty
Canton, town (St. I^wrence Co.)...
Gouvcmeur. town (St. Lawrence Co.)
Masseoa, village (St. Lawrence Co.)..
Ogdensburg (St. Lawrence Co.)
Potsdam, village (St. Lawrence Co.)..
Rest of ooun^
Glois FaUs (Warren Co.)
Rest of county
Fort Edward, town (Washington Co.^
Granville, town (Washington Co.) . .
Gremwich. town (Washington Co.) .
Sandy Hill, vilbiae (Washington Co.)
Whitehall, viUage (Washington Co.).
Rest of eounty
Totab for the Dktriet
MOHAWK VALLEY DISTRICT:
Johnstown (Fulton Co.)
GbvenviOe (Fulton Co.)
Rest of eounty
S'I'ATf: DkI'AIiTMKNT ^•V HeAI.T
Total MvriaUlii for (he Ymr 1910 i
SANITARY DISTMCTS
ill
Wuwicic, IDWB (Orute Co.) !.'.'.!!. .
Cold Sprint, riitet (Piilaim Co.). . .
"■tofoOUDQ
Hoovck F*U>, •^]^^n (Rm
RnwlMt (RmMbcr Co.
F*U>,ii1ku«(RaiLCo.)...
Htimnw, loan (RocUuid Co.).
Nyuk. Tilligi (Roeklud Co.) . . . .
Rtmspa. tom {RocUud C«.) . . . .
S[*iD| Villcr. TUlikti (RodLbul Co
- n{R«llii>dCo.)....
nlL;(Ukla
KinntoD, (UlttaCo.) ,.
MirUetovn, ton (irbts Co.) . . .
R«Dd>b.lo<ni(l1MaCo.}
Swcrtis. villigt (Uklir Co.). . .
Rul ol comity
Plittabiiig (Cliotoo Co,)..
MalDiK.TilUcc(FrukliiiCci.l,... .
Stnuc UIu, Tilbfe (Fnnklio Co.) .
'I\ippa' Lake, TilUge (FnnkliD Co.).
FoUdim, vilitgn (St. Un
Ijwidy Hill, vilUic <W>duii(iuD To.]
Whitahill, Tilkge (Wubintloii Co.).
RMt dI county
TDl«l>lottli«D«i™i..
MOHAWK VALLEY DISTRICT:
JriuMon (Fulton Co.)
alOTonlla {PnhoB Co.)
Rotoloauiit;
Ill ISI «
Division of Vitai, Statistics
133
tlie State During 1910 — (Continued)
BlRTHB
SANITARY DISTRICTS
HUDSON VALLEY DI8T.— (Confrf)
WaUcD. Tilhge (Onnge Co.)
WanricK, town (Onnge Co.)
Rest of county
CoM Sbrinft. ▼iDage (Patoun Co.). . .
Regtofooonty
Hooaidc Falb, villaM (ReuKber Co.)
Reoaebcr (RcDadtetf Co.)
Troj (RcDMber Co.)
Rett of county
HaTcntnw. town (Rockkiid Co.). . .
Nyaek, Tilhce (Rockland Co.)
Ramapo, town
Spring Valkgr. vUIage (Rockland Co.)
Suffcrn, Tfllago (Rockland Co.)
Rest of county. .
EDoiTUie, TiUaKe (Ubtcr Co.)
bopoa, town (Ubtcr Co.). . . .
Kinoton (Ubtcr Co.)
Bla^btown, town (Ubtcr Co.)
Roandale, town (Ulster Ck>.)
SaogerticB, village (Ubter Co.)
Rot of county
Totab for the Dirtriot
ADIRONDACK AND NORTHERN
DISTRICT:
Flattaburg (Clinton Co.)
Rot of county
Ebbx county
Malone. Tiflage (Franklin Co.)
Sannae Lake, Tflbgo (Franklin Co.)
Tuiiper Lake, TiOage (Franklin Co.).
Rcit of county
Hamilton county
Certhage, Tillage fJeffemn Co.)
Cbyton, town (Jeffcraon Co.)
El^uzg, town (Jeffcraon Co.)
Watertown (Jeffenon Co.)
Rest of county
Lowrille, town (Lewb Co.)
Rest cf county
CanUm, town (St Lawrence Co.) —
CkMtTcraenr. town (Si. Lawrence Co.)
MiBBTOB, village (St. Lawrence Co.)..
OgdeDebun; (St. Lawrence Co.)
Potfldam, TiQage (St. Lawrence Co.) .
Rot of county
GloiB Falb (Warren Co.)
Rcat of county
Fact Edward, town (Waahington Co.).
QranvilleL town (Waahington (To.) . . .
Gfeeawiai, town (Waahington Co.) . .
Sandy Hill. Tillage (Waafamgton Co.).
Whitehall. TiUage (Waahington Co.).
Reatofeouaty
Totab for the Diatrict
■M
70
3
136
7
64
■■■"2
m
"h
167
3
956
61
■ • > ■ •
MOHAWK VALLEY DISTRU^
JohiHtown (Fulton Co.)
r.bverevilte (Fulton Co.)
R«t of county
lU
State Dkpaktmknt of IIkalth
7^otal Morfalitj/ for the Year 1010 in
SANITARY DISTHICTS
MOHAWK VALLEY DISTRICT— (Con/rf)
Frankfort, villafte (Herkimer Co.). . .
Herkimer, villase fHerkimcr ('o.>
I lion, viU««c rHerkimer Vo.) . .
Little Falls (Herkimer Co.;
Reit of countv
AmRterdam (Mont^tomerv Co.)
Fort Plainfl, village (Montgomery Co.) . .
Rest of county
Boonville. town (Oneida Co.)
Camden, town (Oneida Co.)
Rome (Oneida Co.)
rtica fOneida Co.)
Whitefltown. town (Oneida Co.)
Rest of county
Ballaton Spa, villaRe (SaratoRa Co.)
Mechanicville, villaire (Saratoga Co.)
Saratoga Springs, village (Saratoga Co.) .
Waterford, town (Saratoga Co.)
Rest of county
Schenectady (Schenectady Co.)
Rest of county
Coblcakill, town (Schoharie Co.)
Rest of county
ToUls for the District ....
SOUTHERN TIER DISTRICT:
Welisville, village (Allegany Co.). . .
Rest of county
Binghamton (Broome Co.)
I^estenhire, village (Broome Co.) . .
Rest of county
Olean (Cattaraugus Co.) . .
Salamanca, village (Cattaraugus Co.)
Rest of county
Dunkirk (Chautauqua Co.)
Frcdonia, village (Chautauqua Vq.) .
Jamestown ((Miautauqua Co.)
Westfield, village (Chautauqua Co.).
Rest of county
Elmira (Chemung Co.) .
Horscheads, town (Chemung Co.). .
Rest of county
Bath, village 'Steuben Co. ». . .
Coming (Steuben Co.)
Hornell (Steuben Co.)
Rest of county
Candor, town (Tioga Co.)
Owego, village (Tioga Co.)
Waverly, villuge (Tioga Co.) .
Rest of county
Totals for the District . . .
EAST CENTRAL DISTRICT:
Norwich, village (Chenango Co.)
Rest of county
Cortland ((\)rtland Co.) .
Homer, village ((^ortland Co.) .
Rest of county
Sidney, town (Delaware Co.>
Walton, town ( Delaware Co.)
3
S
**©
cca
. "^
e
1
.2
It
1
i
3
o
O
H
' il
9
3,321
7.559
6.616
12.326
26,650
31.586
2.769
23,547
3.193
3.413
20,632
74.879
7.8.3S
44,786
4.138
6.666
12.680
6.134
32,282
73.450
15,516
3.574
20.223
488.414
56
If
121
22
90
12
194
29
406
45
540
160
61
10
390
44
57
7
52
4
411
71
1.297
314
107
28
638
69
74
15
117
24
255
35
109
23
526
57
1.070
289
179
31
57
4
338
32
7,818
1,452
4.383
36.958
48.671
3,764
26.608
14,814
5.806
45.299
17.308
5.290
31.523
2,991
48.380
37.238
5.398
12.115
3.891
13,742
13.637
52.112
2.9f)2
4,617
4,853
13,204
65
10
657
52
765
13^
63
6
503
461
188
28
85
18
628
67
279
76
79
15
4C4
66
64
9
718
89
554
74
76
3
236
36
67
6
200
30
174
20
780
76
43
1
54
4
83
7
224
19
2
16'
37;
41
19'
Hi
lOj
36
37
4
21
4
22
20
2
10
1
8
7
21
0
0
3
8
7.434
28.089
11.517;
2,701
15.026,
4.142
5.094;
122
»",
476
38
219
36
49
2i
26(1
21
72
41
88
s.
10
19
11
1
12
1
3
AOES
1
s
s
s
>k
«>*
• ** 1
oa
«
iO 1
3
5
5
o
^H
lO
•*
2
1
i
J
1
8
t
t •
Q
O
Q
5
3
4
1
12*
m
1
12
16
27,
1
5
16
11
11
18
23
41
18
12
47
87
61
30
71
95-
V
1
11
10
V2
14
46
77
2
4
5
8
?
2
8
7
21
14
49
79
102
64
166
221
12
1
18
12
21
25
65
94
1
1 3
6
16
15
5
14
28
16
9
42
59
12
4
15
17
18
22
61
74
111
52
177
1981
12
9
31
30
2
4
7
12
16
1
12
27
47i
500> 350i 989
2
20
41
4
16
19
3
32
28
2
23
3
271
30|
i'
2!
12
14
30'
2;
0>
8'
6
455.504' 6. 889 896 1 3031 331
4
12
5
1
9
3
5
4
55
128
14
49
32
9
51
38
8
71
5
57
78
8
31
m
I
34
21
59
3
3
11
13
789
19
25
20
5
11
10
11
«o >
t
13
36
45
71
217
122
29
192
SI
29
177
42«
36
364
33
31
94
38
292
243
65
28
201
1.378 3.131
11
75
158
»l
90!
41i
20,
88*
39 1
9
80
12
103
114
13
41
9
41
40
122
8
16
10
41
1,190
28
78
39
9
37
17
17
36
336
263
26
282
57
25
353
61
41
143
31
419
236
49
HO
42
75
72
466
29
31
44
136
3,363
51
304
108
31
169
37
44
Diviftiox OF Vital Statistics
ir;
ihr Sfafp Duruu/ 11)10— ((^ontimiea)
•
E
PIDBMIC DUBA8B8
.s
SANITARY DIbTRKrrS
1
1
s.
1
a
OQ
1
Scarlet fever
Whooping cough
Diphtheria and
eroup
0
9
S3
a
I
Cerebrospinal
^ Meniotitis
1 Pulmonary tuberculuii
MOHAWK VAIJ.KY DI8T.-(C«iUrf)
Frankfort, village (Herkimer Co.) . . .
Herkimer, village (Herkimer Co.)
Tlkfn riHiure (Herkimer Co.) . .
1
1
1
2
1 1
3 2
1
1
1
3
5
4
Utile Falls (Herkimer Co.)
••• J,
12
"3
10
14
6
i
2
3
1
15
3
3
Hi. .
2i 1
1...
61 5
1.. .
1' ..
7i 1
18. 2
3 .
6 2
3 ...
1. 1
5i .
1
161 2
4 2
2 .
10
Reat of oountv
3
8
34
Am«ierdam (Montgomery Co.) .
Fort Plain. Tillage (Montgomery Co.)
7
2
1
4
] 32
3
Reat of eountv
BoonviLe. town (Oneida Co.)
2
'"4
5
2
5
2
2
2
2
5
5
1
1
1 3
....
25
3
Camden, town (Oneida Co.)
Rome(0nei'1aCo.)
rtiea (Oneida Co.)
Whitestown. town (Oneida Co.). .
Reat of county
Balbton Spa. vUlage (Saratoga Co.). .
Meehanicville. village (Saratoga Co.).
Saratoga Spring, "nl (Saratoga Co.)
Watcrford. town (Saratoga Co.)
Reat of eountv
Schenectady (Schenectady Co.)
Reat of county
Coblnkill. town (Schoharie Co.) . .
1
....
....
......
1
..."
. . .
4
. ...
1
11
3
2
::.: 't
1 3
2
2 1
4 ...
8 1
3 10
1
1 1
1 5
5
1
3
1
3
1
8
26
04
9
52
5
6
22
13
28
72
11
4
Reat of county
1
53
2
....
6
2
10|....
18
1
1
i
18
Totab for the District
■- ■
56
30 60
80
114
17
J>27
SOUTHERN TIER DISTRICT:
WeHarUle. village (.Mlegany Co.) .
R<«t of eountv
Binghamton (Broome Co.)
Ijeaterahire. village (Braome Co.) . .
Rert of oountv
6
5
4
<
3 5
1 ...
7 1
2 ".'.'.'.
3 1
25 .
1
4 1
I'
3 6
1 5
■.' 1
....
11
.... ^
5
1
3
9
5
3
5
8
1
\7
t
10
2
4
2
15
^4
31
Olemn (Cattaraugus Co.)
..
2
6
4
2
1
3
2
1
7
Salamanca, village (Cattaraugus Co.)
•■ "i'..
2
16
3
Rest of county
6
4
1
9
I
10
1
2
4
2
1
3
.TO
Dunkirk (Chautauqua Co.)
Frerionia, village (Chautauqua Co.) .
Jamestown (Chautauqua C« ) . . .
Weatfield, village (Chautauqua Co.).
Rort of county
2.....
2 . .
4 ....
28 6
11
7
23
2
23
Elnura (Chemung Co.)
n .1 19
Horaeheads, town (Chemung Co.). .
Rest of eoonty
'""4
1
8
5
1 . ! 10
9. li 1 25
Bath, village (Steuhen Co.)
Coramg (Steuben Co.)
Homdl (Steuben Co.)
6
3
1
1
4
1
i ..
5
16!. .
.. ' 7
1 5
Reat of eoonty
4. ...
5
1
2 27
Caodor. town (Tioga Co.)
J .
Oweao. village (Tioga Co.)
y-
. . * • ■
41";'
5;...
... . 4
WavCTly. village (Tioga Co.)
...! 5
Reat of county
21 ...
1
7
1
Totals for the Dtttrict
74
3
1
31
60 26
55
139
16
1
16
331
EAST CENTRAL DISTRICT:
Norwich, village (Chenan^ Co.) . .
Rest of county
Cortknd (Cortland Co.)
Homer, villav- (CortUmd Co.) .
3
9
1
3
1
1
2
' 1
3
1
2
1
i
4
20
2
2
5
1
2
2
1
1
6
19
3
1
Rest of county
Sidanr. town (Ddaware Co.) . . .
2
3
1
1
9
5
Walton, town (Delaware Co.)
1 ...
...
. • . .
i
•
5'... : ... 3
136
State Depaktment of Heai^tk
Total Mortality for the Year !010 in
SANITARY districts
MOHAWK VALLEY DIST—(Co»U<r I
Fnnkfort. villajre (Htrkmn Co.).. .
Herkimer, villftce ("Herkimer Co.) . . .
Ilion. vilUice (Herkimer Co.)
Little Falb (Herkimer Co.)
Rest of eoontv
Amirterdam fMonteomery Co.) . . .
Fort PUuw, village (.Montgomery Co.
Rest of county
Bconville, town fOneichi Co.).. . .
Camden, town (Oneida Co.)
Rome ' Onei'Ja Co.)
I'tica fOneida Co.)
WTiitestown, town (Oneida Co.)
Rest of county
BalUton Spa, villaie (Saratoga Co.).
Mechanicville. villace (Saratoica Co.)
Raratoffa Sf rings, vil. (Saratoca Co.)
Waterf< rd, town (Saratoga Co.)
Rest of county
Schenectady i Schenectady Co.)
Rest of county
CobleskiU. town (Schoharie Co.)
Rest of county
Totals for the District
SOrTHFRN TIER DISTRICT;
WellrvjUc, rUlage (AUegany Co.)
Rest of county
Binehamton (Broome Co.) . . . .
LestCTshire, village (Broome Co.)
Rest of county
Olean (CattarauRua O).)
ailamanca, village (Cattaraugus Co.)
Rest of county
Dunkirk (Chautauqua Co.)
Fredonia. village (Chautauqua Co.).
Jamestown ^Chautauqua Co.)
Westfield, village (Chautauqua Co.).
Rest of county
Elm ra (^Chemung Co.)
Horsehcarlfl, town (Chemung Co.)
Rest of county
Bath. viHwre (Steuben Co.)
Comine <Ste«jl)en Co.) ....
Homcll ( StoLben Co.)
Rest of county
Candor, town (Tioga Co.)
Owego. village (Tioea Co.).
Waverly, village i Tioga Co.)
Rest of county
ToUb for the District
EAST CENTRAL DISTRICT:
Norwich, village ((^hcnanso Co.)
Rp<!t of county
Cortland (Cortland Co.) ....
Homer, villajre ((\)rtlund C%».^
Ke«»t of county.
Sidney , town ( Dt-laware Co )
\Valt4,n. town Dihiwan- <\t >
Division' of N ital SrA'n.-«ri( s
.*'>:
the Sanitary Distrirt^ — (Continued)
SANITARY DISTRICTS
MOHAWK VALLEY DIST.— (C«iK'rf
nukfort. yilbksv rHerkimer Co.) . .
Heriomer. villMe (Herkiiner Co ) . . .
IKoQ. TiDiae (Harkimer Co.)
UtOe Falls (Hericimer Co.)
Rett of eounty
Amiterdain (Montgomery Co.)
Fort Pkia. Tiliace (MoDtgomery Co.)
RcRt of county
BooDTille. town (OnakU Co.)
C^ndeo, town (Onoda Co.)
Rome (Oneida Ca)
Ulka (Oneida Co.)
WUteeftown, town (Oneida Ck>.)
Rest of eoonty
BaBiton Spa. TilOfle (Saratov Co.).
Mechaoieyille, ▼iOiNBe (Santoc» Co.)
Saratoga Sprince, vil (Saratofia C^.)
Waterford. town (Saratoca 0>.) ...
Rest of ooonty
Sebeneetady (Schenectady Co.)
Rest of county
CobleskOl, town (Schoharie Co )
Rert of coonty
Totak for the DiBtrict
SOUTHERN TIER DISTRICT:
WdbWDe. TiUage (AUegany Co.) ... .
Rest of ooonty
Bini^iamtoo (Broome Co.)
Lestoshire, village (Broome Co.) —
Rest of county
Olean (Cattaraagus C^.)
^^"TTira. village (Cattaraugus Co.)
Rest of county
Dmikirk (Chautauqua (^.)
Fredonia, riUage ((jhautauqua Co.) .
Jamestown (C^fiuitauqua 0>.)
WertaeU, Tillage (ChauUuqua Co.)..
Rest of eounty
Elmira (Chemung Co.)
Homheada, town (Chemung Co.) . . .
Rest of eounty
Bath, Tilhce (Steuben Co.)
Coming (^keoben Co.)
Honeil (Steuben Co.)
Rest of county
CSmdor. town (Tioga Co.)
Ovego. ▼iUage (Tioga Co.)
Wanrjy.^lkge (Tioga O.)
Rert of county
Totals for the District
EAST CENTRAL DISTRICT:
Norwieh, Tillage (Chenango Co.) .
nert of county
Cortland (Cortland O.)
Homer, villaite (Cortland 0>.)
ReHof county^
Ridwy, town (Delaware Co.)
Wilton, town (Delaware Co.)
3
i
o.
s
s
f
1
11
7
13
44
34
5
2«
I
5
35
77
7
51
6
3
9
3
42
63
14
5
34
577
8
49
65
6
36
8
3
37
4
2
43
3
51
8fi
7
17
6
10
9
68
4
18
639
8
43
24
3
32
8
10
i
1
1
1
1
f:
11
3
5
1
c,
36
I
10
2
4
2
11
25
a
3
m
I
• »
1
10
12
4
16
6
1
14
7
1
9
4
13
17
1
9
2
p
10
15
3
2
5
8
178
II
u!
6
3|
13
2'
10
12
2
1
63
1
9
12
3
3
3
CO
hi
o
a
3
I
O
2
74
3
If
It
27
I
i
1
!»'
If
2
1
2
141
2
9
2
1
3
5
10
11'
1
5
5
3
3
a
S
<
1
II
8
15
19
31
4
36
2
3
19
61
3
34
4
14
10
7
29
C2
20
I
17
442
3
29
39
2
28
1?
13
24
26
n
20
2
42
36
3
14
1
16
14
.2
1
8
:a
5
2
4
1
6
11
1
7
2
7
11
3
6
83
2
7
13
2
6
5
3
5
2
5
8
I
1
12
1
9
13
392
14!
2
12
4
5i
1
14
85 10
1
"2
2
1
4
2
4
>■
1(
2?
3
27
1
15
1
I
5
10
20
16
3
1
12
197
(J
JB
5
7
5i
12
15
25
3
8
4
1!
131
781
6i
311
II
^
8
6
22
8O:
6
II
393'
2
28
17
2
16
4
3
19
2'
2
61
5 1
.30'
4'
3
7
3.
35 1
6
4
3 1
7'
41
25;
35
6
22,
11
7;
24
1 91
3
28
1
25
217
2
16
8
4
5
2
6
3
22
19
10
2
5
Births
i
J3
3
«j>
^
.!a
,^
M
1
^
H
ra
119
5
17?
5
115
1
335
10
095
14
38
0
5'2
1
46
1
571
16
1.902
79
152
11
8.11
1
2is|
5
2211
10
79.
0
1,8171 70
44
1
100
2
908
44
49
0
328
12
139
10
666
20
129
6
659
18
47
1
30
694
39
3
54
4
16
5
57
1
11
268
9
6
233
11
27
46
2
2
62
1
1
74
0
6
316
150
5
264
39
6
1
681
104 1
1
0
138
Statk Department of Healtii
Tofal Mortallti/ for the Year 1910
in
SANITARY DISTRICTS
EAST CENTRAL DISTRICT— (Cimhmiaif)
Rest of oountv
Canastota, village fMaiison Co.)
Caienovia. town CMaHlisoii Co.)
Hamilton, town (Madimn Co. )
Oneida (Madimn Co.)
Rest of oountv
Baldwinsville, vilUure ^Onondaga Co.)
DeWitt. town (Onondaga Co.)
East Sjrraruw, villase (Onondaga Co.) ...
Solvay, village (OnonHaa Co.)
Syracuse (Onondaga Co.)
Rest of eounty
Coopentown, village (Otsego Co.)
Oneonto (Otsego Co.)
Worcester, town (Otsego Co.)
Rest of county
Liberty, town f Sullivan Co.)
R«t of county •.
Totals for the District
WEST CENTRAL DISTRICT:
Auburn (Cayuga Co.)
Rest of county
Batavia. village (Genesee (^o.).
]je Roy, village (Genesee Co.)
Rest of oountv . « .
Daosvillc, village (Livingston Co.) .
Mt. Morris, village (Livingston Co.)
Rest of county
Cananiaigua. village (Ontario Co.). .
Geneva (Ontario Co.)
Manchester, town (Ontario Co.)
Phelps, town (Ontario Co.)
Rest of oountv . .
Hector, town (Schuyler Co.)
Rest of county
Seneca Falls, village (Seneca Co.)
Waterloo, village (Seneca Co.).
Rest of county
Ithaca (Tompkins Co.)
Rest of county
Perry, village (Wyoming Co.)
Warsaw, town (Wyoming Co.) . . .
Rest of oountv
Penn Yan, village (Yates Co.)
Rest of county
Totols for the District
I -•
LAKE ONTARIO AND WESTERN
DISTRICT:
Amherst, town (Erie Co.)
Buffalo (Erie Co.)
Depew. village (Erie Co.)
East Aurora, village rErie Co.)
lAckawaona (Erie Co.)
Lancaster, village (Erie Co.)
Tonawanda (Erie Co.)
West Seneca, town (Erie Co.)
Rest of countv
Brockport, village (Monroe Co.)
9
s
V
x: I
s
o
a.
I --
.3A.2%
3.247
3.003
3.83.')
8.316'
20.190
3.1041
4.181
3.283
5.17Q
138.087
47.407'
2.485
9,552
2.180
32,965
5.399
28.374!
431.778
34.760
32.378
11.673
3.787
22.230
3.939
2.789
31.340
7.212
12.45S
4.893
4.733
22.984
3.500
10.461
6.582
3.923
16.447
14,815
18.818
4.415
4.302
23.190
4.600
14.014
320.243
4.635
425.715
3.9.37
2.795
•14.549
4.385
o,,JUO
19.335
47.679
3.. 577
AOBS
1
>.
g
1
S
S
>k
Si"^
»>»
>»
i
1
3
•<•
s
3
S
1
1
i
i
J
J
1
1
n
Q
1
1
1
,566
.56
23
38
71
89
2«7
62
It
4
4
5
11
27
65
7
1
3
8
10
36
61
8
0
3
3
4
43
118
20
6
3
8
24
57
313
29
5
15
25
47
191
52
4
1
1
7
11
2«
4«
1
2
1
3
13
22
47
7
5
6
10
6
13
4 t
28
11
10
9
9
10
2.124
448
114
128
291
450
693
700
72
13
29
72
121
401
58
3
0
0
7
11
87
181
27
4
/
35
28
77
49
4
3
2
• 4
5
31
5.59
48
8
17
39
76
368
200
10
4
7
81
SO
47
471
51
23
42
83
76
194
7.046
959
284
355
862
1.266
3.306
522
101
22
22
73
97
207
477
45
11
22
48
81
270
206
32
6
9
33
39
87
47
5
3
2
7
11
19
337
35
5
9
28
63
197
74
8
5
0
8
13
40
58
12
14
2
9
9
12
409
47
17
25
45
49
225
157
20
3
6
19
25
84
175
18
6
12
19
35
83
116
12
2
2
9
20
70
54
5
0
2
4
4
99
279
32
5
9
19
33
181
.59
6
3
0
4
7
39
1,56
11
5
5
9
29
96
114
13
2
4
14
18
62
52
0
1
1
5
9
36
246
19
6
7
23
37
153
244
24
8
16
34
49
113
304
25
6
3
17
45
207
58
11
2
1
4
6
34
51
3
1
2
5
7
33
350
40
11
16
27
49
216
70
1
3
3
7
8
41
210
28
2
4
16
29
130
4.8;J4
,559
149
184
486
772
2.674
65
9
3
1
9
8
35
6.877
1.482
683
452
1.067
1,433
1,760
8,5
41
18
10
8
5
3
41
6
2
1
2
4
26
,197
243
69
8
43
13
19
67
15
9
5
8
15
15
106
20
1
4
17
20
44
63
12
4
5
6
12
24
845
141
50
46
99
122
386
50
6
0
1
5
5
33
* Excise censuf.
Divisiox OF Vital Statistics
MO
fhe Sanitary Districts — (Continued)
Epidemic Disk asks
S\NITARV DISTRIPTS
EAST CENTRAL DIST.— (ConTd)
Rot of eountv
CanMtoto. ▼illaxe (Madison Co.) —
CanooYta, town (Madison Co.)
Hamilton, town (Madison Co.)
Oneida (Madison Co.)
Rest of county
BaMwinsrille. villave (Onondaga Co.)
DeWiit, town (Onondaca Co.)
East Synpme, villatte (Onondaga Co.)
SolTay. vi11*i<e (Onondava Co.)
Svracase (OiM>ndaga Co.)
Rest of county
Coppentown, viUave (Otsego Co.) . . .
OneooU (OtMRo Co.)
Woreestar. town (Otsego Co.)
Rett ofnranty
libertv, town (Sullivan Co.)
Rest of county
Totals for the district
>
S
Xi
a.
13
1
2
1
38
12
I
M
8.
18
S
12
2
j:
bt
3
83
O
t
M
«S
.S
**
&
9i
r;
a
O
S
^
2
11
a
Q
22
5
1
104; 1
WEST CENTRAL DISTRICT:
Attbuni (Cayuga Co.)
Rest of county
Batavia Tillage (Genesee Co.)
Le Roy, rillace (Genesee Co.)
Rest of county
DansriUe. village (Liyintcston Co.) .
Mt. Morris, village (Livingston Co.) . i
Rert of county
CanaiMlai«ua. village (Ontarb (3o.) . . <
Geneva (Ontario Co.)
MandMstcr, town (Ontario Co.) —
Phelps, town Ontario Co.)
Rest of county
Hector, town (Schuyler Co.) ,
Rest of county — I
Seneca Falls, village (Seneca Co.). . . . 1
Waterloo, village (Seneca Co.)
Rest of county {
Ithaca (Tompkins Co.) j
Rert of county '
Perry, village (Wyoming Co.)
Wamw. town (Wyoming Co.) 1
Rest of county
Penn Yan. village (Yates Co.)
Rest of county
Totab for the district
3
lA
4
1
3
1
1
3!
2t
3
1
H
2.
32 1
1
3,
I
3
1
1
7
41
4
1
3|
1
1
UKE ONTARIO AND W^ESTERN
DISTRICT:
Amherst, town (Erie Co.)
Buffalo (Erie Co. ^
Depew, village (Erie Co.)
East Aurora, village (Eric Co.)
Lackawanna (Erie Co.)
Lancaster, village (Eric Co.)
Tnoawanda (Erie Co.)
West Seneca, town (Erie C^.) . . ..
Reit of eountv
Broekport, village (Monroe .Co.)
1
5
2
1
3
6
2
3
65 1
1
1
4 1
... . 1
• . . .
5 . . .
19 21
7s
1
3
4
II
97
3i
23'
•>'
-I
223
8
14
1
1
10
II
1
27
2<
I
ll
2
1
10
SOI
2'
1
1
3
25
3
52
d
15
2
1
2
4
lOi
s
1
1
Ed
1
15
15
4
3
22
5
12
-I-
150' 15
2
13
3
2'
7,
1
8
1;
2.
4
1
5
3
«l
3
4
»
12
9
&
■&
a
is
I
o
«
15
6.
4"
5
17
•?!
106 14
163!
16
■>
1
1
11
1
1
3
19
1
26
3
1
2
14
3
1
"3
I
3
b
3
o
J
0U
20
3
2
1
3
17
2
2
2
8
123
50
3
6
1
22
111
78
500
41
26
7
4
15
4
3
21
4
13
5
1
13
2
7
10
4
15
15
14
3
12
5
11
255
4
510
3
18
5
t
4
61
2
i:34
State Dkpaktment of Health
Total Mortality far the Year 1910 in
JJANITAUY DISTRICTS
MOHAWK VALLEY DI8TRICT-< Con/'rf)
Frankfort. vUlftfie < Herkimer Co.)
Herkimer, villaee (Herkimer Co.)
Ilion. village (Herkimer Co.)
Little Falls (Herkimer Co.)
Rest of county
Amsterdam (Montgomery Co.) .
Fort Plains, village (Montgomery Co.) .
Rest of county
Boonville. town (Oneida Co.)
Camden, town (Oneida Co.)
Rome (Oneida C^.)
Utica (Oneida Co.)
Whiteatown. town (Oneida Co.)
Rest of county
Ballston Spa, village (Saratoga Co.)
Mechanicville, village (Saratoga Co.)
Saratoga Springs, village (Saratoga Co.). .
Waterford, town (Saratoga Co.)
Rest of county
Schenectady (Schenectady Co.)
Rest of county
Cobleskill, town (Schohwic Co.)
Rest of county
Totals for the District ...
SOUTHERN TIER DISTRICT:
Wellsville, village (Allegany Co.) .
Rest of county
Binghamton (Broome Co.)
liestershire, village (Broome Co.) ...
Rest of county
Olean (Cattaraugus Co.)
Salamanca, village (Cattaraugus Co.)
Rest of county
Dunkirk (Chautauqua Co.)
Fredonia, village (Chautauqua Co.) .
Jamestown (Chautauqua Co.)
Westfield. village (Chautauqua Co.)..
Rest of county
Elmira (Chemung Co.)
Horseheads, town (Chemung Co.). .
Rest of county
Bath, village (Steuben Co.)
Coming (Steuben Co.)
Hornell (Steuben Co.)
Rest of county
Candor, town (Tioga Co.)
Owego, village (Tioga Co.)
Waverly, village (Tioga Co.)
Rest of county
Totals for the District
EAST (^ENTRAL DISTRICT:
Norwich, village (Chenango Co.)
Rest of county
Cortland (CortUnd Co.)
Homer, village (Cortland Co.) .
Rest of county
Sidney, town (Delaware Co.) . .
Walton, town (Delaware Co.)
"3
S
e
.2
££
3.321
7.559
fi,616
12.326
26.650
31.586
2,769
23,547
3,193
5,413
20,6;i2
74.879
7.8.38
44,786
4,138
6,666
12,680;
6,134
32.282
73.450
15.516
3.574
20.223
488,414
4,383
36,958
48,671
3,764
26,608
14.814
5.806
45.299
17.308
5.290
31.523
2,991
48,380
37,238
5.398
12.115
3,891
13.742
13,637
52.112
2.902
4,617
4.853
13.204
65
557
765
631
503
188
85'
628'
279 1
79,
4C4,
64'
7181
554'
76'
236
67
2001
1741
780,
43|
54|
83
224
10
2,
11
36
455,504! 6.889
7,434
28,089;
11,517
2,701
15,026
4,142'
5.0941
122
4761
219
49
260 i
72
88.
52
16
20
55
75
336
13^
37
41
128
158
263
6
4
4
14
9
26
46
19
16
49
90
282
28
11
19
32
41
67
18
10
3
9
20
25
67
36
32
51
88
353
76
37
28
38
39
61
15
4
2
8
9
41
66
21
23
71
80
143
9
4
3
5
12
31
88
22
27
57
103
419
74
20
30
78
114
236
3
2
1
8
13
49
36
10
6
31
41
110
6
1
2
7
9
42
30
8
12
34
41
75
20
7
14
21
40
72
76
21
30
59
122
466
1
0
2
3
8
29
4
0
0
3
16
31
7
3
8
11
10
44
19
8
6
13
41
136
896
303
331
789
1.190
3.363
10
10
4
19
26
51
38
19
12
25
78
304
36
11
5
20
39
108
2
1
1
5
9
31
21
12
9
11
37
169
4
1
3
10
17
37
8
3
5
11
17
44
Division of Vital Statistics
i:]r;
ilic Sfnfr Durbui 1010— ((^ontinued)
sanitary districts
MOHAWK VALLEY DIST.-lCoiU'rf)
Frankfort, rilUge (Herkimer Co.) . .
Herkimer, village (Herkimer Co.) . .
Ilion. viQace (Herkimer Co.)
Little Falb (Herkimer Co.)
Rcft of counts'
AmHerdam (Montcomery Co.)
Fort Plain, village (Montgomery Co
Rett of county
BoooviLe, town (Oneida Co.) . .
Camden, town (Oneida Co.) ...
Rome (Oneida Co.) . . .
rtira (Oneida Co.)
Wbitertown, town (Oneida Co.) .
Rent of county
Balbton 8f>a, village (Saratoga Co.).
Meehanieville. village (Saratoga Co.).
Saratoga SpringB. vil. (Saratoga Co.)
Watcrford. town (Saratoga Co.)
R*wt of countv
Schenectady (Schenectady Co.) .
Rart of eounty
Coblericill. town (Schoharie Co.)
Rart of county
Totals for the DMtrict.
SOUTHERN TIER DISTRICT:
WeUaville, village (ADegany Co.) .
R«at of countv
Bingfaamton (Broome Co.)
Lestenhire. village (Braome Co.) .
Rcvt of eounty
Olcu (Cattaraugus Co.)
Salamanca. viUage (Cattaraugus Co.
Rest of eounty
Dunkirk (Chautauqua Co.) . .
Fredonia, viUage (Chautauqua Co.) .
Jameittown (Chautauqua Co ) .
Westfield. ^-illage (Chautauqua Co.).
Rett of county
Elnura (Chemung Co.)
Horaebeads, town (Chemung Vo.).. .
Rent of county
Bath, village (Steuben Co.)
Oornmg ^teuben Co )
Homcll (Bteuben Co.)
Rot of county
Candor, town (Tioga Co.)
OwegD. viUate (Tmga Co.)
Wavcrly. village (Tioga Co.)
Rest of county
TotakfortheDwtrict.
EAST CENTRAL DISTRICn-:
Norwich. viHage (Chenango Co.) . .
Rest of county
Cortknd <Cortknd Co.)
Homer, village (Cortland Co.)
Rest of coun^
Kidney, town (Delaware Co.)
Wahoo. town (DeUware Co.)
)'
Kpidsmic Diskasks
3
4
5
2
5
2
21
2
2
5
5|
1 1
QQ
53
7
6
1
6|
41
1
9
r
10
8
4
I:
11
7
4,
I
11
3
6|
56
4
4<
6
4,
2
1
3
2
741 3
3
9
1!
2
3!
1
31|
3
4
i
2
4
8
3
1
1
30
2
3
1
7
2
3
25
1
4
1
3
1
1
1
4
I
60
9
8
8
ja
1
1
2
3
8
Q.
121
3
11
2,
2
i;
3
2
1
1
10
I
1
5
60
—
li
I
i;
10
14
1
2
3
l!
151
2|
1|
111
!
2
5
1
3
9
5
3
5
8
1
1
7
18
3
6;
3
1*
t!
16
4
2i
• I
101
17
5
1
10
2;
16
21
2
4
28
11,
1
9
1
5
16'
4
5
.a
e
"e
.3
J
3
1
e
o
s
3
eu
5
1
I
80< 114i 17
3
1
1
2
1
3
5
4
10
34
32
3
25
3
8
26
94
9
52
5
6
22
13
28
72
11
4
18
18 527
2
15
58
4
31
7
3
.30
II
7
23
2
23
19
10
25
6
7
5
27
4
5
7
26i 55; 139 16| 16 331
31
4i ..
2
6
1
20 1
2
19
2:
2
1
3
1,
2
1
1
1
5
... 1
9
i
1
. .
5
i
5'. .
3
136
Statk IJepaktment of Health
Total Mortality for the Vcar 1910 in
SANITARY DISTRICTS
MOHAWK VALLEY DI8T.— (Con/'rf)
Frankfort, vUlace (Herkimer Co.).. .
Herkimer, villaee (Herkimer Co.) . . .
Ilion, nllase (Herkimer Co.)
Little Falla (Herkimer Co.)
Rest of county
Amsterdam (Montffomer>' Co.)
Fort Plains, village (Montgomery Co.'
Rest of county
Boonville, town (Oneidh Co.)
Camden, town (Oneida Co.)
Rome (()neiHa Co.)
Utica (Oneida Co.)
WTiitertown, town (Oneida Co.) ....
Rest of county
Ballston Spa, village (Saratoga Co.).
Mechanicville, village (Saratoga Co.)
Saratoga Si rings, vil. (Saratoga Co.).
Waterford, town (Saratoga Co.)
Rest of county
Schenectady (Schenectady Co.)
Rest of county
Cobleskill, town (Schoharie Co.)
Rest of county
Totals for the Datrict
SOUTHFRN TIER DISTRICT:
WellsviUe, village (Allegany Co.) . . , .
Rest of county
Binghamton ^roome Co.)
Lestershirc, village (Broome Co.) —
Rest of county
Olean (Cattaraugus Co.).
Salamanca, village (Cattaraugus Co.).
Rest of county
Dunkirk (Chautauqua Co.)
Fredonb, village (Chautauqua Co.).
Jamestown (Chautauqua Co.)
Westfield, village (Chautauqua Co.).
Rest of county
Elmira (Chemung Co.)
Horseheads, town (Chemung Co.) . . . .
Rest of county
Bath, village (Steuben Co.)
Coming (Steuben Co.)
Homell (Steuben Co.)
Rest of county
Candor, town (Tioga Co.)
Owego, village (Tb^ Co.)
Waverly, village (Tioga Co.)
Rest of county
3f
6
14
4
1
1
108
1
4
1
5
?
1
6
6
2
10
i?
7
Totals for the District ! 74
EAST CENTRAL DISTRICT:
Norwich, village (Chenango C^o.) ,
Rest of county
Cortland (Cortland Co.)
Homer, village (Cortland Co.). .
Rest of county
Sidney, town (Delaware Co.)
Waltcn, town fDelawar«' Co.^
f
45
4
4
22
3
3?
41
11
5
20
411
4
30
41
4
3?
17
6
46
1?
2
21
7
48
38
5
11
5
6
P
53
2
3
4
11
418
9|
25 1
14i
2'
16'
4
5
2
4
2
6
6
7
2
P
1
1
2
11
1?
3
1
5
10
1
95
13
6
83
1
1
4
13
12
2
17
3
1
17
52
2
19
2
1
8
3
22
60
6
6
9
277
3
25
35
1
20
8
4
21
6
4
14
19
18
4
10
5
5
8
31
3
2
2
9
23
^'
2\
7
2
3
9
o
>
4
8
14
14
60
44
4
53
10
7
55
126
14
74
12
8
21
13
75
90
20
6
66
887
5
75
77
4
84
19
10
95
29
18
43
9
85
62
13
26
7
29
26
128
7
7
15
37
267' 910
I
9
i
I
10
15
5
31
60
39
8
41
11
7
58
142
10
86
8
13
25
9
64
84
17
8
44
859
7
89
81
4
71
22
5
89
18
5
47
13
124
63
5
31
12
20
26
134
1
9
10
32
•s
o
5
12
9
19
1^
54
1
36
6
1
le
101
11
52
3
4
19
8
40
108
13
5
23
618
4
27
6?
4
27
16
5
48
25
4
30
3
42
33
9
13
.«»
ly
14
41
2
3
4
11
9181 450
14
10
12
65
72
21
26
25
21
5
G
7
38
33
2(>
111
5
4
7
5
14
7
16
5
10
16
32
4
21
3
2
18
79
7
35
5
15
19
7
30
74
6
3
17
463
6
31
39
4
23
B
2
37
9
6
23
37
30
3
10
1
9
3
31
4
3
A
10
333
14
24
10
3
16
2
3 .
DUIWHCA
anh
i
7
3
1
11
12
89
2
9
1
3
27
100
15
16
8
7
10
5
19
115
15
3
504
3
9
39
2
8
9
6
16
33
7
8
3
27
14
1
6
1
4
4
18
1
2
3
7
221
6
10
4
V
4
K
1
4
10
r
d
3
12
2
75
2
10
17
2
7
1
13
2
e
1
7
4
3
1
3
1
19
107
2
14
1
1
2
I
7
9
11
23
30
6
20
1
2
28
88
5
47
3
5
19
4
23
59
4
3
17
477
4
35
55
6
35
19
4
41
21
3
31
2
40
29
2
10
4
24
10
48
4
5
5
16
453
7
43
11
3
15
U
5
tttf ^
^ Ui
-*
*ii.::ir.*
<i* -^
^>r"=J" BPTKl
*
-i ■ *
i. <
I
i
3
J
IIFT— '
80CTHESK TIER DISTRICT:
Eflitorcoa^.
Biiw^aatoa (BrooBM Co.)
Tilnihiii villi«e (Broome Co.) .
Rcmtofeoiaity
OlttB (Csttaransoi Co.)
B«u».^.>>« TiBAie (CtettanugoB Co.)
Ralof eoontx
(CliMitaBDgaft Co.)
TiDace (OhaotanqtiA Co.)
(ChMtauqnft Co.)
WciCfield, vOkce (ChMtaoquft Co.).
Rflrtof ooooty
Efanira (Chantiiig Co.)
HonehflMfa, town (Cbomunc Co.) . .
Rot of OOOBty
B«Ui. TiOase (Steaben Co.)
{^tmbenC
HarmlKSlfliibeQCo.).
Cornuut
Co.).
Ratof eoonty.
Ctador, town (Tiota Co.). . .
O«c(0.Ti]lMB(TwaCo.) .
WsVcfhr. Tftiee (Tioift Co.)
Rotoccovoty
TolablbrtkeDiftnet ...
EAST CENTRAL DITTRTCT:
NorwidL inOm (CtwMcn Co
RMkoTcmtr
v«^'CortlM4 0>
R^oTcpMlr
Cl»u,
1
5*
14
U
I'
4
4
t
1
49
6
35
3
37
4
2
43
3
51
89
7
17
0
10
g
58
4
4
n
53"
43
24
1
1'
1?
4
16'
5
1
14
I
I
0
4
13
17
1
0
2
Id
15i
3i
2
ft'
M
1
>»
12
3
3
3i
«
I
I
h
4
4
4
I
I
3
0
9
IS
'i
I
3
"l
I
2
I
17s 74. Ir
J''«
II
r
13
2
7
4
2
1
2
t
«
\:
5771 I : ** >41 44;
N
3^
•»
'{i
10
M
2'
I,
n
Vi/
7
17
.'1
M
?
4
1/
4
i
I
13
3
ft
I
I
131
1'
I
A
I
2
4
2
2
1
r
r
I
4
IU
J
n
\u
4
ft
4
3
7
\
n
4
I
/
4
V
*■
V
u
4
'\
^^
n
})
n
*
lu
I
,1
in
ft
M
ft
'J/
J
I
n
I') ii; at,
A
n
to
1
\
4U
M»»
nnn
4.'
ftUlt
ft*l
or
Mil
I n
I
* \1 *'
4« ^
\»
lU
•Xl
M
I*
I
i
I
u
II
I
0
I
0
j)Kl'.\iiiMKNT <1K WkAI-TU
Toial Morlaidij for (he I'car I'JIO m
SANITARY DlRTRlfTV*
I i
EAST CENTRAL DI3T.— (CrmCifl
CiiwitaU. vutg* (MadiKin Co.) . . .
CucDoriL town (Mudwui Co.) . - -
nundloB, iDirD (MBdnn Co.) ....
Onads (MuJaon Co.)
RatolKmity.
BiUiriimilla. villigc (OnoDiliciI Co.)
DtWiU.Unni(Ou>iiiUaCit.)
Emi Bstuuk. viUm* (Onoodiii Co.)
Eolny, liltace (OnmidM* Co.)
CoapgnitDirt.Tiibce(OUegaCo.). .
OMonta (OMfo Co.)
WonHliT, lovn (OlaegoCo.)
Kalofooimty
LilwtT. Ion (SuIUnn Co.)
TDUlifurtbEDklriot...
ii.imics(i
TDUkloiUieDiitiict...
■" "llM«(trii'Co.)
■. Tfll^ (EiH Co.).
Bnekport, •iui(t (Mimroe V'n
i i
i i
3
!■!
-a
Divisio.N OF Vital Statimtics
(he Sanitary Districts
—
Continued
1
1
1
1
f
1
1
P
1
J
ill
1
1
a
1
Burm
flNlTARY DISTRICTS
11
E*8T CENTRAL DiaT.-(Ci>iifJ)
17
s
8
3
i
j
1^:
■
i
1 i ■
.; !
-3
J
sSssKr:"-''
!,...';...■
i. V
i
S^S*"
■■■j
Bfl 0
e
""s
3
t: 'Si '^i '
^1 -
2\ i
M 11
C<»[«»towii. TiilUe (OW Co.) . . .
..,. ; :
ItOi ■
»\ 18 i|'.:::
104 6
HI7 lit
K
« «,| »i „
18t
307
WEST CBNTRAL DBTRICT;
»i 1
lo' <
12 i
2fl i:
''■■•■«
S
■ 1
. 1.' >! I
3!
1
V
■
....
1
64E' n
'1 "i
4 1
^sS&."^?CL%'
Ii:;:::
W 3
01 1
.....
SS^.I^SSIWiwc^j::;;::;"
■i\ Ji j:
Vi 3
»-rt»i«7iffliir®«. Co.)
;
i
Li'
....J -if::::
« !
fta.-fc'Sa'Ki;:;;:
67 3
Si T^CJ^ (t«iii ci.')'.'.' : ■ :
3
1
2
38
7
W' <.< 7
X
IS
1
■»
1
»
70
lO.ON
1
M
'g
771 iU
Ml
IB
12
»
.
1
48 si
142
Statk Dkpaktmknt of IIkaltii
Total Mortalitii for the Year 1910 in
S.VNITARY DISTRICTS
LAKE ONTARIO AND WESTERN DIS-
TRICT—(Conltntt«f)
Kairport, village (Monroe Co.)
Rochester (Monroe Co.)
Rest of county
T^ockport (Niagara Co.)
Niagara Falls (Niagara Co.)
North Tonawanda (Niagara Co.)
Rest of county ,
Albion, village (Orleans Co.)
Medina, village (Orleans Co.)
Rest of county
l-\ilton (Oswego Co.)
Oswego (Oswego CJo.)
Richland, town (Oswego Co.)
Re^t of county
Clyde, village (Wayne Co.)
Lyons, village (Wavne Co.)
Newark, village (Wayne Co.)
Palmyra, town (Wayne Co.)
Rest of county
Totals for the District
Totals for the State
Deaths in State institutions.
a
■s
o
3,133
219.693
58,676
17.993
30,617
12,033
31.719
5.010
5.707
21.309
10.550
23.410
3.799
33.986
2.701
4.446
6.274
4.175
32.637
1,062,781
9,i68,St8
6
S
48
3.084
781
209
551
160
392
85
101
314
155
385
60
523
38
75
85
71
497
16.300
147.629
•1.992
I -a
1(1
445,
141
36i
1431
57!
52,
12
18i
30i
31
76'
5
48
2
11
7
8
67
i7,4S7
Agbs
0
>i
8
a»
e«9
3
a
2
*n
^
i
i
i
1
1
i
2
2
4
206
168
479
41
35
93
9
20
42
59
33
120
28
9
20
13
15
36
2
I
9
7
4
5
IP
8
28
7
13
25
17
24
52
2
2
5
23
IP
36
0
1
2
7
2
8
1
3
21
1
2
6
11
18
37
1.294
91?
2.29?
tt.tss
8.069
is.sio
3
43
404
s
3
a
I
5
716
104
54
107
13
6<*
13
19
52
18
65
6
81
6
13
14
9
81
3,083
30,567
i
I
055
25
1.070
366
131
»8
32
205
48
4S
177
61
151
40
312
27
34
30
45
212
5.5>6
4SJ^
882
* Previous to March these deaths wore classified in " Rest of county" in which each institution is located.
Divisiox OF Vital Statistics
143
ihe Sanitary Districts — ( C'oiitiiiueil)
SANITARY DISTRICTS
UKE ONTARIO AND WESTERN
DISTRICT— (ContfniMrf)
Faimrl. riOace (Monroe Co.) . .
RoeMrter (Monroe Co.)
Reit of eoonty
Loekport (NiMVft C^.)
NiMvsFftns(Nift«MmCo.)
North Toiuwsndft (NtsgarA CTo.) .
R*rt of county
Attnon, rilbse (Orleans Co.)
Medioft, Tillage (Orleans Co.)
Rert of coantv
Fohon (Oswego Co.)
Oewe^ (Oswego Co.)
Ricfakad, town (Oswego Co.)
Rest of county
Hyde. Tillage (Wayne Co.)
Lrotm, Tilbge (Wayne Co.)
Newark, rillaw (W»yne Co.)
Palmyra, town (Wajmc Co.)
Rest of eounty
Totals (pr the District.
Totals for the State
Deaths in State institution
1
30
8
2
30
5
5
2
1
1
12
1
6
195
1.574
13
Epidbmic Dibbabbs
I
II 1
e5\
8
i
15
3
14
2
1
I
47
7
3
5
3
5
1
169
1
s
Q.
I
1
%
{l
-5
g
•S
9
s
d
1
10'
7,
..I
9
■3!
II
I
I
5
1
5:
34
9
4
10
7
2)
2,
331 136! 256
I
17
11
1
6
1
6
11
6
1
14
2
I
111
.1
51
2I
131
134 57
1,$86\ t,et7\ 7i7\ t,m\ tA6t\ 5t
. . • n 7i~i"i
11
6 .
I
0'
11
2
2
277
41
25
32
S
20
9
1
25
13
17
2
33
1
3
6
4
19
37 1.152
~~2\~~'.72
144
State Depaktmknt of Heal= r
Total Mortality for iht ' r 1910 in
SANITARY DISTRICTS
•LAKE ONTARIO AND WtlSTERN
DISTRICT— (r<m«nu«/)
Fairport, village (Monroe Co.) .
RocnestCT (Monroe Co.)
Rest of county
Ix)ckport (Niagara Co.)
Niagara Falla (Nia<atra Co.)
North Tonawanda (Niagara C»».) . .
Rest of county ...
Albion, village (OrUsiiis Co.)
Medina, village (Orleans <\>.)
Rwt of county
Fulton (Oswego Co.)
()8wogo (Oawcfo Co.)
Richland, town (Oswego Co.)
Rest of county
Clyde, village (Wayne Co.)
Lyons, village (Wayne Co.)
Ncwaric, village (Wayne Co.)
Pahnyta, town (Wayne Co.)
Rest of countv
57
i::
4
IS
4
4
3
•>
5
2
4
1
3
Totals for the District
Totals for the State
Deaths in State institutions.
2
43
47
12
14
6'
261
^!
21
t
20
3
32
5
6
3
3
20
221 83v
i,27f^
22
7,62k
38
29
4
5
4
2
105
21
10
2^
7
21
2
6
13
6
12
5
26
1
7
6
13
731
5.057
27
E
4>
■2|
12
270
93
33
41
13
57
16
16
30
15
59
II
7i
13
6
11
95
1,69:
n,^oj,
485
I
3
415
111
49
401
8
49
14
43
9
84
14
14
12
70
3
153
28
20
37
8
23
5
4
24
9
19
2
33
3
8
4
4
23
2,083 646
19,J,9', 9,867
30.
123
1
254
48
20
29
18
20
6
S
22
6
11
2
22
DURMIEA I |g
AND sr
Ektcbitu
5
5
4
27
1,373
U,6€t
236
t
2
ao3
70
11
45
21
9
5
5
9
7
18
r.
4
1
2
19
884
9,0S6
1
c«
I
35
10
4
8
1
5
2
1
3
3
7
1
5
2
203
37
20
26
10
21
1
K
13
17
32
7
32
1
3
6
4
39
lU 1.231
t.947
9i
7,691
63
^.
M
Division of Vital Statistics
145
fhe Sanitanj Districts — (Concluded)
BlRTHH
SANITARY DISTRICTS
LAKE ONTARIO AND WESTERN
DISTRICT— (C<m«mii«d)
Fairport, vilbge (Monroe Co.)
RoehtBttT (Monroe 0>.)
Rest ct ooonty
Loekport (Niasva Co.)
Nacva Faik (NiBRMra C«.)
North Tonswanda (Nagvm Co.) . . . .
Rest of county
Albion, villaee (Orlnnt Co.)
Medina. vilk«e (OricMU Co.)
Rest of county
FultoD (OBwego Co.)
Oswe«o (Onr^ Co.)
Rirhhtpd. town (Oswego Co.)
Restofeoun^
CIyd«, vilkife (Wayne Co.)
Ljrona, TiUan (Wume Co.)
Newark. ▼ilfii«c (Wayne O).)
I^Jmyr*, town (Wayne Co.)
Reat of county
Totals for the District
Totals for the State
Deaths in State institutions
150 Statk Dki'artmkxt hf IIkaltii
Total Mortality in Cities for the Year 1910 — f <'onc]u<led )
1 1
i
i.
F
]
A..
k
1
1
>
i
4
1
2
i
o ■ 3
« : s
III
i
s
1
Tklri-r>auiMa, hk-Iit 10.000
OonoU
Touwudi
sf.m
».M2
8.30S
181
in
27
M
2(1
I, MS
w
•5
57
ToTtLUui^MoBTlUTT..
Tor»i.RDiuLMoiiTAl,rrT..
ST.SJI
".'.
*,r»
i.m K,iffi
e.m
n.tu
Divisiox OF ViTAT^ Statistics
14'
Total Mortality in Cities for ike Year 1010 — (Contiuueil)
Epidemic Diseasks
Fint<Uu eitiea, over llSfiOO
CUt •/ S9W Ymk
BoBocoH or
BoKoroB or
BosocoH or
BotovoB or
BoftouoH or
Buffalo
Roehca^er
Manhattan
THE Beonx
Beookutn .
QrEEm
RicHuo?rD
Skcomd^Uu nHn, SOflOO tom.OCfO_
Svneoae .
ARmov...
Yonkcn
Trov
Utk*
Scbowctady
ThinMau citie$, iOjOOO to SOjOOO
Buwhamton .
Efanin. .
Auburn
AmsterdaiD. .
jEmestown
Mt. Vernon
NiEcnn Falls
Sew Roehdle
Poughkeepsie .
Newbur^ . .
Watertown . .
KinKston. .
Cohoa
OSWCKO
(tUivcrarine.. .
Runw
Tkird-dau eUU$, lOflOO to iOfiOO.
Lockpwt
Dunkirk
White PbuM. village. . . .
OKdensbunt
Peebriull. Tillage
Middletown
GlenaFalb
Watcnrliei
Itliaca
Clean
Lackawanna
Cominic
Homdl
Portcheater. village
Saratoga Springs, village.
Geneva
UtUe Falls
North Tonawanda
Batavia, village
Oaining, villi«c
Cortland
Hudaon
Plattaburgh
>
o
.9
666 \ i7,
FoHon
johnatowa.
5
6
4
4
5
1
8
5
2',
2
3
1'.
5
4
2
<»
3
3
1
1
S6
■T,
I
3
13i
3
55S
260
41
198
30
I
78
30
9S\
38
15
15
15
5
*i
15i
6
10
3
7
9
3
30
1
5
12
24
5
19
12
2
4
n, 8\
I
S
6
6
4
I
J
886
77J,
271
45 1
422
301
6'
97|
15'
70'
I
24
2
9
6
*2
231
I
3
4
4
2
3
6
4
1
li
15i
63
3
1
1
1
14
6
1
5
15
2
3
4
3
75
3
4
^ I
96g
44«
75
384'
331
t?
223 1
47
691
I
22 1
9
181
17'
62
3
1
5
4
4
2
5
2,
32
1
69
3
25
1
1
2
3
1
2
2
14
1
1
M
M
S3
8
be
a
^ I
ja I
JS.il l,9tf
154
2'<
02
21
4
80
10
4P
4
9
8
4
14
10
6.-
5
5!
li
8
1
4
9
8
7
4
5
1
5
SS
1
s
89^
136
55«
104
IP
163
34
lie
25
17
28
13
14
15
tit
II
6l
12'
61
101
8'
ti
3l
7
13
I
3
10
64
4
9
3
4
7
2
3,
2
2
I
1,
31
e
4)
3
162
26
144
24
10
16
17
».5
15
2P
5
24
18
4
77
5
11
2
2
4
4
6
1
2
5
4
14
4
7
61
1
2
1
1
«>
1
4
3
6
■ 1
1
5
2
5
2
3
1
3
1
2
2
3
6
3
I
1
3
o
E
a.
399, 369. 5/7
23",
161
79 1
5
3'
26;
14l
/5|
5,
4'
2
2i
4
4
1
1
o
3
4'
1'
1
//
1
1'
J!
947
366 \ Sift 29 4 \ 8,6 fO
29!
7?
12
4
14
9
1
9,
5
3;
1
3,976
1,779
2.429
358
148
510
277
gj «f.T
123
239
120
175
94
72
f/ 6iS
2
4
I
3,
1;
1
1'
II
58
19
41
32
23
34
32
24
35
50
21
46
49
17
16
26
38S
25
11
16
17
23
27
18
21
15
7
18
7
5
9
22
13
10
8
7
15
3
26
23
15
19
U
].':J SiATK Dki'aujmk.nt 111-- Health
VVtii Uorlaiity in VUies fur the I'ear I'JIO — ■ (Concluded)
DiviaioN OF Vital Statistics I'l-'t
T'fftit Mortality hi, Cilu-s for lite JV«r ]!) 10 — (Concluded)
1
1
1
1
i
II
1
1
1
Biinu
1
i
1
1
8
1
9
1
i
1
li
no
r.
*
H
M
(81
ISO
IH
is;
\i.i
"
JEM
ass
/.W(
17S.0W
W.tt!
TorU. RUK«L MOBTIUTT
t.tm
.»
•'•
■■■"
.,<
l,M)
150 StaTK Pkl-ART-MK-NT OF HkALTU
Total Morlalitij in f.'ities for the Year 1910 — «"oiiclii(led )
k
T-lirtf^ou «Ha. Hufrr 10/000
is.m
fl.SM
R.30S
To»«»il.,.
ToTiL U.iu» MonTiLnr .
...|.,«»
TUTIL RrUL MOKTIUTT .
..«../..
Division (ii- Vitm. SrAiisTirs 1."
Total MorlaUlyii, rilinforlhe Year 19!0— (ronchijcj)
e !i
ToML t'uix Mm
Torn. RnAL Mm
,,j „,|
i I
^:r2
Statk Depaktmkxt of Hkalth
Tlvc Morialiiy in Cities for the I'car 11)10 — (Concluded)
Tkird-dau eitu$, tinder WfiOO.
Oneonta
Port Jcrris.
Ondda
Tonawaoda.
Total Urban Mobtautt
Total Rural Mortalitt
I
3
3
1,853
4S6
t
I,
»s
11
1
57
13
10
9
5
6,U7
9,076
1,093
406
1
S4
9
12
9
4
S,786
t,t7»
i
•a
ee
17
24
11
14
6,tSS
6,171
•3
SB
21
12
14
11
H,64»
4,966
41
17
10
7
7
7,4S1
i,586
$t
5
4
7
6
9,60»
i,ieo
DURRHKA
AND
Entiritis
I
94
9
5
5
5
7,666
1,S71
S
10
2
2
5
1
1,056
.»
S4
10
11
6
7
5.95«
Wfl f.OM
Bivisiox in' ViTAi, Statistii's I'i;!
Tofal Mortalilij in VUies for Ihr Yair 1!U0 — (Concluded)
1
1
1
1
i
II
i
1
1
s
1
B»rai
,
i
J
J
1
1
nM^lu eMit. m-Jt lO/XtO.
■■
i
::;
:
11
3
1
....
a
\
IH
!»:(
ToTtL Besu. Mdhtiutt
Jl
na
m
t.lN
«W
us
i.m
]Z
tn.ow
«.!
;::
15G
SlATii DkPAKTMKNT OF HeALTII
liecord of ench reporting local board of health, slvowhuj total
deaths from all causes and from the principal zynwlw diseases
for 1910, by counties
[Cities are printed in small caps, villages in ikdia and towns in Roman type.}
•
COUNTY AND
REGIBTRATION
DBTRICl'S
1
3
Cerebrospinal
1 meningitis
ca- *. •
1
o
44
15
19
73
i
1
51
9
32
1
S7
24
3
1
1
1
11
9
1
•a
S4
17
13
1
A
140
56
54
1
1
3
8
Tuberculosis
of lungs
1
46
29
4
""4
1
2
1
.....
1
189
135
14
2
3
2
9
2
1
3
3
2
8
5
55
2
rt
1
0
3
ALBANY COUNTY. . .
Albany
3Jg8
1,943
509
34
67
55
119
50
14
53
24
28
261
71
ets
32
11
9
27
35
29
38
27
7
21
30
20
9
8
51
51
9
13
5
19
14
13
18
20
3
12
65
7
11
P
1,S06
765
49
1
7
5
4
3
1
4
2
COBOBS
Berne
Bethlehem
3
1
Coeymans
Colonie
1
1
(tuilderland
■ 1
Knox
1
2
New Scotland
2
1
Rensselaerville
Westerk)
1
11
2
12
Watbhvlibt
i
1
7
2
6
S
6
2
21
8
17
3
1
17
2
Grtenldand
ALLEGANY COUNTY.
Alfred
6
• • • • •
4
/
630
28
Alien
!
11
Alma
1
2
1
6
Almond
1
1
25
Amity
1
1
3
1
1
2
2
30
Andover
24
Angdica
1
1
.....
30
Betfast
1
24
Biidsall ,.
7
Bolivar
1
1
•
5
14
Bums
1
29
Caneadea
1
1
2
1
"3
2
16
Centerville
1
1
6
ClarkiviUe
1
2
3
7
Cuba
1
1
45
Friendship
1
44
Qenesee
0
Granger
1
1
11
Grove
*
5
Hume
1
1
i
1
16
Independence
13
New'Hudson
1
1
2
1
11
Rushford
1
1
1
""4
14
Scio
14
Ward
3
Wellsville
2
2
1
1
"4
9
WeUtviUe
'
56
West Ahnond
6
Willing
1
10
Wirt
....
1
1
76
41
1
i
2
2
1
1
7
BROOME COUNTY...
BlKOHAMTON
1
10
6
9
3
4
4
6. 13
5! 11
49
39
88
58
17
5
1
1
.....
1
. ...
1
1
....
l,OSi
592
Barker
12
12
10
Binghamton
11
Chenango
15
37
18
1
1
"I
1
5
4
1
12
Colesvifle
1
1
26
Conklin
1
14
Dickinson
53
19
12
r»3
2(1
1
f
1
1
2
45
Fenton
1
. . _ .
1
.... 1 ' 1
r 1
IS
Kirkwood
11
Lntmkirt
Lisle
1
. . . . ' , . .'....
51
2
Muiiic j
Nanticokr
' 1 _ . .
1
Saiiford
ll
ll
9
4
*■■■.'
8.
4
ISutinnartf of Mortaliiij m the Sauitiiry Diiflriclm for the Yrar
1(H0^ (Continued)
..
:
PASITARY
1
-
^
DIJrRICTSi '
■5
■^
i?
1
i
s
o
1.483
*w
Irisn ntorUlit]' II.KIJ, I.SUr 1
Ron] morUElr . ?.8U' 4U :
Stniiiiini:!/ of MorUifHi/ in the Sanilary Districts- for the Year
lltlO— (Concluded)
15G
State Department of Health
Uncord of eadv reporluuj local hoard of health, slvowifu/ total
deaths from all causes and frovi the priiwipal zynuHic diseases
for 1910, by counties
[Cities are printed in small caps, viilai^os in UaUct and towns in Roman tiype.]
COUNTY AND
REGISTRATION
DISTRICTS
ALBANY COUNTY.
Albany.
COHOBS
Berne
Bethldiem
Coeymans
Colonic
Guilderland —
Knox
New Scotland.
Rensselaerville.
Westerlo
Watbrvlht...
Grtenldand. ..
ALLEGANY COUNTY.
Alfred
AUen
Alma
Almond
Amity
Andover
fast.
BitdsaU
Bolivar
Boms
Caneadea
Craterville. . .
Clarksville....
Cuba
Friendship —
Genesee
Granger
Grove
Hume
Independence.
New Hudson.
Rushford
Scb
Ward
WellsviUe
WeOinUe
West Almond.
Willing
Wirt
BROOME COUNTY...
BraOHAHTON
Barker
Binghamton
Chooann)
CoIesviUB
Conklin
Dickinson
YeaUm
Kiricwood
LuUnkire
Lisle
Maine
Nanticoke
Sanford
1
•3
a"
3
>
15
19
IS
1
1
51
9
32
1
S7
24
3
n
9
1
•a
S4
17
13
1
ll
b
140
56
54
1
1
3
8
Tuberculosis
of lungs
3
i
e
4e
29
4
"4
1
2
1
• • . . .
1
o
189
135
14
2
3
2
9
2
1
3
3
2
8
5
55
2
e4
1
0
3
3,ti8
1.943
509
34
49
1
7
5
4
3
1
4
2
A7
3
1
55
119
1
1
1
50
1
14
1
2
53
2
1
24
28
1
11
2
12
261
71
i
7
2
6
i
6
2
21
8
17
3
1
17
2
ets
32
6
4
;
6S0
28
11
.....
11
9
1
6
27
1
1
5
25
35
1
1
3
1
1
2
2
30
29
24
38
1
"•'il:::;:
30
27
1
24
7
7
21
1
1
»
5
14
30
29
20
1
1
1
2
3
2
1
'3
2
16
9
1
6
8
7
51
1
1
45
51
(
44
9
9
13
1
,
'
11
5
i
5
19
1
1
.....
1
16
14
13
13
1
, ,
1
11
18
1
1
1
""4
• • • • •
14
20
14
3
3
1?
2
2
1
"*"4
9
65
,
3
56
7
6
11
1
10
9
1
49
39
1
76
41
1
" \
2
2
1
'-i
••
1
7
t,S06
765
12
1
10
6
9
3
4
4
6
5
IS
11
88
58
17
5
1
1
.....
1
.....
1
1
...
l.OSt
592
10
12
!
11
15
1
1
2
2
1
5
4
I
12
37
1
1
26
18
1
14
53
. .. 1 ....
1
1
45
19'
12j
fi3'
26
20
1
1
::;:■ ;:;;■ ""■i
t
2
15
11
51
2
1
•»
1
54
1
ll
ll
4
, , , . ,
SI
4
Divisiox OF Vital Statistics
1 "^^
Record of each reporting local hoard of health, showing total
deaths/ etc. — (Continued)
(Cities are printed in small C4ps, villages in itdiet and towns in Roman type.]
COUNTY AND
REGISTRATION
DISTRICTS
1
3
1
1
1
9
1
1
1
Whooping oottgh
1
1
1
■""4
Tabercak»s
of hugs
1
* 2
19
* 3
1
1
3
2
3
68
17
3
3
1
S3
<
BROOBIE COUNTY-
(Cmtinued).
25
04
30
34
904
188
1
5
2
3
S9
7
6
•
21
Vnicm
1
1
1
- • • ■ •
2
1
78
Vestal
24
Windsor
26
CATTARAUGUS CO...
OUIAF
5
1
7
/
6
7
2
/
9 St
7/5
147
Alkgsny
47
23
35
Atijerd.
1
1
17
CanoQton
15 2
1
1
1
1
1
12
Cold Spring
0
26
18
9
5
27
11
1
3
.....
2
1
7
Conevango
20
Dayton
1
13
EMtOtto
8
Elko
....
1
1
3
EDioottTiUe
2
24
Farmcrarille
1
10
FianklinTille
41
13
29
2
1
3
2
1
1
35
Freedom
11
Great VaOey
2
1
1
24
HiiMdale ..
20
9
11
10
22
5
35
10
n
1
2
18
1
6
Isehitt
1
1
1
4
1
1
1
3
1
1
9
Lmn
....
9
Little Valley
1 . .
. • . . .
1
1
16
Lyndon
4
Madiias
1
3
2
"2
30
Maufield
. . .
6
Napolt
10
New Albion
31
11
13
12
22
27
41
3
26
85
7
32
522
17
46
16
26
10
26
18
21
18
26
11
27
14
9
20
14
82
26
47
1
2
1
1
1
1
24
Okui
8
Otto
J
2
9
Perrysbnrg
1
1
3
11
Pema
■
1 . .
1
2
1
18
Portville
1
1
2
1
23
......
•■■?
1
36
Red House
'
3
Salamanca .... . . .
....
1
3
3
■ 2
3
6
19
Sottmonn
' 1
2
1 A
64
Sooth Valley
'l
•■•■I
, 1 . . .
1
6
Yorkshire
: il i
\
1
2
68
41
1
1
2
IS
2
"2
7
69
39
2
I
1
1
1
3
18
CAYUGA COUNTY ...
AlTBUBN
/
18
3
/
6 3
5 3
/
1
rl n
6 -^A
760
386
Aiirelin
^
14
Bratus
2
J
1
> • • • ■
3
39
Cato
1
i
12
Cooqaest
2
. . .
••
23
Flemmg , .
2
1
i
i
6
1
2
....
7
Genoa
1
19
Ira
1
1
....
16
Ledyard
1
-
1
1
1
17
Loeke
15
Menu
20
Mcmtesoma
2
■"■4
1
1
8
Moram
1
20
Niks
> • • ■ .
13
Owaseo
.... 1 . . - .
1
2
• • ■ • •
6
\
18
IfQIBPfOQIIIf ,
14
r Scnaett
6
1
2
.....
4
4
2
4
22
L BDrtSCDOfY
6
2
.....
16
liSSSt.
. . . • .
■ 3
32
158
Statk Dki»ai{t\ikxt of Health
Record of each reporting local hoard of health, showing total
deaths, etc. — (Continued)
[Cities aro printed in small caps, villages in Ualici and towns in Roman type.)
.s
Diarrhea (under 2
years)
M
COUNTY AND
1 ."S
; 1
1
b
Whooping cough
i
REGISTRATION
DISTRICTS
1
<
Cerebroepin
m
1
1
J
1
i
J
Q
3
i
c
s
8
a
o
<
CAYUGA COUNTY—
1 ■-' ■■■
1
(Cond'ntMd)
1
Summer Hill
5
1 • • •
. . ■ .
5
Throop
6
[ 1
1
.....
5
Venice
18
21
* . . .
4
14
Victory
1
I
19
CHAUTAUQUA CO .
1,639
4 15 j S4
11
7
2l\ 63
. '^^I
S6
88
1.194
Dunkirk
279
4
25
4
9 23
ll'
2
13
188
Jaukbtown
404
1 9;
4
1
1
5
8
23,
4
21
327
Arkwright
» 7
! «
2
I
5
Busti
38
29
16
83
1
1
1
3
1
2
1
1
1
3
1
31
Carroll
1 1 . . . .
1
* ' ' ■ . . -
23
Charlotte
1
•
14
Chautauqua
1! .. V.
1
5
75
Cherry Credc
14
1 1
2
2
10
Clymer
26
1 ..... 1 .... 1 ....
1
?
5
18
Dunkirk
I
Ellery
21
1
. . . . 1 ....
1
.
1
20
EUicott
56
::... 1
__
4
2
3
1
4
41
EU'mKton
19
79
1
2
7
* 2
2
2
15
Frtdonia
1
....
1
2
7
57
French Creek
10
19
'
1
1
9
Gerry
2
. .
1
i
2
13
Hanover
98
43
4
8
14
2| ....
(.....
■.'...'
9
2
4
1
...
'2
2
1
9
5
3
73
Harmony
32
Kiantone
4
Mina
6
Poland
1
10
Pomf ret
23
38
28
24
22
37
14
22
64
.. ..1
2
I
1
1
■ 2
1
1
2
4
i
1
.
3
• • • t •
1
20
Portland
34
Ripley
Sheridan
25
1
18
Sherman
20
Stockton
. . .
1
32
Villenova
1
11
WestfieW
■ ■ ■ ■ 1 ■ ■ ■
1
'
1
18
Wettfidd
1
1
3
3
3
2
45
CHEMUNG COUNTi'
865
s' 14
1
2' 1
B 9
to
62
22
53
684
Eluira
554
1, 10
21 1
5, 8
14
19
11
38
445
Ashland
8
10
1 I
1
1
1
6
Baldwin
• • •
10
Big Flats
19
. 1 1
2
1
15
Catlin
10, 1 ....
.1
1
10
Chemung
27. i....
. . .
4
2
20
Elmira
73 1 1
1
1
i7
2
1
49
Erin '
18;
1
1
2
15
Hora^eads
76
27
12
1
1 ...
1
....
10
1
. . . . 1
1
2
5
1
1
3
5.5
58
Sou^port
VanEtten
22
1
1
11
Veteran
31
698
■ ■ 1
1
2
15
3'
23
Si
23
CHENANGO COUNTY
5 S
1
/!
5
l\ 4
488
Afton
30
1
1
1
1
I
1
2
23
Bainbridge
31
i
1,
1
1'
3
1
1
23
Columbus
14
1
1
1
1
.
H
Coventry
171 .,
.
1 .
0
15
German
2i . .
1
1
1
Greene
48
- ■ . .
.
1
4
3
40
Guilford
391
,
1
1
2
35
lincklaen
4 .
1
... . ....
. . . . 1
.
1
3
MoDonough
17
■ ■ ' ' i ....
1
1
15
New Berlin
41
1
i
1
1
3
34
North Norwich
13
. .
• • •
3
10
Division of \*itak Statistics
159
Tircord of each reporting local hoard of health, shomn<j total
deaths, etc. — (Continued)
(Cities are printed in small caps. Tillages in Ualiet and towns in Rfjman type.]
COUNTY AND
REGISTRATION
DISTRICTS
t
<
Cercbro-«pinal
meningitis
1
0
1
1
Whooping cough
1
Diphtheria
1 Diarrhea (under 2
i years)
Tuberculosis
of lungs
9
1
1
1
1
1
2
1
1 0
1
\
3
" '1
2
1
1 1
i 27
.....
1
1
All other causes
CHENANGO COUNTY
Norvieh
NerwitA
11
122
17
75
9
12
9
17
41
2
6
2
7
2
1
1
1
3
6
1
01
OtreBc
Oxfocd
14
67
Fliarmlia
8
Pitdia'
Plymooth
2
1
1
2
i
9
. . - . .
7
12
Sberbome
37
SmithTiUe
11
18
.....
9
^QIYfBft ■ . '
1
17
CUNTON COUNTY
AUoDa
676
21
S
r.
// 8
16
6
S5
2
1
1
69
3
2
4
18
3
1
1
486
[ 13
Aosable
Bfif4in>nto«^
27
40
23
. . . .
'.'.'.'. 2
1 I
3
21
28
BhdcBiook
3
3 4
18
Champliii
Chasy
CUntoa
61
36
27
1
2
1
3
5
1
4
3
7
23
3
1
62
26
1
2
4
2
! 5
2
1
40
1
1
1
5
. . .
27
19
Daanemora
EOenburgh
27
1
22
14' 1
61
5
:':;'i
12
7
2
1
.....
17
•j
2
I
3
1
.. .
■■■ 2
1
1
"2
....
8
1
1
9
3
2
^i
1
5
4
. . . . 1
2
2
3
1
1;
7'
1
1
2'
1'
1
32\
. .1
41
Peni
28
i
8
3
S
1
1
... ....^
....! 7
2
2
S SS
2 17
23
Hattabnrg
51
195
47
18
768
236
18
10
14
67
70
20
26
8
1
i
1
3
1
39
PLktrnvma
Saraoae
Sehnjlo' Falls
2
4
1
136
35
12
COLUMBU COUNTY
12
6
/
696
HrMON
174
Ancmn. ...
13
Ausierlita
8
Canaan
i
1
1
1
- • - • •
41
4i
ll
1
2
2
2
6
1
2;
6
2
13
1
4
'•
1
1
2
1
13
Chatham
54
CkTcraek
Clcnnoot
Copake
3
..' ;.■ 2
1
56
19
21
Gabatia
1
1
4
22 ,
54
15
22
6-^'
20 . .
20
47
1
1
2
1
2
1
21
Ghent
.
45
Grccnpoft
HJlUale
Kinderbook
2
*
....
11
18
46
Lirinaion
Nev Lebanon
• 1
. 1
1
16
15
Stockport
... 1
]
35
StuyreMnt
Taghkanir
CORTLAND COUNTY
25
11
628
15
219
16
•*
11
22
49
8
23
111
15
t
1
i2\
1
1
2 2
1
2
1
3 8
. ' 2'
•• 2, 4
1
20
6
U6
14
Cortlaodville
COBTlAlffO
1
1 9
. ...
1
2
1
■ 2
8'
14
i
2
1
2!
■■ '21
1'
. 1
45
184
Cttyler
Freetown
....
1
15
6
Harford
HooMr
1 1
....
1
1
9
18
Htmer
Lapefr
2
1
1
40
5
Marathon
Pktble
Scott
-.'■■■
1
20
10
10
100
Statk 1)ki»aimmi:nt of TIeai.th
liecord of each reporting local hoard of health, showing total
deaihs, etc, — (Continued)
(Cities are printed in small caps, villagci in ifolict ani towni in Ram in t/no.)
COUNIT AND
REGISTRATION
DISTRICTS
AU deaths
Cerebrospinal
moiingitis
1
Malarial diseases
Scarlet fever
J
Whooping cough
Diphtheria
Diarrhea (under 2
yean)
Tuberculosn
of lungs
t3
Ni4
Cancer
CORTLAND COUNTY
—{CmHnwi)
Solon
11
9
18
22
12
7U
41
11
45
26
45
9
46
20
70
17
Taylor
TruxUm
1
1
Virgil
1
Wifiett
1
DELAWARE COUNTY.
Andes
t
i
/7
2
5
....
It
3
11
2
4
16
V
3
SI
1
4fi
1
Bovina
2
Colchester
3
1
1
1
1
2
?
3
Davenport
1
Ddhi
1
4
3
Deposit
Fn^nklin
1
1
1
1
?
1
4
Hancock
1
2
4
?
fi
Harpersfield
1
1' 1
Kortaight
20
i
1
3
1
1
.....
4
?
, 4
5
2
5
79
27
1
Maaonville
13
19
1
Meredith
Middletown
76
35
72
1
1
1
4
4
2
?
2
2
5
I
\
ISO
35
1
2
2
1
2
3
6
2
1
]
IS
2
Roxbury
Sidney
3
4
1
1
IS
5
2
Stamford
46
Tompkinii ,
26
88
466
30
15
20
37
24
58
67
41
4
2
... 1
2
1
Walton
t
1
6
DUTCHESS COUNTY.
PoUOHKKEPSn
5
1
1
9
7
IS
4
69
21
1
Amenia
Bedcman
Clinton
1
2
1
8
1
1
.....
1
1
Dover
4
EastFishkill
1
Fishkill
2
2.
Fishkill Landing
1
1| 3!
HydePftrk
1
2! li
T^^Gr^ngf , ,
15
122
1
I
1
5
1
6
1
4
5
1
1
4
4
2
1
1
2
5
4
S74
305
3
3
7
1
4
3
MaUmwan
10
4
Mili^n
13
44
41
24
"i
North East
1
2
3
1
1
2
1
■•■2
i
2
1
4
16
4
I
3
1
7
5
eo8
510
7
3
4
• • * .
■ 1
.....
. • • • •
• • ■ • -
16
3
• • • • •
Ptwling
■
Pine Pfiiins
1
i F
Pleasant Valley
34
68
... . J
1
1
PcNighkeeneie
1
1
Red^Hook'
52,
651
35 1
2
2
.'.'... 1
Rhinebeck
2
Stanford
1 1
Union vale
11
30
51
69
-
1
WapiHnger
1
1
4
3
2
1
264
5
4
6
Wappinger Falls
Wasnington
1
1
i
1
ERIE COUNTY
BUPPALO
8,658
6.877
106
49
65
26
16
S3
111
19
14
86
78
3
tS7
223
tst
97
86
80
1
18S
163
1
ToifAWANDA
Akleo
Anihcfflt
Aurora
1
1
1
8
1
Boston
I
1
11
3
1
1
9
1
""2
Brant
1
5
. . • • •
Cheektowaga
......
1
i
Clarence
37
.,,,,,
10
9
17
22
12
667
29
8
36
21
34
9
36
18
53
14
15
10
18
69
25
56
34
19
73
i,its
362
26
13
15
29
20
42
55
35
13
97
U
36
31
20
27
45
39
55
22
7
22
32
58
6,318
5,127
83
39
49
24
9
27
79
99
Division of Vital Statistics
161
Record of each reporting local hoard of health, showing total
deaihs, etc. — (CSantinued)
[Cities are piinted in small OAn, rillaffes in UdUa and towns in Roman type.]
COUNTY AND
BB0I8TRATI0N
DlirrHICTS
1
3
Cerebrospinal
meningitis
8
J
1
b
I
s,
1
1
1
>%
A
Tuberculosis
of lungs
1
1
b
o
3
ERIE COUNTY—
(CofKiaiMf)
CoWen
14
35
53
85
41
28
37
25
54
16
85
16
397
3?
67
23
56
28
22
27
14
63
6^3
1
6
2
8
13
CoDiM
1
1
1
16
2
2
5
2
5
.....
6
3
20
Concord
1
3
.....
44
. • • • .
6
• 8
2
47
Eatt Awitra
33
Ea«t Hamburg
1
1
3
3
5
23
Eden
1
2
2
29
KYma
"i
1
7
21
K*siw
1
2
35
Grand Island
..A.
16
Hunburg
1
1
1
1
1
3
2
7
1
18
2
6
1
1
1
.....
1
2
8
1
4
1
3
3
2
1
t8
3
3
1
2
2
69
Holland
U
hadnwfum/n
14
2
1
23
1
2
1
7
98
1
6
230
lAncairtfr
25
Lonevttr
48
Marina
22
Newstcad
2
.....
8
2
i
4
.....
39
North Collins
1
22
Sardinia
1
19
24
Wales
1
5
1
11
West Seneca
1
1
4
57
3
6
1
1
2
3
3
1
'■' io
1
9
IB
" z
3
1
51
ESSEX COUNTY
5
6
5
6
991
Cbepterfiekl
36
19
30
Crown Point
27
Eliaabethtown
1
1
12
Easez
25
36
13
13
17
11
138
2
27
8
10
19
Jsy
1
1
2
1
27
Keene
1
3
8
hakgPlaeid
^
7
Lewis
1
1
3
1
"l
1
14
Minerva
1
9
■'15
9
Moriah
3
2
95
North Elba
I
2
1
14
North Hudson
%
3
1
9
2
2
7
Scbroon
15
63
30
"2
....^
1
2
1
3
2
St
2
.....
1
13
Tioonderoga
1
1
.....
2
.....
46
Weatport
26
Willsboro
25
18
8»S
21
30
• • • .
15
Wilmington
1
/
1
11
1
2
14
PRANKLIN COUNTY..
10
i7
t8
58
3
2
in
2
2
»0
"l
sot
13
Bmucot
2
1
20
Pefanont
27
24
Boabay
36
0
16
23
48
32
25
3
32
22
13
108
75
4S
2
• • • • ■
4
1
1
6
1
22
Braodoo
1
1
6
Brighton
5
3
1
5
1
10
Burke
2
1
• • « . •
1
3
1
3
2
.....
14
Chateaugay
4
40
Constable.'
1
2
■ • • • '
S3
Didcinson
2
• • • • •
18
Duant
3
Fort Corington
1
2
....
1
....
1
1
1
5
6
2
3
6
4
16
7
1
1
1
24
FrtokUn
13
Harriettatown
7
MoUmt
2
3
2
5
4
1
3
2
6
4
1
4
6
1
72
Malooe
41
Moira
31
Santo Clara
2
^
2
6
162
State Department of Health
Record of each reporting local hoard of health, showing total
dealhs, etc. — (Continued)
[Cities are printed in small caps, villages in iialiet and towns in Roman type.]
COUNTY AND
REGISTRATION
DISTRICTS
FRANKLIN COUNTY-
{Contin\t/td)
Saranac Lakt
TvpperLake
Waverlv
Westville
FULTON COUNTY...
Glovbrsvillk
Bleecker
Broadalbin
Caroga
Ephimtah
Johnstown
Johnstown
MayfieW
Northampton
Oppenheim
Perth
Stratford
GENESEE COUNTY..
Alabama
Alenmder
Baiavia
Batavia
Bergen
Bethany
Bsrron
Darien
Elba
Le Roy
LeRoy
Oakfield
Pftvilion
Pembroke
Stafford
GREENE COUNTY...
Ashland
Athens
Cairo
Catakill
CaUkiU
Coxsackie
Durham
Greenville
Haloott
Hunter
Jewett
Lexington
New Baltimore
Prattsville
Windham
HAMILTON COUNTY
Arietta
Benson
Hope
Indian Lake
Inlet
Lake Pleasant
Long Lake
Morehouse
Wells
1
B
'1
1
^
1
1
1
2
2
c
'1
3
1
i
•a
Q
1
2
u
b
2
4
1
1
9
' 1
*1
14
6
J
4
1
2
4e
15
150
50
39
19
ere
321
6
29
11
29
143
39
34
25
15
7
13
689
31
28
206
30
35
30
20
19
11
47
24
17
25
44
22
628
^ 8
41
41
68
96
72
32
26
4
46
7
11
33
14
29
66
4
1
3
8
5
11
10
0
14
99
10
2
1
40
16
4
2
•f • ■ '
1
4
4
/
5
3
14
2
3
2
1
11
5
1
1
• • • • >
2
.....
4
ft. . . .
....
"■3
.....
2
13
2
2
1
2
1
7
2
1
1
1
. • . • «
2
IS
2
"■3
1
1
S6
2
1
17
2
3
/
8
t
6
5
t4
2
1
9
1
ee
3
2
7
2
1
2
1
4
2
3
2
1
1
1
1
2
2
2
1
1
2
1
.....
3
1
1
1
4
2
3
1
1
61
1
4
5
10
15
. 6
3
2
.....
2
6
« • • • •
. ..
■ 3
1
1
3
St
1
1
4
3
5
4
3
2
1
1
to
1
5
t
15
> . • . .
1
1
5
1
4
2
3
• • • ■ "
2
2
.....
1
1
1
1
7
1
1
2
2
3
6
1
0
I
1
1
2
4
f
1
... .
5
1
1
5
1
"l
2
1
. . ,
3
I
....:
.....
2
1
1
s
39
29
34
17
6Sr
260
6
18
9
26
108
30
29
22
12
7
10
22
24
158
23
31
27
20
16
8
34
21
16
20
37
15
400
5
35
31
48
72
57
24
16
3
37
7
8
29
9
19
41
2
1
3
6
4
9
6
Division of Vital Statistics
163
Record of each reporting local hoard of health, showing total
deaihs, eic. — (Continued)
(Citiea are printed in small caps, villages in italiea and towns in Roman type.]
COTT^TY AND
REGISTRATION
DISTRICTS
1
3
'3
la
1
s
1
1 Typhoid fever
•a
1
1
4
8
1
5
1
7
1
Diphtheria
• Ot
1
|1
Q
55
TuberottkNns
of lungs
\
z
d
^•*
15
2
1
40
3
1
1
<
HERKIMER COUNTY
Cohimbia
869
26
8
13
25
56
55
121
35
90
u
194
8
21
21
10
4
42
27
10
19
17
18
6
29
1,S6S
468
73
67
40
51
36
57
36
59
73
22
36
44
18
30
32
25
35
18
32
39
11
46
5
S74
32
43
38
8
9
5
12
32
68
13
26
6
1
64
1
rot
18
Dmnibf^
7
Fairfield
13
Frmnkf ort
2
3
2
5
6
4
1
1
.....
1
1
e
7
•••j,
2
5
20
Frankfort
1
1
42
German Flats
46
Btrkiwur
2
1
1
102
ff crKfmcr
28
JliOH
1
1
1
78
Litchfield
9
Ltttlb Taus
1
3
2
.....
11
10
3
159
Little F^
7
Manbeim
3
1
i
2
4
1
17
1
1
1
17
Norway
8
Ohio
3
Russia
2
2
3
1
33
Salisbury
19
Schuyler
1
1
• • . • •
. 7
Stark
1
1
2
1
16
Warren
1
2
6
1
12
Webb
u
Wihnurt
5
WinfifM
1
5
3
3
73
23
6
6
1
■ 1
1
3
4
2
1
3
1
1
1
3
25
JEFFERSON COUNTY.
t
1
SP
24
1
1
1
1
/
55
15
1
•7
45
20
2
2
I
69
21
4
5
3
2
4
3
1
5
2
4
2
1
1
2
1
2
1
ts
4
1
1
1
.....
2
3
4
"3
.....
1.064
357
Adams
59
Alexandria
47
Antwerp
33
BrownviDe
47
Cape Vincent
3
28
Cartiiao*
2
4
2
46
Champion
1
27
Clayton
2
44
EHkburg
65
Henderson
. 2
15
Houi^eld
28
LeRoy
• -*••••
1
8
1
1
1
1
3
1
37
Lorraine
14
Lyme
25
Orleans
2
1|
22
Pamelia
22
Philadelphia
34
.
1
1
1
1
1
1
3
3
8
"3
13
Rntland
1
1
1
■ ■ ■ ' *
1
2
1
.....
1
23
Thftesa
26
Watcrtown
10
Witaa
Worth
i
3
. . .
2
38
4
LEWIS COUNTY
t
;
10
1
rr
1
6
7
1
14
2
1
3
te
1
2
1
1
t9i
Croglnn.
27
Pmmark
34
Diana
27
Qm^
6
HarrinMinr, ..........
1
8
High Maitet
1
2
3
5
1
5
4
Lews
1
3
2
9
Lerden
1
1
5
i
2
26
LowviDt "..'..!
1
54
L^oosdale.
MartinrtrarR
10
1
19
Montague
6
164
State Department of Health
Record of each reporting local hoard of health, showing total
deaths, etc. — (Continued)
[Cities are printed in bmall caps. TiUaffni in UaHet and towns in Roman type.]
county and
registration
districts
LEWIS COUNTY—
(CvnHnuei)
New Bremen
Oic«ola
Pindmey
Turin
Wataon
West Turin
LIVINGSTON COUNTY
Avon
Caledonia
Conesus
GeneMO
GroveUmd
Leicester
Lima
Livonia
Mt. Morris
m.Mam»
North Dansville
DamvilU
Nuoda
Ossian
Portage
Sparta
Sprinffwater « . .
West Sparta
Yorlc
MADISON COUNTY ..
Brookfiftki
CanatU^a
Caienovia
DeRnyter
Eaton
Fenner
Geovptown
Hamuton
Lebanon
Lenox
Lincoln
Onvida
Madison
Nslson
Smithfield
Stockbridge
Sullivan
MONROE COUNTY. . .
ROCHBSTBH
Brighton
chm;
Clarkson
Pttirport
Gates
Greeoe
Hamlin-
Henrietta
Irondequoit
Mendon
Ogdso
Panaa
PenfieJd
PerintoB
I
16
3
8
10
22
23
690
51
39
13
42
12
17
32
30
13
58
U
74
42
7
8
7
16
0
30
619
35
62
65
25
54
8
17
61
15
22
10
118
32
16
10
20
49
8,9St
3.084
42
15
23
48
52
127
18
28
40
. 44
49
35
27
52
SB
30
J
S4
47
1
8
1
t
15
IS
10
1
I
4i
34
1
.•«
1
1
«5
1
2
1
1
1
8
fO
1
3
1
976
203
5
2
3
42
1
2
2
1
3
10
H
1
8
2
1
2
8
919
277
8
2
3
5
77
1
2
1
1
1
99
17
2i
2
99
2
1
8
2
8
5
4
3
2
1
8
5
965
213
3
1
3
2
8
5
3
3
13
3
6
8
19
17
45
31
9
33
12
14
28
25
10
41
11
59
38
5
6
6
15
6
27
SOS
20
47
58
19
49
7
12
49
13
16
10
88
26
12
7
19
42
9,865
2.228
24
18
18
41
41
73
12
23
26
31
44
31
22
39
Division of Vital Statistics
165
Record of each reporting local board of health, showing total
deaihsj etc. — (Continued)
(CitiH are priatei in small cam, villaffee in iiaUa and towna
m Roman type.]
COUNTY AND
REOTSTRATION
DISTRICTS
1
3
•3
e
1
1
1
1
1
{
1
C9
•
2
1
•8^
1
.....
I
3
3
1
1
4
3
3
57
15
3
3
2
1
3
2
3
3
.....
1
6f
27
10
17
2
6
5, TOP
1,915
323
1,212
185
74
68
12
14
1
1
3
3
2
1
t
1
MONROE COUNTY—
(CoatffiiMd)
Pittrfoid
48
26
20
21
50
51
32
994
540
54
59
10
17
45
34
61
46
. 52
27
49
t.iss
457
278
311
41
46
78,760
38.668
6.968
25,676
3,971
1,467
i.m
299
551
15
28
41
62
42
16
15
30
70
34
15
160
26
i,6se
1.297
411
17
24
57
16
52
15
1
2
1
1
2
1
38
Rin
1
19
TiaOi
18
Sweden
1
20
BaOOKFOBT
1
1
■ 1
3
1
101
89
4
2
2
2
1
60
32
5
3
1
2
7
2
"2
41
W^jetv
1
1
1
a
1
38
Wbealiand
1
10
8
25
MONTGOMERY CO...
AMsmoAii - -
1
10
7
1
6
4
1
• • . • .
i
1
747
369
Amitardam
39
1
1
47
Charleetown.
8
Floricb
1
1
1
2
15
Glen
1
1
3
4
5
2
4
70
32
7
23
2
6
8,690
3.976
1.779
2,429
368
148
85
25
32
2
.....
1
.....
P
3
1
4
1
see
162
26
144
24
10
14
1
6
.....
40
Minden
30
fori Phin
2
51
Mohawk
1
37
Palntm
•
1
45
Root
24
StJohnsriUe
1
1
9t
34
29
20
3
6
6,656
2.904
316
1.996
335
104
85
11
45
42
NASSAU COUNTY
HempBtead
North Hempatead
Oyster Bay
t
1
i
6
2
3
t
1
1
9
7
2
f
* 2
6
2
2
2
^ 14
5
4
4
1
859
343
219
238
BodniB* denkr
32
mT^^V^^m
994
177
29
72
12
4
6
1
2
1
658
26»
41
19g
3»
11
*i
3&
27
NEW YORK, CITY OF
Bor. of Madliattan
Bor. of Bronx
te
71
3
13
3
95t
448
75
384
33
12
16
3
5
774
271
45<
422
3(V
&
19-
3
14
M94^
154
23
92
21
4
It
"9
1,715
898
136
558
104
19
t2
4
10
55,777
27.487
4.172
Bor. of Brooklyn
Bor. of Queens
Bar. of Riehaiond
NUCTARA COUNTY...
LOOKPOST
18.156
2.827
1.075
1.047
237
NiAOAKA Falls
384
12
Hsrtbmi
1
25
Lewiiton
2
1
1
1
1
1
'"■3
3
3
1
31
Loekfort
1
54
New^
36
Ntagm
■ 1
1
12
Pendleton ..........
-
4
3
3
3
1
6
2
'^
23
1
1
1
6
1
3
1
11
Forter
1
1
2
i
2
3
1
8
1
187
91
26
""5
.....
35
18
7
23
RoyahoB
> • • • •
I
1
2
1
1
21
55
1
26
Wheatfield
1
&
11
N. TOHAWAMDA
Wibm
3
2
7
107
23
ONEIDA COUNTY. . . .
Utica 1
6
5
5
/
i
IS
11
3
19
14
2
1
5a
14
10
les
100
27
i.m
971
R(k|ft . .
309
AnnffTiDe
15
Aiimla
1
3
1
18
Ava
1
. . , , , 1
7
1
3
47
BndgBwatv
3
12
OBuim...../. ......
L
..... 1
3
8
2
1
36
DMrMd
::::: .::;:i
12
166
State Depabtment of Health
Record of each reporting local board of health, showing total
deaihs, etc. — (Continued)
[Cities are printed in small caps, villaises in italiet and towng in Roman tjrpe.t *
COUNTY AND
REGISTRATION
DISTRICTS
1
3
.5
•|
c
'1
1
J
.•2
1
1
1
i
Whooping cough
1
1
1
1
,•8
5
.....
1
1
3
3
2
1
1
6
1
1
1
ONEIDA COUNTY—
(Continued)
Florence
•
15
10
19
56
10
13
25
01
, 37
28
1
1
2
4
11
Floyd
7
Forestport
1 1
1
12
Kirkland
2
1
46
Lee
17
Marcy
12
Marshal]
2
7
3
5
.....
22
New Hartford
1
6
2
71
Paris
1
29
HftniffTi , .......
1
21
Rome
Sangerfield
16
13
25
38
44
28
22
33
107
S,0S8
2,124
36
29
29
48
47
49
26
10
13
46
52
87
27
141
18
33
45
53
77
11
24
33
781
16
11
16
157
25
23
7
175
17
30
116
17
54
17
33
2
2
1
2
3
2
5
12
Steuoen
3
1
1
2
8
4
1
2
4
0
189
123
' 2
8
Trenton
10
Vernon
1
1
SI
Verona
1
36
23
Western
20
Westmoreland
6
5
1
2
6S
38
•
■■"3
51
15
.....
.....
3
2
2
17S
125
1
'■"4
4
2
1
2
26
Whitestown
1
7
4
S6
25
15
198
166
3
76
ONONDAGA COUNTY.
Stra cubx
te
22
If
9
9,Si7
1.692
CamilhiB
30
Cicero
i
1
1
24
Clav
1
2
2
3
1
1
1
2
2
5
1
25
22
De Witt
1
1
40
Bast Svraeuu
2
.....
3
87
Elbridge
1
42
Fabius
20
Geddes
1
8
La Fayette
""2
2
2
1
1
3
2
7
2
6
2
1
3
1
3
11
Lysaiuler
3
2
83
BaUwinnUU
1
1
46
Man lias
1
1
68
MarceUus
« 21
Onondaga
1
1
108
Otisco
16
Pompey
2
1
2
8
8
28
Salina
1
88
Skaneateles
2
1
1
47
Solfay
1
8
45
Spaff ord
9
TuDy
1
• • •
2
1
66
1
1
1
22
20
Van Burcn
4
36
1
1
1
4
1
16
1
2
1
27
ONTARIO COUNTY..
Bristol
/
9
1
5
1
5
ff
6tS
13
Canadice
7
Canandaigua
1
2
1
9
Canandaiava
1
123
East Bloomfield
23
Farmington
1
' 2
10
Geneva
2
13
2
1
5
5
GentM
1
3
1
2
2
11
ISO
Oorham
13
Honewell
1
7
1
11
1
5
27
Manchester
1
2
2
88
Naples
16
Phelps
»
3
1
1
1
1
44
Richmond
16
Seneca
l" 3
20
Division of VitxVl Statistics
167
Record of each reporting local board of health, showing total
deaths, etc.— (Continued)
(Cities are printed in small caps, riUa^es in ttitici nnd towns in Roman type.]
COUNTY AND
REGISTRATION
DISTRICTS
ONTARIO COUNTY
(Continued)
Sooth Bristol
Vtetor
West Bloomfield
ORANGE COUNTY..
NlWBUKOH
BflDDLSTOWlf
Blooming Grove
Chester
Com Will
Crawford
Deerpsrk
Port Jenris
Goshco
GreeDTiUe
Hamptoobur^
Hi^hlaods
Mmisink
Monroe
MoDtg(»nery
Mount Hope
Newborgh
New Windsor
Tuxedo
WallWl
Warwick
Wawayaada
Woodbury
WaUUn
ORLEANS COUNTY.
Albion
Albion
Barre
Carlton
Clarendon
Gaines
HoDcy
KendaU
Murray
Ridgeway
iMna
Shelby
Yates
OeWBOO COUNTY..
OawMO
AlbioQ
Amboy
Boylston
Coostaatia
Granbv
Hannioal
HMtinp
M«doo
N««HaT«D
OrweU
Oivego
Pklorno ^.
VviA
BedMd...'.
RieUand
Sandy Creek
I
9
38
20
t,OOS
610
275
26
32
93
27
35
170
124
8
22
62
25
50
47
37
76
51
60
40
121
26
39
49
496
85
35
25
37
25
27
11
19
52
23
101
28
28
t,lt7
385
24
11
10
27
22
30
41
73
19
7
46
18
25
9
60
39
f7
12
4
18
12
16
3
3
IS
6
i
14
4
2
II
6
it
5
2
1
1
2
1
86
25
1
3
1
3
2
2
6
4
5
1
6
1
5
3
17
6
4i
18
3
167
60
27
4
7
1
4
11
11
2
1
2
4
1
10
5
2
6
3
9
3
6
66
9
6
1
2
4
3
2
1
3
tt
5
1
//
19
98
26
16
3
1
10
9
1
1
3
1
2
6
64
6
2
4
1
2
4
. • • > •
1
4
3
1
1
8
1
1
1
66
20
1
I
I
3
5
83
14
1,660
372
220
22
23
72
22
29
136
96
6
19
49
19
36
39
24
69
42
46
82
88
17
29
34
669
61
26
18
80
17
18
9
16
40
20
85
24
26
90S
812
17
10
8
24
16
26
84
64
14
7
40
14
20
6
64
31
168
State Depaetment of Health
Record of each reporting local hoard of health, showing total
deaths, etc. — (Oontinued)
(Citie* are orinteH in an ux cam, Tillaffei in UaMct and towns in Roman type.)
COUNTY AND
RBOISTRATTON
DISTRICTS
J
1
1
1
1
2
1
s
1
il
&
c
1
e
.....
6
1
i
8
OSWBOO COUNTY-
Sohro^pd
43
23
37
155
12
11
84B
11
8fl
2S
22
18
24
23
31
51
82
2?
12
12
181
32
27
68
10
12
45
20
20
47
8
40
46
18
16
W
15
M
50
tjst
1.5fl7
23
32
27
13
m
35
87
36
15
13
38
16
27
72
69
24
1
1
3
13
s«
Seriba
3
18
Volney
1
1
1
30
PrTLTOIf
1
1
3
7
116
Went Monroe
11
Williamstown
1
81
1
1
tr
.....
2
2
2
2
1
61
1
8
OTSEGO COUNTY....
Burlincton
4
/
/
/
t
fff
70S
9
Butternuts
34
Chemr Valley
24
Decatar
1
■
4
EHmeston
1
17
Exeter
15
Hartwiek
2
1
2
1
3
5
2
1
17
lianrens
1
21
Maryland
2
■'2
I
25
Mi^dlefield
40
MUfoid
SO
Morris
3
3
2
13
1
2
4
18
New Lbbon
2
7
Oneonta
1
2
9
OlfBOMTA
9
1
1
6
1
3
.....
2
4
150
Oteito
28
Otseco
22
x^Of^WT^^O^W^ ••••>#•••..
47
Pittsfirid
10
PWnfield
1
1
1
1
1
1
"2
10
Richfield
1
40
Roaehoom
19
21
8i!)nn<'fi(wl
1
1
2
1
3
UnadiBa
2
3
41
Weetford
R
Worcester
3
//
2
1
18
2
4
3
3
3
6
2
2
18
40
PUTNAM COUNTY....
f
/
f
/
i08
Cannd
5 35
Kent
1
13
Patterson
1
2
2
10
Philipetown
1
2
1
57
' 13
41
Putnam Valler
1
1
South East
1
2
3
8t
67
2
4
t$8
176
3
2
2
1
.....
8
Cold Spring
1
/
3 39
RENSSELAER CO
Trot
//
0
15
it
17
16
15
tt
4
18
13
114 1,700
83 1,176
Berlin .•
3. 16
Brunswick
1
1
1
J
14
27
East Qreenbush
21
Grafton. . '.
12
RlFSeBLAIR . ,
3
1
1
1
7
1
1
1
2
15
3
3
.....
no
Hooeick
80
Boontk FalU
1
1
3
1
11
4
2
06
Naasau
26
North Oreenbosh
1
11
Petersburg
13
Pittsiown
1
2
1
1
3
1
2
1
2
1
8
1
4
7
1
.....
3
2
3
32
Pbesteakill
1
9
Band Tjike
24
Sshashtfeoke
1
8i 56
Behodaok
2
1 54
Btfephflntown
1
• • • • •
11 18
Division of Vital Statistics
169
Record of each reporting local hoard of health, showing total
deaths, etc. — (Continued)
[Cittea are pfrinted in small ooe, villaReB in itaUet and towns in Roman type.)
COUNTY AND
REniRTRATION
DISTRICTS
3
•B
1
i
4
1
1
1
4
1
i
1
4
2
1
1
5
1
7
2
■*"8
2
S4
5
8
8
9
6
1
ROCKLAND COUNTY.
Clarkitown
668
99
97
133
97
122
21
52
47
i,ssi
268
29
104
7
24
26
26
14
25
24
15
95
23
25
23
23
29
22
14
24
15
50
40
3P
43
23
16
20
12
61
78
15
21
• 36
23
l\076
74
31
11
40
46
8
12
22
'I
31
24
IIT
41
39
1»
9
s
37
5
6
7
2
9
1
4
3
61
16
1
3
2
2
1
03
9
13
9
5
16
2
4
5
66
17
4
30/
73
HavsUaw
71
Onuwetowa
....*.
f
.....
103
tiyoA
2
2
1
.....
75
RAinapo
1
2
1
86
Svrina VaOm
16
StonT Point
2
1
37
1
1
4
1
2
35
14
1
1
1
3
?
40
8^€m
37
ST. LAWRENCE CO...
OODKHBBCBO ..........
9
t
ti
•
f
1
17
f
9
4
'•SS?
Praflh*
27
1
1
87
Clar«
4
CliftoB
> • • • • •
1
1
19
CottMi
i
1
4
5
20
DeKaS)
1
16
De Pevster
10
Fidwanfa
1
1
2
1
■**'j
1
2
2
1
6
1
2
1
17
Tine
1
1
1
6
4
1
i
17
Fowkr
IS
GouTwnear
t
1
f
1
4
2
2
1
6
4
1
.....
6
67
12
Hermon
1
18
Hopkintm
21
litWf^lMM, ^ . . ,
21
LasboB
23
LotiigTille
1
2
1
1
19
Maconb.
1
1
2
1
.... .
1
9
Madrid
20
■
1
14
Af OAMIM ,
5
1
1
43
Morriaioini
...
i
1
1
2
1
1
8
1
1
2
34
Norfolk
1
I
4
3
1
4
31
Oswecatehie
1
u
ParMhTille
2
1
17
Pkrecfield
1
10
Ptenepont
8
1
6
6
2
8
1
74
5
1
1
2
4
4
16
PHeaira
1
2
1
8
Potsdam
1
43
Pcfnrfani.. . . .
I
3
62
Ti^jnif
13
Rnmfl
1
2
ts
■'2
• • • ■
66
4
3
1
2
1
2
I
8
2
• •
2
1
4
2
2
18
Stoekhohn
30
WaddiagtoD
it
SARATOGA COUNTY..
BaUtttnS^
4
2
H
li
i
7
4S
8
B09
50
BallftoB
26
CHarHon
10
l/DtSDD HBB
1
8
3
38
Corbth
8
1
1
86
Day
5
Ivdnibttfgh
11
OalvavT.
1
8
.....
1
.....
17
6
21
Ha^ty , . u
5
1
1
1
2
1
6
1
2
24
MaHa ,
1
7
2
2
20
MtAaniagU
3
2
7
1
86
Maion
85
MoffftQ
1
82
NflVvatBikn^fl^|in
17
neridaooe
• • • • •
1
8
170
State Depabtment of Health
Record of each reporting local board of health, showing total
deaihs, etc. — (Oontinuod)
(Cities are printed in small caps, nllagea in ^ioUu and towns i
n Roman tjrpe.]
COUNTY AND
REGISTRATION
DISTRICTS
1
S3
.9
1
c
r
.•2
X
£
1
1
"1
•1
1
1
04
A
1
3
1
5
1
1
o
6
1
22
4
3
s
1
=3
<
SARATOGA COUNTY-
(CanHniMd)
SaratogA
54
13
256
66
109
18
l,f49
1,070
25
49
80
6
69
m
12
17
13
57
8
17
29
25
18
43
26
47
19
30
14
19
BIS
19
8
63
59
20
14
16
16
S7i
27
26
19
22
29
29
10
114
5
19
20
62
1,198
200
174
56
40
3
2
22
6
13
40
Saratoga Springs
•
9
Saratoga Springa
Stillwater
i
i
2
2
6
4
4
1
2
10
2
6
1
m
115
185
46
Waterford
2
1
6
5
3
78
Wilton
16
SCHENECTADY CO...
5
3
U
11
1
1
10
10
18
16
84
72
1
2
6
€
4
.....
St
41
3
2
2
1
3
MS
2
1
9tM
791
Duanesburg
20
Gloiville
2
2
41
Niskayuna
1
19
Prinoetown
5
Rotterdam
1
1
6
6
2
f
12
S
3
Ml
2
2
1
4
1
1
1
1
2
2
1
1
1
9
• • • • ■
46
SCHOHARIE COUNTY.
Bloiheim
f
1
f
81S
8
Broome
14
Carlisle
12
Cobleskill
""l
1
"i
1
1
.....
1
1
.....
1
1
1
. • • • •
2
9
1
* 2
3
.....
■"6
.....
2
2
""8
2
1
2
2
'■'2
IS
1
1
4
2
3
45
Concsville
1
1
Esperance
14
Fulton
1
2
1
21
Gilboa
22
Jefferson
1
1
. . . . •
1
1
15
Middleburs
1
1
35
Richmondville
2
20
Schoharie
42
Seward
1
15
Sharon
1
26
Summit . . , ,
12
Wright
1
1
4
2
9
13
SCHUYLER COUNTY.
/
ff
177
Catherine
17
Cayuta
1
4
2
2
6
Dix
2
1
2
1
SO
Hector
.
50
Montour
14
Orange
13
Readmg
16
Tyrone
1
1
2
9
2
2
MS
2
* 1
2
5
2
11
SENECA COUNTY....
Covert
/
t
1
/
1
1
«
8
1
SOM
21
Fayette
1
24
Junitis
1
1
1
1
16
Lodi
1
2
2
.....
15
Ovid
24
Romulus
25
Seneca Falls
10
StMca FaUt
1
2
1
3
10
3
6
88
Tyre
5
Varick."'.!."
1
• 1
17
Waterloo
1
4
1
5
2
5
19
WaUrUo
3
it
1
5
• 2
7
71
6
9
2
4
S3
STEUBEN COUNTY...
COBNIKO
5
i
18
8
6
1
■ • • • ■
• • • • t
6
1
1
8
*'3
6
1
MS
4
4
1,008
172
HOSNELL
141
Addison
1
50
Avoca
2
27
Division of Vital Statistics
171
Record of each reporting local board of health, showing total
deaths, etc. — (Continued)
[Citiea M« printed in bmill caps, vUIhoi in UaUn and towu in Roonan type.)
COUNTY AND
REGISTRATION
DISTRICTS
STEUBEN COUNTY-
[Cmtinutd)
B*th
BaA
Bradford
Cnmcron
Campbell
Cnnieteo
Cntoo
Cohoeton
« Corainv
DnnwiBe
nemont
Greenwood
HwtiviDe
Hornby
HomeOiTille
HowBid
Jaaper
IJndley
Pmttibarg
PuHeney
Rathbone
Thunton
Troopaburg
Tuaearora
Urbaaa
Wayhnd
Wayne
Wert Union
Wheeler
Woodhnll
SUFFOLK COUNTY.
Babylon
BMnn
Brookhaven
Eaat Hampton
t%mwyun
Huntmgton
bUp
Patchotut
Rivcrhead
SheltiT bland
Snuthtown
Southampton
Sag Harbor
SouthoU
SULLIVAN COUNTY
Bathel
Callieooo
Cocheeton
Delaware
FalUmrgh
Forertbvqih
Fremont
Hii^iiand
Liberty
Lumberlaad
Mamakating
Netenink
g
J §
1
3
1
J
1
i
^
1
1
Jl
s
5 '
3
•
7
5
97
1
2
6
2
67
15
1
•
... .
1
15
1
21
1
2
1
43
1
1
1
1
3
1
4
13
33
-
41
1
1
3
1
8
9
30
2
1
12
10
\ . . . .
4
1
1
5
2
1
1
2
9
3
8
31
1
1
1
"3
2
27
18
24
1
1
19
2
1
10
12
1
1
15
25
1
4
3
9
85
1
.....
1
1
3
2
43
1 ■"
1
1
12
■ > • ■ ■
16
3
13
20
2
60
1
1
1
88
4
7
3
22
1
M9
.....
5
8
2
1
•
78
7
1
3
12
4
. 1
7
10
11
4
1,S0S
67
/
li
/
10
ti
IS
10
2
72
1
41
1
2
2
2
202
1
1
4
1
3
4
1
1
7
56
48
.,...
1
"3
4
2
2
1
8
6
1
6
1
7
13
2
6
t8
2
4
1
1
2
3
8
12
2
2
1
2
10
3
9
18t
1
2
1
1
17
1
2
3
111
1
8
2
166
191
1
1
50
1
77
1
2
9
58
3
f
1
1
4
1
18
1
1
1
1
.....
1
6
It
• • • •
1
■ 2
136
2
1
3
1
1
t
53
77
$78
32
1
B
1
2
7
31
15
1
23
63
1
• • • • >
4
5
27
2
26
1
5
1
1
1
.....
"2
200
■•••••
4
1
1
4
1
11
*
42
1
31
1
1
2
67
54
13
14
20
84
11
32
33
8
24
12
12
5
7
24
21
15
21
IS
9
10
15
16
9
33
38
0
12
13
16
989
52
63
31
148
40
36
132
155
80
62
7
46
96
41
51
41S
27
23
11
20
37
4
23
22
72
8
32
21
172
State Depaetment of Health
Record of each reporting local hoard of health, showing total
deaths, etc. — (Continued)
(Cities are printed in amall caps, villages in ittdiet and towni in Roman type.)
COUNTY AND
REGISTRATION
DISTRICTS
1
S3
Cerebrospinal
menin^tis
1
"2
'o
1
"3
a
1
1
8
1
§
>%
l|
6
3
1
//
3
,5
9
1
c
4
1
1
3
1
3
SULLIVAN COUNTY-
{ConHn\ui)
Rockland
60
101
16
S9S
83
25
12
43
27
10
66
54
12
23
31
548
244
28
19
56
12
60
17
32
, 27
63
l,46fi
476
6
6^
47
4
30
7
38
671
62
62
66
23
33
56
H
63
48
33
39
81
47
40
456
18
23
28
10
8
28
13
36
241
6
24
3
H
6
1
34
Thompson
2
* 1
67
Tusten
12
TIOGA COUNTY
1
f
/
1
9
4
1
IP
4
1
1
2
3
i
3
1
3
557
Waverly....
67
Barton
22
Berkshire
11
Candor
1
1
1
2
1
2
1
89
Newark Valley
• ••>••
i
4
1
2
1
1
1
'* 1
22
Nichols
15
Owei(o
2
1
60
Otrego
•
45
Richford
n
Spencer.
1
16
Tioga
31
TOMPKINS COUNTY.
Ithaca
6
5
t
1
S
I
t
9
6
t9
16
17
6
il
5
4
7
1
6
1
5
"2
S9
21
4S5
103
Carcdtne
23
Danby
1
2
2
1
3
1
1
■ "6
11
Drvden
46
EnfieU
10
Groton
1
1
44
Ithaca
1
14
I Ansinff
1
1
• 4
46
.....
2
57
14
26
Newfiekl
25
XJlyHMs *. ..
3
1
t7
5
1
57
12
43
ULSTER COUNTY
Kingston ; . . . .
5
5
2
6
2
7
2
7
1
8
1
t,lt7
361
Denning
6
Eeopiu
1
• • • • •
3
7
1
2
2
45
Gardiner
1
39
Hardenburg
4
Hurley
4
2
2
1
1
3
7
2
6
1
3
1
6
3
3
1
"2
1
2
U
.....
1
.....
2
2
J
12
22
Kingston
6
Llovd
1
1
3
■•'2
1
3
1
2
3
1
1
1
1
1
1
7
i
8
6
2
8
2
6
16
10
1
2
2
10
4
55
1
1
....^
.....
"2
1
1
1
6
2
1
9
. 1
34
Marblefown
1
48
Marlborough
2
2
3
1
1
2
44
NewPalti
1
44
Olive
1
41
Plattekill
18
Rochester .....'
1
1
2
2
.....
22
Roeendale
1
1
2
1
45
Saugerties
68
Sniiferiien
43
Shaadaken
1
1
1
1
1
2
40
Shawanzunk
27
Ulster
1
1
31
Wawarting
1
2
59
EUentiUe
37
Woodstock
2
1
34
WARREN COUNTY. . .
Bol^n
/
5
t
t
1
570
17
Caldwell
1
3
2
1
1
2
2
1
1£
.....
""4
18
Chester
1
23
Haifflte ,
8
Horicon
6
Johasbura
22
Luseme
1
1
• • • •
2
8
Queensbury
•j
1
1
32
Glen»FaU9
1
7
193
Division of Vital Statistics
17a
Record of each reporting local board of health, showing total
deaths, etc. — (Continued)
(Citief art prmted in small cips, TiUaset in Udkt and tow is in Roman tjrpe.l
COUNTY AND
RB0I8TRATI0N
DISTRICTS .
1
3
1
.9
1
1
1
1
s
1
i
1
a
a
9
5
c
1
0
• • • •
1
4
2
2
1
3
WARREN COUNTY-
(ConHnmd)
StonT Creek
13
3
36
796
47
47
7
27
100
74
87
89
14
30
17
0
25
9
44
30
8
96
757
85
31
30
24
38
17
30
35
33
36
71
1
11
Thurman
'\
Waireuburg
2
6t
6
1
1
3
30
WASHINGTON CO...
Antrle
6
i
1
6
/
SO
1
6^8
35
Cambridge
1
43
Dreeden
6
Easton
1
2
1
2
1
2
A
5
21
Fori Ann
2
1
4
2
4
9
3
1
2
1
1
3
1
2
3
2
3
4
4
5
27
Fort Edward
2
5
6
1
89
BudaonFaUt
1
57
GranfiDe
1
' '
62
Greenwich
1
73
Hampton
1
12
Hartford
1
1
1
1
27
Hefaton
1
1
1
12
Jackaon
7
Kinobury
1
...
1
11
5
1
"l
■ 1
2
2
2
3
•
se
1
1
1
5
1
2
1
1
3
1
2
3
2
21
Putnam
7
Salcni
1
39
White Creek
1
1
2
21
Whitehall
5
WkiUhaU
f
1
7
9
fe
1
2
1
1
8
9t
6
2
1
74
WAYNE COUNTY
Nt*»k
t
....
f
1
J,
2
/
ese
67
Arcadia
(
27
Sutler
2
24
Galen
21
Clydi
1
1
31
Huron
15
1
1
1
3
4
3
1
3
1
1
1
3
m
120
34
18
8
4
23
6
5
8
2
2
■ 1
2
1
""4
27
Maeedon
2
3
2
2
30
27
Ontario
1
. . . '
29
Palsiyra
1
59
Krpn' .
35
30
Savannah
22
65
32
46
63
75
4.S7S
1.266
433
69
110
72
280
91
79
1
3
1
2
1
4
S8S
180
36
3
14
14
18
Sodui
■ ■ ■ ■ I
1
51
Walworth
■ r ■ ■ ■
28
WiffiuDaoa
1
42
Wofcott
i
3
3
1
t9
5
4
1
3
1
2
2
1
....
■ 2
6
tu
59
20
5
2
3
13
2
6
2
1
1
52
LyOM
; 1
2
\
1
4
GB
28
6
1
58
WF^rrCHESTERCO...
Yoncm
5
1
S8
15
i
1
S8
18
2
I
1
.....
S,W5
831
Momrr VnKoir
Bedford
a:
1 . ..
323
39
Cortlandt
i 1
84
MAtFmrv
■" 1
60
P$tk4kia.'
t! '
■••2'-- 9
"s
" 1
1
" 2
209
EMtChciter
3i ....'... .
11 ....
1
72
■••••• - 1
1
58
Harriion
59
57
24
1
47
Hutin^^^in-Hudmt....
Irrinfton
! !•■■
5, ..
... . |. . . .
. L . . .
1
26
21
Lewitboro
20
■■■■■| .: ■'
20
Mamarooeek
Mount Pleaaant
Naw CMtle
89 1 ....
264 , 2
6S 1 1
• ■ ■
1
1
9
5
23
2
9
59
4
24
2
1
2
1
65
148
46
NtwRedutU
342;
331
1
6
8
8
2
248
North Caetk
....
26
174
State Department of Health
Record of each reporting local board of health, showing total
deaths, etc, — (Concluded)
(Cities are printed in small caps, villages in UaHa and towns in Roman tjrpe.)
COUNTY AND
REGISTRATION
DISTRICTS
1
3
Cerebrospinal
meningitis
1
"3
'5
e
2
1
1
s
•a
i
a
1
Diphtheria
Diarrhea
(under 2 years)
Tuberculosis
of lungs
9
C
.....
1
1
1
3
1
7
4
3
WESTCHESTER CO —
{Continued)
North Salem
22
79
17
167
26
15
209
49
10
17
84
5
281
51
468
38
32
22
42
12
14
31
9
23
• 29
28
58
22
17
27
51
13
£80
18
25
11
41
19
24
1
9
3
15
20
North Tarrytovm
1
2
1
6
57
Ossining
13
0$sinina ..,
2
6
"'2
8
1
6
127
Pelham
18
Poundridge
1
27
3
14
Port CheiUr
1
2
4
5
0
9
2
2
1
8
.....
1
8
145
Rye
43
Scarsdale
9
Somen
1
1
1
3
4
6
.....
10
TarrytoitH
1
1
1
1
61
White Plains
5
WhU$ PUdM
5
1
J
1
1
3
18
2
18
2
16
6
IS
2
1
2
8
15
gs
4
3
2
2
220
Yorktown
40
WYOMING COUNTY..
Arcade
to
1
1
4
f
S91
29
Attica
1
27
Bennington
2
18
Castile
2
1
4
1
2
3
29
Covington
1
9
EagleT
1
1
2
12
Gainesville
X ■•
1
1
26
Genesee Falls
9
Java
2
21
Middlebury
1
1
1
2
1
1
2
26
Orangeville
1
3
1
1
2
24
Perry
1
48
Perry
21
Pihe
1
2
""2
1
15
"2
1
1
1
3
3
.. ...
1
2
33
11
14
Sheldon
1
3
1
25
Warsaw
1
2
7
1
2
1
1
1
45
Wethersfield
1
.....
16
2
8
1
8
YATES COUNTY
1
5
/
£80
Barrington
14
Benton
21
Italy
9
Jerusalem
1
2
36
Middlesex
17
Milo
1
2
1
5
1
3
1
14
245
68
1
4
1
1
■■* 6
1
18
Penn Yon
70 - .
1
1
54
Potter
21
41
19
Stwkey
1
35
Torrey
IC .
1
7
State cdsons
State Hospitals for Insane
60
1.934
i
i4 ...
6
1
Other public institutions. .
378
2
2 ...
1
Division of Vital Statistics
175
Deaths by Causes 1885 to Date
YBAR
1885.
1886.
1887.
1888.
1889
1890,
1891.
1892
1893.
1894
1895
1896
1897
1898
1899
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
AU
deaths
80.407
86.801
108.269
114,584
113,155
128.648
129,850
131.388
129.659
123.423
128.834
126.253
118,525
122.584
121.831
132.352
131,461
124.657
127,602
142.014
137,222
140.773
147.890
138,912
140,261
147,629
Death
rate
14.3
15.2
18.6
19.3
18.6
20.8
20.5
20.3
19.7
18.6
19.1
18.4
17.1
17.4
17.0
18.2
17.7
16.4
16.4
17.8
17.0
17.1
17.6
16.3
16.1
16.1
Deaths
under
five years
of age
30.027
32,928
35,114
38,345
40.243
37.392
42.740
42.434
41,643
41,472
42,002
40.136
35.771
37,113
35,386
39,204
35,775
31,215
32,768
39,086
38.045
39.292
40.168
37,941
38,278
39,690
Epidemic Diseases
Cerebro-*
spinal
menin-
gitis
446
572
540
490
402
474
589
649
875
489
546
610
538
695
702
531
492
456
454
1.708
2,566
1.178
230
539
485
452
Typhoid
fever
1,067
1,169
1,327
1.483
1,550
1,612
1.926
1,664
1,685
1.640
1.716
1,542
1.351
1.810
1,604
1,948
1,741
1,318
1,665
1,652
1,554
1,568
1,673
1.375
1.315
1,374
Malarial
diseases
944
899
935
813
746
738
619
613
493
.422
409
449
380
404
248
309
283
189
137
149
106
139
136
84'
78
65
Deaths hy Causes 1885 to Date — (Continued)
YEAR
1885.
1886.
1887.
1888.
1889.
1890.
1801.
1892.
1893.
1894.
1895.
1896.
1897.
1898.
1809 .
1900.
1901.
1902.
1903.
1904.
1905
1906
1907
1908
1909
1910
Epidemic Diseases —
■ {Continited)
Small-
pox
Scarlet
fever
Measles
Erysip-
elas
Whoop-
ing
cough
Croup
and
diph-
theria
Diar-
rhea
(under
2 years)
33
1.184
1,170
354
834
4,508
7.301
39
1.011
895
357
1.244
5,597
7,028
175
1.267
1.205
327
447
6,490
9.258
212
2.452
944
342
994
6,448
8.774
30
2,205
899
293
1,303
5,855
8,294
4
913
1.161
312
1,156
4.915
8.468
4
2.262
1,200
367
825
5.072
9.179
143
2.177
1,350
477
921
5.918
9.185
252
1.626
789
366
1,203
5.947
9.056
308
1.227
900
331
1,020
6.592
8.956
11
850
1.266
370
1.169
4.989
9,055
3
759
1.495
340
996
4.597
8.776
27
841
873
303
825
4,115
7.267
1
837
838
237
1,155
2,612
8.499
21
730
756
353
886
2.786
6. 480
14
689
1,333
466
1,020
3.306
7,959
445
1.430
859
363
721
3.026
9.337
442
1,215
929
314
923
2.859
' 8.315
41
1.057
721
354
811
3.035
7,480
13
1.194
1,170
430
426
3.041
8.329
9
726
988
415
847
2,296
8.955
7
690
1.369
452
821
2.691
8,578
10
1.032
997
483
789
2.603
9.213
3
1.688
1,175
419
. 503
2.473
9.111
4
1.205
1,272
472
783
2.313
7.873
7
1.617
1.285
526
727
2.433
9.036
176
State Depaetment of Health
Deaths by Causes 1885 to Date — (Continued)
year
1885
1886
1887
1888
1880
1890
1891
1892
1893
1894
1895
1896
1897
1898
1899
1900
1901
1902
1903
1904
1905
1906
1907
1908.
1909.
1910.
Other Causes op Death
Con-
sumption
11,238
11.947
11.609
12.383
12,300
13.831
13.445
13.471
13.123
12.824
13,267
13,265
12,641
12,079
13.412
13,500
13.766
12.582
13.104
14.159
14.061
14,027
14,431
14,347
13.096
14,059
Acute
respiratory
diseases
10,864
11,380
11,557
13,756
13,833
18.053
20.647
20.432
19.807
15.885,
17.725
16.820
16.277
16.350
17.938
19.232
17.580
16,986
17.330
21.132
17.832
20,178
22,663
18.477
20.820
21,520
Puerperal
074
884
885
1.060
070
028
1,063
1,131
1,054
Oil
030
072
1.013
020
877
1.136
1.068
1.034
1,110
1.272
1.377
1.326
1,413
1,335
1,333
1,452
Digestive
4.343
5.066
5.500
6.146
6.501
7.606
8.486
8.020
8.834
8.745
8.802
8.055
8.963
10.101
10.163
10.644
7.478
7.235
7,282
7,866
8.158
8.741
9.035
8.398
8,791
9,338
Urinary
4,069
4,305
4,582
4,926
5,732
5,688
6.473
6,602
6.055
6,046
7.440
7,770
7.866
8.641
0.064
0.501
0.55S
0.604
O.OOS
10.815
10.607
11.344
12,163
11,320
12,106
12.811
Deaths by Causes 1885 to Date — (Concluded)
YEAR
1885..,.
1886....
1887....
1888...,
1880....
1800....
1891....
1892....
1893....
1894....
1896....
1896....
1897....
1898....
1899....
1900....
1901 ....
1902....
1903....
1904....
1905....
1906....
1907....
1908. . . .
1900....
1910....
Other Causes op Death — (jCond%^ded)
Circtila-
tory
4
5
5
6
6
7
8
0
0
8
0
10
10
10
10
10
11
12
13
14
14
15
16
17
18
10
.060
.238
,737
,304
.886
.306
.480
.013
.042
.451
.066
.486
.005
.511
,606
.676
.949
.889
.561
.309
.547
.395
.952
,233
,784
,497
Nervous
8,651
8,799
9.967
11.174
11.266
11.603
13.166
14.009
13.826
12.948
11.724
11.925
12.124
13.312
13.177
12.903
13.366
12.064
12.066
14.142
13.660
13.621
14.680
11.080
11.101
11.404
Cancer
1.887
2.050
2,363
2,407
2.638
2.868
3.028
3,162
3,232
3.305
3.554
3.780
4.131
4.385
4.533
4.871
6.033
4,990
5.456
5.607
6.056
6.168
6.420
6.554
7,060
7.522
Violence
2.004
3.206
3.780
3,842
3,834
4,542
5.028
5.543
6.295
5.487
5.889
7.022
6,172
6.520
6.093
6.714
7.926
7.058
7,646
8.822
8.352
8.874
9.668
9,183
9,232
9,846
Old age
4.889
5,990
8.676
7,994
5.980
5.484
6.530
6.385
5.826
6.497
6.669
5.377
5.516
5.524
6.068
5.402
5.439
4.949
4.765
5.120
4.923
4.332
2.723
2.516
2,189
1,961
Unclas-
sified
7.72a
8.981
9,736
11.310
12.615
18.728
15.371
14.647
14.622
15.310
16,380
14.836
14,960
14.641
15.324
16.134
17.388
15.833
17.466
19.858
19,026
18,944
20,717
20,181
18.860
20,698
Division of Vital Statistics
177
Infant Mortality
The following table shows the mortality among children imder
five and infants under one year of age, and also relation to total
deaths at all ages and in their relation to the total births.
1885
1886
1887
1888
1888
1890
1891
1892
1893
1894
1895...,
189«
1897
1898
1899
1900
1901
1902
1903
1904
1906
1906
1907
1908
1909
1910
Total
mor-
taUty
80.407
86.801
108.269
114.584
113.155
128.648
129.850
131.388
129.659
123.433
128.834
126.253
118.525
122,584
121.831
132,089
131,335
124.830
127.498
142.217
137,485
141.099
147.130
138.912
140.261
147.629
Mor-
tality
under
five
yean
30.027
32.928
35.114
38,345
40.243
37.392
42.740
42.434
41,643
41.472
42.002
40.136
35,771
37.113
35.386
39.204
35.775
31.215
32,768
tl4,177
12,218
12.176
12.157
11.380
12.201
12,233
Under
one
year*
24.909
25.827
27.114
28,011
26,561
26.077
27,457
Total
birtha
63.536
89.828
102,038
103,089
114,804
112,572
125,909
130.143
136.297
141.827
142,311
147,327
144,631
138,702
136,778
143,156
140.530
146.740
158.343
165.014
172.259
183.012
196.020
203.159
202.656
222.074
Annual
number
of deaths
under
one year
to 1.000
living
births
151.0
150.0
148.1
142.9
130.7
128.6
128.7
Per-
centage
under
one year
to total
deaths
17.5
18.8
19.2
19.0
19.1
18.6
18.6
Per-
centage
of deaths
under
five
years
to toUl
deaths
37.3
37.9
32.4
33.5
35.5
29.1
32.9
32.3
32.1
33.6
32.6
31.7
30.1
30.2
29.0
29.6
27.2
25.0
25.7
27.5
27.7
27.9
27.3
27.3
27.3
27.0
* Until 1904, deaths under one year were not olaanfied separately,
t Mortality one to five years.
1910.
MortalUy undtr one'vear
Rural 4.736 1909..
Urban 22,721
Rural 4,692
Urban 21,485
178
State Depaetment of Health
Population of the Sanitary Districts
DISTRICTS
Maritime
Hudaon Valley
Adirondack and Northern .
Mohawk Valley
Southern Tier
East Central
West Central
Lake Ontario and Weston
Entire SUte
1890
1900
1905
1907
1908
1909
2,743,959
679.647
378.577
368,503
401.864
382,954
314.876
727,473
3.753.614
690,000
394,772
408,974
438.543
401.082
316.945
876.206
4,393.861
703.893
408.116
444,741
438.936
414,209
315.677
947,875
4,686.262
710,679
413,178
460.528
442,574
419.076
314.433
978,703
4,776,624
711,302
415.502
466.496
446.042
421.941
317,252
991,198
4.881.466
729,736
419.664
466.973
449,936
426,973
320.101
1.005.895
6,997,853
7,269.136
8.067.308
8.425.333
8.546.356
8.699.643
1910
5,266,032
727,719
405,856
488.414
455.504
431.778
320.243
1.062,783
9.168.328
Relative Area, Density of Population and Death Rates in the
Sanitary Districts for 1910
Area in
square
miles
(land)
Popu-
lation
per
square
mile
Pkrcev
TAOB OF
Deaths
•
DISTRICTS
Urban
death
rate
Rural
death
rate
14.6
16.0
15 6
15.4
15.5
16 6
14 9
14.3
Total
death
rate
Under
1 year
Be-
tween 1
and 6
years
At 60
years
and
over
From
epi-
demic
diseases
Maritime
1,946
5.679
13,358
5,179
6,419
6.252
4,588
4.199
2,706
128
30
94
71
69
69
253
15.9
19.0
17.0
16.4
14 5
15.7
15.5
15.7
15.8
17.5
15.8
16.0
15.1
16.3
15.0
15.3
20.9
14.6
16.7
18.5
13.0
136
11.6
19.4
10.3
5.5
5 7
6.4
4.4
4.0
3.1
7.9
22 7
40 0
44 2
400
48.8
46.9
653
33.9
6.8
Hudson Valley
6.4
Adirondack and Northern
Mohawk Valley
7.6
6.6
Southern Tier
6.1
East Central
6.2
West Central
6.4
Lake Ontario and Western
8.0
Entire State
47.620
192
16.1
16.3
16.1
18.6
8.3
31.0
6 7
t
MORTALITY
FROM
PI lARY
TUE LOSIS.
DEATHS PER
100,000 POPULATION.
SINCE 1885. A
^IVyOfW STATt IXfiVfnUENr OF HEA17H
Division of Vital Statistics
179
Mortality from Pulmonary Tvberculosis
The following table shows the total deaths in the State, annual
death rate per 1,000 population; reported mortality from tuber-
culosis, and deaths, per 100,000 population, due to tuberculosis
since 1885 ; also percentage of deaths due to tuberculosis.
YEAR
1885..
1886..
1887..
1888..
1889..
1890..
1891..
1892..
1893..
1894..
1895..
1896..
1897. .
1898. .
1899..
1900..
1901. .
1902. .
1903..
1904. .
1905. .
1906. .
1907..
1908. .
1909. .
1910. .
Population
5.609.910
5.719.855
5,831,947
5.946.246
6.062,764
6,182.600
6,316,333
6,438.283
6,537,716
6,638.606
6.741.246
6,845,375
6.951,111
7,058.459
7,167,491
7.281,533
7.434,896
7,891,491
7,751.375
7.914,636
8,081,333
8.251,538
8,425,333
8.546.356
8.699.643
9.158,328
ToUl
Death
deathfl
rate
80.407
14.3
86,801
15.2
108,269
18.6
114.584
19.3
113,155
18.6
128,648
20.8
129.850
20.5
131.388
20.3
129,659
19.7
123.423
18.6
128.834
19.1
126.253
18.4
118.525
17.1
122.584
17.4
121.831
17.0
132,352
18.2
131,461
17.7
124,657
16.4
127,602
16.4
142,014
17.8
137,222
17.0
140,773
17.1
147,890
17.5
138,912
16.3
140,261
16.1
147,629
16.1
Deaths
from tu«
berculosif
11.238
11,947
11,609
12,383
12,390
13,417
13.445
13.441
13,123
12,824
13,267
13.265
12.641
12,979
13,412
13.591
13.766
12,582
13.194
14.158
14.059
14.027
14.406
14.316
13,996
14,059
Deaths
per
100.000
popula-
tion
200.3
208.8
199.0
208 2
204.3
217.0
212.8
209.2
200.7
193.1
196.7
193.7
181.8
183.8
187.1
186.6
185.1
165.7
170.2
178.8
174.0
170.0
171.0
167.5
161.0
153.5
Percentage
of aU
deaths due
to tubercu-
losis
14.0
13.7
10.7
10.8
10.9
10.8
10.4
10.3
10.2
10.5
10.5
10.7
10.8
10.7
11.0
10.6
10.6
10.2
10.4
10.0
10.3
10.0
9.8
10.3
10.0
9.5
Reported Mortality from Pulmonary Tuberculosis in the Sanitary
Districts for past 10 years
DISTRICTS
Msntime
Hudsoo Valley
Adiroodack and Northern .
Mohawk Valley
Southern Tier
EsBt Central
Wcit Central
Lake Ontario and Western
Entire Bute
1901
1002
1003
•
1904
1905
9
1906
1907
1908
1909
8.730
8.080
8.582
9.124
9.096
9.540
9.590
9.517
9.252
1.342
1.180
1.259
1.346
1,286
1,126
1.235
1.226
1.181
564
521
493'
552
583
550
549
571
556
608
517
570
579
588
523
604
612
585
441
431
378
459
431
395
400
419
362
563
482
479
567
576
491
526
525
512
363
341
355
357
352
315
357
340
335
1.155
13.766
1.030
1.078
1,175
1.152
1.086
1.145
1,137
1.213
12.582
•
13.194
14.159
14.064
14.026
•14.431
14,347
13.996
1910
9.265
1.205
552
527
331
500
255
1.152
114,059
* Inchidfi twenty-fire delayed returns not classified by district in which they occurred,
t InchideB 272 deaths in State InstitutJooa.
180
State Depaetment of Health
The following table gives the number of deaths per 100,000 popu-
lation from Pulmonary Tuberculosis in the Sanitary Districts
in the State during the past 10 years
DISTRICTS
Maritime
Hudaon Valley
Adirondack and NOTthem .
Mohawk VaUey
Southern Tier
East Central
Weit Central
Lake Ontario and Western.
Entire State
1001
1902
1903
1904
1905
1906
1907
1908
1909
224.9
201.5
207.4
213.8
207.0
210.8
204.6
204.6
189.6
193.7
169.9
180 2
189.1
182.6
159.7
173.8
172.1
161.8
141.9
130.2
122.4
136.1
142.8
134.0
132 9
136.7
132.5
146.1
122.1
132.4
182.3
132.2
115.7
131.1
132.7
125.8
102.4
99.6
86.9
105.0
96.1
89.0
90.3
93.7
80.4
139.4
118.6
117.1
137.7
139.0
118.1
125.5
•124.7
120.2
114.9
107.9
121.4
113.1
111.6
99.1
113.6
105.7
104.6
129.6
113.8
117.2
125.8
121.5
113.8
117.1
116.8
167.5
120.5
186.1
165.7
170.2
178.8
174.0
170.0
171.0
161.0
1910
175.9
165.5
136.0
107.0
72.7
115.8
79.6
108.4
153.5
In ea^h 1,000 Deaths there were from Tuberculosis in the —
DISTRICTS
Maritime
Hudson Valley
Adirondack and N<niheni.
Mohawk Valley
Southern Tier
East Central
West Central
Lake Ontario and Western.
Entire State
1901
1902
1903
1904
1905
1906
1907
1908
1909
115
110
117
110
113
115
111
119
114
113
107
100
108
104
93
95
100
96
110
105
92
96
97
89
87
95
89
93
85
90
85
87
73
79
81
82
76
75
65
60
67
61
57
60
52
96
90
80
87
90
77
78
76
77
80
77
75
71
70
. 64
68
70
69
90
85
80
85
82
74
73
77
80
106
102
104
100
103
100
98
108
100
1910
111
95
86
67
48
71
53
71
95
Division of Vital Statistics
181
The following table shows the mortality from Pulmonary Tuber-
culosis in the cities of the State grouped in order of population
CITIES
First-da— ciiif, over 176,000:
Cityof New Yoric
Buffalo
Rocbeoter
SeeondrdoMt dliet, 60,000 to 176,000:
Ssmouae
Albany . . .
YonkeTB
Troy
Utica
Sohenectady
Third-dau ciHtt, iOjOOO to 60,000:
Bitt(|h»fnton
Elmira
AuburB
Amsterdam ,
Jameatewn
Mount Venion
Niagara F^ls
New Roehelle
Poughkeepcie ,
Newburgh ,
Watertown
Kingston ,
Cohoet ,
Oswego ,
GlovenviUe ,
Rome
TkirdrdoM cUiea, 10,000 to 90,000:
Lockport
Dunkirk
Ocdensburg
Middletown
Glens Falls
Watervliet
Ithaca
Olean
Lackawanna
Corning
Homell
Geneva
Little Falls
North Tonawanda
Cortlsnd
Hudson
Plattsburg
Rensselaer
Fulton
Johnstown
Third dau cUies, under 10,000:
Oneonta
Port Jenris
Oneida
Tonawanda
1901>1005
Deaths
per
100.000
popular
tion from
tubercu-
losis
1006
215.8
132.0
138.2
135.2
228.0
188.2
276.5
174.7
141.7
130.0
134.0
143.3
149.5
03.0
115.1
99.8
94.9
174.2
261.4
95 6
209.0
220.8
150.0
107.9
171.7
135.8
81.4
331.7
202.5
149.5
177.6
129.7
54.9
119.7
116.3
83.7
105.3
92.6
73.6
184.3
171.0
148.6
121.3
104.9
91 0
173.4
126.2
117.1
Percent-
age of
total
deaths
from
tubercu-
losis
11.6
8.7
9.5
9.4
12.6
11.6
13.6
9.6
9.3
8
8
9
9
9
1
7
1
5
0
8.1
6.2
7.0
8.8
11.9
6.
11
11
9
7.
,4
.0
.3
.4
,8
10.0
8.7
5.1
12.5
10.0
9.5
10.6
8.4
4.8
'8!2
8.0
5.9
9.2
7.6
6.0
9.7
11.3
8.6
8.3
7.9
5.9
10.0
8.9
8.7
Deaths
per
100,000
popula-
tion from
tubercu-
losis
218.2
129.9
135.2
116.2
206.1
160.9
270.6
130.8
116.3
121.3
131.7
158.1
129.2
82.7
101.6
71.9
116.3
136.0
192.5
88.8
T84.3
233
177
3
.3
107.5
73.4
91.4
100.6
141.9
106.9
147.3
172.4
68.0
70.0
123.1
104.0
127.3
60.0
87.0
133.3
60.0
93.4
11.4
135.4
97.1
92.8
71.4
113.9
Percent^
age of
total
'deaths
from
tubercn-
losis
11.8
7.7
8.8
7.6
11.5
9.4
13.4
6.9
7.9
8.1
9.1
9.5
7.4
0
5
6
3
.7
8.
6.
4.
7.
7.
9.7
5.0
9.9
11.9
10.3
7.2
4.3
6.6
6.3
7.8
7.1
8
10
4
6.
4
1
7
0
5.0
8.5
6.4
9.2
4.3
6.6
6.9
4.6
6.2
0.73
10.9
6.1
5.1
4.6
10.8
1007
Deaths
per
100.000
popular
tion from
tubercu-
losis
212.0
128.5
126.5
122.3
177.0
126.0
275.8
186.3
117.4
100.5
128.9
124.6
104
70
113.2
89.7
66.
112
240.
126.
185.3
254.2
118.9
63.8
186.4
.0
4
1
.0
.7
.4
122.9
119.8
135.1
157.2
117.4
176.9
126.7
90.0
'7i!4
100.0
124.0
154.
76.
91
200.
120
100.
77.8
122.5
5
2
.7
.0
.4
.0
59.4
ni.i
126.4
87.5
Percent-
age of
total
deaths
from
tubercu-
losis
11.4
8.1
8.1
7.7
0.8
8.0
13.2
0.7
7.9
8.2
7.7
6.2
6.1
7
4
.4
5
12
6
10
12
5
0
4
5
3
7
0
0
7.6
3.9
0.7
8
7
7
10
7
10
7
0
5
6
4
9
2
7
6.5
3.7
7.1
8.9
0.4
5.8
7.1
10.6
9.4
7.0
6.0
8.1
3.0
6.3
8.6
6.4
182
State Depabtment of Health
Mortality from Pulrnonary Tuherculosis — (Concluded)
1908
1909
1910
CITIES
Deaths
ioSTooo
popula-
tion from
tubercu-
losis
Percent^
age of
total
deaths
from
tubercu-
losis
Deaths
per
100.000
popula-
tion from
tubercu-
losis
Percent-
age of
total
deaths
from
tubercu-
k>sia
Deaths
per
100.000
popula-
tion from
tubercu-
losis
Percent-
age of
total
deaths
from
tubercu-
losis
Firat'class cities, over 176,000:
Citv of New York
204.4
134.3
133.6
124.6
210.0
166.9
237.7
177.9
92.3
110.7
92.3
141.9
124.5
82.5
129.0
84.9
100.9
158.8
132.6
80.2
142.7
202.9
102.3
128.2
178.2
150.5
80.7
94.0
152.6
101.8
178.4
104.5
86.1
12.1
8.7
9.5
7.6
11.4
10.9
11.9
9.4
7.0
6.7
6.1
10.0
7.5
7.4
9.0
5.8
7.3
8.5
8.2
5.4
8.4
11.4
6.1
7.0
9.2
10.8
5.8
5.6
9.4
• 7.7
10.3
6.4
6.5.
194.2
131.8
143.3
115.6
168.7
148.2
239.5
159.8
117.7
78.6
97.3
99.2
150.3
63.2
104.0
106.2
92.2
130.5
156.8
106.6
237.4
244.0
97.6
117.2
111.0
127.3
55.3
114.0
120.4
147.4
198.5
83.4
50.0
11.7
8.6
9.7
7.6
9.6
9.5
12.5
9.7
10.2
5.1
6.2
6.8
9.0
5.3
7.4
7.3
7.1
6.8
9.1
7.0
11.9
12.1
6.5
7.3
5.5
8.3
5.0
7.0
7.8
10.6
12.6
6.1
4.3
181.1
119.8
126.1
89.1
238.1
148.9
227.8
125.5
98.0
• 119.2
51.0
118.0
101.3
73.0
109.1
104.5
82.1
124.8
179.4
78.3
177.4
198.0
72.6
77.2
126.0
138.9
63.4
106.4
176.5
117.9
139.1
101.2
47.2
123.7
50.9
36.7
104.4
81.1
66.5
26.0
226.8
207.7
140.0
123.2
105.0
62.8
118.2
36.1
84.3
11.3
7.4
9.0
5.8
12.3
9.8
11.0
7.2
6.7
7.6
3.4
7.9
5.9
5.7
7.9
5.8
7.0
7.1
9.8
4.5
9.7
9.6
4.4
5.0
6.3
8.4
3.9
6.3
9.8
7.6
8.0
6.1
3.7
4.5
3.5
2.9
7.4
5.2
6.0
1.4
11.0
11.8
9.5
8.4
7.7
3.3
6.5
2.5
6.6
-■ s
Buffalo
Rochester t
Seeond'clas9 cities, 60,000 to 176,000:
SvT&cufle
Albanv
Yonkera
Trov
Utica
Sohenectadv
Third^ase cities, BOfiOO to 60,000:
Dinffhamton
Elimra *...
Auburn .'
•Amrterdam ,
Jamestown
Mount Vernon
Niacara Falls.
New Rocbelle
«
PouicbkeeDsie
NewDuncn
Watertown
Kimrston
£!!ohoefl
Osweso
Gloversville
Rome
Third-class cities, 10,000 to S0,000:
Lockoort
Dunkirk
OffdensburiE
Middletown
Glens Falls
Watervliet
Ithaca
Olean
Lackawanna
Coming. . . .'
107.6
72.0
83.4
140.0
102.1
73.8
165.7
90.0
108.2
97.9
73.3
58.1
141.7
114.0
62.5
6.9
4.8
7.3
11.8
7.2
5.1
. 10.8
7.8
8.7
6.0
6.7
3.2
8.3
7.5
4.9
78.0
95.0
110.7
155.6
72.9
47.8
126.9
139.7
90.0
68.0
105.5
125.0
80.4
49.5
123.0
5.5
6.5
8.9
9.9
4.9
8.7
8.1
8.1
7.0
4.8
6.4
7.2
4.4
3.6
8.6
Homell
Geneva
Little Falls
Cortland
Plattsburs
Rensselaer
Fulton
Johnstown
Third-class cities, under 10,000:
Oneonta
Port Jervis
Oneida
Tonawanda
A study of the above table shows that there is a pretty uniform
lessening of the number of deaths in cities from pulmonary tu-
Division of Vital Statistics 183
berculosis, and also of the percentage of the total deaths repre-
sented by the mortality from consumption. In some cities, nota-
bly Syracuse^ Utica, Schenectady, Cohoes, Watertown, Dunkirk,
Watervliet, Little Falls, HomeU and Cortland, the reduction is
marked.
The table following shows the deaths from pulmonary tubercu-
losis in, Greater New York and in the rest of the State. The
mortality is shown month by month for the series of years from
1890 to 1910 inclusive.
It will be seen that the lowest annual mortality from pulmonary
tuberculosis occurred in 1902, when the total for the State was
12,582. In 1903 it increased to 13,194, and to 14,158 in 1904,
It remained in the 14,000 mark until 1908, the highest fig-
ure, 14,406, being reached in 1907. In considering these figures
it must be borne in mind that they are the records of years during
which increasing attention has been called to the ravages of tu-
berculosis, and it is fair to assume that the returns have been in-
creasingly accurate and complete from year to year. In 1909 the
mortality, for the whole State dropped to 13,996, and the figures
just compiled for 1910 show an increase to 14,059, or only 63
more deaths from this cause in 1910 than in 1909.
In 1910 there were 154 deaths from consumption per 100,000
population as against 205 deaths per 100,000 population in 1890.
For a period of 25 years 11 per cent of the deaths have been from
consumption; in 1909, 10 per cent.; in 1910, 9.5 per cent.
And while this reduction in mortality has been taking place,
there has been an increase in the population, and an increase in
the total number of deaths from all causes. The total deaths
throughout the whole State, from, all causes, were, in 1909,
140,261 ; in 1910 they were 147,629.
From these figures it seems fair to assume that the tuberculosis
situation in the State as a whole is improving.
Taking the records for these two fields, the lowest mortality
from pulmonary tuberculosis in Greater New York wae 7,589 in
1902 ; and in the same year the rest of the State had its minimum
mortality of 4,993. The maximum annual mortality for Greater
New York was 8,996, recorded in 1907; the maximum mortality
in the rest of the State occurred in 1892, the figures then being
184 State Depaktment of Hjjaxth
6,180. The anti-tuberculosis campaign began in New York city
several years before it was started throughout the rest of the State
in 1907. The annual mortality in Greater New York since then
has been aa follows : 1907, 8,996 ; 1908, 8,867 ; 1909, 8,645 ;
1910, 8,690. The corresponding figures for the rest of the State
are: 1907, 5,410; 1908, 5,449; 1909, 5,351; 1910, 5,369.
The total deaths from all causes were in 1909 : Greater New
York, 74,105 ; rest of State, 66,156; in 1910 : Greater New York,
76,750; rest of State, 70,879. Thus while the total mortality
from all causes in Greater New York in 1910 shows an increase
of 3.5 per cent over the returns for 1909, the mortality from pul-
monary tuberculosis in the metropolis increased only 5 per cent,
during the year. In the rest of the State the total mortality from
all causes in 1910 shows an increase of 5.3 per cent, over the fig-
ures for 1909, while the mortality per 100,000 population from
pulmonary tuberculosis in 1910 dropped 3.7 below the figures for
1909.
Division of Vital Statistics
185
Mortality from Pulmonary Tuberculosis by Mor^ths 1890-1909 —
Greater New York and Rest of State
1890. Greater New York*.
Rest of State
Total.
1891. New York aty*.
Rest of State
Total
1892. New York Gty*.
Rest of State
Total.
1803. New York City*.
Rest of State....
Total.
1894. New York City*.
Rest of State
Total.
1895. New York City*.
Rest of State....
Total,
1896. New York aty*.
Rest of State
"^otal.
1897. New York City*.
Rest of State....
Total,
1898. Greater New York.
Rest of State
Total
1899. Greater New York.
Rest of State
Total
1900. GrMter New York.
Rest of State
Total.
1901. Greater New York.
Rest of State
Total.
1902. OfMter New York.
Rest of State......
Total
1903. Greater New York.
Rest of State
Total.
Jan.
1
Feb.
Nfar.
April
1,008
757
706
549
657
538
575
527
1.765
1.255
1,195
1.102
661
549
520
465
733
585
707
670
1.210
985
1,318
1,377
665
621
598
598
728
544
691
561
1.286
1,196
1,272
1.252
595
504
525
429
750
536
741
588
1.099
954
1.286
1.329
628
512
563
500
609
581
551
540
1,140
1,063
1,190
1,091
728
516
670
491
706
568
653
567
1.244
1.161
1,274
1.220
650
602
582
602
969
521
677
512
1.152
1.084
1.490
1.189
578
473
637
480
620
670
581
577
1,051
1,117
1.190
1.158
615
436
592
430
705
461
629
471
1.051
1,031
1.166
1.100
769
535
726
479
786
498
708
479
1,304
1.204
1.284
1,187
676
464
686
445
816
547
802
500
1,140
1.131
1.363
1.302
817
509
702
428
778
515
761
535
1,326
1.130
1.293
1.296
613
425
666
434
736
499
669
485
1.038
1,100
1,235
1,154
761
444
732
428
734
526
726
498
1.205
1.160
1.260
1.224
May
588
460
1.048
679
555
1«234
654
540
1.194
673
566
1,239
567
526
1.093
627
522
1,149
665
528
1,193
562
492
1.054
669
458
1,127
671
498
1,169
765
620
1,285
659
665
1,224
658
477
1,135
688
451
1,139
June
527
422
504
474
978
508
497
1,005
570
495
1,065
557
425
982
526
448
974
612
485
1,097
542
460
1.002
604
403
1.007
577
451
1,028
616
454
1.070
651
460
1.111
615
365
980
576
402
978
* From 1890-97 the statbtics are for New York City and Brooklyn.
186
State Depaetment of Health
Mortality from Pulmonary Tvhercidosis — (Continued)
July
Aug.
Sept.
Oct.
Nov.
Dec.
Total
1890. Greater New York* . . .
Rest of State
585
432
578
429
598
407.
590
455
558
426
618
427
7.588
5.829
Total
1,017
1.007
1.005
1.045
984
1.045
13.417
1891. New York aty*
Rest of State
569
463
546
495
574
465
603
521
574
443
609
481
7.279
6.166
Total
1.032
1.041
1.039
1,124
1,017
1.090
13.445
1892. New York City*
Rest of State
558
535
519
537
561
445
535
461
615
325
629
516
7,261
6.180
Total
1.093
1.056
1.006
496
416
996
940
1.145
13,441
1893. New York City*
Rest of State
589
484
586
454
570
500
547
410
608
491
7,250
5.873
Total
1.073
600
494
1,040
912
1,070
957
1,099
13.123
1894. New York City*. . . , . .
Rest of State
569
462
538
450
542
471
568
454
637
480
6.929
5,896
Total
1.094
1,031
988
1.013
1,022
1,117
*
12.824
1895. New York aty*
Rest of State
571
469
613
438
579
430
651
461
671
408
614
440
7,609
5,758
Total.'.
1,040
543
507
1.051
1.009
1,112
979
1,054
13,267
1896. New York aty*
Restof SUte
604
455
571
452
576
414
486
390
604
458
7.539
5.726
Total
1.050
549
392
1,059
1,023
990
876
1.062
13,265
1897. New York aty*
Rest of State
593
434
556
442
631
439
550
427
612
444
7 Oil
5.630
Total
941
664
452
1.027
998
1.070
977
1,056
12,641
1898. Greater New York
Rest of State
598
421
647
429
630
422
645
404
732
453
7.730
5.249
Total
1.116
"659"
417
1.076
673
429
1.102
^639~
423
1.019
639~
395
1,034
619
428
1.076
568
379
947
562*
418
1.052
1,049
628
399
1.185
12.979
1899. Greater New York ....
Rest of State
537
527
652
436
7.919
5.493
Total
1.064
663
415
1,078
^639
473
1.027
623
388
1,088
661
421
13,412
1900. Greater New York
Rest of State
8.162
5.429
Total
1.047
980
404
1.021
1,011
^640"
423
1.063
1,082
13.591
1901. Greater New York
Rest of State
632
446
606
444
8.141
6.626
Total
1.082
632
406
1.078
585~
399
1.112
638
389
1.060
13.766
1902. Greater New York
Rest of State
550
367
613
338
614
409
7.589
4.99?
Total
1.03S
695
396
991
984
626
399
917
^564~
382
1,027
640
398
1.038
951
1,023
712
440
12.582
1903. Greater New York
Rest of State
649
427
8,003
5.191
Total
1.025
946
1.076
1,152
13.194
♦ From 1893-97 the statistics are far Naw York City aad Brooklyn.
Division of Vital Statistics
187
Mortality from Pulmonary Tuberculosis — (Continued)
1904. Greater New York
Rest of State
Total
1905. Greater New York
Rest of State
Total
1906. Greater New York
feM Rest of State
Total
1907. Greater New York
Rest of State
Total
1906. Greater New York
Restof SUte
Total
1909. Greater New York
Rest of State
ToUl
1910. Greater New York
Restof State
Total
Jan.
702
485
1.187
731
438
1.169
731
452
1.183
816
419
1,235
804
427
1.231
749
420
1.169
767
437
1,204
Feb.
728
451
1,179
686
454
1.140
732
466
1.198
822
470
1.292
862
457
1.319
707
446
1.153
706
450
1.156
Mar.
869
563
1,432
830
552
1.382
872
515
1,387
907
548
1,465
830
644
1.374
840
522
1.362
859
668
1.427
April
871
528
1.399
814
526
1.340
774
575
1.349
903
491
1.394
816
678
1.393
861
638
1.399
809
502
1.311
May
1.242
June
783
514
643
493
1.297
1.136
767
619
648
467
1.286
1.105
793
435
758
383
1.228
1.141
. 801
501
692
447
1.302
1.139
765
484
693
434
1.249
1,127
775
483
717
425
1,258
1.142
755
487
656
412
1.068
188
State Depaetment of TTeat.th
Mortality from Pulmonary Tuberculosis — (Concluded)
July
Aug.
Sept.
Oct.
Nov.
Dec
Total
1904. Greater New York
Rest of State
674
472
652
423
590
400
654
415
670
434
680
464
8.516
5.642
Total
1.146
1.075
990
1.069
1.104
1.144
14,158
1905. Greater New York
Rest of State
657
433
655
435
619
437
679
436
714
417
732
423
8.532
6.527
Total
1,090
1,090
1,056
1.115
1,131
1.155
14.059
1906. Greater New York
Rest of State
725
382
708
366
670
327
733
357
714
380
766
413
8.976
5.051
Total
1.107
1.074
997
1.090
1,094
1.179
14.027
1907. Greater New York
Rest of State
676
444
665
461
596
377
661
419
664
408
793
425
8.996
5.410
Total
1,120
1.126
973
1.080
1,072
1,218
14,406
1908. Greater New York
Rest of State
728
423
639
430
674
415
650
434
689
412
718
411
8.867
5.449
Total
1.151
1.089
1.089
1,084
1.101
1,129
14.316
1909. Greater New York
Rest of State
683
445
635
404
585
373
649
440
695
395
740
460
8.646
5.351
Total
1.128
1.039
958
1.089
1.000
1.209
13.996
1910. Greater New York
Rest of State
728
452
665
420
674
404
666
389
662
398
743
450
8.690
5.360
Total
1.180
1.085
1.078
1.055
1.060
1.193
14.059
TOTAL DEATHS BY YEARS PREVIOUS TO 1890
1885
1886
1887
1888
1889
%
Greater
New York
7.189
7.722
6.841
7.312
6.629
Rest of
State
4,049
4.225
4.768
6.071
5.761
Total
11.238
11,947
11.609
12.383
12.390
MORTALITY
FROM
CANCER.
DEATHS PER
>'I00.000 POPULATION>.
/ SINCE 1885. \
N£V/yOP/( STATE 0£fWiTMafr OF HCALTH
Division of Vital Statistics
189
Mortality from Cancer
The reported mortality from cancer, and deaths per 100,000
population due to cancer in the State since 1885 is shown by the
following:
YEAR
1885
1886
1887
1888
1889
1800
1891
1802
1803
1804
1805
1896
1807
Deatha
from
cancer
.887
.050
.363
.497
.638
.868
.028
.162
.232
,805
,554
.789
,131
Deaths
per 100.000
popu^- <
tion
33.6
35.8
40.5
41.9
43.5
46.3
47.9
48.9
49.4
49.7
52.7
55.3
59.4
YEAR
1898
1899
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
Deaths
from
cancer
.375
.535
.871
.033
.456
,697
.055
.169
,420
,554
.060
.522
Deaths
per 100,000
popula-
tion
62.0
63.2
66.0
67.6
65.7
70.3
71.9
74.9
74.8
75.9
77.0
81.1
82.1
Reported mortality from Cancer in the sanitary districts for past
10 years —
DISTRICTS
Mantone
Hudaoo YtXky
Adirondack and Northern .
Mohawk VaUejr
SoathemTier
EMtCeotral
West Central
Lake Ontario and Western.
Eotire State
1901
1902
1003
1904
1905
1906
1907
1908
1909
2,651
2.557
2,828
2.967
3.151
3.288
3.514
3.564
3.841
459
497
536
535
549
580
571
609
657
208
220
239
255
288
278
272
265
341
267
282
276
314
331
310
352
336
397
261
259
309
338
342
831
349
388
412
295
304
314
325
335
343
337
351
383
227
246
276
250
,291
276
288
295
296
665
624
678
713
768
763
717
746
783.
5.033
4.969
5.456
5.697
6.055
6.169
6.420
6.554
7,060
1910
4.093
689
314
411
418
395
325
839
•7,522
* ladodes 38 deaths in State Institutions.
Deaths from Cancer per 100,000 population in the —
DISTRICTS
Maritime
Hodwn Vsllasr
Adirondack and Northern.
MobawkVaOeir
SoothemTier
EsfltCeotna
West Central
laka Ontario and Western.
Entire State
1901
1902
65
1903
1904
1905
1906
1907
1906
1909
66
61
71
72
72
75
75
79
67
72
n
78
78
82
80
86
80
53
58
60
64
75
68
66
64
81
65
67
66
73
76
69
76
72
85
63
60
72
78
78
75
80
87
91
74
76
79
80
80
82
80
83
90
71
78
86
80
90
87
91
93
92
75
71
75
78
81
80
75
73
75
73
68
60
70
72
75
76
77
81
1910
78
95
76
84
92
91
101
79
82
190
State Depabtment of Health
In each 1,000 Deaths there were from Cancer m the —
DISTRICTS
Maritime
Hii<te)n Valley
Adirondack and Northern.
Mohawk Valley
Southern Tier
East Central
West Central
Lake Ontario and Western
Entire State
Decade
1885-1804
21.6
Decade
1805-1004
1005
1006
1007
1008
1000
31.8
30.4
MO
40.7
44.6
47.4
25.8
37.6
44.2
48.1
44.1
40.5
53.3
32.0
42.0
48.0
45.1
43.1
43.8
54.5
34.2
42.5
48.8
42.8
46.1
44.6
55.8
35.5
46.5
53.5
51.3
50.5
55.7
50.1
36.4
51.8
52.0
53.8
50.8
51.2
57.8
37.5
40.5
57.2
56.1
55.2
60.8
60.5
30.2
. 46.5
54.0
44.2
52.1
45.8
50.0
48.4
25.0
37.0
43.0
43.4
47.3
50.3
1010
48.0
54.2
48.8
52 6
60.7
56.1
67.2
51 5
51.0.
During the past four years there were reported 26,516 deaths
from cancer in this State, 10,567 (or 39.8 per cent.) being due
to cancer of the stomach and liver, as will' be seen from the
following :
SEAT OF disease
Cancer of mouth
Cancer of stomach and liver
Cancer of intestines and peritoneum .
Cancer of skin
Cancer of breast
Cancer of female genital oraans
Cancer of other or unspecined organs
Total
1907
1908
1909
206
169
267
2.396
2,561
2.677
812
849
926
201
200
202
617
599
665
946
1,043
1,146
1.222
1,113
1.177
5,400
6,534
7,060
1910
285
2.933
1.121
192
732
1.096
1.163
7,522
Mortality from Typhoid Fever
The following table shows the reported mortality from typhoid
fever and deaths per 100,000 population due to typhoid since
1885:
YEAR
1885
1886
1887
1888
1889
1890
1891
1892
1893
1894
1895
1896
1897
Deaths
ktlia
per 100,000
iins
popula-
tion
.067
19.0
,169
20.4
,327
22.7
,483
24.9
,550
25.6
,612
26.1
,926
30.5
,664
25.8
,685
25.7
.640
24.7
,716
25.4
,542
22.6
.351
19.4
YEAR
1898
1899
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
Deaths
1.810
1.604
1.948
1,741
1.318
1.665
1.652
1,554
1,568
1.673
1.375
1.315
1.374
Deaths
per 100.000
popuU-
tion
25.6
22.4
26.7
23.4
17.4
21.5"
20.9
19.2
19.0
19.8
16.0
15.1
15.0
MORTALITY
FROM
TYPHOID FEVER.
DEATHS PER
inn nnn nnniiiATinki
NlWymX SrAT£ IXPA/fTMCNr OF HEALTH
Division of Vitai- Statistics
191
Deaths from Typhoid Fever per 100,000 population in the —
DISTBICTS
Hodm VaOcy
AdJroodMtk and Northern.
Mohawk VftOey
SootberaTier
EMt Central
Wert'Ccatfsl
Lake Ontaiio and VttaAan.
Entire SUte
1901
20.0
34.3
24 4
26.4
24.8
25.7
190
28.0
234
1902
20
36
24
19.8
233
17 7
15.8
27.8
1903
16.8
25.4
27.8
23 4
25.5
17.1
36 7
30.4
17.4 21.5
1904
1905
170
16.2
35 1
28.4
31.5
26 7
19 4
18 4
21.2
17 5
194
169
20.5
18.0
245
25.2
20.9
19.2
1906 1 1907
15 2
26.1
27.9
19.4
27.9
14.1
19.4
25.8
17.2
27.3
26.1
17.2
20.3
18.8
14.3
27.1
19.0 19.8
1908
13
21
18
17
20
17
19
22.8
16.0
1909
12
20
19
13
22
16
13
20
15.1
1910
11
21
24
10.
16
34
20
18
tf.O
In each 1,000 deaths there were from Typhoid Fever in the —
DISTRICTS
1
1901
1902.
1903
1904
9
20
22
13
11
12
13
17
1
1
1906 ,
1
1906
1907
1906
1909
1910
Maritime
Hodaon Valley
Adiraodark and Northern.
Mohawk VaUer
10 ;
20
17
17
18
18
13
20
13 J
11
23
20
14
17
13
11
20
10
14
21
16
20
14
24
21
9 1
" i
18
12
12
11
11 .
17,
.1
19
12
19
9
13
16
9
15
17
10
13
11
9
17
8
13
13
11
13
10
13
15
8
12
13
9
15
11
9
13
7
12
15
7
Soathem Tier
11
Evt Central
15
Wert Central
11
Lake Ontario an^ Wertcm.
12
Entire State
14
"
12
12
11
11
1
10
9
9
City Mortality from^ Typhoid Fever
The following shows the annual mortality by months from
typhoid fever in the cities of the State since 1900; also total
deaths from all causes, and typhoid death rate.
The death rate for years other than those in which official
census wad taken is based upon estimated population as shown
by the average yearly increase between census periods.
State Department op Health
Mortality fbom Typhoid Feveb
Greater New York
Buffalo
Syracuse
Divisiox OF ViTAT, Statistics
Mortality FROsr Typhoid Feveb — (Continued)
Albany
\UR
1
1
1
1
1
J
i
1
f
1
1
Totel
P"^'^
ToU
1
1
IMO
IMl
!
i
1
1
:
"e
i
11
.":■•■
;;;
Ml
Mi
Ml
itot
ItM.
not
■ 1
ii ;
looidia
ill
If!
i*
JOO
;i^
H.t
TaUl
"1 "1 -
U' 1!
J2
,.|.
J!
_J!
J!
J!
«*
i..i»
„
« i }[ 2 l' to 9
Troy
State Depabtmknt of Health
MoKTALiTT FRou Typhoid Fevek — {C(mtinued)
Schenectady
YEAR
1
I
1
1
1
1
1
1
i
1
1
i
1
ToUl
^^!r
TdW
1
is
3
3
2
1
3
2
■J
j
!
IS
*^
1
iS 'I
-TiMO
^
,.j 1
MS
1.070
'»
Total ..
^j.
J
J
_1
_!;
J?
. "1 _•
-i!
'"
B.tSO
Binghamton
Division of Vital Statistics
MoBTALiTY FBou Typiioid Fevee — {Continued)
Jamestown
■no.
1
1
1
i
1
J
1
1
■
1
1
1
ToW
PopuU-
tun
3
1
-1
■,
1
\
«.m
2B0
291
3B3
2£
»
23
(
11
tos
S:;;:
1
i
:■
\\ 3
\
■ ie.iw
I
•07 ....
... j '
'J
.,,,,,.,
3i:
~i
Total..
10
_!
_!
1
J
!
„•
1!
<
10
Jl
»^l 1 ^-'^
_
2
1
■■■■23'MS
3W
BBS
*2C
MO
1
2
3
"i
1
1
1
•ss
■■■■J^JM
I?"
'
1
1
1
22.1
TeW...
^
_J
_!
_L
t
_!
_!
_J
I
_*
_?
5?
==^
SSf
...| ..j..^
t;
...":"''
2W «8
-,l
.1 ■■; ■
1 •
■ 2S;«M
...
...
....
«3 lot
IK
i
«!
37.
l"*'j
Total -
ai 3
I
1 fi
«]
3.S4S
Niagara Falls
3
1
3' 1 3 1
!| ! ■ J !; 1
I;"' ii....' 1
24
9
1S.»S7
301
1
m.3
1!!?
!
».Ha
j
■■■3o:«i7|
nv
7
'*
" "i i " "
JSP
t.m
State Department of Health
MoETALiTY FKOM Typhoid Feveb — (Conitnued)
New Bochelie
'ye*r
1
1
J
1
i
1
i
1
1
1
j
1
ToUl
P°£^
1
IMO . ..
tm.' ...
1«B
,
'
■
1
::■
i
}
i
14.720
M.»80
ICf
33!
3S.a
1
S::
-i
Si
1»10. ...
jP
i 1 '
■sflim
34;
■J:i
ToUJ.,,
> 1 ,
=
=
i
7
17
Poughkeepsie
Kingston
4M
MS
..
DiTisiow OF Vital Statistics
Mortality fbom Typhoid Fevee-
Newburgh
-{Continued)
JKAB
1
1
1
1
s
1
J
1
1
1
J
i
ToUl
"r-
i
(MM)
1
i
1
!
■"■;
1
24,«43
HI
1
■■ Hi.m
IS
"2
2
'
:•
«■?
!
1
■■■ islBM
J S
Totol, ,.
s
_2
_i
2
=
_!
_!
^1^^
j._i,i_™
t S.«8
!
»....
i
& i
M,»10
i
=
,. 1
'
:
2
'
"si !(
"■"'
IS
13
^i
_i
: • I
a' 2ii
1.K7
Oswego
^
3
1
■:::ii
2
3
!:
';
71 m
g
3K
(0.
1
«■!
i
'"^'M
WO
I
■ --l -l-*
2J.«0
2sa
13
Ifi
7 IS 13
122
*,0S3
.
198
State Department of Health
Mortality from Typhoid Fever — (Continued)
Rome
YEAR
1900.
1901.
1902.
1903.
1904.
1905
1906.
1907.
1908.
1909
1910.
Total.
S
6
<
&
9
I
I
C
55
10
Total
Po|>uIa-
tioii
1
2
15.343
239
277
4
261
2
248
3
270
7
5
10.552
366
299
3
340
5
360
3
382
4
20.632
410
39
8.362
ill
65
12.2
25.2
18.6
24.6
43.3
28
17
26
16
19
1900
Lockp
2 1
4! 1
ort
3
12
6
13
6
9
12
9
11
9
2
16.581
266 18 0
1901
2
2
3
1
1
1
....
2
5
1
....
1
2
2
1
2
284
237
283
287
261
241
274
250
276
299
71 5
1902
i
1
1
3
• • ■ •
• • • ■
2
1
1
1
1
35.4
1903
1
2
....
2
75.7
1904
1
1
34 6
1905
1
"3
3
17.552
51.8
1906
2
2
#
67.6
1907
1
2
1
1
2
1
60.1
1908
2
* 1
3
4
60 7
1909
1
4
1
49 7
1910
1
8
17,993
11 I
3
2
10
14
7
5
12
10
Total...
14
92
2.958
Dunkirk
1900
3
1
1
2
1
1
1
1
6
4
10
4
6
6
5
13
2
2
4
11.616
184
165
233
r»7
274
228
255
265
241
202
279
51.6
1901
1
1
33.4
1902
1
1
1
1
4
1
....
1
1
....
76.5
1903
29.0
1904
1
1
1
2
1
1
1
41.3
1905
1
2
2
1
1
* • • •
2
2
1
1
15.250
39.3
1906
1
3
1
31.4
1907
1
1
1
....
1
71.8
1908
11.1
1909
(
1
1
....
6
11.1
1910
1
3
2
1
3
1
6
17,308
23.1
7
7
7
7
3
4
Total...
7
62
2.563
1900
1901
1902
1
2
....
1
1
1
1903
1904
2
2
1
2
1905
1906
1
1
1907
1908
1
"l
"2
'"2
1
1909
1910
....
Total...
7
3! :
— 1 —
7
Ogdensburg
1>....
2
5
4
8
8
6
7
10
7
4
4
6
12.633
205
252
204
233
23^
251
269
265
252
245
266
39.5
11
31.4
2 1
0
....
1
62.3
1 ...
1
1
• • • ■
61.7
4 1
"2
1
• • • ■
2
68.9
■r-
1
3
1
1
• • • •
2
9
2
1
i
1
"3
1
1
13.179
53.1
67.3
1
1
47 1
■■'ic;
""i5.98i
26 8
1
36.8
|. . . .
1
f
4
37.5
"•"i
11, 2
6 3
6
72
2.680
Division of Vital Statistics
MoBTALiTT FROM Ttphoid Fevee — (^Ccmttnued)
Middletown
YEAR
1
1
1
!
1
i
f
1
i
1
1
1
ToW
-fi^
ToUl
sun)
1
•
„,»
231
221
241
S
1
'
1
3
M.5W
1
:::.
■■
....
U.IBT
7~
"1
~2
_!
_!
t
_•
_!
!
^
-?
^
=.»
WatervUet
14.131
...
i
4
1
22i
2(0
s:
:
-1
[
1
....":"
1
1
J
•
T
'
'
. '*■'*'
TWil,..
_I
8
l>
_1
10
1
2
J
_•
=!
_2
_J
_y
lU...
-,
!
i
I
1
1
u.m
'i '
"
* '
2
.-.^.
.'.
».«ii
....
~4
'":
■Uisii
rMd...
4 10
J?
4 S
_1
_1
i
7
_«
_J
200
State Depabtment of Health
MoBTALiTY FROM Typhoid Fever — {Coiitinued)
Olean
YEAR
1900.
1901
1902
1903
1004.
1905
1006
1907
1908
1909
1910.
Total
I
1
1 1
-&
1
J
I
J6
ToUl
I
2
3i
3|
2.
201
Popula-
tion
Total
mor-
tality
(an
causes)
Q
9.462
130
110
117
104
138
12^
139
138
139
211
188
105
20.8
30.7
30 3
ao.o
10.163
0.0
ao.o
19.1
22.1
111
14,814
0 0
1.536
LacJcawanna^
1910
(
Total...
1
14,549
397
547
1
6.0
1900
1
Cormng
1 2t 11 I 1
2
6
5
3
6
6
4
6
10
12
19
8
11,061
1901
1
1
2
1
1902
1
....
1903
2
1
1
1
1
....
1
1
..
1
"z
1
1
2
1
10
1
1904
i
1
1
1
1
4
1905
11....
2: 2
4i 1
13.515
1906
1
1907
2
1
1
....
1
1
6
1908
1
1
3
2
3
2
• • • •
1909
1910
2
1
3
1
7
3
3
1
2
13
2
1
10
13^74?
3
Total..
6 11
85
202
512
178
43.2
149
24 9
167
48 0
200
46 1
217
30 0
188
43 I
268
69 0
232
78.2
217
12 3
200
58 2
2,218
Homell
1900
1
1
1
i.:::::::
3
1 '"
5,
11.918J
1
165
174
154
191
204
202
189
IH
209
1P5
174
25 1
19C1
1
32.8
1902
....
1
1
1
1
••j
32 1
1903
1
2
■ 13.259
55.0
1904
' I
■ "2
1
7 7
1905
1
1!
30 2
1906
ll
7.5
1907
)
13.637
7 5
1908
2
1
3
9
14.1
1909
1
....
5
:;::::.:::: 1
21.2
1910
1
4
36.6
1
........
....
3
Total..
2 3
3', 5
35
2.031
I
rt-=:=r
♦ iDcorporated in 1909; formed from part of the town of West Seneca.
Divisiox OF Vital Statistics
Mortality from Typhoid Fevee — (Contititted)
Geneva
VEAR
|!|
1
}
1
1
S
j
1
1
1
1
Toui
Ifi-
.»>
:::
:■
:■
,..«
m
00
IS i i
1
ij ia.MB
Ml
1(09
:;J ■ i
-j "
"2
a
..
'
IK. :.
■■■
::::|.
;■■
1
S ■■»..»
!!I
Total .
_1
_;i_!l_:;_i[_!| I
_i
_!
"
1.810
North ToTtawanda
I0.3S1
IS
18C
183
182
IIS
11.122
»
iz.Sia
S
B.ON
'l3»
10,157
■■i2;033
180
State Department of Health
MoBTALiTT FBOM Typhoid Fever — (CmtHnued)
Hudson
YEAR
1
1
1
a
I
1
g
1
1
1
1
1
i
To«d
■s-
Total
.1,
i.
2
!
1
'i
■.5»
1
1
19
M.4
^
I
... ,^
■"■i6;»o
t
:;:: ,
1
was ,
,.'■
~
~ro
'u
,..'
"iiiiM
Total..
10
!
a
1
3
s
2
^
_1
"
I.IM
Platt^urgh
ii 1
■ i
■■
n
[■ '
I
Otal...
=
1
=^
=
=4
=i
1
=L
3 3 4
=
EE:
2
..."
■f'l:
Be
laaelaer
* 1
2
■j
..'
s
S
Total..
_!•
_J.
•! '
^
_^
_J
-J 3
S
_
io^iiz|
Division of Vital Statistics
203
MoBTALiTY FROM Typhoid Fevee — {Continucd)
Johnstown
TEAR
1900.
1001.
1902.
1903.
1904.
1906.
1906
1907.
1906.
1999.
1910.
Totol
I
I
1
J6
6
I
Total
Populft-
toon
2
1
18
10.130
9,845
10,476
ToUl
mor-
UUty
(aU
causei^
Ik
1§l
lOP
117'
134
156
124
145
IIP
UP
123
155
143
1.474
6)1
30.1
10.2
20.4
21.1
9.5
1900.
1901.
1902.
1003.
19:h.
1905.
1906
1907.
1906.
1909.
1910.
Totel.
2
Oneonta
V.
6
2
1
7,147
5
2
4
2
4
8.064
2
6
7
2
9^552
1
37
1
89
112
09
no
139
135
131
164
156
152
181
1.468
27.9
13.6
56.5
26.0
60.8
24.8
48.6
23.8
68.2
79 6
20.9
Port Jervis
190O
1901
• • •
1
1
1
• • « ■
1
1
1
1
_
1
1
"2
1
1
3
3
5
7
7
7
3
5
9. 385
163
164
176
1902
1
2
• • • •
3
2
1
i
- • • •
1903
1
....
9.695
165,
1904
3
:::::: 1
19S
1905
1
2
2
2
17*
1906
1
"1
176
1907
1
2 ...
176
1908
16^
IW
170
1909
1
....
1
' 1
6
'.'.'.'.'\ "^
""'3
5
2
6
1910
9.304
4
1
3
2
4
6
5
3
4
Totol...
— ■
6
48
1.9131
(
31.0
31.8
52.5
73.1
72.6
72.2
31.0
51.0
20
64
1900.
1901.
190S.
1901.
1904.
1906.
1906.
1907.
1906.
009
1910.
Total.
Oneida
2
4
16
7,538
8,420
8.316.
86
111
108
111
112
1311
1311
12H
134
13i!
1171
13.3
25.9
38.0
36.3
ir.8
i9!8
48!i
1.308
^
204
State Department of Health
MoHTALiTY FROM Typhoid Fever — (Coticluded)
Tonawanda
YEAR
1
u*
1
1
<
^
s
»n
^
^
-<
1
1
1
1
i
i
55
i
Total
Popula-
tKm
Total
mor-
•a
causes)
Death rate per
100,000 pop-
ulation
190U
' 1 "
1
1
1
7.421
86
106
114
98
89
98
83
109
103
1C6
106
13.4
1901
18.3
1902
....
1
2
1
1
....
5
2
67.3
1903
1
26.0
1904
1
1
3
2
38.4
1905
1
1
1
1
7.904
25.3
1906
1
1
....
1
4
2
7
2
3
50.6
1907
25 0
1908
1
1
I
1
1
1
1
95.6
1909
1
1
5
27.3
1910
2
4
8.308
36.1
*> ' '
2
1
2
2
1
2
1
^Total...
5
3
4
32
1.097
Mortality from Diphtheria
The reported mortality from Diphtheria since 1885 and deaths
per 100,000 population is shown by the following:
YEAR
Deaths
from
diphtheria
1885
1886
1887
1888
1889
1890
1891
1892
1893
1894
1895
1896
1897
.508
.597
,490
,448
.885
.915
,072
.918
,947
.592
.989
.597
.115
Deaths
per 100.000
population
aue to
diphtheria
80.3
97.8
111.3
10S.4
96.9
79.5
80.3
91.9
91.0
99.3
74.0
67.1
59.2
YEAR
1898
1899
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
Deaths
from
diphtheria
2
2
3
3
2
3
3
2
2
2
2
2
2
,612
.786
,306
,026
,859
,035
,041
.296
.691
,603
,473
.313
.433
Deaths
per 100.000
population
due to
diphtheria
37.0
38.9
45.4
40.7
37.7
39.2
38.4
28.4
32.6
30.9
28.9
26.6
26.5
Deaths from Diphtheria per 100,000 potpulation in the —
DISTRICTS
Maritime
Hudion Valley
Adirondack and Northern
Mohawk Valley
Soutliern Tier
East Central
WeitCc&txal
Lake Ontario and Western
Entire State
1901
1902
1903
1904
1905
1906
1907
1908
1909
55.3
52.6
54.6
51 3
37 5
43 5
39.7
38.8
37.0
33 7
25.1
19.4
23.2
21 1
22.9
31.6
21.6
14.4
23.3
11 4
14.1
16 0
10 2
16.3
16 2
12.7
7.6
34.1
28.5
22 5
24.6
15.6
25.4
17.4
15 6
11.8
18.5
27.9
17 2
23.5
16.1
13.7
20.0
14.1
15.8
15.8
10.8
12.2
14.3
8.6
10.5
15.2
19.1
10.0
8.8
10.4
12 6
15 2
11.7
8.4
15.0
10.9
7.8
26 7
22.9
34.5
32.7
25.5
26.4
19.1
11.0
17.6
40.7
37.7
3)2
38.4
28.4
326
30.9
28.9
a«6
1910
34.2
16.7
11.3
16.4
13.1
la.o
5.3
24.a
26 6
MORTALITY
FROM
DIPHTHERIA.
DEATHS PER
inn nnn nnniii ATinM.
/MfM' mW STAm S£PAmM£ffrQFH£ALm
/\
\'\
\
\../
MORTALITY
FROM
SCARLET FEVER
AND MEASLES.
DEATHS PER
100,000 POPULATION^
SINCE 1885. ^
40
30
20
10
/Vl
\
/
■
r
V
/
_l
\
/
/
)
/
/
II
f
/
\
k
>
1
/
ft
i
k
^
^
V
fi
\
i
r"
i
V
~~1
i
\
r
\
\
f
V
J
^
>
V
A
k
/
V
/
\
J
/
X
\
•i^
N
/
)
^
><
^
\
^
^
•^
^
L
V
/
X
1^
^"
^
^
''
A
~
r
18
86
•8
8
•9
0
•9
2
•9
4
•fl
«
•9
8
i»
00
0
2
'0
4
•0
6
'0
8
•1
0
30
20
10
Ibciti
SCARLET FEVER.
MEASLES.
/V£Wyom STATE D£PAP7Af£Nr or HIAITH
r\
Division of Vital Statistics
206
In each 1,000 deaths there were from Diphtheria in the —
DISTRICTS
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
Muitime
28
20
17
22
13
11
8
18
28
16
9
20
21
8
8
17
31
12
10
16
14
9
8
22
26
13
11
15
19
9
10
22
21
21
12
7
11
11
6
7
17
24
13
11
15
9
7
5
17
21
17
11
10
13
10
9
12
23
13
9
10
9
7
7
12
22
9
5
7
10
6
5
12
22
Hudaon Valley
10
AdirondAck ftod NorthcrD .
Mohftwk Valley
7
10
Soathern Tier
8
EastCeotnl
7
Weit Central
4
Lake Ontario and Western .
16
Entire State
23
23
24
17
19
18
18
16
17
Scarlet Fever and Measles
The reported mortality from scarlet fever and measles, and
deaths per 100,000 population is shown by the following:
YEAR
18S5.
1886.
1887.
1888
1889.
1890
1891
1892
1893
1894.
1895
1896
1897
1898
1899
1900
1901
1902
1903
1904
1905
1900
1907
1908
1900
1910
Deaths
from
scarlet
fever
1.184
1.011
1,267
2.452
2.205
913
2.252
2.177
1.626
1,227
850
759
841
837
730
689
1.430
1.215
1,057
1.194
726
690
1,032
1.688
1,205
1.617
Deaths
per 100.000
popuIaiioD
frona
scariet
fevOT
21.1
17.7
21.7
41.2
36.4
14.8
35.6
33 8
24.8
18.8
12.6
11.1
12.1
11.8
10.2
9.4
19.2
16.0
13.6
15.1
9.0
8.4
12.2
19.8
14.0
17.6
YEAR
Deaths
from
measles
1886.
1886.
1887.
1888.
1889.
1890.
1891
1892
1893
1894
1895
1896
1897
1898
1899
1900
1901
1902
1903
1904
1905
1906
1907
1906
1909
1910
Deaths
per 100,000
population
from
measles
1.170
20.8
895
15.6
1.205
20.7
944
15.9
899
14.8
1,161
18.8
1,200
19.0
1.350
20.9
789
12.1
900
13.6
1,266
18.8
1.495
21.8
873
12.6
838
11.8
756
10.6
1.333
18.3
859
11.6
929
12.2
721
9.3
1.170
14.8
988
12.2
1.369
16.6
997
11.8
1.175
13.7
1.272
16.0
1,285
14.0
^
206
State Department of Health
In each 1,000 deaths ihere were from Scarlet Fever in the —
DISTRICTS
KUntime
Hudson Vdley
Adirondack and Northern
Mohawk VaUey
Southern Tier
East Central
Wert Central..
Lake Ontario and Western
Entire SUte
igoi
1902
15
13
7
5
6
6
4
13
3
5
5
2
2
1
4
4
11
11
1903 1904
10 '
7 ,
4 I
11 I
5
2
1
6
8
11
3
5
11
9
6
1
2
8
1905
1906
1907
1908
1909
6
6
9
17
10
4
1
3
5
3
2
2
1
2
1
6
7
3
7
7
3
1
3
2
3
9
4
3
2
5
2
2
3
2
3
5
4
4
9
15
5
5
7
12
9
1910
12
8
3
4
7
6
4
2
11
In each 1,000 deaths there were from Measles in the —
DISTRICTS
Muitime
Hudson Valley
Adirondack and Northern
Mohawk Valley
Southern Titf
East Central
West Central
Lake Ontario and Westo-n
Entire State
1901
1902
1903
1904
1905
1908
1907
1908
1909
6
10
7
11
7
14
8
13
13
5
2
3
8
9
5
4
3
4
15
5
3
1
11
. 3
2
1
4
8
3
3
2
5
1
4
2
2
5
5
2
9
2
1
4
2
2
13
2
5
4
4
3
1
4
6
6
3
3
3
4
3
2
2
1
6
7
6
3
11
4
7
4
8
6
8
9
10
8
10
7
8
9
1910
10
7
12
7
5
5
4
10
Deaths from Violence
The reported mortality from Violence and deaths per 100,000
population due to accidents is shown by the following:
YEAR
1885
1886
1887
1888
1889
1890
1891
1892
1893
1894
1895,
189rt
1897
Deaths
from
violence
2.994
3.296
3,780
3,842
3.834
4.542
5.028
5,543
5.295
5.487
5.889
7,022
6.172
Deaths
per 100.000
popula-
tion
YEAR
1898
1899
1900
1901
1902
1903
1904
1905
1006
1907
1908
1909
1910
Deaths
Deaths
per 100.000
from
popula-
violence
tion
6,520
02.4
6.003
85.0
6.714
02.2
7.926
106.6
7.058
93 0
7.646
98.6
8.822
111.5
8.352
103.3
8,874
107.5
9.668
114.2
9.183
107.4
9.232
106.1
9,846
107.6
r
ilo
no
100
90
80
70
60
90
MORTALITY
FROM
VIOLENCE.
DEATHS PER
100,000 PGPULATIONy
SINCE 1886. ^
NEW Y(mK STATE i
Ml
h
E,
Division of Vital Statistics
207
In eac\ 1,000 deaths there were from Violence in the —
districts
Ifantune
HudsoDVaDey
Adirondack koA Northern.
Mohawk VftUey
Soathem Tier
Eaat Central
Wert Central
Lake Ontario and Western
Entire SUte
Decade.
1886-1894
Decade.
1895-1904
1905
1906
1907
1908
1909
3«.0
57.7
53 5
63.1
66.4
69.0
65.4
40.7
49.3
64.6
58.3
60.3
61.9
70.0
36.7
46.2
52.3
56.1
54.0
60.4
58.7
43.5
53.1
58.8
60.9
61.5
60.4
68.4
51 0
55 5
67.0
59.4
63.3
62.7
66.9
44.0
50.0
54 5
60.9
63.7
62.1
61.5
44.5
51.7
58.0
63.6
63.3
64.1
65.8
48.5
57.0
66.2
74.2
71.2
63 1
73.4
40.3
55.8
61.0
63.3
65.3
66.1
65.8
1910
64.
74.
58.
67.
70.
67.8
65.7
62.8
.6
1
.3
.6
.6
65.0
In each 1,000 deaths there were from Diarrhea {under 2 years
of age) in the —
DISTRICTS
Maritime
Hudsoii Valley
Adirondack and Ncrthem
Mohawk Valley
PcuthemTwr
East Central
Wect Central
Lake Ontario k Western .
Entire State
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
56
93
£5
75
76
83
74
79
81
69
68
40
42
35
36
43
36
20
43
35
72
41
33
38
23
43
34
86
46
39
65
41
44
35
40
41
44
47
63
50
55
30
34
35
23
29
37
25
34
22
68
31
33
28
20
32
36
37
41
36
67
28
35
26
26
36
36
22
30
26
86
60
66
50
53
50
57
46
62
48
62
72
67
60
60
66
61
63
66
56
1910
74
39
40
64
33
44
33
54
61
In each 1,000 deaths there were from Pneumonia in the —
DISTRICTS
Maritime
HudKn Valley
Adirondack vod Northern.
Mohawk VaOey
Soathem Tio
East Central
WestCentral
Lake Ontario and Western
Entire State
1903
1904
1905
1906
89
110
125
137
70
78
76
79
57
60
66
74
64
73
77
76
55
70
70
60
64
83
75
61
60
72
70
65
' 51
65
65
60
fM)
95
104
109
1910
72
67
64
79
65
69
57
40
67
As one of the representatives of the Department designated to
attend the annual meeting of the American Public Health Asso-
ciation, held in Milwaukee, Wis., September 5-9, 1910, I respect-
208 State Depabtment of Health
fully report that I attended the sessions of the Section on Vital
Statistics and took part in the prc^ram, which was as follows :
September 6
Business meeting of the Section, followed by an address by the
chairman.
Presentation of papers as follows:
1. " Kegistration of Births/' by F. D. Beagle, Director Division
Vital Statistics, Xew York State Department of Health, Albany,
N. Y.
2. " Premature Still Births," by Dr. Jno. S. Fulton, Secretary
General International Congress on Hygiene and Demography.
Washington, D. C.
3. " The Importance of Birth Eegistration to Determine In-
fant Mortality," by Dr. J. H. Mason Knox, Jr., Physician in
charge of the Thos. Wilson Sanitarium for Children, Balti-
more, M. D.
4. *^ The Work of the Association for the Study and Prevention
of Infant Mortality," by Dr. Marshall L. Price, Secretary State
Board of Health, Baltimore, Md.
September 7
5. " The Practical Side of Eegistration and the Obstacles En-
countered in the Application of the Registration Laws in Ne-
braska," by Dr. E. Arthur Carr, Secretary State Board of Health,
Lincoln, Neb.
6. " The Prevalence of Tuberculosis in European Immigrants
to Canada," by Dr. P. H. Bryce, Chief Medical Director, Depart-
ment of Interior, Ottawa, Canada.
7. " The Importance of the R^istration of Marriage Certifi-
cates," by Dr. F. W. Shumway, Se^cretary State Board of Health,
Lansing, Mich.
8. " Occupational Statistics for Tuberculosis in Wisconsin," by
Mr. L. M. Hutchcroft, Statistician, Stat^ Bureau of Vital Statis-
tics, Madison, Wis.
Respectfully submitted,
F. D. BEAGLE,
Chief Clerk and Director Division of Vital Statistics
SPECIAL REPORT ON VITAL STATISTICS
1900-1909
BY
Prof. Walter F. Willcox, Consulting Statistician
I209I
212
Statk Department of Health
The table shows that the number of deaths in the last years was
between 4i and 6 per cent greater than the number in 1900. As
the population of the State has been increasing more rapidly than
this and in 1910 exceeded that in 1900 by more than one-fourth
(25.4 per cent), it is clear that the ratio of deaths to living
population has been falling.
The simplest and so the first mode of classifying these deaths
is by sex. During the ten years the deaths of males were 730,134
and those of females 631,658, an excess of nearly 100,000, or
7.2 per cent, in male deaths. This is probably not due to any
excess of males in the population of the State, for in 1900 and
earlier females were more than half of the State's population.
To determine whether the ratio of deaths of either sex to the total
has undergone any change during the period, the deaths by sex for
each year as well as for the two quinquennial periods are given
below.
Table 2. — Deaths in New York State Classified by Sex,
FOR Each Year, 1900-1909, inclusive
Total
Dbathh
Per C«nt
Excses OP Maim
Deaths
year
Male
Female
Male
Female
Number
Per cent
1900
1901
1902
1903
1904
1900-04
1905
1906
1907
1908
1909
1905-09
132,352
131.461
124,657
127,602
142,014
658.086
137.222
140,626
146.882
138,883
140.073
703.686
69.687
70.070
66,841
68.030
75.985
350.613
73.432
75.990
79.922
74.691
75.466
379,501
62.665
61,391
57,816
59.572
66.029
307.473
63.790
64.636
66.960
64.192
64.607
324.185
S2.7
53.3
53.6
53.3
63.5
53.3
53.5
54.0
54.4
53.8
53.9
53.9
47.3
46.7
46.4
46.7
46.5
46.7
46.5
46.0
45.6
46.2
46.1
46.1
7.022
8.679
9,025
8.458
9.956
43.140
9.642
11.364
12.962
10.499
10.869
66.316
5.4
0.6
7.2
6.6
7.0
0.6
7.0
8.0
8.8
7.6
7.8
7.8
In each of the ten years deaths of males outnumbered those of
females by from seven to thirteen thousand and by 5 to 9 per
cent. The excess of male deaths was greater absolutely and
relatively toward the close of the decade. This may be due to an
increasing proportion of males in the population (about that we
are not yet informed) or to a fall in the death rate of females
greater than the fall for male^ or to some combination of the two.
Special Report ox Vit.vl Statistics
213
A classification almost as obvious as that by sex And exercising a
greater influence upon death is the classification by age. The
tabulations by age are for single years under five and by five year
age periods above five. The deaths during this ten year period
were distributed to the several ages as shown in Table 3.
Table 3. — Deaths in Xew Yokk State Distributed by Age
Fon THE QnxQUENNiAL PERIODS 1900-1904 and 1905-1909
AND FOR THE Decexnial Period 1900-1909
AGE
Under 1
1
2
3
4
5-9
10-14
16-19
20-34
25-29
3Q-34
35-39
40-44
46-49
50-64
55-fiO
GO-^
66-69
70-74
76-79
SO-S4
86-89
90-94
95 and over. .
Age unlcDowo
Total ...
1900-1909
1900-1904
Ratio
•
Ratio
Number
per
10,000
Number
per
10.000
257.010
1.887
122,783
1.866
63.981
470
32.010
486
27,488
202
14.036
213
17,122
126
8,764
133
12.261
90
6.637
99
33.496
246
17.599
267
19.069
140
9.529
145
30.644
225
15.012
228
47,716
350
23.569
358
57.286
421
29.103
442
61.221
450
30,592
465
67,016
492
32.289
491
65,096
478
31,210
474
64,120
471
29.291
445
68.129
500
32.288
491
69.330
509
33.082
503
78,648
578
37.076
563
80.583
592
37,705
573
78.750
578
37,719
573
70.078
516
33,327
607
51,580
379
24.957
379
27.636
202
12.535
191
9,277
68
4.414
67
2.638
19
1.239
19
1.698
12
1.420
22
1.361.772
10.000
658.086
10.000
1905-1909
Qttinqueimial
change
Number
Ratio
per
10.000
De-
crease
In-
crease
134.227
31.971
13.452
8.358
5.724
15,897
9,540
15,632
24.146
28.183
30.629
34.727
33.886
34.829
35.841
36.248
41,572
42.878
41,031
36.751
26.623
15.001
4.863
1.399
278
1,907
454
191
119
81
226
136
222
343
401
435
494
482
495
509
515
591
609
583
522
379
213
69
20
4
"32
22
14
18
41
9
6
15
41
30
"is
41
3
8
50
18
12
28
36
10
15
22
2
1
703.686
10,000
This shows that much the largest number of deaths, between one-
fifth and one-sixth of the total, occur in the first vear of life and
that more deaths occur in each of the three following years than
at any later year of age. After four is reached the annual num-
ber of deaths fall below that in and beyond middle life, 35 to 79
\-ears of age, and continue to sink to a minimum at the age of
puberty, when only about one three hundred and fiftieth of the
total number of deaths oc^-cur in any one year of age. The
largest number of deaths after the years of infancy are passed
214
State Depabtment of Heai^th
occur at the ages 65 to 69, when about one eighty-fifth of the
total deaths occur in any one year of age. A rough distribution
of the total deaths to age periods has been made and shows that
each five deaths in the State on the average occur within the fol-
lowing limits of age:
One between birth and the age of 1 year, 3 months — interval 15 months.
One between 1 year, 3 months and 27 years, 2 months — interval 311 months.
One between 27 years. 2 months and 48 years. 6 months — interval 256 months.
One between 48 years, 6 months and 65 years. 1 month — interval 199 months.
One between 65 jrears, 1 month and limit of life.
The interval requisite to result in one-fifth of all the deaths
is least in infancy and, as the oldest person to die among the
1,861,772 was probably more than. 100, it is greatest in old age.
A second maximum is found in youth and early adult life, after
which the interval diminishes because the increasing danger of
death more than counterbalances the diminishing number ex-
posed to it.
Table 3 in showing the distribution of deaths by age for each
quinquennial period reveals the fact that deaths under 1 and
deaths over 35 years of age were a larger proportion and deaths
between 1 and 34, inclusive, were a smaller proportion in the
second five years. Failures to report ages have decreased and
their number is now insignificant. These changes in distribution
are summarized below:
Propobtion or Dsaths in
Increase (+)
or decrease ( — )
AGE PERIOD
1900-04
1905-09
Under 1
1.86«
2.830
5.276
22
1.907
2.608
5.481
4
-HI
1-34
36 and over
—228
+205
Unknown
— 18
Total
10.000
10,000
The decrease in the proportion of deaths at ages of 1 to 34 and Ht
unknown ages and the increase in the proportion at ages of 35 and
over are just what would be expected. But it is surprising to
find an increase in the proportion of infantile deaths. In previous
Special Repoet on Vital Statistics
215
reports reasons have been given for believing that in the State
outside of New York City the unrecorded deaths are still numer-
ous, but less so now than in 1900. Omission of infantile deaths
is more oommon than omission of deaths at other ages. This
seeming increase of infantile mortality may then be due, at least
in part, to an improvement of the records. To test this con-
jecture, the total has been broken into two parts, one for New
York City, where the omissions in 1900 and since were probably
very few, and the other for the rest of the State, where omissions
were more common.
age period
Under 1
1 to34
85 and oyer . .
Unknown age
Total
Pbopobtion or Dkatrb in
OTDw TosK cmr
190(M)4
1905-09
2,198
3.309
4.490
3
2.208
3.047
4.744
1
10,000
10,000
Increase (+)
or decrease ( — )
+10
—262
+254
—2
IUB8T or BTATa
1900-04
1,475
2.284
6,197
44
10.000
1905-09
1.662
2,105
6.325
8
10,000
Increase (+)
or decrease ( — )
+87
^179
+128
—36
The table shows that ages have been reported much more uni-
formly in New York City where the age return is lacking on only
one certificate in 10,000. The proportion in the rest of the State
is now eight times that and in the first five year period the dif-
ference was even wider. In the city the proportion of infantile
deaths to the total has changed very little, but in the rest of the
State it has noticeably increased. This supports but is far from
proving the conjecture that much of the apparent increase in the
proportion of infantile deaths is due to more accurate returns.
The table gives no ground for concluding that infant mortality
in New York City is greater than in the rest of the State. To
determine that, the living population under one year of age, or
better yet, if possible, the annual number of living births is
needed. This point must be passed by for the present with a
caution against such a misinterpretation of the figures.
216
State Department of Health
The mass of deaths may next be analyzed by sex and age oom-
bined, as in Table 4.
Table 4. — Deaths in New York State Classified by Sex and
Age, 1900-1909, inclusive
age
Under 1 . .
1..
2..
3.
4..
5-9..
10-14..
15-19..
20-24..
25-29..
30-34..,
35-39..
40-44..
45-19 ..
oO-54..
55-59..
60-«4..
65-69..
70-74...
76-79...
80-84...
85-89...
90-94..
95+ ..
Inknowu.
Total
Total
257,010
63.981
27,488
17,122
12,201
33.496
19,069
30.644
47.716
57,286
61.221
67.016
66.096
64.120
68.129
69.330
78.048
80,583
78,760
70.078
51,580
27.536
9,277
2,638
1,698
Male
142.223
33.933
14.643
8.901
6,308
17,367
9,776
16.864
24.969
30.628
34.609
39,078
37,665
38.481
37,916
41.169
41.408
39.414
34,343
24,575
12,664
3,729
960
1.158
1.3G 1.772 ; 730.114
Female
114,787
30.048
12.946
8,221
5,968
16.129
9.294
14,780
22,766
26.668
26,622
27.938
26.606
26.465
29.648
31.415
of ,4ov
39.175
39.336
35.735
27.005
14.972
5.548
1.688
540
631,658
E^xcEss OF Dkatbs
Auoxo —
Males
27,436
3.885
1,598
680
346
1.238
481
1.064
2.203
3.970
7.977
11.140
12.084
11,190
8,833
6.500
3.670
2.233
78
618
98.456
Females
1.392
2.430
2,408
1.819
738
Male
deaths
to 1.000
female
1,239
1,129
1.124
1,083
1.068
1,077
1.073
1,052
1,097
1,149
1,300
1,399
1,466
1,423
1,298
1,207
1.006
1.057
1.002
961
910
839
672
563
2.145
1,166
An excess of male deaths is found at every age under 75 and
of female deaths at every age over 75. This is probably not due
t4> an excess of males in the living population, for in 1900 such
exces?} of males was reported by the census only at ages below 15
(except 8 and 13) and between 29 and 56, inclusive (except 50,
54 and 55).^ At 63 of the 105 diflFerent age periods included in
the census table the female population of the State was more
numerous than the male. The excess of male deaths between 30
and 54 and of female deaths at ages above 75 must be due at
least in part to the larger num'ber exposed to die. But the excess
of male deaths between 15 >ind 30 and between 55 and 75 cannot
1)0 >^o accounted for and must be due to a greater male death rate.
« Tm-elfth cenaus. volume 2, pages 72. 73.
Special Report on Vital Statistics
217
Much the largest part, nearly 28 per cent, of the net excess of
uiale deaths is found in infancy, the deaths of males under one
year of age exceeding those of females by 24 per cent. As the
births of males exceed those of females by only 5 or 6 per cent and
the male children under 1 living in the Stat© in 1900 exceeded the
female by only 2 per cent, the difference between these ratios is
an evidence of the much greater mortality of male infants.
A table similar to Table 3 but including also the sex classifica-
tion has been prepared, but it adds so little that it does not deserve
ins^ion. It does show that the increase in the proportion of
female infant deaths between the two periods, 1900-04 and 1905-
09, was 2i times the increase in the proportion of male infant
deaths. If this be due in part to improvement of the records,
as has been conjectured, it would seem to follow that during the
five years, 1900-1904, the deaths of female infants were more
likely to escape registration than the deaths of male infants.
The State contains so small proportions of races other than
white that little need be said regarding deaths by race. The fol-
lowing summary shows the general results.
Deaths in New York State Classified by Race, 1900-1909,
inclusive
race
White
N«|po. . . .
laman. . ..
Mongoliui
ToUl.
1900-04
1905-09
642,794
14.477
251
564
686,701
16.245
238
502
658.086
703,686
1900-0<»
1.329,495
30,722
4S<»
l.OrW)
1.361.772
Reported deaths of Indians and Mongolians have decreased in
actual numbers and still more in proportions. That the reported
dealiis of Negroes have increased more rapidly than tot^l de^th^ is
shown by the fact that of each 10,000 deaths Negro deaths con-
stituted 220 in 1900-04 and 231 in 1905-09. Whether these
changes are due to a decrease in the number of Indians and
Mongolians in the State and an increase in the proportion of
Negroes to total population only the unpublished figures of the
census of 1910 can determine.
218
State Depabtment of Health
Because of the much greater numbers involved, the classification
of deaths among the white, population bj nativity is far more im-
portant than the classification of total deaths by race.
From this point of view the deaths are classified as follows :
Number and per cent of all Deaths of Whites in New York
State
NATIVITY
NfttiTe white
Of native pArentB
One or ootfa parents foreignbam
pBrents' country of birth unknown.
Foreign-bom white
Country of birth unknown
Total white
Number
1900-1904
Percent
Number
1905-1909
436.087
193.639
191.602
50.846
197,098
9,609
67.8
30.1 ....
29.8 ....
7.9 ....
30.7
1.5
463.512
203.413
218.087
42.012
216.591
6.598
642.794
100.0
686.701
1
Per cent.
29.6
31.8
6.1
67.5
31.5
1.0
100.0
About two-thirds of the decedents in the State are of native
birth and less than one-third are of foreign birth. Here, too, evi-
dence of improvement in the records is apparent. The propor^
tion of decedents whose country of birth was unknown fell from
1.6 per cent in 1900-1904 to 1.0 per cent in 1905-09 and the pro-
portion of decedents the birthplace of whose parents was unknown
fell from Y.9 per cent in 1900--04 to 6.1 per cent in 1906-09. As
these changes tend to obscure the changes in the other classes a
second computation has been made after subtracting all decedents
whose birthplace or parents' birthplace was unknown. The result
is as follows :
Number and pee cent op White Decedents with Birthplace
AND Pabents' Bihthplace Stated
NATIVITY
Native:
Of naiiye parents
Of foreign-born paronta
Foreign-bom
Total with birthplace and parents'
birthplace stated
Number
1900-1904
Percent
Number
1905-1909
Percent
385.241
193,639
191.802
197.098
66.2
33.3 ....
32.9 ...
33.8
421.500
203.413
218.087
216.591
66.1
31.9 ....
34.2 ....
33.9
682.339
100.0
638,091
100.0
or de>
(-)
—1.4
+1.S
— .1
+ .1
Special Report on Vital Statistics
219
The marked decrease in native decedents bom of native parents
is almost counterbalanced by the increase in native decedents bom
of foreign-bom parents, the increase in the proportion of deatha
among the foreign-bom population being very slight.
The deaths are also classified by reported cause. The numerous
causes are tabulated under 189 heads and these are combined into
14 main groups. These groups may be divided into two classes,
those in which the proportion of deaths to the total tended to de-
crease between 1900 and 1909 and those in which the proportion
tended to increase. Eight groups, as given below, showed an in-
crease and six a decrease. This does not imply any increase in
the mortality from these eight groups compared with the popula-
tion, but merely that they are causing a larger proportion of such
deaths as occur.
Table 5. — Ratio of Deaths in New York State from Speci-
fied Groups of Causes to 10,000 Deaths from all Causes
FOR Each Year, 1900-1909, inclush'^e
Groups causing an increasing proportion of deaths
of ciroahtory
lystttm
DiMMi of digastiTe
lystttm
Tmemm of genito-
urinaiy aystam...
Child-birth
DisMMi of looomotor
■mam
Mftlfannatioia
Early inCaney
ViolflDoa
Total
1000
1001
1002
1003
1004
1905
1906
1907
1908
1909
858
903
1,015
1,05S
1.090
1.U3
1.130
1.219
1.264
1.331
1.328
1,230
1,188
1.122
1.170
1,246
1,262
1,233
1,278
1.179
744
77
783
85
835
83
87?
85
849
89
869
99
877
94
898
99
878
98
920
05
14
67
381
522
18
68
345
636
10
73
371
697
22
78
390
657
18
78
367
633
20
85
403
674
20
93
420
693
18
96
416
091
22
94
440
696
23
97
423
687
3.091
4,068
4.181
4.285
4.344
4.509
4.598
4.670
4,770
4,755
1900- 1905-
1904 1009
085 1.213
1.208 1.230
817
84
18
73
371
620
4,176
97
21
93
421
688
4.600
Groups causing a decreasing proportion of deaths
GaoaraldiaaneB.
DiaeaMB of nervoiu
lyatan.
DiMoea of reapiratory
ayatem
Diaeianw of ricin.
Old ace
lU-dSned
Total.
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
1900-
1904
2.656
1,093
1,635*
44
260
311
2.790
1.064
1.541
46
257
234
2,661
1.086
1,564
42
250
216
2,676
1.044
1,513
46
22S
208
2,570
1.079
1,57S
43
196
190
2.542
1.144
1,389
42
192
182
2,570
1,007
1,418
41
201
165
2.609
962
1,476
37
147
99
2.696
935
1.307
35
149
108
2.632
913
1.449
36
128
87
2.608
1.073
1.568
44
239
232
6.00W
5.932
5.81?4
5.715
5.656
5.491
5.402
5.330
5,230
5.245
1
5,824
1905-
1000
2.010
001
1,400
30
103
128
5,340
220
State Department of Health
The noteworthy fact revealed by Table 5 is the marked increase
in the proportion of deaths from diseases of the circulatory sys-
tem. Each year showed a larger proportion than any preceding.
The total incre^e in these eight groups of causes between 1900
and 1909 was 764 per 10,000. The increase from diseases of the
circulatory system alone was 473 per 100,000, or more than three-
fifths (61.9 per cent) of the increase from all eight groups of
causes. At the same time there has been a marked decrease in
the proportion of deaths from *' ill-defined causes " pointing to an
improved detail and accuracy of diagnosis. As *' heart failure"
is one of the group of ill-defined causes, it may well be tbat part
of the increase in deaths from diseases of the circulatory system
is due to an improved diagnosis. But even if all the decrease in
the proportion of deaths from ill-defined causes were ascribed to
a transfer from that group to the group of diseases of the circu-
latory system, this would not account for one-half of the apparent
increase in the latter. The conclusion that a rapidly increasing
proportion of the deaths in New York State are due to diseases of
the circulatory system seems well established by the evidence.
The figures have been analyzed for New York City and the rest
of the State with the following result.
Pbr Cestt of De.vths From All Cavses Due to —
YEAR
DIABASES OF CIRCULATORY
SYSTEM
ILL-DEFINED CAC«E«
New York
city.
Rest of
State
New York
city
Ke^i of
1900
7.2
7.5
8.4
8.8
8.9
9.4
9.7
10.1
10.5
11.1
10.2
10.9
12,3
12.6
13.4
13.1
13.5
14.7
15.0
15.8
2.2
2.3
1.8
1.9
1.5
1.6
1.4
0.9
1.0
0.8
4 2
1901
2.7
1902.
2.fi
1903
1904
2 3
2.3
1905
2.1
1906
2 0
1907
1.1
1908 ■ .
1.2
1909. ...
10
Chanire
+3.9
+5.6
—1.4
—3.2
Special Repout os Vital Statistics
331
Tile proportion of deaths from diseaeeis of the circulatory sys-
tem in New York City is much smaller than the proportion in the
reet of the Stiite. The main reason no doubt is that these are
diseases characteristic of old age and the proportion of aged per-
sons in New York City is much less than in the rest of the State.
The increase in tlie proportion of deaths from these diseases in
Now York City has been not much more than two-thirds of the
increase in the rest of the fitate. Probably this is connected with
the fact that the decrease in the proportion of deaths from ill-
defined causes has been less than half as great in New York City
as in the rest of the State.
The fact that the average age at death is steadily and rapidly
rising is closely connected with the increasing prevalence of
death from diseases characteristic of old age, like those of the cir-
culatory system. The common saying that a man is as old as his
arteries illustrates this connection. No doubt the increasing ag©
at death is an important element in explaining the increasing pre-
valence of these diseases. If it were the sole cause we should expect
to find that when deatlis are classified by the age of the decedent
the pri^wrtion of deaths, for example, between 50 and 59 years
of age which were due to diseases of the circulatory system was
not greater or not materially greater in 1009 than in 1900. The
following table shows the facts on this point. As these diseases
are not common in early life, the table begins with the age of 30.
Table 6. — Numbee of Deaths fbom Diseases of Circulatoey
System Classified by Age and Propoetion to Deaths from
all Cadses, 1900 AND 1909
Dbatbs Fboh All
Dbatu Fhoii Dueaoes or
CincoLAToaT STmu
Per CtKT Th*t Deathe
Fbdu DiBBAaBE or Ciur
or Dbitbs Fkim Au.
■«„
1909
IfOO
IMS
■«- 1 -
Hi::;;;:;
70-70
ST:-
ii
";S
13:823
'Is
ill
'b75
iItm
4; 442
2.aso
222
State Depaktment of Health
Of all persons dying in New York State at ages above 60 more
than one-fourth die of diseases of the circulatory system. The
proportion of deaths ascribed to this group of causes at each age
period was considerably greater in 1909 than in 1900. Hence
the increase is not adequately explained by the increasing length
of life alone or by the increasing accuracy of diagnosis alone or
by these two cooperating causes.
Is there any difference between New York City and the rest
of the State in the proportion of deaths at a given age period due
to diseases of the circulatory system? As these are diseases of
old age the following table designed to answer the question begins
with the age of 50.
Peb Cent That Deaths from Diseases of the Cieculatoby
System Constitute of Deaths fkom all Causes, 1900 and
1909
age
In New York Citt
In Rest or State
1900
1909
1900
1909
50-50
13.6
16 0
15.5
10.0
17.7
22 7
26.0
27.7
15.6
17 8
17 0
11.8
19 0
60-69
25.9
70-79
28.8
80 +
26.1
The real increase in the mortality from these diseases during
the decade has been much exaggerated by the transfer of deaths
from old age and from ill-defined causes to this group. The
figures indicate that deaths from diseases of the circulatory sys-
tem are a smaller proportion of all deaths in New York City than
in other parts of the State.
Table 5 on page 219 shows that the general diseases as distin-
guished from localized diseases, or diseases attacking some partic-
ular system of the body, cause more than one-fourth of all the
deaths in New York State and almost twice the number ascribed
to any other group. The group of general diseases, therefore,
deserves special attention and a more detailed analysis. The
eight general diseases each causing more than one thousands deaths
annually have been selected and analyzed in Table 7 in the effort
to determine hwtli tb(^ir comparative importance and their in-
ereaso or decrease within tlie decade.
Special Report on Vital Statistics
223
Table 7. — Eatio of Deaths fbom Main Kinds of Qbneeal
Diseases to 10,000 Deaths peom all Causes in New Yobk
State foe Each Year^ 1900 to 1909, inclusive
Tuberoolom.
Cftaoer
Diphtberia and
croup
TjrpboidfeTcr..
Dbbetei
Seariei fever...
MeMlee.^.^^
Ohmt geoeiM
dawMoi. .
Total..
1000
1901
1902
1903
1904
1905
1.177
1.193
1,163
1.192
1.140
1.164
306
394
418
434
411
448
249
228
230
231
212
164
151
141
141
135
119
117
108 201
67
105
123
93
02
72
74
82
86
91
M
112
100
88
88
67
89
66
6U
62
80
65
399
394
408
357
311
343
2.655
2.791
2.660
2,676
2.570
2.542
1906
1907
1908
1009
1900-
1904
1905-
1909
1.174
1.134
1.108
1.159
1.173
1.166
446
450
490
519
405
471
191
174
174
165
230
174
113
116
101
05
137
1C8
53
150
107
67
119
04
94
97
102
108
75
18
54
74
126
88
88
80
89
66
83
03
69
70
356
348
314
330
374
340
2,570
2.609
2.695
2.633
2,670
2.610
1000-
1909
1.160
438
202
123
106
87
84
74
357
2.640
Table 7 shows that typhoid fever is the only general disease the
relative importance of which has steadily and rapidly decreased
through the decade. In 1900 it caused 1.5 per cent of the deaths
in the State and in 1909 less than 1.0 per cent. Diphtheria and
croup were at the maximum in 1900 and very close to the mini-
mum in 1909, but the course during the intervening period was
one of less steady decrease. Still the decrease in the prevalence
of diphtheria and croup as shown by comparing the two five-year
averages has been a little more rapid than the decrease of typhoid
fever. Influenza has undergone even wider fluctuations but in
the second five years, like typhoid fever and diphtheria and croup,
it was responsible for only about three-fourths of the proportion of
jdeaths which it caused in the first five years.
Tuberculosis, the most deadly general disease, unlike the fore-
going, has shown no regular and important change but rather a
zigzag movement well illustrated by the fact that the smallest and
the largest proportion of deaths occurred in successive years, 1907
and 1908, and that the five-year averages show very little change.
This does not mean that tuberculosis carries off as large a propor-
tion of the population as formerly. It does mean that deaths
from tuberculosis and deaths from all causes, if they have changed
at all in rate or ratio to the population, have changed in the same
direction and to much the same degree.
224 State Department op Health
This unchanging proportion of deaths due to tuberculosis may
l>e due in part to a more discriminating and conscientious
diagnosis. Various pieces of evidence, some of which have been
mentioned, concur to support the conclusion that the medical pro-
fession is certifying the cause of death more carefully and more
accurately. Changes of this sort would probably reduce the pro-
portion of undetected oases of tuberculosis. When the deaths are
divided into those in New York City and those in the rest of the
State no noteworthy difference appears in the trend of deaths from
tuberculosis. The proportion of deaths from tuberculosis to
deaths from all causes is greater in New York City than in the
rest of the State, but this may be due to the larger proportion of
young adults in the city and the large proportion of deaths from
tuberculosis at that age. Neither in the city nor in the rest of the
State has the proportion of deaths due to this cause undergone any
steady and material reduction during the decade 1900 to 1909.
We may hope that the next decade will show different results.
Monthly Di^tribuH&ti of Deaths
A study has been made of the distribution of deaths through the
months of each year in the ten-year period. This, like the fore-
going analysis, can be made without constant reference to the
population. The number of deaths in each month has been di-
vided by the number of days in that month to obtain the daily
average. In a similar way the daily average for the entire year
is computed and on dividing the daily average for each month by
the daily average for the year a series of twelve quotients is
reached, each of which is not very far from 100 and indicates the
proportion between the mortality of that month and that of the
7X3ar.
The average results for the ten years are as follows:
Special Kepobt on Vital Statistics 225
Table 8. — Monthly Distbibution of Deaths in New York
State, 1900-1909
Ratio of daily
mortality in
montha to
daily mortality
of year
January 105
February >. .■ . 112
March 112
April 109
May 98
June 90
July 103
August 101
September 95
October 89
November 89
December 97
Total • 1200
The table shows six healthy and six unhealthy months. If the
results are grouped by seasons they are:
Winter 105
Spring % 106
Sxunmer 98
Fall... 91
Total 400
This shows that in New York State on the average of the last
ten years spring is the most unhealthy season of the year and
fall the most healthy. Winter is almost as unhealthy as spring
and summer is a healthy rather than an unhealthy season.
Returning now to the preceding table, it may be noticed that
there are two healthy periods, one of four months, the other of
two, and that the unhealthy periods are similarly divided. Stated
l>riefly, the first four months of the year are unhealthy with the
maximum mortality in February and March ; the last four months
8
220 State Depaktment of Health
are healthy with the minimum in October and November; of the
middle four months the first two are healthy, the second two un-
healthy. An earlier study of this subject for the years 1894-
1898 has been brought into connection with the present by comput-
ing the distribution for the separating year 1899, thus yielding
a total period of siyteen consecutive years for which the preceding
statements hold true. One important difference appears. In the
six-year period 1894-99, July (116) was the unhealthiest month
and August (107) was almost as unhealthy as February (108).
This suggests either that the years 1894-99 were characterized
by abnormally high summer mortality or that since 1894 there
has been an increased control of summer deaths. The following
figures showing the relative mortality of July in each of the six-
teen years test the accuracy of the conjecture.
Ratio of daily mortality
in July to daily
Year mortality of year
1894 125
1895 113
1896 124
1897 '113
1898 Ill
1899 109
1900 107
1901 '. Ill
1902 104
1903 103
1904 101
1905 Ill
1906 100
1907 97
1908 101
1909 98
The first three years include the two with the highest July
mortality; the last three years include the two with the lowest
July mortality and throughout the period the tendency to a re-
duced July mortality is clear and unmistakable. The change in
the August mortality has been in the same direction. The average
for 1894^99 was 107; that for 1900-09 was 101. Apparently the
Special Report on Vital Statistics 257
reduction in summer mortalitj has progressed so rapidlj- eince
1894 that the midsummer months are no longer the utihealthiest
of the year. This subject deserve© further study in order to de-
termine whether similar changes have occurred in other states or
countries. In Europe as a rule the winter months from Decem-
ber to March, inclusive, have the highest mortality and in coun-
tries, like Italy and Spain, in which the summer mortality is high
it has apparently decreased of recent years jusit as it has in New
York.
The detailed figures for each of the sixteen years 1894-1909
with the averages for 1894-99 and 1900-09 are given below:
Table 9. — Moxtiily Distbibdtio:^ op Deaths ix New York
State, 1894-1909, inclusive
MONTH IBM I^M I!tH|I8fi7'l8»l
inn
IfKI
.«
«r,f
'S
Dicembcr
UJ
"'
KU
Similar tables have been prepared for New York City and
for the rest of the State for each of the ten years 1900-Od and for
the entire period. The general results are as follows :
-c,;
oiV
Re.l ..(
98
^
»'
Iffi
S-";::;;;::;:;;;::;;;;;:;;:: :■:;::;;;;:;;;:;;::;
'm
228
State Department of Health
The preceding figures show that on the average June and
especially July in New York City are much more unhealthy than
the same months are in the rest of the State, but that August,
October and especially September in New York City are much
more healthy than the same months are in the rest of the State.
In the other seven months the differences between, city and country
are very slight. Apparently in the country the heat of summer
takes a longer time to cause death than it does in the great city.
When the figures for July are analyzed by successive years
for New York City and the rest of the State, it appears that
in both areas the July maximum diminished between 1^00 and
1909, but the decrease in New York City was much greater than
in the rest of the State.
•
Analysis of Mortality Rates
From the United States census population figures for 1900,
those of the State census for 1905 and those for 1910 published
thus far by the Census Bureau it has been possible to estimate
the population of the State on July 1st of those years and of
each intervening year. This has been done by the arithmetical
method used in previous reports. Similar figures have been
computed also for all incorporated places having at least 10,000
inhabitants in 1910 and included in the Federal Mortality Re-
ports for the entire period, 1900-1909. The word urban as
used throughout this analysis is to be nnderstood in this sense.
Similar computations have been made for each county and
sanitary district.
The population estimates for the entire State and for the urban
and rural districts are given below.
Table 10. — Estimated Population of New York State and
ITS TJeban and Rural Districts, July 1, 1900~July 1,
1910
year
1900.
1901.
1902.
1903.
1904.
1905.
1906.
1907.
1908.
1909.
1910.
New York State
Urban
7.282,217
4.899.408
7.441.886
5,049.689
7.601.574
5.199.981
7,761.257
5.360,281
7,920,940
5,500,576
8,085.190
5,654.972
8.299,732
6.854.523
8.614.289
6,054,074
8,728,843
6,253.634
8.943.403
6.453.196
9,167.963
6.652,772
Rural
2.382,.<»11
2.392.197
2.401.593
2,410,976
2.420.364
2.430,218
2,445,209
2.460.215
2.475.209
2.490,207
2.505,191
Special Report on Vital Statistics
229
By the use of these more accurate estimates it is possible to
obtain more trustworthy birth, death and marriage rates for the
decade than was possible before the census figures for 1910 were
available. Table 11 shows the main statistical results of regis-
tration in the State since 1885. •
Table 11. — Popclatiox, Births, Deaths, Stillbirths, Mar-
riages AND Divorces in New York State, 1885-1910
YEAH
1885.
1886
1887.
1888.
1889.
1890.
1891.
1892.
Is93
1894
1895.
1897.
1898
1899.
1900.
1901.
1902.
1903
1904.
1905.
1906.
1907.
1908.
1909.
1910.
Estimated
population
I ^
5.fi09
5.719
5,831
5.946
6,062
6,182
6.316
6.438
6.537
6.638
6.741
6.845
6.951
7,085
7,167
7.282
7.441
7.601
7.761
7,920
8.085
8.299
8.5U
8.7^8
8.943
9,157
.910
,855
,947
,246
,764
.600
,333
,283
.716
,696
,246
,375
.111
. 459
.491
.217
. HSC)
.574
.2.57
.940
.190
.732
,289
.843
,403
,963
Births,
excluding
still-
birth«i,
according
to state
Depart-
ment of
Health
63..'>36
89.828
102,038
103.089
114,804
112,.'>72
125.909
1.30.143
136.297
141.827
U2.311
147.327
144.631
13S.702
136.778
143,156
140.539
146,740
1.58.343
165.014
172.259
183,012
196.020
203.159
202.6.56
213,290
Deaths, Exclvdino
.*^TiLL-BiRTHs, Ac-
cording TO —
State
Depart-
ment of
Health
80.
86.
108.
114.
113.
128.
12(».
131,
129.
123.
IJH.
126.
118.
122.
121.
132.
131.
124,
127,
142.
137,
441,
147,
138.
140.
147,
407
801
269
.584
1.55
648
.S.'O
388
6.59
423
S.34
253
525
5S4
831
089
335
830
498
217
433
099
130
912
2il
629
Census
Bun»au
132.3.52
131.461
124.651
127.602
142,014
137.222
140.626
146.H8_>
1.38, 8S3
140,073
.«ftill-
birthn,
according
to Stat«
Depart-
ment of
Health
MARRIAQKn,
ArCOKDI>0 TO —
9,401
10.261
10.291
lo.O'-g
9,9.52
State
Depart-
Census
ment of
Bureau
Health
24,409
30.764
44,438
44,542
43/83
44,645
50,96)
49,997
41,195
49,201
51,468
51,277
52,725
.52,798
52,805
52,.5o9
.59,059
58,990
57.530
57,392
61,167
63,225
65,216
68,903
73,011
74.677
78,2«U
87,870
95,:in
72.28'3
78,363
84.543
.52.999
,52,621
.58,889
.59,189
57.025
57,165
59.907
63,743
65,158
69.439
73.338
74,581
ST, 162
88,979
230
State Department of Health
Table 11. — Continued
Population, Births, Deaths, Stillbirths, Marriages and
Divorces in New York State, 1885-1910
year
Divorces,
accordint;
to Census
Bureau
Births
per 1 .000
popu-
lation
Deaths
per l.OOD
popu-
ration
Persons
married
per 1.000
lation
Persons
divorced
per 100.000
popu-
lation
1S85
936
1.006
1.042
1,034
1.095
901
1,052
1.155
1.175
1,386
1.434
1,270
1.324
1,493
1,600
1.800
1,832
1,533
1,774
1.952
2.144
2,069
11.3
15.7
17.5
17.3
18.8
18.2
19.9
.20.2
20 8
21.4
21.1
21.5
20.8
19.7
19.1
19.7
18.9
19.3
20.4
20.8
21.3
22.1
23.0
23 3
23.7
23.3
14.3
15.2
18.6
19.3
18.6
20.8
20.5
20.3
19.7
18.6
19.1
18.4
17.1
17.4
17.0
18.1
17.7
16.4
16.4
18.0
17.0
17 0
17.3
15.9
15.7
16.1
8.8
12.8
15.2
14.6
16.8
13.4
16.2
16.2
16.2
15.8
17.4
17.2
16.6
16.2
17.0
17.4
17.5
18.1
18.8
18.8
19 4
21.2
22.4
16.6
17.5
18.5
33
1886
35
1887
1888
36
36
1889
36
1890
29
1891
33
1892
36
1893
36
1894 .• .
42
1895
42
1896
37
1897
38
1898
42
1899
47
1900
49
1901
49
1902
40
1903
46
1904 .•
49
1905
53
1906
50
1907
1908. . . '
1909
1910
It is interesting to note that, although the population estimates
for the years 1905—1909, inclusive, are somewhat altered through
the use of the 1910 figures, the rates do not show any material
(lilferences from those given in my report for last year.^ The re-
vised figures confirm and emphasize the statement then made that
** 1909 stands at the high water mark of public health in the his-
tory of New York State.^
In Table 12 are given the death rates from all causes for the
State and sanitary districts during the last decade.
1 State Department of Health, 30th Annual Report, Vol. 1. p. 239.
* Ibid. p. 241.
Special Report ox Vital Statistics
231
Table 12. — Death Eates of New Yobk State and of the
Sanitary Districts, 1900-1909, I^X'LUSIVE
year
1900
1901
1902
1903
19CM
1905
1906
1907
1906
1909
Adiron-
State
dark A
North-
ern
18.2
15.7 '
17.7
15.0 1
16.4
13.1
•IfiA
13.5
17.9
14.3
17.0
14.8
16 9
14.9
.17.2
15.0
15.9
14.8 1
15.7
15.1 '
1
Lake
Ontario
Western
14 9
14 9
13 9
15.0
15 2
15.2
15.3
15.9
14.6
14.7
Mo-
hawk
Valley
16.1
15.9
14.5
15.5
15.6
15.1
15 8
16.4
15.9
14.7
West
East
Central
Central
15.4
15.6
15 3
15 3
14.5
13.8
15.5
14.3
15 7
15 6
16.0
15.7
15.5
15.2
16.1
15.8
15.2
16.1
15.1
15.3
South-
ern Tier
15.0
14.3
13 7
13 9
15.6
14.6
14 4
15.4
15 5
15.3
Hudson
Valley
18 6
17 8
16 1
16.9
17.8
17.6
16.9
17.9
17.1
16.9
Mari-
time
20.2
19.5
18.2
17.6
19.7
18.1
18.1
18.1
16.2
15.9
The table indicates that the mortality from all causes has de-
creased during the decade, but not uninterruptedly. At no time
since. 1900 has the rate risen as high as in that year (18.2). A
study of the rates according to sanitary districts indicates that the
same is true of the Hudson Vallev and Maritime districts, that
the high rate in the State in 1900 was due to excessive rates in
those two districts and that the general decline in the State is
largely due to the improvement in the same districts.
Although for the State as a whole 1909 was the healthiest year,
yet for every sanitary district, except the Maritime, 1902 shows
the minimum rate, the decrease from 1901 ranging from .6 to 1.9
per thousand and in five of the seven sanitary districts being 1.0
or above. These minima seemed so notable as to make a brief
studv of the deaths by cause for 1902 worth while. Below are
given the deaths in 1901 and 1902 from all causes and from each
cause showing a difference between the two years of at least 200
deaths.
232
Stat? Departmext of Health
Table 13. — Deaths in New Yoek State in 1901 and 1902
FROii Principal Causes
CAUSE
All causes
Scarlet fever
Whooping cough
Influenza
Tuberculosis of lungs
Meningitis
Other diseases of the nervous system . . .
Diseases of circulatory system
Pneumonia
Other diseases of the respiratory system
Diarrhea and enteritis under 2 years . . .
Violence other than suicide
Ul-detined causes
Deaths
Deaths
1901
1902
131,461
124,657
1.469
1,249
633
900
2,643
713
13.877
12,657
2.328
2,092
11.6o4
11,438
11,871
12.649
11.400
10,303
8,850
9,194
8.053
7,016
7.557
G.546
3,030
2,622
Excess ( +
or de-
crease ( — )
in 1902
—6.804
—220
4-267
—1,930
—1.220
—236
—2m
+778
—1.097
-f344
—1,037
—1,011
—408
It will be seen that the decrease of 6,804 deaths in 1902- was
largely due to fewer deaths from the following causes: Influ-
enza, tuberculosis of the lungs, pneumonia, diarrhea and enteritis
under two years and violence other than suicide. An investigation
of this last class reveals the fact that the decrease is due to a de-
cline in deaths from heat and sunstroke (from 1,465 in 1901 to 46
in 1902), a decrease so great as to more than account for that in
the whole class and so offset the increase in other forms of violeuco
to be expected with the growth in population. The character of
the five causes noted above, which account for 6,295 of the 6,804
fewer deaths, points to climatic conditions peculiarly favorable to
health in 1902.
The year 1907 shows a high death rate, the highest in the de-
cade for three districts (Lake Ontario and Western, Mohawk Val-
ley and West Central) and an increase over several preceding
years for the State as a whole and for every other district, except
the Maritime where it was the same as for the two preceding years.
To throw light on the reasons for this high rate, the deaths from
the principal causes in 1907 were compared with the average in
1906 and 1908. Table 14 indicates the results for causes showing
significant differences.
Special Report ox Vital Statistics
233
Table 14. — Deaths in New York State from the Principal
Causes, 1907 and Average op 1906 and 1908
cause
Average
number
deaths 1906
and 1908.
Number
deaths 1907
Excess ( +)
or de-
crease ( — )
in 1907.
All causes
139.755
1.118
11,683
146.882
2.204
12.107
17,902
11.136
10.539
0.827
11.675
8,872
1 ,455
+7.127
I tnflucnaa
+1,086
Nervous diseases other than meningitis
+424
Diseases of the circulatory system
16,781
+1,121
Pneumonia
9,4 0
9.552
9,453
10,821
8,296
1,882
+1,646
CHber diseases of the respiratory system
+987
Diarrhea and enteritis under 2 years
+374
Bright's disease and nephritis
+854
Violence other than suicide
+576
Ill-defined causes
— 127
Some increase in the number of deaths was to be expected with
the growth of population and the improvement in registration, but
these factors seemed insufficient to account entirely for an increase
of more than 7,000. The causes which suggest further study are :
Pneumonia, diseases of the circulatory system, influenza, other
diseases of the respiratory system, Bright's disease and nephritis,
violence other than suicide. In some cases it is necessary to study
the figures for the entire decade to appreciate the significance of
those for 1907.
The increase of deaths from diseases of the circulatory system
and its connection with the decline in deaths from ill-defined
causes have been discussed. The increase in the former in 1907 is
slight in comparison with that for many of the other years of the
decade, not at all accounting for the increase in the general death
rate. The mortality from diseases of the nervous system other
than meningitis, from Bright's disease and nephritis, from di-
arrhea imder 2 years and from accidents reached its maximum in
1907. On investigation, the increase in accidents is found to be
connected not at all with mortality from heat and sunstroke as
was the decrease in 1902, but rather with increases in several sorts
of casualties. A study of the death? from influenza during the do-
cade indicates that the great increase in 1907 over 1906 is due
to an exceedingly favorable condition in the earlier year, although
the fact that the deaths from this cause in 1907 were considerably
w
234 State Department of Health
more than in any other year with one exception (1901) partially
explains the increase in the general death rate. The mortality
fron^ pneumonia and other diseases of the respiratory system,
while not at its maximum in 1907, was nevertheless heavy. Deaths
from causes more or less influenced by climatic conditions (in-
fluenza, diseases of the respiratory system, diarrhea and enteritis
under two years) account for about four-sevenths of the difference
between the deaths in 1907 and the average for 1906 and 1908.
The rest of the heavy mortality in 1907 was due in varying de-
grees to disekses of the circulatory system, nervous diseases other
than meningitis, accidents, Bright's disease and nephritis.
A study of the rates in the various sanitary districts reveals in
the Adirondack and Northern, Lake Ontario and Westeni, Mo-
hawk Valley, West Central and East Central distlricts an increase
from the minima in 1902 to or past the high rates in 1907,' a tend-
ency not uninterrupted in some districts. Doubtless much of this
increase is due to improvement in the completeness of registration.
This hypothesis is strengthened by the fact that in the Maritime
district where the influence of New York City's more perfect
registration is predominant, a decrease throughout the decade is
obvious. While the organized public health movement of the
metropolis is to be credited with this decrease, it is not to be sup-
posed that similar work in other portions of the State has been
without results. In my report for 1907 this point was discussed
in the light of figures then at hand.^
Improvement in registration may also account for the fact that,
while no general tendency of any sort may be traced in the South-
em Tier, yet the last three years of the decade had the highest
rates with the exception of 1904.
The Maritime district shows the greatest decrease of any dis-
trict from 1900 to 1909 (20.2 to 15.9) and also the greatest by
individual years. In the Hudson Valley a decrease is apparent
but it has not been at all steady.
»8tate Department of Health. 28th Annual Report, Vol. I, pp. 215-210.
Special Report on Vital Statistics
23
0
Table 15 shows the urban mortality for the State and the sani-
tary districts.
Table 15. — Urban Death Rates of New York State and
OF THE Sanitary Districts, 1900-1909, inclusive.
year
State
Adiron-
dack &
North-
em
Lake
Ontario
A
Western
Mo-
hawk
Valley
West
Central
East
Central
South-
ern Tier
Hudson
VaUcy
5
Alari-
time
1900
1901
1902 ..
1903 .
1904
1905 . .
1906
1907
1908
1909
19 5
18.8
17.6
17.4
19.1
17.7
17.8
17.9
1G.2
15.9
18.2
19.3
16.4
17.0
18.8
18.0
21.4
20.8
18.2
18.4
14.6
15.2
14.3
15.6
16.7
15.5
15.9
16.4
14.8
15.0
17.4
16.5
16.2
17.0
17.0
16.0
17.3
17.9
16.8
15.2
17.0
13.9
14.7
17.0
15.6
15.3
16.3
15.9
14.7
14.7
15.0
14.1
12.9
14.3
15.0
15.0
15.1
15.1
15.7
14 5
16.2
14.8
14.1
14.3
16.3
15.6
14.6
15.5
15.2
15.0
21.2
19.9
18.1
18.8
19.9
19.5
18.9
19.7
18.6
18.5
20.5
19.8
18.4
17.8
19.9
18.2
18.2
18.1
16.2
15.9
The urban death rate of the State as a whole has fallen from
19.5 to 15.9, a decrease interrupted materially only in 1904.
The higher rate in that instance is seen to coincide with a
higher rate for that year in every district except the West Cen-
tral, but most clearly marked in the Southern Tier, Hudson Val-
ley and Maritime.
Downward trends are noticeable in the Hudson Valley and
the West Central urban rates and a less marked one in those of
the Southern Tier. At no time during the decade has the urban
rate in the Hudson Valley been as high as in 1900, but its de-
cline has not been without interruptions. At all times its rate
has considerably exceeded the urban rstte of the whole State, rang-
ing in most instances between 1.1 and 2.6 per thousand higher.
It has exceeded the rate in the Maritime district in every year ex-
cept 1902 and the difference between the two has been rapidly
widening.
The Mohawk Valley has a comparatively high urban rate and
it is difficult to see any decided trend in it. The rates of the
East Central and Lake Ontario and Western districts have been
increasing, due partly no doul)t to improved registration.
Perhaps to the same cause in part is due the increase in the
urban rate of the Adirondack and Northern district. Its rate.
however, deserves special attention, as it is high in comparison
236
State Department of Health
with the urban fate of other districts. In six of the ten years its
urban death rate was higher than the corresponding rate for the
entire State, in four of the years being between 2.0 and 3.6 per
thousand higher. This is the more striking because the district
contains no large cities. A study of the rates of its three cities
having over 10,000 population in 1910 (Watertown, Glens Falls
and Ogdensburg) shows that its high- urban rate is due to that of
Ogdensburg. Since 1901 tiie rate for that place has not been
below 24.4 and has risen as high as 30.1 and 31.1 (1907 and
1906). This excessive mortality is due in part to the fact that
the St. Lawrence Hospital for the insane is situated there. The
figures for deaths ip that institution, available in the State De-
partment of Health Reports since 1905, show that it has fur-
nished from 24 to 30 per cent of the city's total mortality. If
these deaths be substracted, however, the city rate is still high ; in
fact, for every year, higher than the urban rates of any other dis-
trict except the Hudson Valley.
The most significant feature of the decrease in the urban
mortality of the State appears in the noteworthy decline in the
Maritime district, from 20.5 in 1900 to 15.9 in 1909, a down-
ward trend broken only by the year 1904. The excess of its rate
over the urban rate of the entire State has only twice been as
much as 1 per thousand.
Table 16 gives the rural deuth rates for the State and the
sanitarv districts.
Table 16. — Rural Death Rates of N'ew York State and
OF THE Sanitary Districts 1900-1909, inclusive
year
1900
1901
1902
1903
1904
190r>
1906
1907
190R
1909
State
15.5
1 5 3
13.9
14.4
15.3
15.2
14.9
15.7
15 3
15.1
Adiron-
North-
ern
15 3
14.4
12 G
13 O
13.7
14.4
1.1 9
14.1
14 3
14.6
1 Take
Ontario
i &
; Western
15 4
14.5
13.1
14 1
14.3
14 7
14 2
15.0
14.1
14.2
Mo-
Hfiwk
Valley
We-^t
Fast
Central
Central
15 2
15.0
15.8
15.5
15 6
15 S
13 3
14.4
14.1
14.3
15.2
14.2
14 5
15.S
16.0
14 4
16.1
16 1
14.4
15.3
15.2
15.1
16.2
16.1
15 1
15.3
16.3
14.3
15.2
15.7
South-
Hudson
ern Tier
Valley
14 5
16.7
14 1
16 2
13.6
U.6
13 8
15 3
15 2
16.1
14 2
16.1
14.4
15.3
15 3
16.5
15.6
15.8
15 4
15.7
Mari-
time
15 6
16.3
15.5
15.5
17.0
16.2
16.5
17.4
16.1
15.7
Special Report on Vital Statistics
237
In comparing the rates of the various districts it should be
home in mind that differences in accuracy of registration may
accoimt somewhat for differences in rates. The Adirondack and
Northern has had, on the whole, the lowest rural rates. Those in
the West Central, East Central, Hudson Valley and Maritime
districts have in almost every year exceeded that of the State, the
last district showing the highest rate for nearly every year.
Xo decrease in rates can be traced in the rural portion of the
State as a whole. This is probably to be accounted for by im-
provement in the registration masking a real decrease. In my
last report^ the difference between the urban and rural rates was
discussed. As the revised estimates of population give rates
differing a little from those there presented, the urban and rural
mortality with excess in the former is given below. The urban
rates here are for cities of 10,000 and over; those given last year
were for cities of 8,000 and over.
Death Rates in Urban and Rural New York
year
1900
1901
1902
1903
1904
1903
1906
1907
190e
1909
Decrease 1900-09
In iirbfln
In rural
districte
dUtricts
19.5
15.5
18. H
15.3
17.6
13.9
17.4
14.4
19.1
15.3
17.7
15.2
17.8
14.9
17.9
15.7
16.2
15.3
15.9
15.1
3.6
.4
Excess
in urban
districts
4.0
3.5
3.7
3.0
3.8
2.5
2.9
2.2
.9
.8
These figures emphasize the statement made last year that the
difference between urban and rural rates has been rapidly grow-
ing less. As there suggested, this is probably due to two causes,
greater advances in sanitation in the cities and improved
registration in the rural districts so great as to hide a probable
decrease in mortality.
Respectfully submitted,
WALTER F. WILLCOX,
Consulting Statistician
* State Department of Health, 30th Annual Report, p. 243.
DIVISION OF COMMUNICABLE DISEASES
(2391
J
DIVISION OF COMMUNICABLE DISEASES
Hon. Eugene H. Porter^ A. M., M. D., Commissioner of Healthy
Albany, N. Y.:
Sir: — I have the honor to submit the following report of the
work of the Division of Communicable Diseases for the year 1910.
This division of the State Health Department has developed
greatly since 1907, at which time it was placed under the direc-
tion of Dr. John T. Wheeler, whose efforts in the preservation of
the public health were beginning to bear fruit when the grim
reaper saw fit to call him to his long home. Through his untiring
efforts and those of his successors in the division, a friendly feel-
ing has been created between the health oflficers of the various mu-
nicipalities throughout the State and this portion of the machinery
of the State Health Department, and it is a pleasure to be able ta
report that there are but few of the health officers delinquent with
their monthly reports. Some, however, are rather dilatory, espe-
cially in making reports of the first cases of infectious diseases
which appear in their districts, and I would remind the health
officers that it is only by the cordial support of those interested in
the conservation of the health of the State that this division is
enabled to keep in touch with the morbidity of the different local-
ities and render such aid as may be required either by advice or
assistance through the medical officers of the State Health De-
partment, whenever needed either to control or when possible to
prevent an epidemic.
The State institut^'ons and State hospitals are now reporting
all cases of communicable diseases occurring among their inmates
to the State Department of Health, either directly or through the
health officer of the municipality in which they are located. This,
with the increase of the number of reportable diseases, has some-
what increased the clerical work of this division. The following
table will show the distribution of the morbidity of the State by
counties :
[241]
242
State Department of Health
Albany
AQeeany —
Broome —
CatUmuKus.
Cayuica
Chautauqua
Chonung. . .
Chenanfo...
Clinton
Cohirobia . . .
Cortland...
Ddaware. . .
DutcbcM
Erie
Ebmx
Franklin —
Fulton
Genesee
Greene
Hamilton ...
Herkimer . . .
Jefferson
Lewis
Livingston. .,
Madison
Monroe
Montgomery.
Nassau
Niagara
Onada
Onondaga —
Ontario
Orange
Orleans
Oswego
Otsego
Putnam
Renssdaer. . .
Rockland....
StLawrenee.
Saratoga
Seheneetady..
Rchoharie
Sfthuyler
Seneca
Steuben
Suffolk
Sullivan
Tioga
Tompkins
Ulster
Warren
Washington..
Wayne
Westchester .
Wyoming
Yates
518
23
208
66
88
60
190
16
39
61
12
11
223
1.238
438
652
14
14
14
4
33
55
10
13
27
263
92
47
94
145
248
29
121
15
30
33
2
222
30
30
58
218
17
13
32
41
114
631
8
19
22
30
16
17
394
11
4
Greater New York 32.006
263
32
54
48
38
113
111
33
48
28
8
25
91
1.437
74
53
41
26
13
""■44
51
6
5
20
245
103
101
152
215
477
40
182
17
46
22
6
168
95
83
54
131
8
9
15
66
12
7
9
121
24
22
25
472
13
8
17.226
411
149
101
226
184
341
152
72
51
64
21
78
203
2.549
34
39
32
119
19
3i
81
5
161
125
1.818
228
189
298
128
1.103
78
353
63
75
97
11
212
121
67
64
142
19
17
123
53
162
71
16
71
140
24
68
51
1.282
32
8
19.284
Measles
1.161
281
385
851
181
1.121
60
47
364
191
286
341
456
7.042
240
158
425
603
265
6
302
2.708
338
290
226
678
235
378
1.092
707
2.311
47
1.259
34
189
461
62
877
167
1.318
1.044
1.437
407
22
128
386
<855
74
13
144
502
72
59
254
1.369
406
194
35.816
Tvphoid
fever
259
50
77
46
111
188
74
26
96
56
68
72
80
483
38
40
10
18
67
10
20
216
18
9
11
258
45
46
321
90
312
64
152
20
106
66
12
130
18
98
74
140
17
7
51
147
56
28
14
52
64
23
35
63
278
45
19
3.735
spinal
Qenm*
gitis
2
8
3
1
3
31
1
4
2
3
1
1
1
2
1
2
4
2
230
SmaU-
pox
3
1
1
54
21
30
22
1
72
1
5
1
1
1
1
95
8
1
1
4
1
2
16
Oph^
ntona-
tcvum
1
8
3
2
1
Polio-
myelitis
1
5
2
1
4
1
5
4
8
3
1
6
2
6
3
1
1
1
1
2
1
8
1
i
1
3
3
1
8
4
1
1
1
14
3
10
3
'4'
4
8
3
Two counties were not visited by the diphtheria germ and only
one escaped scarlet fever.
A mortality table of the different infectious and contagious dis-
eases has not been prepared, as this is dealt with by the Division
of Vital Statistics in an able and exhaustive manner.
The medical oflScers have frequently been called upon to render
valuable assistance to the health officers throughout the State, not
a
Division of Communicable Diseases
243
onlj in cases of doubtful diagnosis but in establishing and main-
taining an efficient isolation and quarantine of infectious and con-
tagious diseases. Their counsel is often of great benefit both to
the health officer and the community in the prevention and con-
trol of epidemics.
There have been reported to the Department during 1910, as
shown by the following table, which likewise shows the distribu-
tion of them through the year, 171,345 cases of those communic-
able diseases, of which a report is required and which are here
designated :
Cases of conimunicahle diseases reported during 1910
TabcreukMns. .
Diphtheria. . .
8ciirletfe\'er..
McMict
Typhoid fever.
Cerdnxapinal
Citii
SniAUpox
Ophthalmia
torum
PoUomyditis .
menin-
neooa-
Jan.
2.416
2.018
3.636
»,728
456
27
51
Feb.
3.203
2.025
4.565
10.047
566
32
50
Mar. April
4,497
2.489
5.346
13.770
457
34
69
3.969
2.447
4.412
9.931
322
32
61
May
June
July
Aug.
Sept.
Oct.
Nov.
Dec.
3,418
2.692
2,621
3.375
2,856
2.684
3,240
2.996
2.654
1.835
1.468
1,303
1.010
1.509
2.144
1.668
4.061!2.486
987
688
579
924
1,673
2.128
10.490(6.837
2,474
883
452
722
1,593
2.953
374 356
486
i,2ai
1.457
1.293
989
577
36 20
21
36
28
22
17
26
55; 41
10
10
1
1
2
2
4 4
6
1
7
5
5
2
57
35
18
2
Total
37.963
22,630
31.504
09.878
8.530
331
353
38
112
Diphtheria
There were 22,630 cases of diphtheria reported. This is 2,000
more than in either of the two years preceding. The number of
deaths is 2,431, an increase of 125 from last year. The average
number of deaths yearly for the past ten years has been 2,675 ; of
the five years preceding this year, 2,470. There have been only
two vears in which the number was less than in 1910.
New York city reports more than half the increase in reported
cases, but the number of deaths is identical with last year. The
rural mortality is likewise identical. The increase in cases and
deaths is in Buffalo, where the disease became more prevalent dur-
ing the last quarter; in Rochester, Ut ica, Troy and some of the
cities of the third class.
The urban mortality from diphtheria was 2.0 per cent, of the
total mortality; the rural 0.6 per cent. These were the proper-
244 State Depaktmeat of Health
tions of last year j in 1009, of 2,300 deaths from diphtheria 2,100
were urban; this year, of 2,431 deaths, 2,100 were urban, this
population being two-thirds of the State, In 100,000 urban pop-
ulation there were 33 deaths during the year; in 100,000 rural
population there were 11 deaths.
In the State l.G per cent, of the mortality was from diphtheria
and there were 27 deaths per 100,000 population. For the ten.
years prior to 1895, 5.3 ix?r cent, of the deaths were from diph-
theria, the average yearly mortality being 5,734, and there were
nearly 100 deaths a year per 100,000 population. Since 1895
there have been about 3,000 deaths yearly from diphtheria, the
population having increased from six to nine million.
There have been no noteworthy epidemics from diphtheria dur-
ing the year; the State institutions have been mostly free from
it. The experience of the year has given further evidence of the
value of the prophylactic use of antitoxin. The early use of anti-
toxin has been urged for clinical cases, and when question has
arisen as to the ability of subjects to pay for it, it has been urged
on health oflScers that the first thought should be the safety of
the people and the conservation of their lives.
Of questions ask^d, one has been as to quarantining subjects
who have been exposed during the period of incubation, and it
has been found safe to release such imder observation with im-
munizing doses of antitoxin. Emphasis has been laid on the
laboratory test for diagnosis and as a guide for release from quar-
antine. The question of management of cases of persisting germs
long after clinical symptoms hav^e disappeared, in one case as long
as six months, has come up. The infectivity of such subjects is
recognized and the virility of the bacilli is established, but it has
been advised to modify the strict quarantine, excluding the child
from school and from contact with other children. Indefinite iso-
lation is hard to enforce and no harm is known to have come in
this instance. In one locality not a few of the school children, not
ill, had persistent positive cultures, and the school was closed for
a length of time.
The relation of bad sanitation to diphtheria has been asked
about. Emphasis should be laid on the fact that the disease can
only arise from specific infection. Insanitary surroundings can
Divisiox OF Communicable Diseases 245
Lave only a general bearing on its vinilence and dissemination;
doubtless it may influence tbe septic nature of the disease.
The relation of the dairy to diphtlieria has been the subject of
inqniry. ^Hiking or washing of milk pails by members of a fam-
ily in which diphtheria exists, where the dairy product is to be
sold, has been interdicted.
^lild cases have* frequently 1 .cen the source of spread, the na-
ture of the disease having Ik^cu overlooked. If there is reasonable
doubt the public should have the l)enefit of it, pending a laboratory
test. The experience of the year has emphasized the value of iso-
lation and of antitoxin w^oi] earlv in a clinical case and for im-
inimizing those, especially chihlren, exposed to diphtheria. There
has been no recognized ca-e rep(»rted of spread of the disease by
a germ case, though this has been discovered heretofore. The dis-
ease has not l>een as viruhiit as formerly and few septic cases have
l)een reix)rted. In this diphtheria has been in common with the
other infectious diseases and it is }><^ssibly due to the better sani-
tary surroundings wliich are U'ing made more and more general.
In Xew York city there was one deatli to ten reported cases, which
is a considerably lower lethality than last year: in the rest of the
State 1 death to 7.7 reported eases. Tn the city it chiefly pre-
vailed in the s])ring months; outsi<le the city it increased abruptly
in October and chief prevalence wa> from then till December.
The most deaths were from January to April.
Scarlrt Fever
From 1895 to 1000, a period of six years, there were less than
SCO deaths a year from scarlet f(»ver ; then for four years the num-
Ler was 1,200 ; two years followed of 700 deaths ; and now for four
years there have been l.GOO deaths yearly. Periods of prevalence,
four to six years in duration, follow period of abatement. The
disease is of milder type and virulent eases are infrequent. From
1888 to 1802 there were, with the break midway of one year of
abatement, from 2,000 to 2,500 deaths a year from it, a mortality
never since reached. This year there were 1,600 deaths, a larger
number than has oe*urre<l, save one year, since 1802.
There were 31,000 eases rej>orted. a number exceeded only by
measles and tulx^rculosis, and exc(H^dinc: by 8,000 the number in
240 State D^paktment of Health
1909. Jn 1908 the number both of cases autl deaths was somewhat
greater. Greater Xew York reported nearly 20,000 cases, against
13,000 last year; with one death to 20 cases. The rest of the
State had a rate of 1 death to 18 cases, which, however, probably
shows that 1,000 cases failed of report. And many cases must
have failed of detection, for our investigations have disclosed
the overlooking of the disease repeatedly by' physicians, and
the existence of cases which never came under the care of a
physician.
One of the embarrassments of the year has been the diflSculty of
diagnosis in the case of mild forms of scarlet fever. Some out-
breaks have been overlooked by the medical men. In some the
sore throat has Ix^en the conspicuous symptom and erythema if
present has been regarded as t^econdarv; ** epidemic tonsilitis "^
has been entertained as the diagnosis of a number of outbreaks
until not a few cases have developed and the fact of scarlet fever
was established. The eruption has often been evanescent or irreg-
ular in its appearance. Physicians err often in attaching weight
to the absence of certain sjTuptoms, unmindful that in scarlet fever
no symptom is pathognomonic and no one symptom necessarily
present. It has heen found that emphasis can be laid on the
abrupt onset, early sore throat and the orderly occurrence of a
rash after twelve hours and usually first on the upper chest,
though it may occur elsewhere, and in rare cases ha« not been de-
tected even evanescently ; the red tongue with enlarged papillae
has been very commonly present; streptococci in the throat have
been regarded as of positive value; glandular tumefaction has
much of the time been lacking. Desc[uamation is often so slight
or to be detected only by such careful scrutiny as to be overlooked
or declared absent.
As an instance of the tracing of an outbreak: A young man
came home from abroad ill with fever and a sore throat, for which
he received office treatment once by a physician; nine days later
his sister has a similar illness, which after two weeks abates and
she returns to school ; the teacher is taken ill nine days after her
return and is variously diagnosed as having tonsilitis and scarlet
fever; pupils follow with illness and eruptions called "teething
rash " and " humor of the blood,'' but in some instances recognized
Division of Communicable Diseases 247
as scarlet fever ; the disease even appears, though without further
result, in the family of a man employed in a milk depot; scarlet
fever becomes widespread in the community before its nature is
recognized.
Frequent inquiry is made for a rule as to duration of quaran-
tine. This has been left indeterminate, as no certain period can
be given to cover every case, ^ild cases may recover fully in a
shorter neriod than severe cases; in anv case discharge from the
ear set up in the course of scarlet fever may prolong infectivity
indefinitely. All clinical symptoms may abate in three weeks,
and in others may continue for twice that length of time. It has
been advised during the year to keep children from school for not
less than five weeks and to release from quarantine after six weeks
provided the mucous surfaces are clear.
Closing schools and churches and other congregations has been
regarded an extreme measure and not to be resorted to without
good cause. Personal inspection by teachers under instructions
from the health oflScer has been an eflFective means for detection of
mild cases, for which the maintenance of schools has had com-
pensatory advantage. Clandestine cases, and mild ones recognized
by no one, restiveness under their efficient quarantine, the quaran-
tine of apartments, the possibility of isolation that shall allow lib-
erty to the male adult breadwinner, the use of placards, are ques-
tions and difficulties that have called for investigation by the De-
partment and have swollen the corres|X)ndence of the year. There
has been no well established instance coming to attention of a
milk-borne epidemic.
Scarlet fever was most prevalent during the first half of the
year; it has become again prevalent in December, with a proba-
bility of being somewhat less so during the coming year.
Measles
There were 70,000 cases of measles reported in 1910 and no
doubt a great many more not reported. In New \^ork city there
were 34,000 cases, not far from half the total for the State, while
60 per cent, of the deaths occurred there. There was one death to
44 cases in the city and one to 70 in the rest of the State. The
i
248 State Department of Health
reported cases in the city were not much in excess of last year; of
the rest of the State the number is very much larger.
The urban mortality which was 18.2 per 100,000 population in
1909 is 16.2 in 1910. The rural is 8.5 against 4.7 in 1909. The
total State mortality is the same as that of last year.
For the first decade of the records of mortality of this Depart-
ment, beginning with 1885, there were 10,500 deaths from
measles and 16,300 from scarlet fever ; during this decade occurred
almost as manv deaths from scarlet fever as in the sixteen subse-
quent years. In these sixteen subsequent years there have been
17,300 deaths from measles and 16,500 from scarlet fever. In
nine of these years the measles mortality has been greater than
tlie scarlatinal. Taken by five year periods the deaths from
measles have been, 5,113; 5,400 ;"5,228 ; 5,012; 5,800. For the
same five year periods the deaths from scarlet fever have been,
8,119; 8,195; 4,017; 5,585; 5,340. This shows that while scar-
let fever i-s decreasing, measles shows no change in actual mor-
tality. Scarlet fever has become mostly a mild disease, while
measles continues pretty much the same as formerly.
The number of reported cases of measles for the year far ex-
ceeds any other reported communicable disease and is more than
double the numl>er for scarlet fever. It is, to be sure, much less
fatal, 1 death in 50 cases against 1 in 20. Probably if the remote
effects of measles were ascertainable by records it would be found
that its credited fatalitv would be increased. As it is much more
contagious, few escape it when it gets a good start in a community;
moreover, the people do not shun it m they do other diseases.
The largest number of cases were reported in March and the
most deaths of any month occurred then and in April; the case-
fatality was also greater then. In the last half of the year there
have been few deaths.
Typhoid Fever
There were 8,536 cases in the State, against 7,894 in 1909 ; of
these 3,735 came from Xew York city, 100 more than last year.
The deaths were 1,374, of which 558 were in the city. This is
rate of deaths to cases of 1 to 6 outside the city and 1 to 6.7 in
the city.
Division of Communicable Diseases 240
For the last three years there have been 1,350 deaths a year;
for the five years preceding, 1,600; and during twenty-five years
the mortality has been between 1,300 and 1,600, in only a few
exceptional years exceeding that number because of some unusual
epidemics. The rate per 100,000 population has decreased from
about 25.0 for five year period averages to 15.0 in the recent years.
There were no large epidemics during the year. Attention was
attracted to unusual prevalence at Syracuse, Union Springs,
Moravia, Ithaca, where there were 35 cases traced to a milk source;
Clayton, where it became prevalent the year before ; Lyons, Pal-
myra, Pine Plains, Jamestown. Besides these, investigations of
some smaller communities were instituted because of an increase
in reporteil cases. At AVillard State Hospital and the Syracuse
Institution for Feeble-Blinded Cliildron there was au exeossive
number of cases of typhoid fever.
With a death rate of 15.0 j^r 100,000 population for the State,
New York city rate was 11.7; Buffalo, 18.4; Rochester, 13.7; the
cities of the second class as a group, 17.3; the larger cities of the
third class, 32.3 ; of twenty-three cities having from 10,000 to
20,000 population, 28.0; and of four cities under 10,000 popula-
tion, 42.0. The rural rate was 15.5. The excess of prevalence is
in the smaller cities, which are generally above the State average.
The cities which have had less than a 15 death rate are, Xew York,
Rochester, Albany, Utica, Schenectady, Binghamton, Auburn,
MU Vernon, New Rochelle, Gloversville, Lockport, Glens Falls,
Olean, Lackawanna, Little Falls, Fulton and Johnstown. Their
combined mortality is 11.5. That of the rest of the incorjX)rated
cities is 30.0, double the entire State rate. Those which have had
this year conspicuously high prevalence have been Niagara Falls,
Watertown, Cohoes, Port Jervis, Cortland, Corning, Oswego, Hud-
son, all having a rate of more than 50, while IN^ewburgh, Ogdens-
burg, Watervliet, Ithaca, Xorth Tonawanda, Hornell, Batavia and
Oneida have had a rate above 30 deaths per 100,000 population,
and Syracuse, Elmira, Jamestown, Dunkirk, Middletown, Peeks-
kill, Geneva, Plattsburgh, Rensselaer and Tonawanda have been
but little below this average.
In some of these cities typhoid fever has been long prevalent
from infected water supply. In Xiagara Falls, the most note-
250 State Department of Health
worthy instance, measures to rectify this are under way. In some
the increase has been recent and not due to long prevalent condi-
tions. Syracuse has had a very complete investigation by the
Sanitary Engineering Division for a prevalence perhaps due to a
not permanent disturbance of the water supply system. A de-
tailed report of the investigation of the Syracuse situation will
be found under the Division of the Sanitary Engineers. Ithaca
had a considerable milk-borne outbreak. Numerous smaller places
have been under investigation for excess of the disease.
Water has been the chief carrier of infection; 136 cases were
traced to direct infection. The ease with which typhoid fever
may be so taken is overlooked, that*is, by so-called contact infec-
tion, in which may be included fly-infection, which likewise is the
result of imperfect care of the sick. Several milk epidemics have
been verified during the year, and of other food infections there
are few established instances; in one instance 10 cases were at-
tributed to ice cream cones a« a possible source of infection.
There is a shifting of the seasonal prevalence of typhoid, taking
the safe guide of its mortality as a basis; it is less a winter dis-
ease than formerly. The average yearly mortality for the decade
1891-1900 was:
For the winter months 406
For the spring months 276
For the summer months 331
For the fall months 666
For the corresponding seasons of 1910 the number of deaths
was, respectively, 305; 223; 298; 518.
This gives a seasonal distribution of the deaths of the year as
follows :
In the winter months.
In the spring months.
In the summer months
In the fall months . . .
r tlie decade
1891-1910
Per cent.
For 1910
Per cent.
24 . 20
22.69
16.45
16.60
19.70
22.17
39.65
38.54
Division of Communicable Diseases 251
A smaller proportion of the deaths occur now in the winter,
and a larger proportion in the summer. It has been found here-
tofore that the winter mortality is high in cities supplied with
water from large sewage-ln^aring streams and low in rural com-
munities. This is illustrated in Niagara Falls, where in the last
two years there have l)een 54 deaths from typhoid fever, of which
19 were in the winter, 10 in the spring, 15 in the summer and 10
in the autumn months.
Unscreened vaults and the convalescent typhoid germ carrier
have been the medium of spreading this disease through the
iigency of flies and" by other means. T^xi-s has been found on our
investigations. Every case of this disease calls for investigation^
iind the local health officer has been urged to personally inquire
into the source. A large part of the work of investigating out-
breaks or of localities where typhoid fever has become established
for a long time ha-s very properly fallen on the Engineering Divi-
sion of the DopartuK nt, as most causes are of secondary impor-
tance to the chief one of an infected water supply.
Cerebrospinal Meningitis
The nmuber of re])orted cases of this disease, 353, is less than
the number of last year. But the reports are incomplete, since
the reported deaths are 45;]. New York city reported 230 cases
and 294 deaths. The rest of the State had 160 deaths, equally
divided between the other cities and the rural population. The
disease is of the cities and the mortality to population is double
that of the country under the conditions of mild prevalence of
recent time.
Smallpox
This disease has much decreased in prevalence; 355 cases oc-
curred and there were 7 deaths. There has been much vaccinat-
ing during recent years and the result has been felt. Thirty-seven
counties had cases, but in twenty-seven there were only the one
imported case or the spread was limited to two or three secondary
cases. Most of the ca-^es of the year came into two areas of prev-
alence. In the fall of 1900 a case came from Canada to Xorth
Tonawanda, Xiagara county, and the outbreak that followed not
252 Statjc Department of Health
only lasted there until July but spread to Niagara Falls and Lock-
port; to Buffalo, Toiiawanda and Wlieatfield, Erie county, and
probably to other towns. About one-third of the cases of the State
and one death came here. Another third or more occurred in an-
other outbreak which started in a lumber camp in the northern part
of Herkimer county and was carried by indifferent and irresponsi-
ble people in the country al>out in Jefferson, Lewis and St. Law-
rence counties. In one of these areas the outbreak was prolonged by
opposition to vaccination and in the other by ignorant indifference
to it. In Steuben comity there were 10 cases in five towns; in
Walden 5 with 1 death; in New York city 16 with 5 deaths*
In no other municipality exee[>t those noted were there as many
as five cases during the year. In every instance, w^here needed^
an expert of the Department has visited the location of smallpox
cases and rendered material assistance to the health officer.
Epidcm ic Pol lorn ijelitis
This juade its a]>pearance iu September. An epidemic occurred
in 1909 about Gouverueur, iu St. Lawrence county; there had
been a large epidemic in 1908 in Xew York and Westchester
county. It had l>een [)reva]eijt iu Massachusetts in 1909 and
l)ecame more so in 1910, as likewise in numerous other States
specially in the middle West, in this State it became extensively
])revaleut in August ami C(»utiuiied until December. In forty-seven
of the sixty-one counties there were cases reported to the total
number of 327. The numl>er of deaths reported was fifty-six*
There were no special centers from which cases spread from one
community to another; a few cases, often but one or two, occurred
in most of the localities. In the cities of Buffalo, Rochester, Svra-
cuse, Schenectady, Elmira there were cases, the greatest num-
ber, twenty-five, occurring in Buffalo. There were at the ^arae
time cases in larger villages and in the rural towTis remote from
railroads. Affected l(K*alitii\s were along the Mohawk Valley
rather numerously, in the SuntlK^'u Tier counties along the Erie
railnad, but also in the s}>arsely settled communities between, in
the northern part of the State, and all the way between Long
Island and Xiagara Falls. Tliere was a recurrence in the towns of
St. Lawrence county in which the epidemic of 1909 appeared.
Division of Communicable Diseases 253
Early in January, 1911, Dr. W. H. Frost, Passed Assistant
Surgeon, U. S. Public Health and Marine Hospital Service, made
a detailed study of the 227 cases of epidemic poliomyelitis which
Tvere reported to the State Department of Health during the year
1910. Dr. Frost has submitted a detailed report of his investiga-
tion which will subsequently 1h» published and circulated by the
State Department of Health.
Whooping Coiujh
Considerable attention has been drawn to this disease owing to
the fact that the average yearly mortality has been almost 1,000.
A measure of control has been advocated which it is believed will
in some d^ree lessen the spread of this very annoying and dis-
tressing malady. A leaflet of instruction has been printed for
distril)ution by the health officers, wherever this disease is
prevalent.
Xo reports of the numln^r of cases Jiave been received, but
iereafter they are to l)e called for from health officers. The
average mortality from it in this State has been 900, that of
measles having been 1,100 and of scarlet fever 1,300 for the last
twentv-five years. This year there were 720 deaths and that has
been its average for the last ten years. Xot infrequently it has
caused more deaths in the vear than has measles or even scarlet
fever. Its midsummer mortality is highest; this year there were
<iouble the number of deaths both in July and August of any other
montJi, which is not unusual.
Ophthalniia Xeonatoi'iim
The campaign which was In^gun in 1909 for the suppression of
ophthalmia neonatorum has betm successfully carried on during
the year 1910. With this disease, as with some others, much
difficulty has been experienced by this Department in getting the
physicians to report its prevalence. For instance, only forty-two
eases of ophthalmia neonatorum were reported to this Department
from January 1 to Decemk»r 31, 1910. Knowing that this small
iiuml>er by no means represented the actual prevalence of the
disease throughout the State, a circular letter was addressed to
about 6,000 physicians outside of Greater New York asking them
to report at once such cases as had occurred in their practice during
the past year. This request was responded to by over 2,000 phy-
254 State Depabtmekt of IlKAi/ni
sicians, from whom reports were received of 277 cases of ophthal-
mia neonatorum.
Cases were reported from 52 counties, while 7 counties failed to
report a single case. Onondaga county reported the greatest num-
ber of cases, 35; Erie, 29; Monroe, 19; Nassau, 16; Oneida, 11 j
Westchester, 10; Chemung and Schenectady, each 9; Steuben and
Wyoming, each 8; Broome, 7; Franklin, Eensselaer and. St. Law-
rence, each 6, and many others from 5 to 1 case. The numerous
replies received from the physicians throughout the State clearly
indicate the educational influence which this campaign has ex-
erted, in that practically all physicians are to-day employing either
the silver solution supplied by the State or some other prophylactic
measure in every case of confinement. It is also very gratifying^
to find in analyzing these 277 cases that only one child was blind
in both eyes, 6 blind in one eye, while 270 cases had a favorable
outcome.
Influenza
The annual epidemic of influenza reached its height in March.
It began in December preceding, and lasted into May. The num-
ber of deaths directly credited to it is 1,439; in 1909, 1,117.
How many cases of it occurred and how many deaths it was the
dominant contributing cause of is a matter only of conjecture.
Since during the epidemic there is increase in the number of
deaths from pneumonia and other acute diseases of the respiratory
system, from consumption, from diseases of the circulatory, nerv-
ous and digestive systems to some degree ; and since this increase
as a matter of record set in abruptly with the first outbreak in
1889 and has continued from that time, it is safe to attribute a
certain proportion of this increase to influenza. This has been
estimated year by year heretofore and the table of estimates is
carried down here. In the twenty years past there has been an
average yearly estimate of 7,000 deaths from influenza, which is
no doubt conservative ; varying with the severity of the epidemic
from 2,500 to 11,500 and in duration three to six months. The
intensity of the epidemic increases to its acme, which may take
two or three months even in mild epidemics, and hence it dimin-
ishes, generally covering a period of five or six months. March
is more often, as this year, the high point of the epidemic, but not
Division of Communicable Diseases
255
infrequently it has been January. In March there were 14,134
deaths from all causes, the largest number in the year ; 400 were
ascribed directly to influenza. One-third of the deaths occurred
past the age of 60 years ; deaths from consumption, acute respira-
tory, circulatory and nervous diseases wei'e all excessive.
Grippe pneumonia is a recognized form of pneumonia by the
medical profession. The United States census report shows the
urban mortality as very much lower than tlio rural. In this State
the actual reported rural mortality this year was 708, while the
urban mortality in nearly three times the population was 641, or
a death rate of 10 in the latter to 33 in the former.
Estimated Mortality from Epidemic Influenza
EPIDEMIC YEAR
1890
1891
1892
1893
1894
1895
1896
1897
1898
1899
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
Heiffht of
epidemic
Duration
Estimated
mortality
Acute
respiratory
mortality
January. .
3 monthly
5,000
18.053
April
6 months
8.000
20,697
January. .
5 months
8.000
20,432
April
6 months
6,000
19.807
January. ,
4 months
3.000
15,885
February .
4 months
5,000
17,725
March . . .
5 months
2.750
16.820
March . . .
4 months
3,000
16,277
March. . .
6 months
2.500
16.350
January . .
5 months
7.000
17.938
March. . .
6 months
11,500
19.232
January . .
5 months
7.000
17 5i»9
February.
6 months
5.000
16,986
March . . .
6 months
8.000
17.339
March . . .
6 months
10.000
21.132
February.
5 months
9.000
17:832
March. . .
6 months
9,000
20,178
January.
6 months
10.000
22.663
January. .
5 months
9.500
18.477
March. . .
5 months
9.000
20.781
March . . .
5 months
10.000
21,487
Pneumonia
It has been decided to place pneumonia on the list of reportable
diseases, a special card for which has been prepared and dis-
tributed to the physicians of the State through the health officers.
The infectiousness and contagiousness of pneumonia has become
more and more apparent and its extensive mortality rightfully
makes it one of the most important diseases with which the De-
partment has to contend. During the year 1910, 9,843 people died
of lobar pneumonia, while 7,240 -^uccumlK^d to broncho-pneumonia.
256 State Department of Health
The combined mortality of the pneumonias exoeeds the total mor-
tality throughout the State from tuberculosis, and as both of these
diseases are in a measure preventable, many valuable lives should
be saved by the systematic management as now planned by the
Department.
Cancer
Cancer, like pneumonia, has been placed on the list of report-
able diseases and a separate card likewise prepared on which to
report the detailed history of each case occurring throughout the
State. The deaths from cancer are increasing far more rapidly,
in proportion, than other diseases throughout the State. During
the year 1910, 7,505 people died in this State from cancer. This
is an increase of 470 over 1909, while from tuberculosis there
was an increase of 100. This Division is carefully studying the
details of 'every case reported and proposes to prepare a map show-
ing the geographical distribution of cancer throughout the State,
for the purpose of locating, if possible, what appears to be certain
localized infected regions, in which this disease is particularly
prevalent. A more extensive report on the prevalence of cancer
and the work which is being done in the investigation of the same
will be found under the report of the Cancer Laboratory, in this
same volume.
Infant Mortality
Infant mortality has engaged the attention of the Department
and special efforts to lessen the death rate under one year have
been made. The causes are many and do not all fall within the
control of the health oflBcer, but it is gratifying to note that the
percentage of infant deaths is decreasing throughout the State.
Improper feeding is the chief cause of infant mortality, and as
milk is the most widely used article of food for babies it is neces-
sary that the health officers not only of our cities but also of the
rural districts should exercise care in the supervision of the milk
supply. Xo milk should ever be shipped from a farm where a con-
tagious disease exists, unless it is absolutely certain that every
precaution has been taken to prevent a possible infection of the
milk.
Division* of Communicable Diseases
257
In the decade 1885 to 1895 the deaths under five years were
35.0 per cent, of the total mortality ; in the last decade this early
life mortality has been uniformly 27.0 per cent, of the total.
Tvi)erculo9is
In 1910 there were reported 38,000 cases of pulmonary tuber-
culosis, of which 32,000 came from New •York city. New York
and Buffalo reported 20,000 cases in 1907; 24,000 in 1908;
27,000 in 1909 ; 33,150 in 1910. In the rest of the State 2,100
cases were reported in 1907 ; 2,635 in 1908 ; 5,820 in 1909 ; 4,800
in 1910. The increments are due to fuller reports, it having be-
come only recently reportable.
The greatest number of new cases were reported in March, in
April and in May ; the smallest in June and July.
Tuberculosis — Registration of Living Cases
1907
Re«tof
State
Januar>' • • •
Total.
February . ,
Total.
March...
Total.
April . . . .
Total.
May
Total.
Junr ... .
ToUl.
July
Total.
Auicu»t. . .
Total.
SrT>f mber
Total.
October. . .
Total.
Xo\'rmber .
Total .
I>rc*'mber.
Total.
Toiftl . . .
262
1.708
222 I
1.466
267 I
2,400
103 I
2.298
136 I
1.864
125 I
1.633
242 I
1.975
204 I
1.701
190 I
1.929
229 I
1.567
229 I
1.592
277 I
2.065
22.098
Greater
New
York
1,446
1,244
2.133
2.105
1,728
1.408
1.733
1.497
1,739
1.338
1.363
1,788
1908
Rest of
State
Greater
New
York
256
1.865
284 I
1.802
330 L
2.775
279 I
2,216
309 I
1.982
347 I
2.021
137 I
2.297
207 I
1.962
226 I
2.657
305 I
2,328
271 I
2,097
359 I
2.228
26,230
1,609
1.518
2.445
1.937
1.673
1,674
2.160
1.755
2.431
2.023
1.826
1.869
1909
Reetof
State
1,469
3,739
587 I
2,352
592 I
3,097
563 I
3,015
374 I
2,671
'!57 I
2.755
725 I
2.638
510 I
2,529
312 I
2.664
437 I
2,276
4(iO I
2.913
422 I
2,208
32.887
Greater
New
York
1910
Rest of
State
2,270
1.765
2,505
2.452
2,297
2,298
1.913
2.019
2,35.
1.839
2,483
1.786
167
2.416
458 I
3.203
523 I
4.497
451 I
3.969
452 I
3,418
514 I
2.092
490 I
2.0 1
485 I
3.:t75
454 I
2.s:,o I
71ft ' i
2.084 I
oil
3.240 '
742 1
2.992
37,9<i:} ,
Greater
New
York
2.249
2,745
3,974
3.518
2,966
2.178
2,131
2.890
.402
1.974
2.729
2.250
The above table should not be accepted as proof that tubercu-
losij* is increasing throughout the State, but rather that the State
9
258 State Department of Health
law requiring the registration of all cases of tuberculosis is being
more generally observed by the medical profession. This, together
witli better methods of diagnosis and a clearer understanding of
the disease by the public, has led to fuller reports of the *' White
Plague " being received.
Doubtless many cases of tuberculosis are not reported, but the
tuberculosis exhibit now on the road and the mass of literature
distributed, not only by this Department but also by the various
social organizations, is having a salutary effect.
A full accoimt of the tuberculosis exhibit work will be found in
another portion of the annual report, together with the report of
the action taken by the different counties and cities in regard to
the establishment and maintenance of hospitals for the care of
tuberculosis.
The deaths from pulmonary tuberculosis for the year are
14,059. This is 100 more than in 1909, and 100 less than the
average of the preceding years. The deaths were 9.5 per cent,
of the deaths from all causes.
In the twenty-five years preceding 1910 there occurred 319,800
deaths from pulmonary tuberculosis, and 3,036,200 deaths from
all causes. This makes 10.5 per cent of the deaths from this
cause.
Is tuberculosis decreasing ? To determine this we have no sta-
tistics of existing cases to throw light, for even after a few years
of reporting them the reports are incomplete and imtrustworthy
for statistical data, and we have no record of the number of exist-
ing cases in past years. Neither do we know the average duration
of illness from tuberculosis. We have a certain guide to the mor-
tality, the record of which is fairly trustworthy. This we have
record of for this State since 1885. The yearly number of deaths
has been pretty constant, with moderate yearly increase; begin-
ning with 12,000 it has gi'own to 14,000. During this period the
number of deaths from all causes has increased from 90,000 to
140,000. The population has grown from less than six million to
more than nine million. While the population has increased fifty
per cent and the total deaths in the same proportion, the tubercu-
losis mortality has increased less than one-fifth. This is shown
by five-year periods, and for 1910:
Division op Communicable Diseases
259
5 YEAR PERIODS
188&-188G
1890-1884
1895-1899
1900-1904
1905-1909
1910
Estimated
population
5,760,000
6,300,000
6,880.000
7,500,000
8,750.000
9,158.328
Death rate
(all causes)
16.43
19.33
18.10
17.50
17.00
16.10
Average
yearly
deaths
from con-
sumption
11,915
13.320
13.115
13.258
14.157
14.059
Per cent
tuberculosis
mortaUty
12.6
11.0
10.9
10.4
10.1
9.5
Tuberouloms
deaths per
1,000 pop-
ulation
2.07
2.11
1.90
1.77
1.62
1.
The second period, 1890-4, shows a larger mortality than the
two following periods, and the largest per capita death rate of the
series. The total mortality is high, with a death rate of 19.33,
which is the highest on our records. This is explained by the
pandemic of influenza which began in 1890. With this exception
there has been a steady decrease in the death rate from tubercu-
losis. That of the year 1910 corresponds to a saving of 50 in
100,000 population over the rate of the decade 1885-95.
Compared with deatlis from other causes the decrease is con-
stant and imbroken. Twenty-five years age one-eighth of the
deaths were from pulmonary tuberculosis, and now they are less
than one-tenth. If the proportion of deaths from tuberculosis
were the same this year as then, there would have been 18,000
instead of 14,000. If the same per capita mortality prevailed
now as then, the number of deaths would be found to be even
greater, almost 19,000. Indeed, the lowering of the general death
rate corresponds pretty closely to the saving in deaths from tu-
berculosis. If the rate of mortality of to-day had prevailed
twenty-five years ago there would have been 9,000 instead of
12,000 deaths annually from this cause.
In what populations of the State is saving in tuberculosis mor-
tality being effected? The urban and rural rates of death from
this, along with the rates in the sanitary districts, for the past
five vears, is as follows:
Deaihs per 1,000 population in the Sanit<iry Districts
YEAK
igoe
1007
IMS
1M9
1910
Urban
Rural
MarU
time
Dis-
trict
Hudson
VaUey
>
Adiron-
dack .
Mobawk
Valley
Soutb-
emTier
East
Cent-
ral
West
Cent-
ral
1.95
1.30
2.10
1.61
1.35
1.17
0.90
1.20
1.00
1.95
1.25
2.12
1.75
1.34
1 34
0.90
1.26
1.12
1.85
1.23
2.05
1.72
1 38
1.33
0 96
1.25
1.13
1.76
1.20
1.90
1.61
1.30
1.25
0 80
1.20
1 03
1.65
1.21
1.78
1.65
1.28
1.10
0.74
1.18
0.80
West-
ern
1 15
1.19
1.16
1.20
1.16
260 State Department of Health
This record shows that the chief decrease is in the city popula-
tion. There is but little change in some of the districts, although
most of them show some decrease, and especially in the last three
years. The Southern Tier District has always been noted for its
freedom from tuberculosis. That tuberculosis is a city disease is
shown by its mortality in districts with large urban population.
In submitting the above report I desire to tender thanks to Dr.
F. C. Curtis, consulting dermatologist, for his assistance in com-
piling the same.
Respectfully submitted,
WILLIAM B. MAY,
Director
REPORT
OF THE
TUBERCULOSIS CAMPAIGN
(2611
REPORT OF TUBERCULOSIS CAMPAIGN
Albany, N. Y., May 1, 1911.
Hon. Eugene H. Porter, State Commissioner of Heulth, Albany,
N. Y.:
Deab Sir: — I have the honor to herewith submit a report on
the work in connection with the tuberculosis campaign for the
vear 4910.
The work of the year was in charge of Mr. C. W. Fetherolf
until November 22, 1910, when Dr. E. G. Whipple was tem-
porarily appointed to fill the vacancy caused by Mr. Fetherolf s
resignation. In an examination on February 18th Dr. Whipple
qualified under the civil service, and on March 15th received the
appointment as director of the tuberculosis exhibit. The work
since November 22d has been in his charge.
During this year the large exhibit of the State Department of
Health has been shown in the following ten cities, in which a
vigorous anti-tuberculosis campaign has been carried on conjointly
with the State Charities Aid Association:
1. Niagara Falls. 6. Saratoga.
2. Lockport. 7. Plattsburg.
3. Amsterdam. 8. Malone.
4. Watervliet. 9. Ogdensburg.
5. Glens Falls. 10. Watertown.
A definite program was agreed upon before starting this series
of campaigns, and wherever possible, it was closely followed.
This program included meetings for church organizations,
which were usually held on the oi>ening Sunday. Meetings for
school children of the public and parochial schools were held dur-
ing the school hours, both mornings and afternoons. One after-
noon during the week was given over to the women of the city and
the meeting conducted under their auspices. The evening meet-
ings were held for fraternal, labor, military, business men's,
religious and other prominent local organizations. Sometime
[263]
i
264 State Department of Health
during the week a meettag was held under the auspices of the
city or county medical society, at which some physician, expert
on the subject of tuberculosis, was asked to be present and speak
on this subject, giving special attention to the diagnosis of early
cases. The series of meetings ended with, the mass meeting
usually held on Friday night, making a campaign of six days, dur-
ing which time every group of citizens and all classes of people
were reached to some extent.
«
It was at Niagara Falls that the first campaign of this year
was inaugurated. Here the usual program was followed, the
opening day including separate meetings for Polish and Italian
residents.
On Tuesday evening a special meeting for physicians was held
under the auspices of the Niagara Falls Academy of Medicine at
the Hotel Imperial. A dinner preceded this session, attended by
41 physicians. The paper of the evening was presented by Dr.
G. W. Beach of Binghamton, N. Y., on " Why Many Cases of
Early Pulmonary Tuberculosis Are Not Found by Physicians."
On Friday night the campaign closed with the mass meeting,
at which Dr. J. H. Pryor of Buffalo, Dr. Francis E. Fronczak of
Buffalo, Rev. E. J. Walsh and Senator James P. Mackenzie were
among the speakers.
Immediately following the campaign, provision was made by
the city for examination of indigent cases, Drs. E. B. Horton and
C G. Leo- Wolf contributing their services. A total attendance
of 5,076 was reached during this campaign.
On Sunday, January 30th, the second campaign of the series
opened in Lockport at the Walton Rink. The opening day was
made " Industrial Sunday," and the meeting held especially for
labor organizations. During the week all of the school children of
the city attended in a body, and special meetings were held under
the auspices of fraternal and benevolent societies, the Board of
Trade, church organizations and the Y. M. C. A. The campaign
closed with the mass meeting on Friday night, which 1,684 people
attended.
The medical meeting in connection with this campaign was
held under the auspices of the Lockport Academy of Medicine at
the home of Dr. F. J. Baker. Dr. John H. Pryor of Buffalo, on
Kepobt of Tuberculosis Campaigx 265
behalf of the State Department of Health delivered a paper on
** The Diagnosis of Early Pulmonary Tuberculosis." There was
an attendance of 23 physicians at this meeting.
Amsterdam was the third city to be visited by the large exhibit
and there, as in the other campaigns, the opening meeting oc-
curred on Sunday, but the number of days was extended to seven
instead of six as in the two previous campaigns. The usual
program was followed throughout the campaign. The mass meet-
ing on Friday night brought out about 1,400 people to hear the
following speakers : Rt. Rev. Monsignor J. L. Reilly of Schenec-
tady, Prof. Chas. McClumpha of Amsterdam, the Hon. Alec H.
Seymour of the State Department of Health and the Hon. Jas. H.
Mitchell, M. D. of Cohoes. Hon. Seeley Conover, mayor of the
city, presided.
The medical meeting usually held during the campaign could
not be arranged at that time, but was held on March 24th while
the interest in tuberculosis was still keen. Dr. A. H. Garvin,
Superintendent of the New York State Hospital at Ray Brook
talked on the subject of *^ The Early Diagnosis of Tuberculosis ''
and luncheon was served by the Montgomery County Medical
Society, under whose auspices this meeting was held. There was
an attendance of 54 physicians at this meeting.
Sunday, March 6th, was the opening day of the Watervliet
campaign, which was continued until Saturday, March 12th. It
was necessary to engage two halls for the exhibit and meetings,
and arrangements were finally made whereby the new city hall
was used on March 6th, 7th, 8th and 9th and St. Bridget's Hall
on March 11th and 12th, there being no meetings held on March
10th. It was impossible to arrange a mass meeting, because no
central auditorium could be secured, otherwise the usual pro-am
was adopted.
Dr. A. T. Laird of Albany was the speaker at the medical
meeting which was held at the home of Dr. B. J. Ward on the
evening of March 10th. Dr. Laird had for his subject "The
Diagnosis of Early Pulmonary Tuberculosis."
The fact that there were no daily newspapers in Watervliet
made the publicity diflBcult, but in spite of this fact 32.2 per cent.
of the population was reached.
266 State Depaktment of Health
The fifth place to be shown the exhibit was Glens Falls. The
dates fixed were from April 3d to 8th, inclusive. The Glens
Falls Committee for the Prevention of Tuberculosis collected
$200 from the citizens to carry on the local work. The usual
program was followed throughout, ending with the mass meeting
at which Col. J. A. Cunningham presided. Dr. F. G. Fielding,
Hon. Philip V. Danahy, Hon. J. A. Kellogg and Mr. C. W.
Fetherolf spoke.
The medical meeting on tuberculosis was held prior to the
campaign. At this meeting Dr. A. H. Garvin, Dr. A. T. Laird
and Dr. H. D. Pease spoke.
From April 3d the active campaign work was not renewed until
September 25th, when Saratoga was made the scene of activity.
This campaign covered but five days and here again the usual
program was followed. The mass meeting, however, was held on
Wednesday instead of the closing night, and a large audience of
2,000 people assembled to hear Dr. E. R. Baldwin "of Saranac
Lake, Hon. Homer Folks of New York and the Hon. E. A. Mer-
ritt address this meeting. Mr. John A. Kingsbury of New York
presided.
From Saratoga the campaign extended to Plattsburg, where a
six day warfare was again waged. Special military meetings
were the feature of the week. The campaign closed on Friday
night, October 15th, with a rousing meeting, at which L. L. Shed-
den presided. Addresses were made by the Hon. C. C. Duryee of
Schenectady, Dr. Wm. J. Brennan, President of the Board of
Health of Plattsburg, the Rt. Rev. Father Reilly of Schenectady
and Mr. C. W. Fetherolf of this Department. This campaign
was notable in being the first campaign of this sort in which
soldiers of the regular army of the United States have partici-
pated. The medical meeting was omitted because it was impos-
sible to secure any physician to give the usual demonstration.
From October 30th to November 4-th the exhibit was shown in
Malone, and it was there that the record percentage attendance
was secured. Seventy-seven per cent, of the population was
registered as entering the State Armory during the campaign.
This town, although right in the territors' influenced by Saranae
Lake and the intelligence coming from that tuberculosis center,
Eeport of Tuberculosis Campaigx 267
•
hsLs been for years very negligeut in public health matters, and
tuberculosis was not considered at all. A slight interest had been
aroused just previous to the campaign, so that it seemed the
psychological moment for such a campaign to, be carried on. Its
effect was remarkable and as a result a tuberculosis nurse was
engaged and a free examination station established. This town
is a striking example and a proof positive of the educational
value of this exhibit in public health w^ork other than that per-
taining to tuberculosis. A recent visit to this town shows better
hygienic and sanitary conditions throughout and an increased
activity of the board of health and health officer along all lines of
public health. The usual program was carried out during the six
day campaign and the mass meeting was a fitting close. Dr. E.
R. Baldwin of Saranac Lake, Dr. Lawrason Brown of Saranac
Lake, Dr. John B. Huber of New York, Mr. M. E. McClary,
President of the Board of Trustees of the State Hospital at Ray
Brook, Hon. J. P. Badger, Mr. C. W. Fetherolf of the State
Department of Health and Mr. G. J. Xelbach of New York were
the list of speakers. The Hon. F. G. Paddock presided.
Owing to the fact that the Franklin County Medical Society
usually devotes most of its scientific program to tuberculosis, the
usual medical meeting was dispensed with.
From Malone the exhibit went to Ogdensburg, where it ex-
hibited in the State Armony from November 2 2d to December 2d.
Here again the usual program was followed and the week's cam-
paign was closed by the mass meeting, at which Major 'W. H.
Daniels presided. Dr. E. R. Baldwin, Mr. John A. Kingsbury,
Hon. F. J. Gray and Dr. G. C. Madill were the speakers. The
medical meeting usually held at the time of the campaign, in this
instance preceded the exhibit Dr. A. H. Garvin gave a clinical
demonstration of the diagnosis of early tuberculosis.
The year 1010 closed its campaign work with a visit to Water-
town, the campai^ being conducted thei^ from December 11th
to 16th. Friday night, December 16th was called "Watertown
Night " and nearly 1,000 people turned out in spite of the severe
weather to hear Dr. Henrv L. Eisner of Svracuse, Mr. W. H.
Stevens of Watertown, Mr. Geo. J. Xelbaeh of Xew York and
Mr. Philip V. Danahy of Albany.
268 State Depaktment of IIealth
These ten local campaigns can be considered the most successful
yet undertaken, and the following figures seem to warrant this
statement :
There has been a total attendance of 55,169. The average
per cent of the population reached has been 37.66 per cent.
There have been held 133 meetings; 50 of these meetings were for
school children, 10 women's meetings', 10 meetings for fraternal
organizations, 9 meetings for labor organizations, 9 mass meet-
ings, 7 joint public meetings, 3 meetings under the auspices of
business organizations, 9 meetings for foreigners, 16 church meet-
ings, 4r military meetings and 8 medical meetings. There have
been distributed approximately 132,705 pieces of literature.
Newspaper space used for publicity has amounted to 51,085
column inches. There have been 232 speakers at the various
meetings, 134 of which have been physicians and 98 others.
The plan of the campaign has been practically the same as that
of the year 1909, and the results should be most gratifying. The
movement seems to have become a very popular one and because
of this fact local co-operation and endorsement are much easier
to secure. The clergy seem more willing to unite on wiping out
this social evil and physicians have assisted us greatly. Labor
organizations are very active and their help can always be de-
pended upon. Through the meetings held under the auspices of
the women's clubs, local health laws and ordinances are enforced
and new ones instituted and we have come to place great depend-
ence on them as the best means to secure these results. Practi-
cally all fraternal and benevolent organizations have been in-
structed by the officers of their order to lend all possible assistance
to "the movement and they are obeying these instructions. Much
credit for the success of this work is due to the co-operation of the
editors of the newspapers throughout the State.
The medical meetings which have been held in connection with
the local campaigns have proved to be one of the most effective
ways of giving to the physician in general practice the essentials
of diagnosis of tuberculosis. So much has been done through
magazine articles during the past few years that it is not
uncommon for the physician to refuse to read the articles that are
appearing because they are merely reviews and contain no new
Eeport of Tubeeculosis Campaign 269
facts. The demonstrations given by this Department are prac-
tical and each physician has an opportunity to examine and
familiarize himself with the essentials of diagnosis. The De-
partment has been especially fortunate in the men who have been
its representatives in this particular work. Much credit belongs
to Dr. John H. Pryor of Buffalo, and Dr. A. H. Garvin, Superin-
intendent of the New York State Hospital at Kay Brook, who
have given their time and ability for this purpose. Their lec-
tures and demonstrations tare very popular with the physicians
and much good has been accomplished through their efforts. If
I might be permitted to recommend one thing for the coming
year which I feel is one of the most important that the Depart-
ment might undertake in this work, I would respectfully suggest
that this particular work with the physicians be continued more
extensively than heretofore. It has been proved that it is the
ideal way to instruct the physicians in a field of knowledge in
which it must be admitted that they are woefully lacking.
The six small exhibits built by this Department during the
summer have been used very effrctively throughout the oovnties,
visiting the smaller towns and villages. Six demonstrators wore
secured and an active county hospital campaign was carried on
jointly with the State Charities Aid Association. The yearns
reports show that these six small exhibits have visted 131 towns
and viUages in 17 different counties. In connection with these
county campaigns, there have been held 361 meetings, 112 of
which have been for the school children. There has been a total
attendance at these meetings of 41,409; 425 speakers have ad-
dressed the various gatherings. These exhibits have been re-
sponsible for securing provision for county hospitals in 16 coun-
ties and 18 other boards of supervisors are seriously considering
this question.
From the knowledge which we have there is no doubt that hos-
pitals are the best solution for the tuberculosis problem, but there
is also no doubt but that they will never prove the success that is
expected unless they are in charge of a competent physician who
must be a resident physician and who will devote all' his time to
the institution, and each institution should have regular and
systematic inspection by this Department.
270 State Depaet:ment of Health
The small exhibits have been used largely to secure county
hospitals but aside from this object in which they have been very
successful, their educational value cannot be over-estimated. The
rural districts are the communities which our statistics show need
most education in regard to tuberculosis and the value of these ex-
hibits has never been in doubt.
The work of the summer months was given over to the recon-
struction of the large exhibit and the building of six county cam-
paign exhibits. The itinerary for the year 1010 and 1911 was
planned at this time and the following cities were placed on the
list of cities to be visited by the large exhibit; Saratoga, Platts-
burg, Malone, Ogdensburg, Watertown, Little Falls, Gloversville,
Johnstown, Ithaca, Batavia, Ilornell, Oneonta, Hudson.
Kindest cooperation has been met with by each and all in the
Department and it is largely through their interest that the Cam-
paign has proved ^the success that it has this year past.
Respectfully submitted,
E. G. WHIPPLE, M. D.,
Director Tuberculosis Exhibit
REPORT
OF THE
ANTITOXIN LABORATORY
1271)
REPORT OF THE ANTITOXIN LABORATORY
Albany, X. Y., April 19, 1911.
Hon. Eugene H. Poetee, A.M., M.D., State Commissioner of
Health, Albany, N. Y.:
Sib : — I have the honor to submit to you a report of the work
of the Antitoxin Laboratory for the year 1910.
For purposes of comparison, the general statements of the
activity of the Antitoxin Laboratory are made in tabular form
corresponding to those of reports of this service in preceding years.
The total amount of diphtheria antitoxin distributed during
1910, consists of 36,916 bottles of diphtheria antitoxin of 1,500
units each or equivalent. The character and total number of
places supplied during the year is shown in the following table,
which covers the period from 1902 :
YEAR
cities supplied..,
VUia«e8 supplied
Towns supplied .
Total
1902
1903
1904
1905
1906
1907
1908
1909
30
161
171
42
204
280
42
}617
42
691
42
793
42
828
43
926
47
(169
\273
362
626
659
733
835
870
969
489
1910
53
168
232
453
Of this amount of diphtheria antitoxin, a total of 66,374,000
units, the proper form of requisition has been filled in and is duly
filed for 46,236,000 units, showing a balance of 10,138,000 unite
of diphtheria antitoxin distributed during that year in some
manner other than the usual form of signed requisition. For
33,480,000 units of this year's distribution of diphtheria anti-
toxin, receipts in due form have been returned to this Depart-
ment and are filed. Eeporta of the use of 18,578,943 units of
diphtheria antitoxin more or less completely filled out and signed
have been forwarded to this Department and are on file. In
addition thereto, 2,751,000 units of diphtheria antitoxin are rep-
resented by report slips received by the Laboratory perfectly
[273]
274 State Department of Health
blank, generally returned with a package containing an empty
syringe of antitoxin and without any address of sender which
would make possible the identification or trace of the person sup-
plied with the antitoxin used in these cases.
Among the reports of diphtheria antitoxin utilized it is found
that this therapeutic agent was used in thirty-five cases that were
other than diphtheria,
Reports of the utilization of the State antitoxin are at hand for
1,863 cases of diphtheria, of which 1,700 recovered and 163 died;
3,921 cases were immunized.
The mortality, therefore, of all reported cases of diphtheria
with the use of the State antitoxin for 1910, is 8.8 per cent. ,
The relative amount of the distribution of 1910, with that of
previous years since 1902, is shown by the following table, which
is a continuation of Table II of the reports of previous years:
Bottles
Nine months of 1902 6^552
Full year, 1903 14,121
Full year, 1904 16,374
Full year, 1905 16,308
Full year, 1906 17,794
Full year, 1907 23,629
Full year, 190S 25,469
Full year, 1909 24,429
Full vear, 1910 ! 36,916
The relative strength of serum issued this year, compared to
that of previous years, is shown in the following table:
1902 300 units per cubic centimeter
1903 325 units per cubic centimeter
1904 375 units per cubic centimeter
1905 350 units per cubic centimeter
1906 350 units per cubic centimeter
1907 450 units per cubic centimeter
1908 350 units per cubic centimeter
1909 370 imits per cubic centimeter
1910 530 units per cubic centimeter
Report of Antitoxin Laboratory 275
Of all the cases reported, involving a total of over 18,000,000
units of diphtheria antitoxin, approximately 5,000,000 units of
antitoxin were used for immunizing purposes, 11,700,000 units
for purposes of cure, and 1,800,000 units of antitoxin were used
in lethal cases.
Special study of the most thoroughly re}>orted series of anti-
toxins utilized during the year, showed that for 3,921 cases im-
munized, 5,000,000 units of antitoxin were used, showing the
utilization of an average dose of 1,530 units.
Of this same series of antitoxin utilization, 163 deaths were
reported, for which 1,800,000 units of diphtheria antitoxin had
been utilized, showing an administration of 19,000 units per case
of the deaths reported.
Of 1,700 cases of reported recoveries in this same series, a total
of 11,700,000 imits are shown to have l)een utilized; an average
amount of under 7,000 units of antitoxin per case for those in the
series that recovered from diphtheria.
A considerable nimiber of State institutions were supplied with
both diphtheria and tetanus antitoxins. A total of more than
2,600,000 units of diphtheria antitoxin is reported as supplied
during 1910 to State institutions, of which practically 675,000
units were supplied for purposes of immunization. Approxi-
mately, therefore, 2,000,000 units were supplied for therai>eutie
use in these State institutions.
Tetanus AufifUvin
It is very noticeable that many health officers fail to keep anti-
toxins on hand, and tetanus antitoxin in particular ; and the mor-
tality statistics of the State from tetanus, showing 111 deaths in
the year, do not indicate that a sufficiently extensive distribution
or, at least, utilization of tetanus antitoxin exists.
A total of 14,482,500 units of tetanus antitoxin was distributed
during the year, and requisitions to the amount of slightly over
6,492,000 units of such antitoxin are in proper form and duly
filed. The form of requisition is lacking for 7,990,000 units of
State antitoxin. The receipts required from such physicians as
have utilized the State antitoxin are at hand and file<l for 1,301,000
units of tetanus antitoxin, and reix)rts of its use to the amount of
2,276,400 units have been received and filed.
276 State Depaktment of Health
Of actual cases of developed tetanus subjected to State antitoxin
treatment, there are reported only fourteen cases, nine deaths
and five recoveries.
Of 2,276,400 units for the utilization of which sufficient re-
ports exist, it is found that 326,400 units were used for prophy-
lactic purposes, and that 1,950,500 units of such antitoxin were
used for treating actual cases of tetanus.
Approximately 3,225,000 units of tetanus antitoxin were sup-
plied to 31 cities in the State; 11,257,500 units to 83 towns and
67 villages and 18,000 units of tetanus antitoxin were furnished
to the State institutions.
During the year 1910, the Laboratory Division has continued
the work of preparing and distributing the outfits furnished by
the State Department of Health for the purpose of prophylaxis
of ophthalmia neonatorum. Quantities were supplied as the de-
mand and utilization of these outfits indicated the necessity, to
the amount of 24,454.
Respectfully submitted
WILLIAM S. MAGILL,
Director of Laboratories
REPORT
OF THE
HYGIENIC LABORATORY
1277]
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315
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310
State Uepaktmknt of Healtu
in co-operatiou with tbo Eugiueeriiig Divisiou a hpecial in-
vt»8tigatiou of the sauitary quality of thu water of the St. Law^-
ivuco river at Cape Vincent aud Chiyton haa been made and else-
where reported.
The work of Group C — diagnostic examinations for the de-
tection of infectious disease and cimtrol of quarantint^ — has l)eeu
carried out by this laboratory for its first full year.
Laboratory Diagnostic Work for 1910
CCLTUREB rOR DlPHTHEBIA DIAGNOSIS
MONTH
January. . .
February . .
March . . . .
April
May
June
July
AuKUst. . . .
September.
October . . .
November .
December .
Total.
POBITIVIO
1
NKQATIVE
TOTAL
1
1908
1
1909
1910
1908
1909
1910
1908
1909
1910
50
120
284
61
150
282
124
303
566
87
83
253
82
54
389
178
153
642
84
30
231
68
40
331
158
74
562
60
59
178
44
35
439
110
110
617
58
32
171
23
52
581
87
129
252
32
54
100
35
69
326
71
143
426
31
49
61
45
55
394
79
121
455
32
26
88
27
81
472
66
121
560
61
34
77
53
68
541
123
122
618
52
24
107
45
68
266
109
100
373
85
101
124
129
169
222
227
281
346
100
143
148
123
173
337
265
314
486
741
765
1.822
735
1.024
4,680
1.597
1,971
6,402
Laboratory Diagnostic Work for 1910 — (Continued)
MONTH
January . . .
February. ,
March . . . .
April
May
June
July
August. . . .
September.
October. . .
November.
December .
T<)tal .
Sputum
EXAMINATIOKS
]
POSITIVE
1 NKGATIVE
1
TOTAL
1908
1909
1910
1
! 1908
1909 ; 1910
1908
1909
1910
14
51
48
1
' 40
92 94
54
143
J42
23
44
43
40
101 110
63
145
153
29
58
76
40
85 150
71
133
226
28
44
61
47
69 162
75
115
223
33
45
53
42
120 121
76
165
174
35
39
as
45
115 89
80
156
127
31
33
36
37
135 79
68
168
115
28
60
5(i
42
113 80
70
173
136
31
32
37
61
110 71
93
142
108
55
39
48
27
115 98
82
154
146
7
36
42
1 ®
89 99
18
126
141
15
45
46
i 68
101 124
92
146
170
33U
526
5S4
49K
1.245 1.277
842
1,766
1
1.H61
Report of Hygienic Laboratory
317
Laboratory Diagnostic Work for 1910 — (Concluded)
WiDAL Tbot
FOR Typhoid Fever
MONTH
POSITIVE
NEGATIVE
total
1908
1909
1910
1908
1909
1910
1908
1909
1910
Janunry •
4
7
6
12
25
18
10
• • • •
2
1
1
3
• a • •
5
15
17
28
21
6
8
9
32
23
26
29
38
17
8
14
13
6
11
16
• 15
33
61
41
48
16
15
24
18
9
15
12
10
8
18
18
16
16
26
21
21
22
13
15
46
41
46
38
62
27
18
24
24
7
21
25
35
84
88
63
76
34
34
77
63
'??
14
11
9
22
18
24
39
43
February
49
\farcli
42
April
28
May
8
6
11
29
19
16
26
16
21
June
34
July
78
AinrtiKt ■
04
September
72
(^tobcr
67
November
I>ecember
100
44
'
Total
147
92
254
282
1
179
378
499
358
632
The special investigations of the mineral waters of Saratoga
hare been continued by the Laboratory Division and reported to
the Saratoga Reservation Commission.
Albany, N. Y., September 2®, IMO.
Hon. Eugene H. Poeteb, A.M., M.D., State Commissioner of
Health, Albany, N, Y.
Sib: — Complying with your instructions to report to you
further details and conclusions of the Laboratory Division in re-
gard to the investigation of the mineral waters of Saratoga; re-
ferring to the preliminary report already in your hands, I sn]y
mit the following matter with the understanding that it is in-
tended only for assistance of various parties concerned in their
actual efforts to determine more precisely the situation and value
of some of these springs.
In the preliminary report, the waters of the springs of Sara-
toga were presented as of three kinds ; the saline alkaline waters,
of which the principal mineral ingredients from the point of view
of quantity, are chlorine of sodium and bicarbonates of calcium
and magnesium.
318 <State IJepautment of Health
•
In all of the waters of this group the relative quantity of
various salts contained may vary, but in so far as the investiga-
tions of the laboratory have gone, it is apparent that any character-
istic mineral matter found in one of the spring waters of the
group is also to be found in every other spring water of that
basin.
The amount of total mineral substances contained in the waters
of the various springs, i. e.j the mineralization factor of each
spring water varies very decidedly and in consequence of this
variation of the quantity .of mineralization is the different
therapeutic action established in all probability ; that is to say, the
difference in the action of various of these spring waters upon the
human organism is more rationally due to the different quantity
of mineral matter in the respective waters considered, more than
to a particular salt or substance existing in any specific water.
The meaning of the previous statements is that the various
saline alkaline waters of Saratoga differ from each other for all
practical purposes merely in the degree of concentration of their
mineral substances.
The most highly mineralized waters of this class, such as the
Carlsbad and Hathorn, show a relatively strong purgative or
cathartic and diarrhetic action upon the human organism,
whereas the less highly mineralized water becomes of relatively
slight immediate therapeutic effect, but is valuable as a pleasant
table water.
The majority of the mineral waters of Saratoga belong to this
saline alkaline class.
A few of the springs are reputed to supply Chalybeate waters.
The investigations of the lal)oratory to this point would indicate
that tJiese waters contained relatively the same mineral &ul)stanoe8
as those of the saline alkaline group, but a somewhat increased
quantity of iron.
(Such iron exists in this water as the ferrous bicarbonate; the
access of air to a water containing this salt of iron results in the
oxidation of this iron to au unstaple compound, the conse-
quenl; precipitation of which causes clouding of the water. Sudh
a water as ordinarily bottled, undergoing this change of oxida-
tion, does not present a pleasant appearance and the exploita-
Hepoet of Hygienic LABoitAtoKY 319
tion of such bottled water is pradiically not undertaken on this ac-
eoimt. Such waters have been for the most part utilized merely
for drinking upon the premises ; as a type of these are the waters
of the Columbian and Clarendon Springs.
A number of waters grouped as saline alkaline also contain
this ferrous bicarbonate in sufficient quantity as to render the
maintenance of its clear condition when bottled very difficult, a
slow oxidation of the iron salt generally resulting in the produc-
tion of a yellow iron compound, causing a dirty and disagreeable
sedimentation. The bottling of such waters containing consider-
able iron, has been successfully accomplished by a special bottling
machine, closing the bottle with the exclusion of all air and thus
assuring the maintenance of a clear content. Such method ds
followed at the Hathorn Spring.
A second method of maintaining a clear fluid in the bottle con-
sists in adding a small amount of tartaric or citric acid to the
spring water, which successfully maintains a clear solution of the
iron compound.
The exploitation of the Congress Spring waters acknowledges
this procedure and a statement to that effect is found on the
labels of their bottles distributed outside of Saratoga.
A third method used to avoid a subsequent oxidation and sedi-
mentation of iron compounds in such water consists in aerating
the water before bottling it, thus bringing about the oxidation of
this nnstaple iron compound, its immediate precipitation and re-
moval from the water by filtration. The Lincoln Spring uses this
method to obtain a water that will remain clear when bottled.
A third group of waters found at Saratoga is made up of the
so-called sulphur water. The so-called sulphur spring at the
Eureka baths is not highly mineralized, but is to some extent
impregnated with hydrogen sulphide. This is the only water
of this class known in Saratoga by the Department.
In considering the value of those different mineral springs as
commercial assets, besides the material condition and equipment
connected with each spring, the extent and organization of its
business, there are a number of factors demanding important
consideration which depend upon the spring itself.
320 State Depaktmext of Health
Foremost among such factors is the question of the relative
mineralization of the waters; that is to say, the quantity and
nature of mineral substances dissolved in each water. The
second consequence of this first factor consists in the amount of
such water that is obtainable daily from a given spring without
affecting the permanent mineralization value of its water; that is
to say, the total volume of the daily flow of each spring showing a
constant mineral content and no trace of exhaustion of the under-
lying mineral water vein.
A third and all important factor is the sanitary^ quality of such
water intended for human consumption.
In the preliminary report to you it was shown to what extent
the bacteriological investigations of some of these waters showed
them to contain fecal organisms, subject to further investigation
and control. A permanent content of such fecal organisms would
of course indicate that such waters were unsafe for consumption
and consequently such permanent contamination would totally
abolish any commercial value that otherwise might be assigned to
such waters.
The problem of determining any possible value in the presence
of these actual investigations showing the existence of fecal organ-
isms, involves a study of surroundings and repeated controls.
It can be said now that the presence of these fecal organisms in
the waters so reported to you would indicate a quite direct infiltra-
tion of surface or close underlying surface water with that of the
springs concerned. This connection being once so made, may
persist and constitute a permanent condition beyond relief, or it
may be that a cessation of pumping or other drainage of large
volumes of Avater and stop to this extent the depletion of the
spring water basins and that consequent changes in such basins,
may immediately again exclude the infiltration of this undesir-
able water of surface source and in such a case it would be per-
fectly possible that such springs could then regain a water of
satisfactory sanitary quality.
The preceding paragraphs indicate more or less natural de-
terioration of such spring waters, but further than that a de-
terioration directly caused by human intervention is perhaps of as
wide or even more disastrous effect.
Repojbt of Hygienic Laboratoet 321
It is persistently rumored that falsification of the natural water
product of numbers of the Saratoga Springs is very prevalent m
the exploitation of Saratoga mineral waters. The investigation
of your Department has secured evidence that in some cases these
rumors are well founded. It is not diflBcult to find incentive for
such falsifications and imitations in the mineral water basins
under the conditions at present prevailing in Saratoga.
Three inducements for such fraudulent action are immediately
apparent :
First, falsification might be reported to cover up, and to this
extent, remedy a deterioration of the degree of mineralization
of the water of some of these springs.
Second, the development and distribution to the public of a
spring water of established reputation might extend beyond the
actual water capacity of the spring, the name of which was a
valuable asset in this business ; and to meet a distribution greater
than the actual production, falsification by the use of other water
might be undertaken.
A third inducement to fraud might be found more or less in the
partial or complete failure of a given spring to supply its water
after a business had been developed in its name which had hereto-
fore been supplied with a perfectly reliable product
The investigations of your Department and minute examina-
tion of various establishments bottling mineral water at Saratoga
have discovered in a number of establishments an arrangement of
pipe systems, tanks, pumping machinery, etc., which make it very
possible to introduce water from a source other than that of the
true mineral spring into tanks in the establishment from which
the water for bottling is taken.
Various chemical substances and the necessary apparatus for
dissolving and intnxlucing solutions thereof into the above-men-
tioned tanks, have been found practically in position that would
indicate such use.
It is vitally necessary in determining a commercial value of a
given spring to determine whether or not any falsification has
ever been practiced in connection with the exploitation of its
waters; for in the estimate of such commercial value the eood
will, name and trade labels which might be of great value if
11
322 State Department of Health
strictly honest, would be totally valueless for any State control of
the water, the reputation of which had been established in any
way by fraudulent practice.
Furthermore, if the addition of chemicals should be necessary
to maintain the iron in solution, and this fact had heretofore
been concealed, the necessary public acknowledgment that a State
control would require, might reduce the volume of business to a
considerable extent and be an important factor in determining
the future value of such a spring water.
It might, on the contrary, be desirable to market such an inm
containing water without the introduction of a chemical solvei*t
and such procedure would necessitate the introduction of a special
method of bottling, with the exclusion of air. The change antl
new machinery and methods thus involved might greatly increase
the cost of placing this water on the market and to this extent
would effect the determination of the value of such water.
Suppose, however, the removal of a subsequently precipitated
iron from a water were undertaken by its aeration and filtration,
this practically should be publicly acknowledged under any State
control and such acknowledgment might involve a considerable
loss of business in a water that had been exploited without the ad-
mission of these truths.
A number of springs exploited at Saratoga would apparently
have great difficulty in maintaining their reputation after a care-
ful investigation of facts. For instance, there is a pavilion in
Saratoga in which are located three healing springs ; one of which
is declared to be a producer of an iron water, the second, of a
magnesia water ; and the third of a lithia water. There are three
wooden tubes in the pavilion supposedly connected with such
springs, but at the time of the investigation made by the De-
partment, your inspector using for five minutes a hand pitcher
pump, had exhausted the flow of all three of the springs. There
remained no doubt that the three tubes were undoubtedlv fed
from one common source and that the water flowing: from each
one of them was the same.
The location of a vSpring, its general and widely established
reputation and the extent to which its water is advertised are
Repobt of Hygienic Laboratory 323
widely important factors in determining the value of individual
springs^
At the present time in Saratoga there are existent springs, the
material conditions and mineral properties of which are far iu
exce^ of their exploitation. In fact, there are springs in Sara-
toga and its vicinity that in quality of mineralization and volume
of flow are worthy of consideration as among the hest springs of
that district, hut the waters of which are little known to the pub-
lic and the exploitation and business developments of whicJi
waters are of very snmll degree.
The progress of your investigation of these mineral waters is
sufficient to show that although it cannot be said that the mineral
content of the waters of many of these springs exactly duplicate
the water of another, nevertheless there are a number of these
springs, the general character of the waters of which is so similar
that the use of any one of these waters would fill all proper aud
therapeutic requirements of a successful exploitation. It would
undoubtedly be beneficial to select one or more of these springs for
its better location, sanitary character or other greater desirability
and utilize the waters of this spring for general exploitation an«l
advertisement to the exclusion of manv of the other less desirable
springs supplying the watc r of practically the same nature.
There is appended herewith a table showing the amounts of ih»*
more important chemical substances found in a number of these
spring waters, (A) as reported in Bulletin Xo. 91 "Mineral
waters of the United States," by the United States Departniei'l
of Agriculture in 1005, and just below each of these quantirif-
in line (Bi the results found bv analvisis of waters taken fron
these same springs in the winter r.f ItHiD to 1010, during the In-
vestigations of your Department and analyzed by your order .t
the State Hygienic Lal)oratory. The quantities in this ta^l^
state the nunilx»r of milligrams i>er liter.
The comparison of these two series of analyses at an inten a!
of five vears shows verv sftrikinsrlv a verv material rethiction in
the mineralization of the-e waters.
The knowle<lge possessed by your technical staff on condition^
and operations at present existing in Saratoga renders the ob-
served lessened mineralization of the=e waters, a confirmation of
324
State Department of Health
the resultaiyts to be expected from the present condition of th'i
mineral basin of Saratoga as we know it.
A number of illustrations or exploitations in this resultant
from the investigations of your inspectors at Saratoga are ap-
pended to this report to you.
Yours very respectfully,
WILLIAM S. MAGILL
LEONARD M. WACHTER
High Rock
Mssnetic.
Cvlsbad..
Hftthorn. .
Lincoln. . .
Oxide,
SiUca
Sul-
phates
Chlorine
Calcium
Magni-
sium
iron,
Alumi-
nium
Sodium
Potas-
sium
33.4
157
483 3
223.0
60 6
175
348.0
34. 3«
5.02
10.8
109.30
14 55
Trace
71 50
11.34
42.7
2.3
1.313.4
326.4
122.8
01.82
80.0
840.7
56.0
53.03
1.80
811 08
138 41
18.8
13.5
2.8
4,410.6
628.6
298.8
18.8
3.014.5
237.8
8.60
Trace
3,014.16
601.80
281.78
10 83
2.732 00
288.18
10.6
5.6
3,685 5
650.7
228.8
14 0
2.430.7
197 2
11.03
0.3
1.759.20
510 87
130 27
33 66
1.284 5
124.06
32.7
3.5
4.068 0
675 8
325 0
10.8
2.688.0
243.7
13.16
2.18
1.290.84-
156 76
70.12
36.16
1.320.82
178.25
Lithium
8)
Trace
3.2
6 3
10.6)
0.5
"I'.'S
Trace
A
B
A
B
A
B
A
B
A
B
A — The numerals of lines marked "A" are the corresponding analytical data of the United States DepirtmcLt
of Agricultural Reports.
B — The numfrals of lines marked " B " are the corresponding analytical data of the New York State Department
of Health Reports.
Albany, N. Y., May 27, 1910.
Hon. Ei'GKNE H. PoRTEE, A.M., M.T)., State Commissioner of
Health, Albany, N. Y.:
Sir: — Under date of May 21st, the attention of your Depart-
ment was called to the washing of vegetables by truck gardeners
in the water of the Erie canal, between Troy and Albany. This
complaint was rec^eived by you on May 2t5d and transmitted U^
Inspector Xumter , with your instructions to investigate
that matter on the following day.
Your inspector called upon the gentleman making this com-
plaint, but was unable to find him at home. He accordingly pro-
ceeded to the direct investigation of the subject-matter.
He found that it is a constant practice and has been for some
Repobt of Hygienic Laboratory 325
time for a number of truck gardeners to wash vegetables in the
water of the Erie canal at various places, which vegetables they
subsequently supply to the markets of Troy and Albany.
In particular at a point in the canal near Schuyler bridge,
spinach was seen by your inspector to be wasl^d and his investi-
gation showed that this spinach was the property of a Mr. Beattie,
who had built a wooden rack pen in the canal, into which pen
vegetables to be washed were thrown from a wagon with forks j
and after remaining in this pen, submerged with water, were
taken out with the forks and thrown upon the bank to drain.
They were subsequently loaded on to wagons, which wagt^ns
as a matter of custom usually left his residence from two to three
in the morning to arrive at the Troy market at an early hour the
following day.
At the time of this inspection a number of boys were in swim-
ming at this place and samples of the water of the canal were taken
at this time for examination at the laboratory.
In this vicinity also another pen, in which spinach, lettuce and
onions were washed, was found existing in the canal, stated to
be the property of O'Leary, a truck gardener who conveyed the
most of his produce to Troy and also to the Albany market.
Another installation of the same sort served for the washing
of products, the property of a man named Keys, who sold this
produce at Troy.
At another point a similar 'installation belonging to Mr.
O'Brien, was found ; he washed practically all of his green produce
in this way; at the time he was washing spinach, lettuce and
onions and he sold all of this produce both in Troy and Albany.
Another installation was visited belonging to a Mr. Mattimore,
where the actual washing of thirteen barrels of spinach, three of
lettuce and a quantity of onions were seen and the two sons of
this proprietor were interrogated. They stated it to be the usual
custom to wash green produce here in this way; that after the
produce remained in the water for some half hour or more, it was
removed therefrom with forks, allowed to drain on the banks, sub-
sequently loaded on to wagons and driven to the barn. From this
bam the wagons started about two or three o'clock in the morning
to arrive at the market at an early hour and sell the produce.
326 State Depaetmext of Health
Another installation for washing the produce of Mr. T. Smith
was also found, where spinach and lettuce were washed, which
produce it was stated was carted early the following morning
for sale at the Troy market
Another installation opposite the farm of Mr. Clancy was said
to be used by Mr. J. Mullen of Island Park, for washing of his
green produce and a further installation was found of this nature,
utilized by Mr. Bums.
Nearer to Albany, in the rear of Altro Park, a Mr. Burns was
found to have a similar wash stand ; and a Mr. Sheller and Mr.
Carmend, vendors of such products, were found in this vicinity,
but these last two were not provided with wash stands. The last
three mentioned bring their truck for sale in Albany.
This method of washing green produce has been known for a
long time by the people dwelling in that vicinity and is easily
observed by passengers in the car line running between Troy an4
Albany and has been so observed in actual operation by members
of the Laboratory Staff.
A report of the actual nature of the water in this Erie canal
at the time of the washing is appended.
Respectfully submitted,
WILLIAM S. MAGILL
•WILLIAM A. BING
Appendix Number 1
Albany, N. Y., May 27, 1910.
Four samples of water from the Erie canal were taken and
designated as follows:
Alta Hotel / Sample number 3358
Key's Fann *..... Sample number 3357
Schuyler Bridge Sample number 3355
O'Leary Sample number 3356
Report of Hygienic Laboratory 327
The designations used for these samples denote the places iu
the canal at which the water was taken, at each of which places
green products for market were washed. The samples were col-
lected between three and four p. m. of May 24th and were plated
before 6:30 of the «ame afternoon. The laboratory examination
reports as follows:
Sample No.
3358 Bacteria per c. c, 3,700
3357 Bacteria per c. c, 4,100
385^ Bacteria per c. c, 1,500
3356 Bacteria per c. c, 800
B. coli iyipe present in 1/10 c. c.
B. coli type present in 1/10 c. c.
B. coli type present in 1/10 c. c.
B. coli type present in 1/10 c. c.
The -water of this canal is that of the Mohawk river, the water
of the last level of the Champlain canal and of at least one small
stream which enters the canal at a point north of the Arch Street
bridge, which crosses the State basin at Green Island.
In addition to the usual polluted condition of Mohawk river
water, there is evident pollution occurring along the canal at the
points covered by your inspection. For the general dangerous
nature of such water and particularly that of the Mohawk river,
reference is made to th^ laboratory reports of previous years of the
water of this river ^nd of these districts.
Albany, N. Y., October 4, 1910.
Hon. E. n. Porter, A.M., M.D., State Commissioner of Health,
Albany, N. Y.:
Sir : — The undersigned has received copies of correspondence
with the president of the State Commission in Lunacy, under
date of June 28th and July 21st, with the replies of this Depart-
ment of June 30th and July 27th, a letter of this Department to
the superintendent of the Gowanda State Hospital, dated July
27th, a reply of that superintendent dated July 29th and tho
acknowledgment of that reply, made by this Department on Au-
gust 2d.
The correspondence has to do with the damage of clothing and
328 State Depabtmbnt of Health
similar material treated at the Gowanda State Hospital for dis-
infection for a scarlet fever epidemic, by immersing this material
in a bath made up of a solution of bichloride of mercury one part
to 500 parts water, and a constant damage of this material is
reported from that hospital.
Complying with your order, the Division of Laboratories has
investigated this matter and it is herewith submitted. The com-
mon name of bichloride of mercury is that of " corrosive sub-
limate " and this name signifies the particular corroding nature of
this substance, which property is very marked, even in' its most
dilute solutions.
It is well established that a solution of the strength heretofore
specified of this chemical compound is quite destructive to fabric
and as illustration of this general knowledge, reference is made to
a book on " Disinfection and Disinfectants,'* by S. Rideal, edition
of 1895, page 138, where referring to the use of such a solution for
disinfection of railway carriages, the following sentence occurs:
" It is to be noted that mercuric chloride solution, especially if
acidified, would rapidly injure the cushions or hangings."
It is well known that such a solution should not be used for
fabric if damage is to be avoided and for this reason the disin-
fection of all clothing, curtains and such material for which steam
disinfection or washing is unavailable is rc^rted to by formalin
gas or sulphur dioxide.
Your attention is respectfully called to paragraph No. 3 on the
second page of the circular issued by this Department, entitled,
" Disinfection and Disinfectants," where the use of such a solu-
tion for disinfection of clothing is distinctly recommended.
Apparently such recommendation should not have been made,
or if made should have been accompanied by a special caution that
a very decided damage to any fabric would result from such
treatment.
Respectfully submitted,
WILLIAM S. MAGILL,
Director of Laboratories
Kepobt of Hygienic Labobatory 329
Albany, N. Y., October 11, 1910.
Hon. Eugene H. Pobteb, A.M., M.I)., State Commissioner of
Health, Albany^, N. Y.:
Sib : — Complying with your order of October 5th, the under-
signed inspector has received the Department file with the corre-
spondence matters pertaining to health conditions at Rouses Point
and has visited that place on October 6th and investigated the
question of the existence of typhoid fever in that village at the
present time; and in further compliance with your general order,
has investigated the general health conditions and the attitude of
the various public boards of the village, upon whom responsibility
for health conditions should rest, and the steps that have been
taken by any such board for improving the conditions since March
of this year, and the reasons why steps for the betterment of
health conditions have or have not been taken.
The immediate determinant of the order for the present inves-
tigation appears in two letters, both dated September 29th, written
from Houses Point and herewith submitted as appendix "A."
The information of these letters states that a number of cases of
typhoid fever actually exists at Rouses Point; that a scandalous
pollution of water used for the public supply is known to exist;
that at least one physician is suppressing all knowledge of typhoid
cases and endeavoring to conceal such from the local health board
and that the village board of trustees are doing nothing to relieve
the known polluted condition of the water supply; that they are
not acting in any way to aid the local health board in improving
conditions; that at least two deaths have very recently occurred
from typhoid fever; that with the exception of cases reported by
the health officer, no cases are reported by any other attending
physician at the present time; flud the charge is made that an
effort to conceal any knowledge is being made.
Complying with your order of October 5th, Dr. W. C. Thomp-
son, medical officer of this Department for that district, was noti-
fied to meet the undersigned inspector at Rouses Point early on
the morning of October 5th and this medical officer accompanied
said inspector in the principal investigations of the health condi-
tions of the locality during his interviews with every practicing
330 State Depabtment of Health
physician at Rouses Point and the official interviews of the in-
spector with the health officer, the first meeting of the local board
of health and the joint meeting of the local board of health, mem-
bers of the village board of trustees, including the president, a
member of the water board of Rouses Point and one or more in-
fluential citizens, including the largest property holder of that
village.
It is recalled that health conditions at Rouses Point have been
unsatisfactory to this Department for more than a year ; that last
winter for a period of several months a decided infection of
typhoid fever existed in that community.
The records of the Department show that the laboratory report^
on the condition of the water supply of that village indicate that
the water taken from Lake Champlain at that point is of such
unsanitary quality as to be dangerous for use in its raw condition.
Because of the imsanitary conditions of that community, an
extended investigation of these conditions was made by your De-
partment and a report embodying the results thereof, was made
to you by the Chief Engineer of this Department under date of
March 2, 1910. A copy of this report was forwarded by you to
a suitable official of Rouses Point under date of March 18th.
Your report included recommendations, very insistently stated,
requiring the immediate action- of the local authorities to protect
the health of the citizens of that community and to take further
action to assure a safe water supply in the future for that
commimity.
I beg to refer you to a copy of your report here attached as
appendix " B " and specifically to the recommendations for the
action of the local authority on pages 12 to 15 of that report.
The Department file shows some correspondence with the vil-
lage president and with the health officer of Rouses Point since
that time and shows also a report of the consulting engineer em-
ployed by that locality for the subject of improvement in the
water supply, and shows under date of July 14th a communica-
tion from the president of the village to you, stating that a propo-
sition to raise funds to build a slow sand filtration plant — ac-
cording to the recommendations of the consulting engineer — was
submitted to vote of town and lost
Report of Hygienic Laboratory 331
It is evident from the file and established by investigation of the
undersigned inspector that since last spring not a single step has
been taken to improve the sanitary condition of the water supply,
to abate the sewage pollution of that water, nor to warn the citizens
to any further degree of the danger of using such water, nor in any
way to protect the health of the citizens from the constant menace
of the admittedly unsafe water of the public supply.
Your inspector has foimd that no notice has been issued to the
citizens concerning the insanitary condition of the water since
last May, when a notice (copy attached as appendix ** C) was
issued and various faucets of the public supply in school buildings
and other exposed public places, were closed by the health officer.
It has been stated to your inspector and corroborated by more
than one witness, that prominent members of the village board of
trustees, or of the water board, have openly and repeatedly stated
since that time that the water was in satisfactory sanitary con-
dition; that tliere was no harm to be feared from the use of the
water; and that investigations made by a private individual, stat-
ing the results of laboratory analyses, showed the water to be quite
harmless.
Furthermore, it was stated and proved that in spite of the
closing of various faucets of the public supply by the health officer,
in particular in public schools, that these faucets had been, with-
out authority of the health officer, reopened and that the water was
actually in daily use in these schools and it was apparent and
admitted at the joint meeting attended by your inspector, that the
use of this water and that the opening of the faucets distributing
this water without authorization of the health officer and contrary
to his repeated insistence that they must be maintained closed,
was well known to the principal member of the water board, to the
President at least, of the village board of trustees of Rouses Point,
Your inspector noted that residences of Rouses Point alonp: the
shore of the lake, most closely adjacent to the point of intake of
the public water supply; residences extending for a half a mile
or more along this lake front and all within the breakwater, consti-
tuting a sort of bay, within which public supply is taken ; that all
of these residences practically discharge their entire sewage directly
into the water at the edge of the lake ; that in some cases the dis-
332 State Depaetmbxt of Health
charge of such drain pipe was not even under water and that in
relatively every case the drain pipe did not go further than a point
of constant submersion.
It was pointed out to your inspector that a number of these resi-
dences, complying with the advice of the health officer, were con-
structing cesspools, into which the house drain would flow directly
and of which the overflow alone would flow into the lake and it was
the contention of the health officer that wherever these cesspools
were constructed (directly on the shore of the lake) he would see
to it that they were properly and thoroughly cleaned at suitable
times.
It was further noted by your insi>ector that practically all of the
houses not directly upon the lake front, but upon streets further
back paralleling the lake shore, were unsupplied with any public
sewer ; that there was a considerable number of such houses extend-
ing for several blocks back from the lake front and for a distance
of perhaps half a mile where all of the house drainage discharged
directly into open ditches, which ran to open ditches on the side of
the street and that these open ditches conducted all of this waste
directly into the lake at the point of abutting of cross streets
upon the lake shore. In a number of cases it was observed there
were for considerable distances, stagnant pools of such house drain-
age, containing putrefying material and giving off offensive odor.
Practically without exception, the privies of every one of these
houses were little outhouses a short distance back of each house,
built from the surface of the ground, or in some cases perhaps, into
a slight excavation about one foot in depth.
As a general rule, however, all of the excreta lay upon the sur-
face, in a large number of cases directly accessible to insects of
any kind and where surface wash would carry it with slight resist-
ance or retardation directly into the open ditches utilized for the
house drainage.
Such material, therefore, would also be poured very directly
into the lake water.
A number of houses were observed by your inspector, in which
there was absolutely no provision of privy, where the human
excreta must of necessity be deposited quite miscellaneously over
the surface of the dooryards, either before or behind the house,
Report of Hygienic Laboratory 33?
and a number of such houses showed a considerable accumulation
of waste, garbage and similar material in close proximity to the
house.
Report of this Department previously alluded to and attached
as appendix '* B," describes very completely the actual inlet of
the public water supply.
It was stated to your inspector, but not verified by him, that
the intake is actually not so far from the shore as is indicated in
that report.
The conditions of wind and current indicated in that report,
which so facilitate the arrival of sewage at the intake of the
water supply, were very manifest at the time of the visit of your
inspector.
It was stated to your inspector and a map was shown to him,
of an original proposal for the establishment of sewers at Rouses
Point and that the sewage system indicated by that map was at
one time approved by this Department.
Whatever the case mav be, it was evident that all of the dis-
charge of sewage from residences on the lake shore and back of,
but parallel to these residences, into the 'lake was illegal. It was
also evident that there was no legal authority for the existing
sewage system, the construction of which is very widely different
from the map shoAvn your inspector as having been the design of
the original sewer system, for which authority was at one time
obtained.
Your inspector called upon every practicing physician in
Rousee Point, three in numher. He found, and the statements
were apparently verified, that one physician had no cases of
typhoid fever in his practice and had had none for a long time.
This physician was not engaged in active practice. Another phy-
sician, not the health officer, who has been previously found at
fault by your Department for not notifying the Department nor
the health officer of cases of contagious disease and who was at
this time directly ac'cused in the correspondence referred to pre-
viously and attached as appendix **A" as concealing cases of
typhoid fever actually existing or having existed within the last
few weeks, was interviewed by your inspector with the assistance
of the medical officer designated, and this physician admitted that
334 State Department of Health
he had actually two cases of typhoid fever in his practice and that
a short time previously a patient under his care had died of
typhoid feven
It was also stated by other parties that a second death in the
practice of this physician had recently occurred from typhoid
fever, but this case was not mentioned by the physician when
interrogated.
The physician in question admitted that he had not reported
any of these cases to the health officer, nor to the Departments He
stated that he would do so as soon as he received proper cards for
such reports and he stated that his excuse for not doing so before
was that he did not have such cards.
In this connection it was stated to your inspector by the health
officer and corroborated by his secretary, that he had at frequent
intervals mailed to the physician now at fault for not reporting his
cases, suitable report cards and that not less than ten days previ-
ous to the visit of your inspector a quantity of cards suitable for
the reporting of typhoid fever, had been mailed by the health offi-
cer to the physician specifie<l, and furthermore, it was stated to
your inspector by the secretary of the local board of health that
he had personally called upon this physician a number of times,
requesting him to report all of the proper cases promptly to the
health officer and that he had personally handed to him such
request in writing; that he had a copy of this written request in
his files and that at the time of handing such request he had also
handed to the physician the suitable report blanks.
It is evident from the file of this Department, from the state-
ments and corrolx)rated statements of members of the local board
of health and the health officer, that the physician specified hag
been unusually well informed of his duty to make prompt reports
of the various matter of vital statistics and of contagious diseases
required by this Dei)artnient ; that this physician has been unusu-
ally well, frequently and amply supplied with the necessary report
blanks and that he has, with scarce an exception, and then only as
a last resort, made any suitable report of the matters required by
him.
It is evident by investigation of this Inspector that the dame
ohysician has repeatedly had cases of typhoid fever in that com-
Eepobt of Hygienic Laboeatoey 335
0
munity; that there were actually eases in his care at the time of
the visit of the inspector that were unreported and furthermore,
in which it was evident that active effort had been made to pre-
vent the health oflScer from having due knowledge of the existenc<»
of this disease and that these conditions and actions of the said
physician had existed for some time and had been maintained even
when at least one patient had died from typhoid fever, the knowl-
edge of which said physician admitted to your inspector and cor-
roborated statements were made to your inspector concerning this
specific case and of other cases in general ; that in such case, under
the care of the physician above alluded to, not a single precaution
had been taken for the disinfection of the excreta from such
patients or to prevent contact infection of the neighborhood.
Statements were made and corroborated that excreta from such
case under the care of this physician, were known to have been
thrown out in the yard of the house, without any effort at burial
or disinfection being made at all and that protests made by neigh-
bors relative to this carelessness were met bv the statements of the
house members where this case existed that the physician declared
it was not typhoid fever and precautions were not necessary.
Your inspector ascertained by inquiry from a number of citi-
zens of the community, that the physician in question never sup-
plied circulars issued by this Department, setting forth the pre-
cautions to take for various contagious diseases and that he practi-
cally never notified the health officer of the existence of such
•liseases, apparently doing all in his power to prevent knowledge of
the existence of such disease from coming to the health officer and
taking any active measures to control such infection.
Your inspector feels that in this investigation it is necessary to
state before you the results of an investigation on a broader basis
than the mere determination of material conditions.
Unsatisfactory as the sanitarv conditions of this community
evidently are, as they are set forth in the report of your Depart-
ment previously alluded to and attached as appendix " C," un-
satisfactory as they are found to be by this present investigation
of your inspector, it is evident that there exists at Rouses Point
an unhealthy condition far more disastrous than anv of the
material conditions heretofore set forth.
336 State Department of Health
«
There exists an unhealthy paychological condition in that com-
miinity, which requires severe and radical therapeutic measurea-
to bring about a tenable condition for the development of a healthy
community.
Your inspector found an energetic, earnest health officer, awake
to the danger of the water supply, perhaps not sufficiently awake-
to some other unsatisfactory material conditions, but eager to do
his full duty. He foijud acting in full endorsement and co-opera-
tion with their health officer the members of the local board of
health, with whom he came in contact.
On the contrary, it was apparent that one or more of the leading
property owners in that community, the President and others of
the village board of trustees and at least one member of the water
board, were not acting in hearty co-operation or endorsement witli
the health board and their health officer. The inaction of the
responsible officials of that commimity since your communication
of last March is very largely attributable to this division in the
community.
Apparently the President and other members of the village
board of trustees have not realized their responsibility for con-
ditions detrimental to the health of their citizens. Apparently
these gentlemen have made no effort to point out to the citizens
of that commimity the individual responsibility of each for im-
])roving their conditions and safeguarding the health, not only of
their community, but of suppressing the danger of health con-
ditions at Rouses Point to the outside world.
It was pointed out to your inspector that during this summer
season over two hundred cruising parties, passing through Lake
Champlain, have stopped at Rouses Point and that with the excep-
tion of the health officer, apparently no official in that community
has taken the slightest precaution to warn such visitors of their
dangerous water supply.
It is apparent that not only have some members of the official
family of that village failed to realize the necessity of improving
their local condition, but that there has existed in the minds of
some'of them a spirit of doubting the statements and recommenda-
tions of the iSt^te Department as of any weight or value ; a dis-
position to dispute all such authoritative communication and to
Repobt of Hygienic Laboratoby 337
play for time and delay by useless remark and argmnent and futile
resort to private analyses for basis for further dispute.
Your inspector failed to see in the minds of many of these men
the slightest indication that they had ever concentrated any
thought or effort to take immediate action to better their con-
ditions. It was manifest that the spirit of strife between at
least two sides existed in this community and that other than
mutual reproach and useless ailment, little had been done.
It is respectfully submitted by the subscriber that the most ener-
getic action of this Department be initiated to immediately cure
this condition of inactivity. It is herewith certified :
Referring to the excuses submitted as appendix "A^^ that
typhoid fever undeclared actually existed at Rouses Point at the
time of your inspector's visit; the parties responsible for these
concealed cases of typhoid fever are signakd in this report and
this failure to declare such cases is not a first offense; that subject
to the conditions described in this report, no proper effort for
bettering of conditions pointed out to that community as dangerous
hy your department last spring, has been made and that there
exists a condition of spite and dissention among the responsible
members of that community which it is necessary to immediately
correct, in order that a period of immediate activity to secure safe
conditions can be brought about.
Very respectfully submitted,
WILLIAM S. MAGILL,
Director of Laboratories
Albany, N. Y., October 17, 1910.
Hon. E. H. Porter, A.M., M.D., State Commissioner of Health,
Albany, N. Y.
Sib: — The undersigned respectfully submit a report of con-
ditions and data of examinations resulting from a series of investi-
gations of samples of water collected at different points from the
public water supply system of Yonkers during the last year.
338 State Department of Health
In this connection we beg to refer you to data concerning the
public supply of Yonkers published in the annual report of this
Department, Volume No. 1, 1907, pages 363 to 365, and to ana-
lytical data concerning samples of water from this public supply
published in that same volume on page 371 and in the correspond-
ing report of the following year, the analytical data of examina-
tions of samples of water from the public supply of Yonkers,
published in Volimie No. 1 of the annual report for 1908, page
459, and to similar analytical data furnished you with this report
on special sheet marked "Appendix A."
In addition to the dates designated as the time of taking samples
within the last year, this plant has been inspected by members of
the laboratory division at several other times, at which particular
times conditions existed which would prevent the taking of a fair
sample at the time of that inspection.
Your particular attention is invited to the following analytical
data from examination of samples taken by Inspector Number
Twelve, of your department, at the time of his last inspection
on October 6th, 1910.
On this date bacteriological samples were collected by this
inspector of the raw water from the Nepperhan River, as it passed
through the inlet chamber of the old filters and corresponding bac-
teriological samples were collected from every filter unit of the
Yonkers system. .
Numbers one and two of these units represent the effiuent
from the so-called old filter beds, numbers three and four from the
so-called new filters. To facilitate the comparison, corresponding
figures from previous examinations of these corresponding
raw waters and effluents from the various units are placed in ad-
joining colimins with the date of such examination.
The conditions of operation at the time of collection of the last
samples — October 6th, last — were somewhat unusual, for the
reason that the low stage of water of the Nepperhan river did not
permit a constant maintenance of level of the raw water on the
filters at the usual elevation, if the normal amount of filtered
water was constantly pumped from the filter plant.
Report of Hygienic Laboratory 339
Therefore, the pumps were operated only part of the time, being
frequently stopped to allow the water level on the filters to rise
again to a suitably high point.
Such intermittenee of pumping would, of course, produce
marked changes in rates of filtration and constant alteration of
filtration rate is, of course, not conducive to filter efficiency, but
these variations of rate could not be easily avoided under the
actual conditions of raw water supply.
Although the low stage of the river complicated the actual situ-
ation, there can be no doubt whatever of the possibility of purifica-
tion of raw water under the actual conditions in a manner that
would render the water of the effluents from the filter units of far
better sanitary quality than that actually found by this examina-
tion.
You will note that the results of the examination of samples of
water of the effluent from every one of the four filter units in-
volved showed fecal organisms to be present in the filtered water
and the conclusion is manifest, therefore, that the water then
actually delivered from every unit of this filtration plant at Yonk-
ers, was unsafe for human consumption.
Information concerning this water supply and filtration plant
gathered at different times and from many sources, would indicate
that for the two filter units, numbers three and four, the construc-
tion of which is noted in your annual report of 1907, as carried out
under the direction of Messrs. Hazen & Whipple, it is evident
that the design included a building to be used as a laboratory and
it was then the intention to maintain a chemist and consequent
permanent chemical control of the operation of this filtration plant.
The new filter units were constructed and the laboratory also,
but no resident chemist has ever been provided.
At about this time the form of city government was changed
and Yonkers commenced operation under a uniform charter, since
which time there has evidently resulted a change of policy for the
operation of this water system.
The water works of Yonkers are now under the direction of the
Commissioner of Public Works and under the immediate charge
of the Superintendent of Water Works.
340 State Department of Health
It is understood by the present reporter that by order of the
Commissioner of Public Works of Yonkers, the Superintendent of
the Water Works has been instructed to operate the water filters
as directed by a specified chemist, an employee for chemical work
in one of the sugar factories of Yonkers.
It is understood that this chemist has at times procured samples
— according to the observation of your inspector, by sending a
boy to collect such samples at the filter plant — at various times
and it is understood that according to the direction of this chemist
a solution of hypochlorite of lime has been added to the raw
water for purposes of purification and it is understood that the
filtration rate for the operation of each filter unit has been directed
by this chemist.
Incidentally, your inspector has learned that the sum of $1,500
per annum has been paid for these chemical services — a sum of
money sufficient in the opinion of your inspector to secure the
services of a competent chemist, who should be permanently estab-
lished and maintained at the filter plant.
It has been determined that the operation and introduction of
the solution of hypochlorite of lime above mentioned, is carried
out by an ordinary laborer, who takes his orders from the chemist.
The method of preparation of this solution and of its distribution
to the raw water is crude in the extreme.
The solution is made by this laborer stirring in an open cask
a quantity of commercial bleaching powder and water and allow-
ing this to settle. By opening a spigot near the bottom of the
cask the solution is allowed to flow into an open trough, eventually
leading the solution into the raw water for treatment. The rate
of flow is controlled only by the cmde attempt of the laborer to
adjust the quantity flowing from such spigot and it is also pointed
out that this laborer leaves his work at four or five o'clock in the
afternoon and that there is no further adjustment of flow of such
solution from casks throughout the night until his return at the
usual working hour of the following day.
At the various times when visited by one or more of your inspec-
tors, it has been found that the raw water going upon one filter
Report of Hygienic Laboratoby 341
was treated by such hypochlorite of lime solution, when the raw
water going upon a corresponding adjoining filter unit was un-
treated and inquiries made by your inspectors to determine the
method of such procedures have been unable to discover any
method whatever, as replies have been given that such introduc-
tion of solution was made to-day for one filter unit and perhaps
on the following day for another filter unit, but no key to any sysr
tern of procedure for the use of such solution has been found by
your inspectors.
It would be scarcely possible to devise a more crude method of
utilization for such a solution, even for a very temporary expedient.
It should be most evident on the slightest consideration that
such solution must of necessity be applied to raw water through
a weir or orifice which would assure a constant flow of a prede-
termined quantity, the delivery of which could thus be maintained
to a reasonable degree of accuracy.
This solution of hypochlorite of lime is applied to the raw water
as it flows upon a filter unit, usually nimibers three and four or
one of these. It is remembered that this solution has a strong and
imm^iate bactericidal effect upon most of the bacteria of the raw
water and that it is used for this purpose.
It is pointed out, however, that one of the paramount conditions
of successful operation of filters of this nature is Jhe biological
(largely bacteriological) activity going on at certain points in the
filter bed — the particular utility of the so-called Schmutzdecke,
the period of formation of which Schmutzdecke constitutes the so-
called period of ripening of the filter bed, after which the filter
becomes most biologically active and of consequent greatest
The direct result of introduction of a solution of hypochlorite
of lime to the raw water would be to sterilize this water to a more
or less d^ree and to this extent sterilize the Schmutzdecke of the
filter unit and to this extent suppress all of the biological processes
of the sand filtration with a consequent retardation and diminu-
tion, if not total loss, of efficiency of every filter imit, in which
case the object of slow sand filtration would be very largely
diverted.
34'2 State Department of Health
To be sure, the prevention of formation of Schmutzdecke would
enable such filter to be operated for a much longer time without
cleansing and for the saving of cleaning expense it might seem
desirable, if no thought of obtaining a sanitary quality for the
water is taken. It is needless to add that sand filtration is resorted
to to render water sanitary and safe and not for puropses of saving
money on cleaning.
It is suggested by your reporter in this connection that if a
solution of hypochlorite of lime is to be used at any place where
sand filtration is resorted to, that such solution should be added in
carefully determined dosage to the effluent water of the filter unit,
thus functioning as a final safeguard of its quality.
When added under these conditions, where all suspended matter
would have been previously removed by the sand filtration, a far
smaller amount of this hypochlorite of lime solution would be more
effective for its germicidal action and the sand filters themselves
would not be injured nor the biological functions be in any way
retarded or diminished by the practice of such sterilization.
Under the present abnormal conditions of the water supply of
Ifonkers, largely resultant of the extreme drought, it would be con-
sidered most desirable to add a suitable dosage of a solution of
hypochlorite of lime to all of the effluent water of every sand filter.
Your reporters are aware of the particular conditions involved
in the water supply of Yonkers. They are of the opinion, how-
ever, that there should be no difficulty if these conditions are
properly met in supplying to that city a water that is safe for
human consumption at all times and with the present filters.
The unsatisfactory situation at Yonkers filter plant, which has
been apparent throughout the past year, is quite similar to con-
ditions of a similar filter plant at Poughkeepsie some time ago.
The unsatisfactory conditions previously existing at Poughkeepsie
filter plant caused the establishment of a resident chemist and
since that time it is to be noted that the work of those filters and
their operation have been quite satisfactory to your department.
Apparently Yonkers has a well designed filter plant, the opera-
tion of which at its highest efficiency is perfectly realizable at once
Eepobt of Hygienic Laboratory 843
and would assure at once a safe potable water throughout any con-
ditions of water supply that are likely to be encountered at that
point for some time.
Respectfully submitted,
WILLIAM S. MAGILL
LEONARD M. WACHTER
Albany, K". Y., January 24, 1910.
Dr. M. Wolf, 9 Dach Street, Yonkers, N. Y.:
Dear Doctor: — I herewith enclose the report of the State
Hygienic Laboratory on the examination of samples of water ob-
tained at the Grassy Sprain pumping station, and at the Sawmill
River filter plant by a member of our laboratory staff on January
11, 1910.
The Grassy Sprain samples did not show that fecal organisms
were prevalent, though there were indications of considerable
organic matter being present.
The results of the ex-amination of the filter plant samples showed
that the raw water was badly polluted and that the filter effluents
examined did not show high filter efficiency.
The samples were from the new filters and it is possible that
they have not as yet settled down to effective work.
Yours very respectfully,
EUGENE H. PORTER,
Commissioner of Health
Albany, N. Y., Atigust 29, 1910.
Dr. W. S. Coons^ Health Officer, Yonkers, N. Y.:
Dear Doctor: — I transmit herewith report of the Division of
Laboratories on the examination of samples of water taken from
the filter plant furnishing part of your public water supply. The
samples were taken by a member of our laboratory staff on August
2, 1910.
344 State Department of Health
The results of the examinations indicated that the raw water
was badly polluted and that at the time the samples were taken
filter unit No. 4 was not operating with satisfactory efficiency.
Your new filters have now been in operation for a considerable
period and should be delivering a better effluent than that shown
by this examination and previous ones made by the Department
for its own information.
Yours very respectfully,
EUGENE H. PORTEK,
Commissioner of Health
• • • •
• • • •
Report of Hygienic Laboeatory 345
Comparatively Tabulated Report of the Work of the New York
State Hygienic Laboratory for the Year 1910
Per cent
Increase
1910 ovor
1000 Number of packages of 1910 1009
23,688 Diphtheria Antitoxin distributed (1500
units) ! 36,916 56
4,313 Tetanus Antitoxin distributed (1500 units) 9,655 124
22,000 Outfitsn-Prophylaxis Ophthalmia 24,454 11
Outfits — Sputum specimens — 10 months
only 3,289
Outfits— Widal test— 10 months only 1,834
Outfits — ^Diphtheria culture — 10 months
onlv 9,152
3,695 Specimens examined for Diagnosis — Total
received 8,914 141
Total
received Positive Negative
1,971 Diptheria cultures 6,421 1,826 4,595 225
1,766 Sputum specimens 1,861 584 1,277 5
358 Widal test (Blood serum) ... 632 254 378 76
2,013 Samples of water examined— Total rec'd. . .2,662 32
761 Chemical examinations 1,097 44
1,252 Bacteriological examinations. 1,564 25
No previous
record Mail matter Total handled of Ist class Pieces
Received— Ist class 3,963 12,471
Sent— 1st class 8,508 12,471
Xo increased appropriations of 1910 over 1909.
Xo decrease in any item of the Laboratories' activities in 1910.
Respectfully submitted,
WILLIAM S. MAGILL,
Director of Laboratories
CANCER LABORATORY
(3471
CANCER LABORATORY
Buffalo, March 6, 1911.
Dr. Eugene H. Poeteb, State Commiss^ioner of Health, Albany,
N. Y.:
Deab Sik : — I herewith transmit to you the annual report of
the Kew York State Cancer Laboratory for the year 1910.
Goiter and Cancer in Fish. In the early part of the oflacial
vear 1910 our studies into the distribution and nature of the so-
called thyroid tumor of fish, which comprehends a series of tumor-
like growths ranging all the way from simple enlargement (goiter)
to infiltrating and metastasising neoplasms (cancer) had reached
a degree of advancement which made it clear that this disease is
little short of a menace to fish culture and that it bears without
question an important relation to the public health. With the
approbation of the Commissioner of Health the State Cancer Lal>-
oratory has since 1908 been engaged in a joint investigation of
this disease with the United States Bureau of Fisheries of the
Department of Commerce and Labor, George M. Bowers, Com-
missioner. The work has thus far consisted of experimental work
in Buffalo at the laboratory and of work conducted during two
summers at a government fish hatchery in a neighboring State.
Besides these activities, with the co-operation of the Forest, Fish
and Game Commissioner of the State of New York, we have
studied for two years an epidemic of this disease in a New York
State hatcher^'. At the beginning of the present year these in-
vestigations were sufficiently far advanced to indicate to us be-
vond all reasonable doubt that the disease is an infectioiis disease
9
transmitted by the water and breaking out in epidemic form;
that it occiirs in fish living under practically wild conditions and
is probably introduced into hatcheries with the fish or eggs ; there
finds favorable conditions for further development and assumes
the astonishing epidemic character frequently observed. The dis-
oa.^ is fundamentally that of goiter.
350 State Department of Health
Goiter in Man. The distribution of goiter in human beings
in the United States has never been carefully tabulated. In
Switzerland and in the Alpine regions of France and Austria
the disease is so extensive as to be of the greatest economic import
to these countries. In Switzerland alone not less than 7 per cent,
of the young men are rejected for military service on account of
goiter. There are regions in which more than 70 per cent, of all
the youthful inhabitants are affected by various forms of thyroid
disease (goiter). In regions in which human beings have goiter
the animals are also affected and it has been recently conclusively
shown by the experiments of Bircher that the water from certain
wells and certain water supplies which have long been known to
be the cause of goiter in man, when given to animals causes the
development of goiter in these animals. It has furthermore been
shown that the ordinary bacteria-proof filters do not hold back
this agent but that it is destroyed by boiling the water. Careful
attention to the water supply in Switzerland has in some cases
controlled the disease. In the district of Aargau where in the
eighties not less than 59 per cent, of the inhabitants had goiter,
changing the water supply and bringing water into the district
from a non-goiterous region has reduced the percentage of the
disease to less than two and a half per cent. We have, therefore,
in goiter a serious disease affecting man and animals definitely
associated with water supply. It is, therefore, not surprising to
find that fish are also subject to this disease.
So important were the facts elicited from the study of goiter
and cancer in fish imder the joint arrangement with the Bureau
of Fisheries that when the facts ascertained were, in April, 1910,
placed b^' Commissioner Bowers and ourselves l>efor© Seert^arv
of Commerce and Labor Nagel and President Taft, it was at once
seen that the Bureau of Fisheries, for the purpose of protecting
fish cultiire against the ravages of this disease and for the purpose
of properly studying this disease in fish under suitable condi-
tions, should be provided with a biological station for the study
of fish disease. The message which the President transmitted to
Congress en April 9th is herewith submitted:
Eetport of the Cancer Labokatory 351
CANCER IN FISHES
Message from the President of the United States, Transmitting
Communications from the Secretary of Commerce and Labor,
the Commissioner of Fisheries, and Dr. H. R. Gaylord, Di-
rector of the New York State Cancer Laboratory, in Respect
to the Necessity for an Active Investigation into the Subject of
Cancer in Fishes.
April 9, 1910. — read, referred to the Committee on Interstate
and Foreign Commerce, and ordered to be printed.
To the Senate and House of Representatives:
I transmit herewith communications to me from the Secretary
of Commerce and Labor, the Commissioner of Fisheries, and Dr.
H. R. Gaylord, director of the New York State Cancer Labora-
tory, in respect to the necessity for an active investigation into the
subject of cancer in fishes, and I respectfully request an appro-
priation of $50,000 for the purpose of erecting one or more labora-
tories at suitable places and to provide for the proper personnel
and maintenance of these laboratories. Were there a bureau of
public health as I have already recommended, the matter could
be taken up by that bureau and if in the wisdom of the Congress
it should be provided in the near future, all such instrumentalities
as that for which appropriation is here recommended may be
placed in that bureau as the proper place for research in respect to
human diseases.
I have directed the Secretary of Commerce and Labor and the
Secretary of the Treasury to forward an estimate for the appro-
priation here recommended, in accordance with the procedure
provided by law.
The very great importance of pursuing the investigation into
the cause of cancer can not be brought home to the Congress or
to the public more acutely than by inviting attention to the
memorandum of Dr. Gaylord herewith. Progress in the pre-
vention and treatment of human diseases has been marvelouslv
«
aided by an investigation into the same disease in those of the
352 State Depabtment of Health
lower animals which are su'bject to it, and we have every reason
to believe that a close investigation into the subject of cancer in
fishes, which are frequently swept away by an epidemic of it, may
give us light upon this dreadful human scourge.
WM. H. TAFT
The White House, April 9, 1910.
Department of Commerce and Labor,
Office of the Secretary,
Washington, D. C, April 8, 1910.
My Dear Mr. President : — I have read the letter of Com-
missioner Bowers to you on the subject of cancer in fishes, and
have also had an interview with Dr. Gaylord. I join in the
recommendations of the Bureau of Fisheries, because the inquiry
into the disease can no doubt be most advantageously pursued by
investigation into the same disease as it is found to prevail in
lower animals. A further reason for the investigation is that
cancer among some of the species of fish seems to have reached
such proportions that we are confronted with the problem whether
we shall control the disease or abandon the hatcheries.
The subject is one which appeals to the judgment so strongly
that I can not believe Congress will entertain any doubt as to the
propriety of the appropriation.
Very sincerely yours,
CHARLES :N^AGEL,
The President, Secretary
The White House.
Department of Commerce and Laror,
Bureau of Fisheries,
Washington, April 7, 1910.
To the President : — With reference to the data for a special
message on the subject of cancer in fishes submitted to you by
Dr. H. R. Gaylord, director of the New York Stat^ Cancer Lab-
Report of the Cancer Laboratory 353
oratory, I would say that the bureau regards this matter as of
great importance and concurs in his statements. Your attention
is respectfully called to the accompanying extract from my last
annual report to the Secretary of Commerce and Labor, outlining
the joint investigations already undertaken and showing the posi-
tion of the bureau with reference to the continuation of this work.
I feel that unless this situation is handled energetically,
promptly, and by a highly efficient staff of specialists, the fish-
cultural operations of the bureau and of all the States will be
seriously handicapped and placed in such a position in the mind
of the public as to greatly impair its usefulness.
The bureau has been giving to the subject all the attention
which the resources and facilities permit, but it is fully realized
that the conditions already disclosed demand a special laboratory
and staff for the determination of the cause and prevention of this
most serious malady.
If Congress will promptly authorize Uie construction of the
necessary laboratory, at an estimated cost of $50,000, to be Iccated
on an advantageous site to be selected later, and provide for its
proper personnel and maintenance, there is every reason to believe
that our fish-cultural work will s<^K>n be reliev^ed of this great im-
pediment, and coincidentally there will l>e acquired information
that will be invaluable in the elucidation of the cancer proiblem as
related to human beings.
This work can, of course, be properly conducted only in this
bureau, and I would suggest that your message should specify that
the proposed appropriation be made for this bureau, under which
conditions we are assured of the continuation of the joint investi-
gation already referred to with the IN'ew York State Cancer Lab-
oratory, which is the only institution that possesses several years'
experience with this particular phase of the cancer problem.
Very respectfully,
GEO. M. BOWERS,
Commi^siotier
12
354 State Depabtment of Health
[^Extract from the report of the Commissioner of Fisheries to the
/Secretary of Commerce and Labor for the fiscal year ending
June 30, 1^09.]
Study of Fish Diseases
The bureau has continued to give attention to the diseases to
which fish, particularly when under domestication, are liable, and
during the past year has devoted special consideration to the oc-
currence of cancers and other tumorous growths. Tumors in fish
have been known for many years, and the bureau has from time
to time collected specimens of various kinds of tumors from dif-
ferent species of fish. Owing to the activity that has characterized
the investigation of cancer during the past ten years, cancer in
the lower animals, and in fact in all the vertebrates, becomes a
subject of great interest.
Certain types of cancer appear to be more frequent than others
in domesticated fish ; and cancer of the thyroid gland has been ob-
served at various time in trout and salmon at government and
other hatcheries. Of late the disease seems to be on the increase,
and the bureau has undertaken a thorough and systematic investi-
gation of the entire subject of cancer in fish, and to this end has
availed itself of the services of the director of the New York
State Cancer Laboratory, who will pursue his studies in conjunc-
tion with the regular work of that institution. The Forest, Fish,
and Game Commission of the State of New York also will co-
operate in this work.
The inquiries already made have shown that the subject is very
important and will require thorough study covering a considerable
period of time. Careful investigation has been made in two
localities where the disease is so prevalent as to constitute an epi-
demic; and the work will be extended so as to include a systematic
examination of wild fish in open waters as well as the young and
adult fish in government, state, and private hatcheries. At Buf-
falo, N. Y., where it is proposed to conduct experiments on fishes,
arrangements have been made for the installation of two aquaria
on the closed-circulation plan, with full provision for refrigeration
and aeration of the water. The bureau is fully alive to the far-
reaching importance of this investigation, and will devote every
Keport of tue Cancer Laboratory 355
energy and facility at its disposal for the prompt and thorough
elucidation of the problems of the cause and prevention of this
most serious malady.
[^Memorandum given to the President by Dr, U. R, Gaylord,
Director of the New York State Cancer Ldbomtory.']
One woman out of every eight, beyond the age of 35, dies of
cancer, and one man out of every eleven.
This terrible disease has increased of late years in all civilized
countries. In the United States from 9 deaths per 100,000 of
population in 1850 it had risen in 1900 to 43 deaths per 100,000.
In the registration area of this country in 1906 it was 70 per
100,000. This astonishing increase has raised the deaths from
this cause so that now approximately half as many die of cancer
as tuberculosis.
The cause of cancer is not yet known, but investigations of the
most promising character are being pressed under the inspiration
of entirely new ideas, and in tliis work American scientists are
taking a leading part.
The most fruitful of these new lines of investigation has to do
with experimentation on and the distribution of cancer in lower
animals.
Domestic animals of various sorts are subject to the disease.
In the United States as well as continental countries cancer in
man is most prevalent in the well wooded, well watered, and
mountainous regions or in poorly drained areas with alluvial soil.
These facts have attracted the attention of scientists to the pos-
sible prevalence of cancer in fish.
We now know that fish are subject to various types of cancer,
certain varieties being subject to epidemics of cancer which have
destroyed thousands in a single summer.
The disease has spread to such an extent that it already con-
stitutes a menace to the propagation of this variety of fish. It is
a further astonishing coincidence that the distribution of this
variety of fish and the concentration of cancer in man in this
country are almost identical. A map of one might well be taken
as a map of the other.
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on the calendar at the end of the session just closed, it failed to
pass. For this reason the expected aid to fish culture by the
establishment of a government laboratory is, for the time being,
postponed and the State of New York will have to meet this
serious problem in some suitable way. A conference with the
Commissioner of Forest, Fish and Game will be held shortly for
the purpose of determining how facilities for the continuation of
this work may be secured at one of our State hatcheries and means
found for the elimination of this important menace to fish culture.
Geographical Study of Goiter and Cancer in Man. There is
reason to believe that goiter in human beings is increasingly
prevalent in this country. With the knowledge we now have of
the distribution of the disease in fish and the evidence indicating
that it is an infectious disease transmitted by the water, at least
90 far as the fish are concerned, it becomes a matter of great im-
portance to determine the distribution of goiter in the State of
New York. The later phase of this disease in fish is cancer of the
thyroid gland. The intimate relationship between goiter and can-
cer of the thyroid in man is well known. No less an authority on
this subject than Professor Kocher told me in October last, on the
occasion of the International Cancer Congress in Paris, that he
had never known a case of cancer of the thyroid which had not
begun as goiter. There is also a geographical relationship be-
tween the distribution of goiter in man and cancer in man.
Gherard has shown that the geographical distribution of goiter
and the distribution of cancer in Switzerland are almost identical.
There is furthermore a rapidly increasing literature indicating a
relationship between water and cancer. In this connection the
distribution of cancer in the United States at the time of the
census of 1900 shows that cancer is most prevalent in the moim-
tainous, well wooded and well watered regions of the United
States. It is very desirable that the geographical distribution of
cancer in the State of New York at the present time should be
definitely determined on a basis of new statistics, covering care-
fully the question of etiologj^ and that such statistics properly
collected should be compared with the distribution of goiter.
International Cancer Congress. In 1908 following a proposal
which originally emanated from this laboratory an international
358 State Depabtment of Health
congress for the consideration of cancer was held in Heidelberg
and Frankfort, on the occasion of the opening of the cancer lab-
oratory and hospital directed by Professor Czerny. The circum-
stances leading to the orgajiization of this congress were such that
America was not represented by any of its qualified investigators.
At that time there was formed an international society for the in-
vestigation of cancer. The American Association for the Investi-
gation of Cancer was organized in the spring of 1908 and became
a component part of this society in 1909 and has been co-operatinj?
with the international society since that time. The second Inter-
national Cancer Congress was held in Paris from the first to the
fourth of October, 1910, under the patronage of the President of
the French Eepublic. The American Association for Cancer
Research sent oflScial delegates to this convention and the director
of this laboratory was designated as one of these del^ates ; there-
fore, as the official representative of the State* laboratory and as
an accredited delegate of the American Association for Cancer
Research, he attended the congress. The international commit-
tee in forming the official program for the congress honored this
institution by naming the director in company with Professor
von Dungern of the Heidelberg Institute, to present to the con-
gress the subject of immunity to cancer. The congress was opened
in the Ecole de Medicine on the first of October by the minister
of education, who, in his address, referred in a complimentary
way to the early and important work of the American investiga-
tors of cancer. The sessions of the congress continued on the
third, fourth and fifth of October. The delegates were received
officially by the mayor and heads of departments of the city of
Paris in the Hotel de Ville on October fourth and were officially
entertained on the fifth by the Academy of France at Chantilly.
There were over 300 registered attendants at the congress and
thirty-eight countries were officially represented. At least 100 of
the registered scientists were specially engaged in cancer research
and perhaps fifty of them exclusively engaged in the investigation
of cancer. The United States sent five accredited delegates. The
underlying note of the congress appeared to us to be the increased
importance attributed by many investigators to the parasitic
theory of cancer. The principal topics of discussion were the
phenomera of immunity and there were reported to the congress
Repoet of the Cancer Laboeatory 359
several cases of cure by vaccination. This laboratory was able to
report the apparent euro of a case of sarcoma in a boy by this
method. Professor Bertrand of Antwerp showed a case which
had been free from evidence of cancer for over a year following
the disappearance of cancer of the breast after treatment by this
method, and two cases of inoperable sarcoma were reported from
Denmark by Rovsing and Madsen. We believe that the principle
on which this method of vaccination is based was first scientifically
demonstrated in animals in 1907 in this la'boratory, which ex-
periments have been referred to in the annual reports of 1908 and
1909. The advance which we were ourselves able to report to
the congress related to the observation first reported in May,
1910, before the American Association for Cancer Research in
Washington, that vaccines prepared from transplantable cancers
in animals produced the same reactions and apparently served
the same purpose in the vaccination of human beings as vaccines
prepared from human growths. It is impossible to determine
what the possibilities of this method may be. It seems best ap-
plicable to cases in the early stages of the disease and has only
given results in selected and favorable cases. The method is cer-
tainly not applicable in its present form to the later stages of the
disease. Tip to the present time we have been obliged to work
with vaccines made from tumor growths which are composed
largely of the tissue of the animal or the individual from which
the tumors are derived. It is our belief that in the future a
method of separating the essential factor from these masses of
tissue may be found, in which case the outlook for vaccination as
a means of treating cancer will be greatly improved.
Parasitic Theory of Cancer. Since 1901 this laboratory has
constantly supported the parasitic theory of cancer. This theory
has dominated the research of the laboratory and has been the
principal factor in suggesting to us lines of experiment which
have proven fruitful. It was the belief in this theory which,
in 1904, led to the discovery of immunity in cancer, now recog-
nized as having been first demonstrated in this institute. Efforts
to test the parasitic theory of cancer by a crucial experiment have
been frequently attempted. In an article on The Analogy he-
twcen Smallpox and Cancer in which a comparison was drawn
360 State Department of Health
between certain features of these diseases, it was pointed out that
in smallpox, vaccine and sheep-pox we had a filterable agent^
and that one point in which tiie comparison up to that time,
failed, was in the attempts to secure a filterable agent in cancer,
but it was pointed out that if such experiments could succeed, we
had almost a complete case for cancer as a parasitic disease. At-
tempts to accomplish the separation from the cancer cell of an
agent capable of producing cancer have been made from time to
time in many laboratories. It is now evident, in the light of
recent developments that some of these attempts have been partly
successful, but were not so recognized. Within the last few
months Dr. Peyton Kous of the Rockefeller Institute, in working
with a transplantable sarcoma (cancer) in the chicken, repeated
these filtration experiments with success. On transferring his
operations to a room heated to body temperature, he succeeded
in passing the agent through a so-called germ proof filter and
with the filtrate thus obtained, he obtained tumors in four out of
ten inoculations. This evidence when extended to other forms of
transplantable laboratory cancers will complete the basis of rea-
soning on which we originally took our stand in favor of the
parasitic theory of cancer, and again endow with significance
the original experiments reported from this laboratory in 1901, in
which in two cases, the peritoneal fluid from human cancer cases
produced tumors in animals after injection into the circulation
of these animals. It is interesting to note that at that time we
took precautions to keep the fluid at body temperature and handled
it by the identical method which has yielded these results which
Dr. Rous has recently reported. It is needless to point out that
the establishment of the parasitic theory of cancer can only endow
us with the greatest feeling of optimism as to the future of cancer
research. If cancer is an infectious disease then it is preventable
and curable and it now behooves us to perfect experiments to
determine the exact nature of the agent, and then continue the
investigations into the nature of the immunity developed in can-
cer and the developments of the recent suggestive results which
indicate the possible value of the principle of vaccination.
One characteristic of the International Congress was the pre-
vailing feeling of optimism; it was the Mief of almost every
Report of the Cancer Laboratory e*]61
one tJiat caucer research has now advanced to the point where we
shall shortly find means of applying to human iKungs the modern
fact^ wo have determined hy pi-olongcd and careful experimenta-
tion with animals.
Value of Animal Experimentation. Xo better evidence of the
value of experimentation upon animals can be found than in the
modern cancer research. Up to 1900 when experimentation with
cancer animals was generally begim, cancer research had not pro-
gressed appreciably in the preceding twenty-five years and none
of the most vital facts relating to the possibilities of cure for
cancer as they now appear were known to medical scienca These
experiments have been carried out without the infliction of cruel-
ties or severe pain of any sort on the animals, and we are to-day
able to begin the application of facts thus obtained to human
beings, with knowledge and some certainty of the results to be
obtained; whereas if we had continued the older methods we
should have had to conduct prolonged and probably fruitless ex-
perimentation upon human beings. If those who advocate the
restriction of vivisection could only know the agony of mind
and the suffering of those condemned to death through this terri-
ble disease, they would better appreciate the services to humanity
now being accomplished through the sacrifice of a few thousand
rats and mice. For some time past in this laboratory we have
been able to successfully treat animals afflicted with cancer,
whereas we are only now prepared to apply these principles to
human beings.
Application of New Principles to Treatment of Human Beings.
It is because these more recent methods are based upon a scien-
tific foundation that the favorable results obtained, although very
meager, are of so much significance. The time has come when
all research laboratories must begin the application of these facts
to human beings and it is for this reason that those institutes
which are equipped with hospital facilities will shortly take the
lead in cancer research, whereas those which are not equipped
with such facilities under their immediate direction are now seek-
ing a means of accomplishing this end. At a meeting held in
Boston in April, 1910, for the purpose of raising funds for a
hospital for incurable cases of cancer, to be under the management
362 State Department of Health
of the Harvard Cancer Commission, ex-President Eliot of Har-
vard University spoke in the following words : " I suppoee we all
know that cancer is the most horrible disease which afflicts
humanity.
" Now, the terrible nature of the disease being clearly in our
minds, what is there to encourage us to hope that science is going
to find a remedy? The basis of hope is the wonderful series
of conquests over formidable disease which has been achieved
during the nineteenth century and the few years of the twentieth.
The conquest of diseases by the progress of medical science and
research is one of the most extraordinary phenomena of the nine-
teenth century. When we look back to .Tenner's discovery, vac-
cination against smallpox, we see the starting point of a wonder-
ful series of rapid and effectual discoveries in preventive and
curative medicine, preventing the spread of formidable diseases,
and curing formidable diseases. That is the blessed encourage-
ment we feel to expect the successful discovery of means of pre-
vention and of cure for cancer. Now that hope is strong, firm,
assured. Without such hope we should hardly 'be justified in
urging the free expenditure of money in the pursuits of defense
against cancer. With that hope we are fully justified in urging
a liberal expenditure in the continuous search for the means of
preventing and curing this formidable disease."
Cancer Hospital. The New York State Cancer Laboratory
has now reached a point where the work of the last thirteen years
justifies the erection of a hospital to accommodate twenty-five or
thirty patients, for the study of cancer in human beings and the
development of methods of treatment. This laboratory was begun
by a State appropriation made in 1898. In 1901 the work which
had up to that time been accommodated in two or three rooms of
the medical school building of the University of Buffalo, through
the munificence of Mrs. William H. Gratwick was provided with
the present laboratory building, erected upon a site provided
with funds subscribed by public spirited citizens of Buffalo.
Through this generous act of Mrs. Gratwick the State for ten
years has occupied for the purposes of this work a perfectly ap-
pointed building. The influence upon the work and the stimulus
which this high minded act of Mrs. Gratwick's has been to the
Report of the Canceb Labobatoby 363
workers of the institution cannot bo overestimated. It is there-
fore a pleasfire to announce tnat Mts. (iratwick is now prepared,
if cenain conditions are lultilled by tlie b-tate, to deed tnis nand-
sonie building to tne tttate. It is lurthermore proposed, in order
that a suitaDle hospital may be erected immediately adjacent to
the laboratory, to purchase with funds to be subscribed by iJulfalo
friends of tne laboratory an extensive site adjoining on the west
whicli, with the present property will likewise be deeded to the
State. In order to accomplisli this purpose a bill has been intro-
duced in the JSenate and Assembly, entitled '*An act to amend
the public health law, in relation to the establishment of a State
institute for the study of malignant disease at Buffalo, providing
for its management and control, and making an appropriation
therefor." The time has come when this laboratory, if it is to
fulhll its final purpose to the people of the State of New York,
should be given a more definite form. Therefore, this bill pro-
vides that the new hospital to be erected by the State and the
Gratwick Laboratory together, shall be known as the State In-
stitute for the Study of Malignant Disease, under the manage-
ment of a board of trustees. The trustees named in the bill are
Roswell Park, M. D., Buffalo; John G. Milburn, New York;
William H. Gratwick, Buffalo; Frederick C. Stevens, Attica;
Charles S. Fairchild, New York; Charles Gary, M. D., Buffalo.
The commissioner of health, is ex officio a member of this board of
trustees. It is fair to remind the Legislature that this laboratory
is the first research institution in the world established for the
investigation of cancer; that since the inauguration of this work
by the State, nearly all the prominent countries have established
like institutions modeled after it. The institute under Professor
Czemy in Heidelberg opened in 1908 has enjoyed from the first
hospital and laboratory facilities combined. The Imperial Can-
cer Institute at the Charite Hospital likewise has hospital and
laboratory facilities. The cancer commissioner of Harvard Uni-
versity has just made provision for the erection of a hospital of
about the size contemplated for this institute, and this laboratory
now lags behind these institutes, although it was the first in the
field and has contributed largely to the advance of cancer re-
search. The property which it is now proposed to deed to the
364 State Dep.vbtment of Health
State represents an actual investment of not less than $85,000,
is centrally located within a block and a half of tl^e University
of Buffalo Medical School. Such a site in the city of New York
would cost many times this sum. The citizens of Buffalo are there-
fore providing the State with an institution complete in every
respect except for a hospital building, which it is now asked that
the State shall provide.
International Hygiene Exposition
In 1911 there will be held in Dresden, Germany, an Interna-
tional Hygiene Exposition under the patronage of the King of
Saxony. An honorary committee of great German statesmen and
scientists has been formed and invitations have been issued to
all the civilized countries. Under the grouping of each disease,
special international committees have been designated and I have
the honor to state that the director of this laboratory has been
named by the general committee of the exposition as a member of
the group committee for the subject of cancer and also as a mem-
ber of the general committee of the United States. This lab-
oratory is preparing to exhibit photographs illustrating the re-
sults of our work. It is of special interest to note the list of sub-
jects designated in the prospectus of the congress for exhibition
under the subject of cancer.
Scheme for Exhibition on Cancer Diseases
Occurrence in men, animals and plants.
Endemic, local prevalence — cancer houses — cancer fami-
lies.
Origin of cancer diseases.
Heredity.
Infection theory — degeneration theory.
Cancer in relation to occupation (chimney sweeps, paraffine,
aniline, arsenic, rontgen rays, radium).
Connection between cancer in man and cancer in plants and
animals.
Influence of nutrition and metabolic diseases on the origin of
cancer.
Significance of syphilis for cancer.
Relation of cancer to injuries by accident.
Ebpobt of the Cancer Laboratory 365
Campaign against cancer diseases.
Protective measures against the further dissemination of
cancer (obligatory notification? Disinfection?)
Success of therapy. Operation statistics. Advantages of
early operation.
Utility of other methods of treatment.
Disposal of incurables.
Mortality statistics; increase of cancer. — The mortality from
cancer and tuberculosis in the State of New York for the years
1909 and 1910 was as follows:
1909 1910 IncreMe
Cancer 7,034 7,505 471
Tuberculosis 13,948 . 14,047 99
This is an increase in cancer over the previous year of 471
and in tuberculosis of ninety-nine. These figures show that in
spite of the increasing population tuberculosis is practically sta-
tionary while cancer has notably increased.
Bulletin eight of the mortality statistics of the United States
census bureau which covers eighteen r^istration States and fifty-
four cities in the nonregistration area, with an estimated popu-
lation of 44,877,893 which is approximately 53 per cent of the
population of the United States in 1909, is now available. The
real population is found by the census just completed to be
91,500,000 and from this it appears that the registration area
represents about half the population. Therefore these figures
already given may be safely doubled to obtain an estimate of the
cases of tuberculosis and cancer in the United States at the time
of the last census 1909. This gives us tuberculosis, 163,000;
cancer, 75,000.
The estimated population of the Stat« of New York is 9,000,000
and the deaths in 1909 were 7,034. This indicates that the deaths
from cancer are a little more frequent in the State of New York
than the average indicated by the estimated statistics for the
entire country. On the basis of 75,000 deatlis from cancer for
the year 1909 estimated from the above bulletin, it is safe to
assume that there are not less than 200,000 sufferers from cancer
in the United States and on the same basis not less than 20,000
366 State Depabtmbnt of Health
cases in the State of New York. The relative increase of cancer
pointed out in our last annual report therefore continues and
cancer is steadily becoming a greater and graver problem. The
purpose of this institute is to determine the nature of cancer and
to find means for its prevention. It represents the modem con-
ception of preventive medicine and it is hoped that by the State
continuing to pursue the policy already inaugurated, the increas-
ing demands upon the State to support the indigent sick may
never include this disease. With the present promising outlook
for the establishment of the parasitic theory of cancer, we may
confidently expect that this enormous increase in cancer, when
we are ahle to attack it with enlightened knowledge as to the
cause, may be ultimately checked.
Financial statement. — The statement of the expenditures of the
laboratory for the past year is as follows :
Sept. 30, 1909 — Balance $230 98
1910 — Stock and material 2,241 57
Equipment 3,316 85
Expense 4,445 57
Salaries 11,199 64
Balance 5,565 39
$27,000 00
Sept. 30, 1909 —Appropriation $18,000 00
July 1. 1910— Supply bill 9,000 00
$27,000 00
The balance shown on September 30th is due to tho reduced
activities of the summer months. The increased activities and
expenses in the winter months will absorb this sum during the
current year.
It has been possible to increase the activities of the laboratory
during the past year and with our increasing responsibilities and
opportunities for work, the staflF of the institution has been some-
Eepoet of the Cancer Laboratory 367
what enlarged. Dr. Burton T. Simpson has been added to the
staflf as clinical pathologist. Dr. F. C. Busch is now connected
with the laboratory as temporary assistant and there have been
several other additions to the staff, so that the laboratory now em-
ploys regularly seventeen people. Mr. Millard C. Marsh of the
Bureau of Fisheries in Washington and an assistant, A. B.
Hardie, have been stationed at the laboratory by the government
during the past year.
The appropriation for the coming year should be not less than
that of the present year, $3'2,000, and if the State begins the
erection of the much-needed hospital, an item of $10,000 should
be placed in the supply bill to enable us to open the hospital when
completed and maintain it until the meeting of the next Legis-
lature when an appropriation for its maintenance should be pro-
vided.
The ultimate activities of this institution on a basis to enable
it to successfully cope with the important problem of cancer will
ultimately require from the State about three dollars per annum
for every case of cancer in the State of New York. It may well
appear that the expending of a sum so small in the fight against
a disease so important and so disastrous is but a small demand
upon the finances of the State in the interest of the public welfare.
Very truly yours,
HARVEY R. GAYLORD, M. D.,
Director
DIVISION OF ENGINEERING
[369]
CONTENTS
Report of Chief Engmeer:
I. Sewerage and sewage disposal: page
(a) Examination and approval of plans for sewerage and sewage disposal:
Auburn 381
Auburn (State Prison) 382
Binghamton 385
Blauvelt (State Rifle Range) 385
Bronxville 386
BronxviUe and Tuckahoe 388
Chappaqua (Convalescent's Home) 389
Clarence (Buffalo Automobile Club) 391
Clifton Springs (Clifton Springs Sanitarium) 394
Comstock (Great Meadow Prteon) 395
Dannemora (Clinton Prison) 397
Depew 398
Elka Park (town of Hunter) 398
Fulton 401
Fultonville 407
Hastings-on-Hudson 408
Hempstead 414
lUon 420
Johnstown 422
Lestershire 427
Letchworth Village 429
Long Beach 431
Medina 433
Monroe County Tuberculosis Hospital 433
Monticello 434
New Rochelle 435
North Tonawanda 438
Ogdensburg 440
Oneonta 442
Oswego 443
Pelham 447
Pelham (Town) 449
Poughkeepsie 451
Rochester 452
Rockaway Beach 468
Rome 471
Sonyea (Craig Colony for Epileptics) 473
Spring Valley (Salvation Army Orphanage) 474
Stamford 476
Ticonderoga 476
Tuckahoe 477
Utica : 477
Watertown 479
Westfield 479
Yorkville 483
Individual Permits 487
(b) General investigations relating to sewerage and sewage disposal:
Akron 488
Central Islip (State Hospital) 490
Cheektowaga 498
ComwaU-on-Hudson 499
East Syracuse 500
Geneva 501
[371]
372 Contents
I. Sewerafce and sewage disposal — Continued:
(b) General inveetigationB relating to sewerage, etc. — Continued: paok
Hamburg 501
Hastings-on-Hudson 601
Long Beach 602
MartviUe 502
Morristown 602
New PaltB 503
Nyack 604
Phelps 506
Port Jefferson 506
Ravena 606
Ray Brook 606
Riverhead 607
Rome 608
Theresa 608
Victor 610
Warwick 610
Yonkers 612
Yorktown Heights 614
List of other investigations 516
II. Protection of public water supplies:
(a) General examination of public water supplies:
Blauvelt (State Rifle Range) 519
Cold Spring 521
Coming 623
Delhi 626
Dobbs Ferry 526
Letchworth Village 527
Monticello 627
Niagara FaUs 628
Ogdensburg 533
Skeineateles (town) 533
Waterloo 535
(b) Preparation of rules for the protection of public water supplies:
Haverstraw Water Supply Company 541
Syracuse Suburban Water Company 545
(c) Inspections of violations of rules for the protection of public water
supplies:
Auburn 549
Kingston 549
Mt. Vernon 549
New Rochelle 549
New York City 549
Saugerties 549
Utica 549
Yonkers 549
(d) Investigation of sanitary conditions on watersheds protected by rules 550
(e) Special investigation of public water supplies:
East Worcester 553
Fonda 556
Glens FaUs 558
Kingston 560
Lyons '. 566
North Tarry town (Consolidated Water Co. of Suburban New York) 569
Oxford (Woman's Relief Corps Home) 572
Round Lake 574
Rouses Point 576
Seneca Falls 581
Sonyea (Craig Colony for Epileptics) 584
Whitehall 586
OONTENTS 373
III. Investigation of outbreaks of typhoid fever: page
Hobart 593
Long Lake and Webb (towns) 600
Moravia 603
Quarryville (town of Saugerties) 609
Rouses Point 612
Syracuse 612
Syracuse (State Institution for Feeble-Minded Children) 612
Willard State Hospital 6I3
Yonkers 61 6
IV. Investigation of complaints relating to stream i)ollution:
Allegheny River 628
Augur Lake (town of Chesterfield) 631
Brant Lake (town of Horicon) 633
Bronx River 635
Cortland 638
Esperance 640
Harriman 640
Oneonta 642
Piermont 645
List of other cases of stream pollution 646
V. Investigation of public nuisances not arising from stream pollution:
Greenport 649
IsUp 650
Nidcayuna 651
North Salem 652
Port Chester 654
Vestal 655
Watervliet 656
list of other cases of nuisances 658
VI« Investigations ordered by the Governor:
Bufifalo (Bird Idand pier sewer) 671
Syracuse (typhoid fever) 662
VII. Inspection of rendering plants:
Barren Island 675
Cheektowaga 676
Rochester Tallow Company 678
VIII. Special investigations:
(a) Investigation of sanitary conditions of cities and villages 681
(b) Investigation of illegal sewer construction 682
(c) Sanitary inspection of summer resorts 684
(d) Investigation of sanitary conditions of State institutions:
West Haverstraw (New York State Hospital for the Care of
Crippled and Deformed Children) 688
(e) Sanitary inspection of labor camps 694
IX. Engineering Division exhibit at the State Fair 697
REPORT OF THE CHIEF ENGINEER
Eugene H. Porter, M.D., St<ite Commissioner of Health, Albany,
N. Y.:
Dear Sir: — I have the honor to submit herewith the report of
the work of the Engineering Division for the year 1910.
Experience during the past five years with methods which have
been gradually developed from year to year to meet the exacting
requirements of securing eflFective results with a limited organiza-
tion indicates in the character and amount of work accomplished
during 1910 that not only have these methods been carefully
gauged with respect to these requirements but that no material
changes are desirable with our present limitation as to resources.
The routine work of the division for 1910 has shown the usual
yearly increment in volume, and as has been pointed out on former
occasions this increase can only be accomplished in the future with
the present organization by a curtailment, if not a sacrifice, of
some of our special investigation work, much of which previous
experience has demonstrated is essential in forming a resource or
a working capital (as it were) for many lines of regular current
work required under the Public Health Law. Notwithstanding
the pressure of work during the past year, however, especially in
the field of special investigations, and the fact that it has been
necessary to abandon certain investigations that have been carried
on for a number of years, it has been possible to concentrate the
eflforts of the division upon certain other special investigations
which our experience has proved to be of considerable importance
and productive of marked results in a practical way in the con-
servation of the public health of the State.
I refer more particularly to the importance and necessity of
concentrating more attention on the conservation of water supplies
in the future than has been done in the past. Not that we should
in any way relax our efforts in restricting stream pollution, for
this restriction does, and always must, bear an intimate relation,
and in many cases be a prerequisite, to the protection of water
supplies. That it is not the sole prerequisite, however, nor in
[375]
376 State Department of Health
many cases a deciding nor even a relatively important one con-
cerning public health we are rapidly coming to learn; and if we
as a Department are to stand ready to accomplish practical re-
sults we must accept promptly the teachings of experience and
take action in accordance with them. In fact the lesson seems to
force itself upon us with eueh year's experience under existing
conditions in this State that public health can be more effectually
conserved through an improvement in sanitary conditions of
streams used for water supplies than through the indiscriminate
restriction against pollution of streams not so used.
So important is this principle and far reaching in its effect upon
public health and the future work of this division, that it de-
serves more than passing notice. We cannot point out too strongly
that it is in the contaminated water we drink and not that which
flows through our community, even though at times it creates a
nuisance from odors, so long as it is not used for potable purposes
without purification, that the danger of contracting typhoid fever
and other communicable diseases lies; and conversely if in the
future we focus our attention on the conservation of our smaller
streams used largely for potable purposes without purification,
and see to it that our other, and, as happens, more numerous and
larger streams, which ordinarily cannot safely be used for water
supplies without purification, are kept in such reasonable degree
of purity as will prevent any local nuisances and insure at all
times a sufficient degree of purity as will make it safe after purifi-
cation, not only will there be a more general conservation of public
health but also of public wealth. In fact the principle of economy
can be no more disregarded in the field of sanitation than in other
fields of engineering; and although we can never sanction the
popular tendency ofttimes observed of judging public health im-
provements by the standard of money value only, our obvious duty
is to see that what money is expended for health work is so con-
served and directed along economical lines as will result in the
greatest saving of human life.
From a strictly engineering standpoint the year 1910 has been
marked by the more general introduction of two comparatively
new principles and methods of water purification and sewage dis-
posal. One is an application of the principle of disinfection or
Report of the Chief Engineek 1577
sterilization of water by the use of hypochlorite of lime ; the other
is the clarification of sewage by the application of the combined
principle of sedimentation and prolonged septic action, accom-
plished in tanks of special design.
Although the sterilization of water by application of various
chemicals is nothing new in principle its application on a practical
and economic scale is, however, of comparatively recent date ; and
during 1910 the introduction of sterilizing plants in conjunction
with other methods of purification or independently has been quite
marked through the State. The views of the Department have
been frequently asked in regard to it and it might be well to state
now that whereas its success has been marked in many cases and
it is destined to play an important part in the future in connec-
tion with water purification, especially as a finishing process to
sand filtration, there is yet much to learn in regard to its general
adaptability to waters of varying qualities. With our present
limited knowledge and experience, therefore, the Department can-
not at this time recommend its general and unrestricted applica-
tion as an independent process, or as a substitute to well tried,
eflScient methods of sand filtration except in cases of emergency or
for temporary use pending the construction of more reliable
methods. It is expected, however, that these views may be modi-
fied in the future as knowledge and experience is joined with this
method of purification.
In r^ard to the introduction of the new type of sewage tank
referred to above for the clarification of sewage it may be said
that although this so-called *' Imhoff Tank '^ has been used with
marked success in the Emscher District in Germany it is prac-
tically a new device in this country ; and that although it has not
up to the present time been applied on a practical scale except in
experimental plants it has, however, been included in a number of
sewage disposal designs presented to and approved by the Depart-
ment This tank is designed not only to remove efficiently the
suspended matters in the sewage but to so control and store the
sludge formed that it may be removed and disposed of in a con-
venient and innocuous manner; and if the results soon to be
tried out in practice in this State prove as satisfactory as they
have Iwen in Germany whore, however, the sewage is of a some-
378 State Depabtment of Health
what different character, these tanks may prove of considerable
value to many municipalities from not only a sanitary but an
economical standpoint.
The personnel of the permanent staff of the Engineering
Division during 1910 has remained the same as during the pre-
vious year with one exception — the resignation of Mr. Chas. F.
Breitzke, Assistant Engineer, to accept a position with the board
of water supply of New York city, and the appointment in his
place of Mr. A. 0. True of New York city, who at the time was
in the employ of the consulting engineering firm of Hering &
Fuller. As has been the custom in previous years, special engi-
neering inspectors were employed during the summer months;
fcur during the months of June to September, in connection with
the special investigation of the sanitary condition of summer
resorts; and five in the month of September in connection with
the special investigation of the sanitary conditions of certain
watersheds of the State used for public water supplies and pro-
tected by special rules and regulations enacted by the State
Department of Health.
In the subject matter of this report, as well as in the general
execution and manner of filing of correspondence and records of
the entire work of the Division, substantially the same classifica-
tion of subjects has been adopted as in previous years and as
presented in my former annual reports to you. This classifica-
tion will not be rejx^ated here since it has been adopted in the
arrangement of the index of this report and is presented in full
in this index.
EespectfuUy submitted,
THEODORE HORTON,
Chief Engineer
SEWERAGE AND SEWAGE DISPOSAL
1370]
378 State Depabtment of Health
what different character, these tanks may prove of considerable
value to many municipalities from not only a sanitary but an
economical standpoint.
The personnel of the permanent staff of the Engineering
Division during 1910 has remained the same as during the pre-
vious year with one exception — the resignation of Mr. Chas. F.
Breitzke, Assistant Engineer, to accept a position with the board
of water supply of New York city, and the appointment in his
place of Mr. A. 0. True of New York city, who at the time was
in the employ of the consulting engineering firm of Hering &
Fuller. As has been the custom in previous years, special engi-
neering inspectors were employed during the summer months;
four during the months of June to September, in connection with
the special investigation of the sanitary condition of summer
resorts; and five in the month of September in connection with
the special investigation of the sanitary conditions of certain
watersheds of the State used for public water supplies and pro-
tected by special rules and regulations enacted by the State
Department of Health.
In the subject matter of this report, as Avell as in the general
execution and manner of filing of correspondence and records of
the entire work of the Division, substantially the same classifica-
tion of subjects has been adopted as in previous years and as
presented in my former annual reports to you. This classifica-
tion will not be repeated here since it has been adopted in the
arrangement of the index of this report and is presented in full
in this index.
Eespectfully submitted,
THEODORE HORTON,
Chief Engineer
SEWERAGE AND SEWAGE DISPOSAL
[379]
Examination and Approval of Plans for Sewerage and
Sewage Disposal
If the streams of this JState used as sources of water supplies
are to be protected against the dangers of sewage contamination,
and if the remaining ones are to be maintained in a satisfactory
degree of cleanliness, it is essential that some adequate control
over the discharge of sewage into these waters be vested in the
central authority of the State, having jurisdiction broader than
those possessed by local authorities which if left to decide these
questions might be swayed by local interest or prejudice. Such
conitrol is in part granted the State Commissioner of Health under
certain sections of the Public Health Law, which provide that
all plans for systems of sew^erage and sewage disposal of munici-
palities must first be submitted to and approved by him, before
they may be constructed or put in operation ; and that in all such
cases the Commissioner shall stipulate the conditions under which
sewage and wastes from these factories or sewer systems may l)e
discharged.
Under these sections of the Public Health Law, which have
been in efFeot since 190'], the date of the passage of the act, there
is required of the Engineering Division the larger part of its rou-
tine work, comprising the examination of plans for original sys-
tems of sewerage and sewage dispf)sal and of extensions or
modifications thereof, and the preparation of permits containing
the conditions as to degree and extent of purification required and
to the location and manner of discharge of the effluent from the
sewage disposal works.
During 1910 plans for sewerage or sewage disposal works w^re
examined, reported upon and approved in the cases of the follow-
ing municipalities:
AUBURN
On April 4, 1910, application was made by the common council of the city
of Auburn for the approval of plans for a proposed sanitary sewer extension
in Boston avenue. These plans were approved on April 16, 1910, and a permit
was issued, allowing the discharge of sewa^ into the Owasco lake outlet on
condition that whenever required by the State Commissioner of Health com-
plete plans satisfactory to this Department for the interception and treatment
of the entire sanitary sewage of the city or any portion of such sewage, which
[asi]
382 State Depabtment of Health
is not treated by sewage disposal plants now in operation or under construc-
tion shall be prepared and submitted to this Department for approval; and
that within the time limit stated in such requirement the construction of
any or all works shown by said plans as may be specified shall be completed.
On September 14, 1910, application was made by the common council for
the approval of plans for a sanitary sewer extension in North Nelson street.
These plans were approved on September 27, 1910, and a conditional permit,
similar to that granted to the common council on April 16, 1910, was issued,
allowing the discharge into the Owasco lake outlet of sewage to be collected by
the proposed sewer.
Albany, X. Y., April 15, 1910.
EicjEXE II. PoBTEB, M.D., State Commissioner of Health, Albany, N, Y,:
Dear Sir: — I beg to submit the following report on the examination of
plans for a proposed sanitary sewer extension in the city of Auburn, Cayuga
county, submitted to this Department for approval on April 4, 1910, by the
common council.
The plans show that it is proposed to construct an eight-inch sewer in Bos-
ton avenue, having a slope of 1.0 per cent. The sewer is to extend easterly
from the intersection of Fulton street and Boston avenue for a distance of
alwut 280 feet.
This sewer is not within the sewer district in which the sewage disposal
plant is beng constructed, namely, the first, sixth and tenth wards sewer dis-
trict, but will discharge into the existing sewer in F\ilton street, which is
tributary to the present outfall sewer discharging into the Owasco lake out-
let near State street. Plans for the sewer in this section of Fulton street
and that portion of the sewer connecting with the outfall sewer were approved
by the Department on December 18, 1908.
The plans now under consideration have been examined by the Engineering
Division and it is found that -the proposed sewer will have sufficient slope to
produce self-cleansing velocities if properly constructed, and since it will never
be extended will be adequate as to capacity to meet the future requirements
of this portion of Boston avenue.
I, therefore, recommend that the plans be approved and a permit issued,
allowing the discharge of sewage to be collected by the proposed sewer into
the Owasco lake outlet near State street, on condition that whenever required
by the State Commissioner of Health complete plans satisfactory to this De-
partment for the interception and treatment of the entire sanitary sewage
of the city or any portion of such sewage which is not cared for by the exist-
ing sewage disposal plant or to be cared for by the sewage disposal in the
first, sixth and tenth ward sewer district now under construction shall be
prepared and submitted to this Department for approval; and that within
the time stateil in such requirement the construction of any or all works
shown by said plans as may be specified shall be completed.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
AUBURN (State Prison)
On October 6, 1910, plans were submitted to the Department for approval
by the State Architect, which provided for intercepting sewers and pumping
station to collect the sewage of the State prison at Auburn, and discharge
into a section of the city sewer system tributary to the fourth, fifth, sixth
and seventh wards sewajre disnosal plant. These plans were approved on
October 19, 1910, on condition that no storm or surface water from grounds,
roofs or other areas shall be admitted to the sanitary intercepting sewers or
pump well.
Sewerage and Sewage Disposal 383
Albany, N. Y., October 14, 1910.
Eugene II. Pokteb, M.D., State Commissioner of Health, Albany, N, Y.:
DcAB SiB: — I beg to submit the following report on an examination of
plans for a proposed intercepting sewer and pumping station to be constructed
for the purpose of collecting the sewage of the State prison at Auburn and
discharging it into the city sewer system and sewage disposal plant.
These plans were submitted to this Department for approval by the State
Architect on October 6, 1910, together with a copy of the specifications and
a short report stating briefly the oasis of design.
The matter of sewage disposal for this institution has been considered by
this Department from time to time for the past three years. In Deceniber,
1907, Prof. H. K. Ogden, Special Assistant Engineer of the Department, made
a report at your direction of the estimated cost of pumping the sewage of
Auburn prison into the city sewer system and thence into one of the sewage
disposal plants and of constructing and maintaining a separate sewage dis-
posal plant and discharging the purified sewage into the Owasco outlet. These
comparative estimates showed that the cost of disposing of the sewage by
pumping into the city sewer system would be somewhat greater than the
alternate plan of separate disposal. From a purely sanitary consideration,
however, the former plans appear to be the more desirable and practicable
owing to the limited space for a sewage disposal plant within the stockades
of the prison where it would be necessary to locate such plant.
According to the report of the State Architect, the maximum population to
be cared for is 1,600 persons and the present average per capita rate of
water consumption is 110 gallons per day, equivalent to a flow of 122 gallons
per minute. It appears also that the men's prison is at present sewered on
the combined plan and that the sewage and storm water is discharged into
the Owasco outlet at five different, points. The women's prison is provided
with storm water sewers. Practically all of the storm water in the men's
prison which is collected and flows in gutters at present will be intercepted
by a storm water sewer. It appears, therefo/e, that according to the report
of the State Architect the only storm or surface water that would reach the
proposed intercepting sanitary sewers in the present design would be that
from a small grass plat at the eastern end of the grounds of the men's prison
where a large amount of pavement and walk cutting would be necessary in
order to collect a small amount of surface water.
Since the sewage from the prison is to be treated in a sewage disposal
plant that will be taxed almost to its full capacity by the additional contribu-
tion of sanitary sewage from the prison it is essential that even this small
amount of storm water be eliminated from the sanitary sewage to be inter-
cepted and discharged into the pump-well. It will, therefore, be necessary
to divert this storm water and dispose of it in some other way.
The plans now under consideration provide also for the collection and
interception of the sanitary sewage and industrial wastes contributed by the
institution, the discharge by gravity of such sewage and wastes into a piunp-
well located inside of the prison walls and the pumping of this sewage into
the sewer system and sewage disposal plant of the fourth, fifth, sixth and
seventh wards' sewer district.
Upon reaching the pumping station the sewage is to be passed through a
horizontal bar screen with bars spaced one and one-half inches apart in the
clear. Adequate facilities are to be provided for cleaning this screen.
Two pumps, each with a capacity of 265 gallons per minute, are to be
installed in an adjacent dry pump-well. These pumps will, therefore, have
a capacity equal to about four times the average fiow of sewage and will be
operated automatically so that both pumps can be operated at the same time
if necessary, although under normal conditions one piunp will be more than
adequate to care for the normal flow of sewage.
liie pumps will discharge the sewage through an 8" cast iron force main
to a manhole at the intersection of Cross and van Anden streets from which
386 State Depabtment of Health
effluent at the rate of about 170,000 gallons per acre per day. A portion of
the filter is to be temporarily used for the disposal of sludge when troops are
not at the range for practice.
The effluent from the sand filters is to be discharged into the Sparkill creek,
which fiows in a southerly direction from Blauvelt and empties into the Hud-
son river near Piermont.
It appears that the design of these plans is in general in accordance with
my views and suggestions expressed auring a conference held with the de-
signing engineer from the office of the State Architect. There are, however,
certain features in the details of the design that require modification in order
that the sewerage system may operate satisfactorily and efficiently, viz., the
substitution of manholes for inspection holes and the installation of manholes
at all points of change of grade and alignment as these changes will facilitate
the cleaning and inspection of the sewers.
I therefore beg to recommend that the plans be approved on the condition
that the changes above referred to be made in the plans for the sewer system.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
BRONXVILLE
On October 18, 1910, application was made by the board of trustees of the
village of Bronxville for the approval of plans for extensions and modifica-
tions to the sewer system of the village. These plans were approved on Novem-
ber 1, 1010, and a permit was issued allowing the discharge into the Bronx
river of sewage to be collected by the proposed sewers after treatment in the
Bronxville sewage disposal plant.
On November 9, 1910, plans for a proposed sewer extension in Palmer
avenue were submitted for approval by the board of trustees. These plans
were approved on November 11, 1910, and a permit was issued allowing the
discharge of sewage from the proposed sewer into the Hudson river on condi-
tion that no sewage shall be admitted to or discharged from the proposed
sewer until the Bronx Valley trunk sewer shall have been completed and con-
nection made therewith.
Albany, N. Y., Novemher 1, 1910.
Eugene H. Pobteb, M.D., State Commissioner of Health, Albany, N. Y,:
Deab Sib: — I beg to submit the following report on an examination of
plans for extensions and modifications to the sewer system of the village of
Bronxville, Westchester county, submitted to this Department for approval by
Rogers & Latimer, civil engineers, of New York city, on behalf of the board
of trustees of the village on October 18, 1910.
The plans and documents submitted comprise the following:
1. Tracing and duplicate sets of blueprints of amended plans for pro-
posed sewers in Avon and Governor's roads, formerly known as Sagamore
Circle and Beverly road.
2. Tracings and duplicate sets of blue-prints of plans and profiles of
proposed sewers in Tanglewylde and Rockwell avenues.
3. Tracings and one set of blue-prints of plans and profiles of a proposed
sewer extension in Tanglewylde avenue.
4. One blue-print showing profile of proposed sewer in Palmer avenue.
5. Report of designing engineers and village president together with
a certified recommendation of the board of health.
The plans show that it is proposed to amend the plans of the sewers in the
streets in that portion of Sagamore Park, formerly known as Sagamore Circle
Sewerage and Sewage Disposal 387
and Beverly road, which were approved by this Department on February 25,
1010, but were never constructed. The location of these streets have been
changed and they are now called Avon and Governor's roads.
The sewage to be collected by the proposed sewers in Avon road is tributary
to the Bronx ville sewage disposal plant, and the sewers in Grovemor's road
are tributary to the I^ckahoe disposal plant. The amount of sewage that
will reach the two disposal plants from the sewers shown by the amended
plans will be practically the same as that provided for by the plans approved
on February 25, 1010, and will be divided in about the same proportions.
The plans for the proposed sewer extension in Tanglewylde and Rockwell
avenues show that it is proposed to construct some 1,543 feet of 8''
sewers in these two avenues. The sewage to be collected by these sewers
will be discharged into the existing sewer at the intersection of Tanglewylde
avenue and Midland avenue and thence into the Bronxville disposal plant.
The plans also provide for a 6" sewer extension in Tanglewylde avenue be-
tween Pondfield road and Gardner avenue, a distance of 275 feet. This sewer
is to be tributary to«the existing sewer in Gardner avenue and the Bronxville
avenue disposal plant.
Inasmuch as only one copy of the plan for the proposed sewer in Palmer
avenue was received, action on this plan must be deferred until a duplicate
copy is received.
The plans for the other sewers now under consideration, however, have been
carefully examined in regard to sizes, capacities and grades and the sewers as
planned are found to be adequate to meet the future requirements of the dis-
tricts to be served by them on the usual assumption as to population and
sewage contribution providing the sewers are properly constructed.
I therefore beg to recommend that the plane be approved and permits issued
allowing the discharge of sewage from the proposed sewers into the Bronx-
ville and Tuckahoe sewage disposal plants and the Bronx river.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
Albany, N. Y., tfovemher 1, 1910.
Board of Trustees^ Village of Bronxville, N, Y.:
Gentleacen: — In response to the application made to me by your board,
imder date of September 12, 1910, pursuant to the provisions of section 21
of the Public Health Law and certifying to me for my approval a recom-
mendation to construct certain additions to the sewer system of the village
of Bronxville made to your board by the board of Health of the vdllage of
Bronxville, pursuant to section 21 of the Public Health Law, on the grounds
that the sewers of such village are insufficient to properly and safely sewer
such village, said recommendation having been duly considered and approved
by your board, I hereby approve such recommendation that certain additions
to said sewer system be constructed, to wit:
An 8" sewer starting at the manhole in the Midland Valley sewer at
its intersection with Tanglewylde avenue, running thence easterly in
Tanglewylde avenue, 400 feet to its intersection with Rockwell avenue,
thence southerly in Rockwell avenue 350 feet, with the necessary man-
holes and appurtenances, as shown on the map submitted therewith.
The above approval is duly given this 1st day of November, 1910, in accord-
ance with the provisions of section 21 of chapter 45 of the Consolidated Laws,
the Public Health Law.
Very respectfully,
ALEC H. SEYMOUR,
Acting Commissioner of Health
388 State Depabtmbnt of Heaxtii
Albany, N. Y., November 10, 1910.
Eugene H. Pobteb, MJ)., State Commissioner of Health, Albany, N. Y,:
Deab Snt. — I beg to submit the following report on an examination of plans
for a proposed sanitary sewer extension in Palmer avenue in the village of
Bronxville, Westchester county, submi4;ted to this Department for approval
by Rogers & Latimer, civil engineers of New York city, on behalf of the
board of trustees of the village on November 9, 1010.
A blue-print showing the profile of this sewer was submitted for approval
on October 18, 1910, in connection with other plans for sewer extensions in
the village, but this plan could not be passed upon at that time inasmuch
as only one copy of the plan was submitted and the plan did not show the
location of the sewer. The designing engineers were therefore notified that
the matter of the apf>roval of the plans for the proposed sewer in Palmer
avenue would be considered as soon as duplicate copies of such plans, showing
both plan and profile of the sewer, were received.
The records of the Department show further that plans for a sewer in
Palmer avenue, formerly known as Glen Road, were approved in connection
with plans for a sewer system and sewage disposal plant approved on May
14, 1902. These plans provided for a 6" sewer in Glen Road tributary to
the then proposed Bronxville disposal plant. It appears, however, that this
sewer was never constructed.
The plans before the Department and now under consideration show that
it is proposed to construct some 400 feet of 8'' sewer on a grade of 2.84 per
cent, in Palmer avenue which will eventually be tributary to the Bronx Valley
sewer now under construction. A flush tank is to be provided at the upper
end and a manhole is to be located near the lower end of the proposed sewer
and about 20' from its junction with the Bronx Valley sewer. According
to the statements of the village president and the engineers the proposed
sewer is not to be used and the outlet of the sewer will be sealed un-til tho
Bronx Valley sewer is in operation.
The plans have been carefully examined in reference to the size, grade,
capacity and other hydraulic and sanitary features of the proposed sewer
and it is found to be adequate to meet the future requirements for sanitary
sewage of the district to be served by it, and I, therefore, b^ to recommend
that the plans be approved.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
BRONXVILLE AND TUCKAHOE
On February 25, 1910, application was made jointly by the boards of trustees
of the villages of Bronxville and Tuckahoe for the approval of plans for
sewer extensions in Beverly road, the Plateau and other streets in these vil-
lages. A portion of the sewage to be collected by the sewers in Bronxville
discharges into the Tuckahoe sewage disposal plant and the remainder of
the sewage from the Bronxville sewers discharges into the Bronxville plant,
and conversely some of the sewers in Tuckahoe are tributary to the Bronx-
ville plant and some to the Tuckahoe plant. The plans were approved on
February 25, 1910, and permits were issued allowing the discharge of sewage
to be colleoted by the proposed sewers into the Bronx river after treatment
in the sewage disposal plants referred to.
Albany, N. Y., February 25, 1910.
Eugene H. Pobteb, M.D., State Commissioner of Health, Albany, N. Y.:
Dear Sie: — I beg to submit the following report on an examination of plans
for proposed sewer extensions in the villages of Bronxville and Tuckahoe,
submitted jointly by the trustees of the two villages on February 21, 1910.
Seweibage and Sewage Disposal 389
The plans aud docuioente comprise the following:
1. One tracing and two blue prints of a map showing plan of proposed
sewers.
2. Five tracings and two complete duplicate sets of blue prints showing
profiles of streets and sewers.
3. Report by the designing engineer.
The plans show that it is proposed to construct sewers in Beverly road,
the Plateau, Sagamore circle, Fairview avenue. Terrace place tributary to
the Tuckahoe sewer system and sewage disposal plant, and that the proposed
sewers in Prescott avenue and in a portion of Beverly road are to be tribu-
tary to the Bronx ville sewers and sewage disposal system.
According to the report of the designing engineer the proposed sewers will
ultimately serve about eighty dwellings and care for about 32,000 gallons of
sewage per day, 50 per cent, of which is to be conveyed to the Tuckahoe
disposal plant and the remainder into the Bronxville. The sewers if prop-
erly constructed are adequate as to sizes and capacities to meet any probable
demand that may reasonably be made upon them for a considerable period
in the future.
The sewage disposal plants of the two villages, especially that of Tuckahoe,
seem to have ample capacity if properly operated to care for the additional
contribution of sewage to be collected by the proposed sewers. The question
of sewage disposal for the two villages by means of separate disposal plants
on the Bronx river watershed has come to be largely a question of temporary
expediency since the sewage contributed by Tucl^hoe and Bronxville will be
intercepts! by the Bronx ValW sewer now under construction.
I beg to recommend that tne plans be approved and permits be issued
allowing the discharge of additional effluent from the two sewage disposal
plants into the Bronx river.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
CHAPPAQUA (Convalescents' Home)
On March 17, 1910, plans for sewerage and sewage disposal for the Con-
valescents' Home of the Children's Aid Society of New York city, at Chap-
paqua, were submitted for approval. After some correspondence with the
designing engineers in reference to the basis of design and rate of operation
of the sewage disposal plant the plans were approved on April 20, 1910, and
a permit was issued allowing the discharge of effluent from the disposal plant
into a tributary of the Saw Mill river.
Albany, N. Y., April 19, 1910.
Eugene H. Porter, M.D., State Commissioner of Health, Albany, y, Y.:
Dear Sir: — I beg to submit the following report on an examination of
plans for the Convalescents* Home, at Chappaqua, Westchester county, sub-
mitted to this Department for approval on March 17, 1910.
TTie Convalescents* Home, owned by the Children's Aid Society of New
York city, is located near the headwaters of the Saw Mill river. Prior to
1909 the property was owned and used for school purposes by the Chappaqua
Mountain Institute. The water supply is at present obtained from a spring
and pumped into an underground reservoir having a capacity of 15,000 gallons.
A new water supply is being developed consisting of a 6" driven well and
a collecting gallery fed by underdrains. A pump is to be installed which
will pump the water from either the well or the gallery to the old dife-
tnbuting reservoir and to the new storage reservoir adjacent to it which
has a capacity of 51,500 gallons. The capacity of this new water supply is
estimated at 12,000 gallons per day.
390 State Depabtment of Health
According to the report by the designing engineers the population of the
home for the greater portion of the year will not exdeed 100 persons, with a
maximum of some 250 for a period from eight to ten weeks during the sum-
mer, and 270 will be reached only on occasional days. The sewage from the
institution is at present discharged into a leaching cesspool near the main
buildings.
It is now proposed to intercept the sewer leading to the cesspool by means
of a 6" vitrified tile sewer and to convey the sewage to the new disposal site
some 300 feet from one of the main buildings. .The plans show only the
location, size, and alignment of this sewer, a portion of which is to be laid
on a curve.
It is stated in a supplementary report by the designing engineers that
the sewer is to have a slope of 0.5 per cent., and that no manholes are con-
sidered necessary inasmuch as the sewer is only about 450 feet long and one
end is accessible through the proposed screen chamber. It is very probable,
however, that, owing to the very flat grade for a sewer of this size and the
curved alignment, it will have a tendency to clog easily. In order, then, to
facilitate cleaning and inspection a manhole or lamphole should be installed
at each change of grade and alignment and the sewer laid straight between
manholes both as to vertical and horizontal alignment, and since no facilities
for flushing are provided, the grade of the sewer should be increased to 0.65
per cent.
The sewage disposal plant consists of a screening chamber, settling tank,
contact beds and sand niters.
The sewage enters a screen chamber provided with a screen 10 feet wide, con-
sisting of %" iron bars spaced %" apart in the clear. Owing to the short
distance that the sewage travels in the sewer before reaching the screen cham-
ber and, consequently, the fresh state of the sewage it may be found necessary
to install a double screen in order to prevent clogging during the night at
the time of maximum flow of sewage. There is a difTerenoe of elevation of
1.4' between the inlet and the outlet pipes in the chamber.
From the screen chamber the sewage will flow into the settling tank located
about fifteen feet away. This tank has but one compartment of suflicienl
capacity to give eleven hours* detention of sewage contributed by a population
of 250 persons based on a daily water consumption of 100 gallons per capita.
The tank is provided with baffle walls and the bottom slopes toward one end
to a blowoflf valve and pipe which extends to adjacent sludge beds where the
sludge is to be disposed of by ploughing into the soil.
Adjoining the settling tank are to be placed two contact beds having a
total area of .023 acres and an eflfi'ctive depth of 3 feet of broken stone vary-
ing in size from ly/' to 3". Each bed is to be dosed alternately by means
of an automatic tipple trough which diverts the flow of effluent from the set-
tling tank to one bed or the other.
It appears that the contact beds which are to have an effective depth of
only 3 feet will be required to operate at a rate of about 1,000,000 gallons
per acre per day for a considerable period during the summer. This is an
excessively high rate for contact beds of this depth and will tend to clog the
beds rapidly during the period of maximum sewage flow thereby increasing
the cost of operation due to more frequent cleaning of the beds.
The cost of cleaning should, however, be somewhat decreased by the fact
that below the effluent underdrains of the contact beds is a space filled with
broken stone and provided with additional underdrains. This space varies
in depth from 1.3 to 1.8 feet below the effluent underdrains and it is in-
tended that any suspended matter that may settle down through the contact
material will be collected and retained in this space to be discharged at in-
tervals to the sludge beds through a blowoff valve and pipe.
From the contact beds the effluent is to be discharged to either of two
sand filters having a combined area of about 0.1 acres and filled with sand
to a depth of 3 feet. These beds will treat cowtact bed effluent at the rate
of 250.000 gallons per acre daily on the basis of 250 persons contributing sew-
age at the rate of 100 gallons per capita.
The distribution of effluent over the surface of the sand filters is to be
Sewebaqe and Sewage Disposal 391
effected by means of a wooden trough over the center line of each bed and
provided with 2" openings about 5 feet apart. Directly below each opening
is to be placed a splash plate intended to break the fall of the liquid and
allow it to spread out over the surface of the filter.
Each sand filter is provided with four parallel lines of tile underdrains
spaced 9 feet on centers, and according to the designing engineer's report
the effluent collected by these underdrains can either be discharged into a
trench and allowed to flow over the surface of the ground to the brook or the
trench can be run continuously iback and forth over the available sloping
ground for a distance of about 700 feet to the brook. The best results would
undoubtedly be obtained by arranging the effluent pipe or drain according to
the latter alternative and in such a way as to dispose of the effluent from
the sand filters by means of subsurface irrigation on the sloping area from
the sewage disposal plant to the stream, and would be desirable inasmuch as
the Saw Mill river is used as a source of water supply by 'the city of Yonkers.
I would add, in conclusion, that although the plants as shown upon the plans
will probably produce a satisfactory effluent if properly constructed and oper-
ated, it is not a well-balanced design, and the cost of operation could be de-
creased and somewhat better results obtained if the contact beds were increased
in area and depth, and if the capacity of the septic tank could be somewhat
decreased.
The slope of the sewer should be increased and manholes or lampholes in-
lerted at all changes of grades and alignments in order to minimize the tend-
ency to clog and to facilitate cleaning and inspection.
I would, therefore, recommend that the plans be approved and a permit
be issued allowing the discharge of effluent from the proposed sewage disposal
plant into a tributary of the Saw Mill river, on condition that either a
manhole or lamphole be installed on the sewer line at each change of grade
and alignment, that the alignment be made straight between manholes, and
that the grade of the sewer he increased to 0.65 per cent.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
CLARENCE (Buffalo Automobile Club)
On October 20, 1910, plans for sewerage and sewage disposal for the BuffaH
Automobile Club, at Clarence, N. Y., were submitted to the Department for
approval. These plans were not in satisfactory shape for approval and were
returned to the designing engineer for amendment and additional data.
On November 7, 1910, plans revised in general accordance with reconunen-
datiotts of this Department were resubmitted for approval. These plans were
approved on November 11, 1910, and a permit was issued allowing the dis-
charge of effluent from the proposed sewage disposal plant into Ransom creek,
a tributary of Tonawanda creek, on condition that a main collecting drain
shall be constructed to intercept the flow from the six imderdrains shown by
the plans; that on this main collecting drain a manhole shall be constructed
through which the entire flow from the six underdrains shall pass; and that
the main collecting drain leading to this manhole shall be placed at least
50 feet from the bank of the pond at all pointe.
Albany, N. Y., November 3, 1910.
Eugene H. Pobteb, M.D., State Commissioner of Health, Albany, N, Y,:
Deab Sir: — I beg to submit the following report on an examination
of plans for sewerage and sewage disposal for the Buff'alo Automobile Club
at Clarence, N. Y.. submitted to this Department for approval on October 20,
1010.
3&2 State Depabtmbnt of Health
According to the statement of the designing engineer in his letter of trans-
mittal, dated October 19, 1910, the club has at present about 2,200 members and
the sewage disposal plant is designed on the basis of a daily contribution of
sewage of 5,000 gallons.
The disp<M»al plant consists of a s€?ttling tank, dosing chamber and subsurface
irrigation field. The settling tank, which is 8'ic23'x5' deep, has a capacity of
about 6,900 gallons. This is adequate to give a detention of sewage of six
hours when serving a population of 276 persons on the usual assumption as
to sewage contribution. The settling tank, if properly constructed and oper-
ated, should furnish a satisfactory means of preliminary treatment and re-
move a large percentage of suspended solid matter before the discharge of
the sewage to the subsurface irrigation system when serving a population of
up to some 300 persons.
No means, however, are provided for cleaning the tank when required and
caring for the sludge. A sludge pipe should he connected with the settling
tank so that the sludge and supernatant liquid may be drawn off and dis-
charged to a properly constructed sludge bed.
The plans also show that it is proposed to discharge the settled sewage
intermittently through a 3" Miller siphon to the subsurface irrigation field
located near a pond on Ransom creek tributary 'to Tonawanda creek. The
irrigation field has an area of about 0.1 acres and although no data are sub*
mitted as to the chartuster of the soil this area is too small to properly care
for 5,000 gallons of settled sewage per day even under the most favorable soil
conditions. It is impossible, however, to properly pass upon the plans unless
complete data are furnished in regard to the character of the soil at the dis-
posal area.
There are also a number of discrepancies between the plans and specifica-
tions submitted as follows:
( 1 ) The plans show an 8'' pipe from the settling tank to the disposal
area while the specifications call for a 4" pipe or carrier. (It may be
noted also in this connection that a .5 per cent, slope of a 4^^ effluent pipe
from settling tank to disposal area, as specified, is too flat and should
not be less than 1 per cent, for that size pipe.)
(2) The plans show 10 lines of 3" tile laterals to be laid 12" deep
for the irrigation field, while the specifications call for 4 lateral drains
of 4" porous tile to be placed 12" to 18" under the surface of the ground.
(3) The plans show four lines of 4" cross underdrains spaced 20 feet
apart on centers and to be placed four feet deep, while the specifications
call for three under cross drains 3' tt) 4' deep.
No data is furnished as to the proposed method of caring for the storm
water from roofs, walks, grounds and other areas. Such storm water should
not be admitted to the disposal plant.
It is al*^o noted that while the elevation of each end of the sewer is shown
the rate of slope or gradient is not given. Manholes should also be placed at
all changes of grade and ali^niment.
In conclusion I would say that there were not sufficient data submitted with
the plans to properly pass upon them and that additional data should be fur-
nished in reference to the character of the soil at the disposal area; more
definite data as to the area of the disposal or irrigation field which should also
be enlarged; the number, size and length of the lateral distributors; the size
and slope or gradient of the effluent pipe from the settling tank, and of the
main sewer; and the proposed method of caring for the storm water. The
plans should also provide means for cleaning the settling tank and for the
proper disposal of sludge.
In addition to the above, more complete information should be submitted as
to the number of persons it is expected will be at the club house at any one
time, the number of inside closets, lavatories and sinks installed, the dining-
room facilities provided at the club house and other data which would lead
to a conclusion as to the probable a«iount of sewage to be treated by the
plant.
Sewebaoe and Sewage Disposal 393
I therefore beg to recommend that the plans be returned for amendment
along the lines suggested above and that the designing engineer be asked to
submit additional dftta as noted.
Yours respectfully,
THEODORE HORTON,
City Engineer
Albany, N. Y., November 9, 1910.
EUOENS H. POBTEB, M.D., State Commissioner of Health, Albany, N, Y.:
DjUkU SiB: — I beg to submit the following report on a re-examination of
amended plans for sewage disposal for the Buifalo Automobile Club at Clarer.ce,
X. Y., resubmitted to this Department for approval on November 7, 1910.
The plans have been revised in general accordance with the recommenda-
tions of my report of November 3, 1910, on the examination of the first set of
plans submitted and the additional information required to finally pass upon
the plans has also been received.
It appears from the plans and letter of transmittal of the engineer dated
November 4, l^UO, that all storm water is to be eliminated from the sewage
disposal plant. The storm water from the roofs is to be cared for by a storm
water sewer which is to discharge directly into the pond and that from the
grounds, walks and drives, is to be allowed to soak into the soil.
Ihe settling tank has been provided with a sludge pipe connected with
the low section of the tank toward which bottom of the tank slopes. When
ever it is required to clean the tank, the sludge and supernatant liquid is to
be discharged by gravity through a 6" vitrifi^ pipe to a sludge bed having
an area of 400 square feet. This bed is to be locatea near the West Shore rail-
road track and about 400 feet from the club house.
Ihe gradient of the 4" effluent pipe from the dosing chamber of the settling
tank to disposal area has been increased to 1.0 per cent. Ten lateral dis-
tributing lines have been added to the disposal area and their length increased
from 80' to 140', giving in all some 2,800 feet of tile in the distributing system.
Two additional crogs underdrains have been added, making a total of six lines
as against four lines provided for by the first set of plans.
It appears, however, that the second discrepancy noted on pase two
of my former report in reference to the size of the distributing laterals has not
been corrected. The plans show that it is proposed to use 3" porous tile while
the specifications call for 4" tile. It appears that a better distribution of the
settling tank effluent would be obtained by using 4" tile for laterals as specified
in the specifications.
The area of the subsurface irrigation field has been increased to about 0.4
acres so that the disposal field will be required to treat settled sewage at the
rate of about 13,000 gallons per acre per day when the maximum contribution
ooeurs. This will amount to 5,000 gallons daily on such days of maximum at-
tendance at the club, according to the report of ihe designing engineer.
The subsurface irrigation field, if properly prepared, should be able to prop-
erly care for this amount of sewage and produce a satisfactory effluent, inas-
much as the engineer states that the soil at the disposal area is of a sandy
loam of good absorbing quality.
The underdrains of the irrigation field as shown by the plans discharge
separately into the pond, so that if from any cause such as the work of burrow-
ing animals or the damage to the field from surface wash during storms, holes
are formed through which the effluent from the settling tank would pass directly
to the underdrains, no ready means of determining such defective condition
of the surface irrigation field and of insuring a proper operation of the plant
would be had. For this reason it is recommended that a main collecting drain
be constructed parallel to and fifty feet from the bank of the pond to intercept
the six underdrains and that a central manhole be constructed on this main
collecting drain or such a manhole be constructed below the last underdrain
from which the final outlet will lead to the pond. In this way opportunity
will be had to obtain samples of the filtrate reaching the underdrain system
and any breaks in the surface of the field would be readily discovered.
394 State Depabtmbnt of Health
In view of the above^ I would recommend that the plans be approved and
a permit be issued allowing the discharge into Ransom creek, a tributary of
Tonawanda creek, of eflQuent from the proposed sewage disposal plant and that
the permit contain in addition to the usual revocation and modification clauses
the following provisions:
(1) That a collecting drain be constructed to intercept all cross under-
drains and convey the effluent to a manhole from which it shall be dia-
charged into the stream or pond through a single effluent or outlet
sewer; and that such collecting intercepting drain shall not be nearer
than fifty feet from the pond or stream at any point.
(2) That the laterals of the distributing system shall not be less than
4" in diameter.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
CLIFTON SPRINGS (Clifton Springs Sanitarium)
On September 12, 1910, plans for sewage disposal for the Clifton Springs
Sanitarium were submitted for approval. These plans were approved on
October 29, 1910, and a permit issued allowing the discharge into Sulphut
creek of effluent from the proposed sewage disposal plant.
Albany, N. Y., October 27, 1910.
Eugene H. Pobteb, M.D., State Commissioner of Health, Albany, y, Y..
Deab Sir: — I beg to submit the following report on an examination of
Slans for sewage disposal for the Clifton Springs Sanitarium at Clifton Springs,
•ntario county, submitted to this Department for approval by the business
manager of the sanitarium on September 12, 1910.
Clifton Springs is located on Sulphur creek at its confluence with Canau-
diagua outlet and about five miles above the village of Phelps. At the village
of Lyons, about twelve miles below Phelps, the outlet joins Ganagua creek
and forms the Clyde river. This river empties into the Seneca river which is
tributary to the Oswego river.
According to the report of the designing engineer the present population of
the institution is 500 and the metered daily water consumption about 100,000
gallons, equivalent to 200 gallons per capita per day. It is proposed to pr(^
vide for an ultimate population of 600 persons and a sewage contribution of
120,000 gallons per day. The sewage is at present discharged into Sulphur
creek through a 9" outfall sewer.
The proposed sewage disposal plant which will intercept the existing sewer
is to consist of a grit or screen chamber settling tank, sprinkling filter and
sludge bed.
The grit chamber is divided into two compartments and has a total capacity
of about 800 gallons which is sufficient to give about nine minutes' detention
of sewage when kept free from detritus. The velocity of flow through the
chambers will be about 6" per minute with a detention of about nine minutes
when treating the sewage contributed by a population of 600 persons at the
rate of 200 gallons per capita per day which is the basis of design of the
plant.
One inclined bar screen is placed at the end of each grit chamber adjacent
to the settling tank. The screens are to be made of l%" x %" steel bars spaced
%" apart in the clear. A platform is provided to facilitate cleaning the screens
and handling the screenings.
After passing through the screens the sewage flows into the settling tank
divided into two compartments having a total capacity of some 3,100 gallons.
Each compartment is eight feet long, four feet wide and varies in depth from
six to seven feet. The average time of detention of the sewage in the tank wiil
Sewerage and Sewage Disposal 395
be about 36 minirtes and the average velocity of the sewage through the tank
about 2^" per minute when the ultimate rate of contribution is 120,000 gal-
lons per day.
A sludge pipe and 12" sluice gate is connected with the low end of the tank
by means of which any accumulated sludge may be discharged by gravity to a
properly construoted sludge bed located near the tank. The sludge bed is
twenty feet square and is provided with underdrains placed beneath a layer
of sand and gravel about one foot deep.
The sewage passes from the settling tank into a dosing chamber three feet
deep through submerged outlets. The doses are to be discharged to the
sprinkling niter through a 12" float valve which will tend to give intermitten
discharges to the filter and in connection with the distributing system, an even
distribution of sewage on the filter.
From the dosing chamber the settled sewage is to be discharged through an
8" cast-iron pipe to the sprinkling filter located about 260 feet away. The
filter has an area of 0.062 acres and is to be filled to a depth of five feet witn
broken stone VsT to 1" in size. The distributing system supported on piers
two feet below the surface of the filter oonsierts of a 6" castiron main, 4"
cast-iron laterals and 2" cast-iron soil pipe risers provided with nozzles of the
''Columbus" pattern spaced 10" on centers. The head at the nozzles will be
about five feet.
The sprinkling filter will be required to operate at the rate of about 1,930,000
gallons per acre per day when the average contribution of sewage amounts to
120,000 gallons per day. The effluent from the disposal plant will be dis-
charged through the existing outlet sewer into Sulphur creek near its con-
fluence with Canandaigua outlet.
The area of the watershed of the Canandaigua outlet at the point where
the eflluent from the disposal works will reach it is some 216 square miles, so
that, although complete purification of the sewage treated will not be obtained,
there will be at all times a high dilution of the effluent entering the stream.
The Canandaigua outlet is not used as a source of public water supply below
Clifton Springs.
The underdrain system consists of six parallel lines of 4" farm tiles which
connect with a 9" tile drain.
The plans have been carefully examined in reference to the design and rates
of operation of the different parts of the plant and it is found that the pro-
posed sewage disposal plant, if properly constructed and operated, should pro-
duce a satisfactory effluent.
I therefore beg to recommend that the plans be approved and a permit be
issued allowing the discharge into Sulphur creek of effluent from the proposed
sewage disposal plant.
Respectfully eubmitted,
THEODORE HORTON,
Chief Engineer
COMSTOCK (Great Meadow Prison)
On January 29, 1910, plans for sewage and sewage disposal for the Great
Meadow Prison were submitted for approval by the State Architect. These
plans were approved on February 8, 1910, on condition that the sewage dis-
posal plant be enlarged whenever the number of persons contributing sewage
to the plant is materially increased.
Albany, N. Y., February 2, 1910.
Eugene H. Porter, M.D., State Commissioner of Health, Albany, N. Y,:
Dear Sir: — I beg to submit the following report on an examination of
plans for sewerage and sewage disposal for the Great Meadow Prison to be
located at Comstock, Washington county, submitted to this Department for
approval on January 29, 1910.
396 State JDepabtmbnt of Health
It is stated in the report by the State Architect that the proposed prison (s
under construction and that this year accommodations will be provided for
some 300 prisoners. It is also stated that the ultimate number to be pro-
vided for in the future is about 1,300 and that the assumed rate of water
consumption is estimated at 100 gallons per capita per day based upon the
quantities used at existing prisons in the State.
The water supply for this institution is to be taken from Dolph pond, located
in a wooded and uninhabited region about two miles northwest of Gomstock.
It is estimated that this source of supply will furnish a daily yield of 260,000
gallons and a storage capacity of 31,210,000 gallons. Plans for this water
supply were approved by the Department on October 25, 1909.
The plans now under consideration provide sewerage facilities for the ulti-
mate population and sewage disposal for a population of 1,000. The sewage
disposal plant consists of a settling tank and four sand filters.
The settling tank is divided into two equal compartments having a com-
bined capacity of 27,000 gallons which is adequate to g^ve about six and one-
half hours' detention of sewage for a daily contribution of 100,000 gallon
Each compartment is to be built with a hopper-shaped bottom for the accumu-
lation of sludge which can be discharged to adjacent sludge beds through two
six-inch blow-off pipes extending to within six inches of the bottom of the
hopper-shaped compartment.
The last compartment of the settling tank is connected with the dosing
chamber and is so arranged that one foot of sewage is drawn from the top
of this compartment at each discharge of a siphon. The dosing chamber,
located at the center of the filter bed area, is provided with four eight-inch
alternating siphons for discharging the settling tank effluent upon the four
intermittent sand filters in rotation.
These filters have an average depth of about 2.7 feet. While this depth
may be adequate, a greater efficiency would undoubtedly be obtained
by increasing the depth of the beds to three or three and one-half feet.
Each bed is provided with an efficient system of troughs for distribution and
underdrainage and have a combined area of about .45 acres. At the assumed
rato of contribution of 100 gallons of sewage per capita per day for 1,000
persons, the beds have a sufficient area to treat settled sewage al the rate
of 220,000 gallons per acre daily.
The plans have been carefully examined by the Engineering Division and it
is found that the design of the sewage disposal plant is well balanced and if
properly constructed and operated should produce a satisfactory effluent for a
population up to 1,000 persons contributing sewage at a daily rate of 100
gallons per capita. The location of the plant is sucli that it can readily be
enlarged as may be required in the future.
The plans show that it is proposed to discharge the effluent from the dis-
posal works into a 24-inch pipe designed to carry the flow of a small stream
which flows through the site of the disposal works and is tributary to the
Barge canal. The flow of this stream is also carried under the proposed sfewer
above the disposal plant site through a 16-inch pipe. No data has been fur-
nished by the State Arcliitect as to the area of the watershed tributary to this
stream and no attempt has been made while examining the plans to pass upon
the adequacy of these pipes to care for the flow of this stream, it being assumed
that the design provides for adequate waterway.
I would, therefore, recommend that the plans be approved on condition that
the sewage disposal plant be enlarged as may become necessary whenever the
number of persons contributing sewage to the plant is materially increased.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
Seweraqb and Sewage Disposal 397
DANNEMORA (CUnton Prison)
On January 4, 1010, plans for sewerage and sewage disposal were submitted
to this Department for approval by the State Architect. On January 28, 1910,
these plans were approved on the following conditions:
(1) That the capacity of the settling tank be increased whenever the
daily contribution of sewage shall materially exceed the amount of flow
which the tanks as now designed will properly treat.
(2) Ihat a complete separation of sanitary sewage and storm water
shall be effected at such time as additional purification of sewage shall
become necessary.
(3) That sludge beds shall be installed if the proposed method of caring
for the sludge is found to be inadequate or unsatisfaotory, and at no time
shall sludge be discharged into the stream.
Albany, N. Y., January 19, 1910.
Eugene H. Pobteb, M.D., State Commissioner of Health, Albany, N, 1.,
Deab 8ib: — I b^ to submit the following report on an examination of
plans for proposed sewers and sewage disposal works for the Clinton Prison,
located at Dannemora, Clinton county, suomitted to this Department for ap
proval on January 4, 1910.
The present sewers are on the combined plan and discharge into an open
ditch and a small stream tributary to the Saranac river. This discharge of
sewage is causing and has in the past created insanitary conditions in and
near the village of Dannemora.
The plans show that it is proposed to intercept the dry weather flow from the
existing combined sewers which serve the State Prison, Dannemora State Hos-
pital and part of the village of Dannemora, and to provide overflows at three
different points in order to control the amount of flow through the new sewers
and settling tanks in time of storms. It is stated in the report by the State
Architect that owing to extensive outlay of work and money that would be re-
quired to separate the storm water from the sanitary sewage of the village,
prison and hospital, it is proposed to postpone the matter of separation imtil
such a time as filtration of the effluent from the settling tanks shall be found
necessary.
It was learned that there are no records of the existing connections to the
present sewer system and that it would be necessary to construct about 6,000
feet of additional sanitary sewers in order to effect a complete separation for
which construction there are no funds available at the present time. The pro-
posed sewers are, however, so designed that they can be made a part of a
complete sanitary sewer system whenever the separation of sanitary sewage
and storm water shall be required.
The report also states that the present population of the State institution
is about 1,800 with allowance for a future population of 2,500 and that,
while 100 village people are at present tributary to the sewer system, the
ultimate number of persons of the village to be served by the proposed sewers
is estimated at about 500 persons. The ultimate future population therefore
to be served by the proposed sewers and sewage disposal plant will be about
3,000.
Although no definite data is submitted as to the source of the water supply
and rate of consimiption, it is intimated that the design of the sewer system
is based upon an average rate of 100 gallons per capita per day allowing for
a maximum rate of twice the average rate of contribution of sewage. On this
assumption the proposed sewers are adequate ks to sizes, capacities and grades
if properly constructed to care for the contribution of sanitary sewage from
the future estimated population of some 3,000 persons.
The sewage disposal plant consists of a settling tank divided into two equal
longitudinal compartments, each of which is divided into two parts by a
398 State Depabtmbnt of BLealth
division wall which extends to within four inches of the surface of the sewage
in the tanks when full and forming a submerged weir over which the sewage
must flow in passing through the tank. This arrangement is intended to
facilitate the cleaning of the tank. The sewage before entering the tank is
discharged into a small receiving chamber containing two six-inch outlets, one
leading to each of the two longitudinal compartments of the tank and one
ten-inch outlet so arranged that all the sewage can be by-passed whenever the
tank is not in operation or to care for excessive contributions of sewage during
storms.
The settling tank has a capacity of about 66,000 gallons which is adequate
to give an eight-hour detention of sewage for the present population of 2,000.
The capacity of the tank can be readily increased by a slight alteration of
the outlet and inlet chambers so as to give a proper time of detention when
the contribution of sewage is materially increased.
Although the plans do not show an area for the disposal of sludge, it wajs
found upon further inquiry, that the owner of the property upon which the
sewage disposal plant is to be located intends to use the sludge for the purpose
of irrigation and that the land is to be properly prepared to receive and dis-
pose of this sludge.
In conclusion I would say that although the sewer system and sewage dis-
posal works are satisfactory as to engineering features to adequately meet the
present needs of the institutions, the capacity of the settling tank should be
increased whenever the contribution of sewage is materially increased, and
complete separation of the sanitary sewage and storm water shall be made
at such time as additional purification shall be required or upon the unsatis-
factory operation of the proposed sewage disposal plant. Sludge beds should
also be installed if the proposed method of caring for the sludge is found to be
inadequate or unsatisfactory.
I would, therefore, beg to recommend that the plans be approved on the
above conditions.
Respectfully submitted,
THEODORE IIORTON,
Chief Engineer
DEPEW
On September 23, 1910, application was received from the board of trustees
of the village of Depew for the approval of plans for proposed sewer extensions
in Elliott avenue and tributary sewers. These plans were approved on Septem-
ber 27, 1910, and a permit issued allowing the discharge into Cayuga crcSek of
sewage to be collected by these sewers after treatment in the village sewage
disposal plant.
ELKA PARK (Town of Hunter)
On February 18, 1910, plans for sewage disposal for the Elka Park Associa-
tion in the town of Hunter, Greene county, were submitted for approval by the
superintendent of the association. These plans were returned to the designing
engineer for revision and were finally resubmitted for approval on May 11,
1910.
The revised plans were approved on May 24, 1910, and a permit was issued
allowing the discharge of effluent from the proposed sewage disposal plant
into ('ook creek, a tributary of Schoharie creek, on condition that the sewage
contributed by not more than 200 portions shall be tributary to or treated by
the sewage disposal plant approved this day.
Sewerage and Sewaqe Disposal 399
Albany, N. Y., February 26, 1910.
EUQBNK H. POBTEB, M.D., State Commiasioner of Health, Albany, N. Y.:
Dbau Sib: — I beg to submit the following report on an examination of
Slans for sewage disposal for the Elka Park Association in the town of Himter,
treene county, submitted to this Department for approval on February 18,
1910, by the superintendent of the association, application for their approval
having been submitted later by the town board.
The association comprises a summer colony having a present population of
about 200 persons, and is located near Cook creek, a tributary <to Schoharie
ereek, about three miles south of the village of Tannersville. The ultimate
population is estimated at 350 persons.
Ihe report of the designing engineer states that the association is provided
with an adequate supply of pure spring water but that the present system of
sewage disposal, by means of subsurface irrigation for each individual cottage,
has not been entirely satisfactory.
It appears from the report, specifications and plans submitted for approval
that it is proposed to provide sewerage facilities for the existing twenty-two
cottages, club house and laundry.
Ihe plans submitted show the sewage disposal plant more or leas in detail,
but does not show the proposed sewer system.
In order to intelligently pass upon the plans, a general plan of the sewers
showing sizes, alignments, grades, manholes at all changes of grade and
alignment and profile of the main sewer should be submitted for approval.
The sewage disposal plant consists of settling tank, dosing chamber, contact
beds and an underground storage chamber to be used for the purpose of equal-
izing the discharge of effluent into the stream. The settling tank has a capacity
of about 6,500 gallons, which is sufficient to give eight hours* detention for
sewage contributed by the present population of 200 persons at the rate of
100 gallons per capita per day.
From the settling tank the sewage is to pass into a dosing chamber having
a capacity of some 6,400 gallons and provided with two alternating siphons
arranged so as to discharge the settled sewage to either or both contact beds.
Ihese beds are to be filled with broken stone to a depth of five feet and have
a combined area of about 0.04 acres.
Each contact bed is provided with a timed siphon which will discharge the
effluent into the storage chamber, referred to above, so that the discharge into
the small stream may be regulated and not occur in large, intermittent doses.
It appears from the plans that the general principles upon which the design
is based are in accordance with good practice. There are, however, several de-
fects in details of construction and operation.
While the plans and report of the designing engineer show that it is pro-
posed to construct both contact beds it appears from the specifications that only
one of the beds is to be operated for an indefinite period after the plant is
installed since the specifications require the contractor to furnish one alter-
nating dosing siphon and one timed discharge siphon complete. The total
capacity of tha beds should be operated as soon as the present population is
connected with the system inasmuch as these beds, with a combined area of
0.04 acres, will be required to treat settled sewage at the rate of 500,OGO gallons
per acre per day (with a daily contribution of 20,000 gallons). This is as
high a rate as should be allowed on contact beds five feet deep.
The sewage disposal plant as designed is, however, not well balanced in re-
gard to the relative capacity of the dosing chamber and contact beds. In
order to utilize the full capacity of the contact beds the dose of sewage applied
at each filling should be sufficient to fill each bed to within a few inches of
the top of the broken stone. This can be accomplished either by increasing
the size of the dosing chamber or by dividing the contact bed area into three
compartments so as to form three beds instead of two.
The Utter arrangement would be the better since ihe capacity of the dosing
chamber shown on the plans could not be increased materially without making
the time of detention too long. It appears, therefore, that in order to make
the proposed plant more efficient and satisfactory there should be installed three
400 State Dbfabtmknt of Health
coniact beds having a combined area of not less than 0.04 acres, and a dosing
chamber having about the same capacity as the one shown on the plans or
sufficient to fill the voids in each bed so that the effluent from the tank wUl
rise to within a few inches of the top of the bed. It will be necessar>% of
course, to add one dosing and one discharge siphon. In this connection it is
important to so design the size of the dosing chamber that each dose will
nearly fill the voids in one bed, basing the estimated percentage of voids on
that obtained when the beds have been in operation for some considerable
time.
It appears from the plans 'that the underground chamber is not to be pro-
vided with manholes. It would be advisable to place such manholes ovei
both the inlet and the outlet of this chamber in order to facilitate inspection
and cleaning. Better control of the discharge of effluent from the chamber
would also result if a valve chamber were constructed at one end of the com-
partment or outside and on line with the effluent pipe extended.
The effluent pipe to the stream, which is only four inches in diameter, should
be increased to at least five inches, and manholes or inspection holes should be
inserted at each change of grade and alignment.
In conclusion I would say that before the plans can be finally examined and
passed upon, a plan of the proposed sewer system should be submitted and, in
order to make the sewage disposal plant efficient and satisfactory, the relative
capacity of the dosing chamber and contact beds should be readjusted and
balanced.
The underground chamber should be provided with manholes and valve
chamber and the size of the effluent pipe should be increased to at least five
inches. Inspection holes or manholes should also be inserted at all changes of
grades and alignment.
I therefore recommend that the plans be returned to the designing engineet
for revision together with a copy of this report.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
Albany, N. Y., May 18, 1910.
Eugene H. Pobteb, M.D., State Commissioner of Health, Albany, N, Y,:
Deab SiB: — I beg to submit the following supplementary report on the ex-
amination of revised plans for sewage disposal for the Elka Park Association,
in the town of Ilunter, Greene county, resubmitted to this Department for
approval on May 11, 1910, by the superintendent of the association.
Original plans for sewage disposal for this association were submitted for
approval on February 18, 1910, but owing to a lack of sufficient data as to the
sewer system and the unsatisfactory design or arrangement of details of the
contact bed and underground equalization chamber the plans were returned to
the designing engineer for amendment. These plans have been revised in sub-
stantial accordance with the recommendations embodied in my report dated
February 26, 1910.
The plans and documents received and now under consideration consist of:
(1) Report in duplicate.
(2) Specifications in duplicate. Tracing and blue print of:
(3) Topographical map showing location of cottages, sewers and pro-
posed disposal works.
(4) Plan and cross-sections of disposal works.
According to the plans and report of the designing engineer the present sewer
system consists of four-inch house drains connected with six-inch castiron
sewers laid on a grade of not less than 1.5 per cent. These sewers carry sani-
tary sewage only and serve thirteen cottages, one laundry, a casino and club
house. The remaining eight cottages are provided with subsurface irrigation
systems which are giving satisfactory results but are located so that they can
be connected with the present sewer system and proposed disposal works when-
ever such an arrangement shall become necessary.
SEWEaAQE AND SeWAQE DISPOSAL 401
Ihe sewer system which has been constructed for a considerable period is
not provided with manholes. Such manholes should be constructed at all
changes of grade and alignment in order to facilitate cleaning and inspection.
It appears from the plans that the association is at present provided with
two Beetling tanks each having a capacity of some 5,500 gallons. One oi
these tanks serves the clubhouse and three cottages and the other tank, which
is located at a considerable lower elevation, serves all but eight of the present
cottages.
it is now proposed either to continue using the present settling tanks aud
to construct a dosing tank in connection with the proposed contact beds
and equalizing chamber or to abandon the use of the present tanks and con
struct a new settling tank adjacent to the proposed dosing -chamber. Inas-
much as the present tanks are of adequate capacity to give sufficient deten-
tion for the sewage contributed by the present population it seems unnecessary
to construct a new settling tank unless these tanks are found to operate
improperly.
ihe proposed dosing chamber is to have a capacity of 5,300 gallons and is
to be provided with three alternating dosing siphons arranged so as to dis-
charge the sewage to any one of the three contact beds. These beds have a
combined area of about 0.04 acres and are to be filled with broken stone to a
depth of five feet.
'Ihe rate of operation of the contact beds will be about 500,000 gallons per
acre per day, assuming that 200 persons will ultimately be served by the
proposed sewage disposal plant and that the rate of water consumption will
amount to 100 gallons per capita per day.
The contact Ms are also to be provided with automatic time siphons which
are intended to regulate the time of contact and discharge the effluent into the
proposed equalizing chamber.
It appears that the contact beds and equalizing chamber have been rede-
signed in accordance with the recommendations of my former report and the
disposal works, if properly constructed and operated, should produce a satis
factory effluent.
In conclusion, I would say that the present settling tanks could be used
in connection with the proposed dosing chamber and contact beds with such
modification as may be foimd necessary to produce a satisfactory effluent or
until such time as a material increase in the population or in the quantity
of sewage shall require a settling tank of greater capacity.
I would, therefore, recommend that the plans be approved and a permit
issued allowing the discharge of effluent from the proposed sewage disposal
works into Ck>ok creek, a tributary of Schoharie creek.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
FULTON
On September 16, 1900, plans for a change in the alignment of the sani-
tary sewer along the towing path in the city of Fulton were submitted for
approval by the city engineer on behalf of the board of public works. A
proper application was not received until January 19, 1010. On January 28,
1910, the plans were approved subject to the provisions of a permit issued
on July 27, 1900, allowing the discharge into the Oswego river of sewage
from the then proposed intercepting sewer.
On July 18, 1910, application was made by the board of public works for
permission to discharge sewage into the Oswego river from extensions and
XBodificationB of the existing sewer system in the West Side sewer district
in the city of Fulton after such sewage shall first have been passed through
the sewage disposal plant. These plans were approved and a conditional per-
mit was issued on September 30, 1910.
402 State Dbpabtmbnt of BLealth
On October 25, 1010, plans for a proposed extension to the sewage disposal
plant were submitted for approval hj tne citv engineer on behalf of the board
of public works of the city of Fulton, in conformity with the permit issued on
Seotember 30, 1910. These plans were approved on November 12, 1910, on
conditions embodied in a letter to the city engineer, dated November 12,
1910, which is printed below.
Albany, N. Y., January 28, 1910.
Eugene H. Pobteb, M.D., State Commissioner of Health, Albany, N. Y.:
pEAB Sib :— 3.1 b^ to report on an examination of plans for a proposed
change in the alignment of the sanitary sewer along the towing path in the
city of Fulton, Oswego county, submitted to this Department for approval by
the city engineer, September 16, 1909.
Owing to some delay complete duplicate plans consisting of five blue prints,
each showing the proposed location or alignment of the sewer along the
towing, path, were not submitted until December 18th, and an application
properly filled out by the board of public works was not received by the De-
partment until January 19, 1910.
Plans for this section of the intercepting sewer were approved on July 27,
1909. The plans now under consideration cover changes in the alignment of
this sewer near Lock No. 2 on the New York StaAe Barge canal, and in
passing through the walls of this lock. It is stated in the letter by the city
engineer, accompanying the plans, that the Barge Canal Board desired the
proposed changes " to better accommodate the construction which they con-
template." The size and grade of the proposed sewer is to remain the same
as that shown on the plans approved in July.
I recommend that the plans be approved subject to the provisions of a
permit issued on July 27, 1909, allowing the discharge of sewage from the
proposed intercepting sewer into the Oswego river.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
Albany, N. Y., September 14, 1910.
Eugene H. Pobteb, M.D., State Commissiofier of Health, Albany, N, Y.:
Deab Sib: — I beg to submit the following report on an examination of
plans for extensions and modifications of the existing sewer system in the
West Side sewer district in the city of Fulton, submitted to this Department
for approval by the city engineer on behalf of the board of public works, on
July 12, 1910.
The plans show that it is proposed to construct nineteen sewer extensions
on the west side of the river. These sewers are to be extensions or modifi«*4-
tions to the existing sewer system in what is known as the West Side sewer
district. They, however, modify but slightly the West Side sewer system ap-
proved on August 25, 1904.
The plans have been carefully examined in regard to grades, velocities,
capacities and other hydraulic and sanitary features in connection with the
proposed sewers, and it is found that except in the case of five of these exten-
sions the sewers are adequate to meet the future rquirements of this district
on the usual assumptions as to population and water consumption, and as-
suming that in the construction the sewers will be made sufficiently water-
tight to prevent excessive infiltrations of ground water.
The five sewers which are not satisfactory are the proposed 6*' sections in
(1) West Second street between Walnut and Maple, (2) Cedar street . between
West Fourth and Wickham, (3) W^orth street between West First and West
Sixth, (4) Wickham street between Walnut and Cedar, and (5) West First
street between Walnut and Cedar. Some of these sections of 6" sewers have
Sewebage and Sewage Disposal 403
slopes of .45 per cent, which are entirely too flat for sewers of this size. In
order to secure self-cleansing velocities i" sewers should be constructed on a
slope of not less than 0.7 per cent. The plans show that slopes of 0.7 per
cent, can readily be obtained for all of these sections of 6" sewers either by
raising the invert elevation of the manholes at the upper ends of these sewers
or by lowering the invert of the manhcrfes at the lower ends.
The consideration of these plans brings up the question of sewage disposal
which is an important one, inasmuch as Oswego at present derives its public
water supply from the Oswego river below Fulton.
I'he records of the Department show that plans for a sewer system and sew-
age disposal plant for the West Side sewer district were approved by this
Department on August 25, 1904. On December 23, 1908, plans for sewage
disposal were approved and a permit issued allowing the discharge of effluent
from the proposed settling tank to be constructed as part of the sewage dis-
posal plant to treat the sewage to be collected by the West Side sewer system
on the condition that whenever it is deemed necessary by the State Commis-
sioner of Health sand filters shall be constructed in accordance with the plans
approved and the effluent from the settling tank shall be passed through
them. This permit also limits the amount of sewage to be passed through
such settling tank and subsequent filter beds to that contributed by 500 per-
sons until the capacity of such sewage disposal plant shall be increased in
accordance with plans approved by this Department.
The settling tank which is now in operation is divided into two compart-
ments having a combined capacity of 12,960 gallons, and is adequate to give
about 6 hours' detention of sewage contributed by 500 persons.
According to the. report of the city engineer this settling tank serves about
250 persons at present and, after the completion of the proposed sewer exten-
sion for which plans are under consideration, will serve a population of about
2«500. It appears, therefore, that in order to comply with the requirements
of the permit granted on December 23, 1908, and provide for sufficient set-
tling tank capacity to properly treat the sewage to be contributed by a pop-
ulation of 2,500 it will be necessary for the board of public works of the city
of Fulton to submit for approval complete, detailed plans, satisfactory to this
Department, either for 4 sJdditional 2-compartment settling tanks of the size
and capacity of the existing tank so as to provide for a total capacity equal
to about 5 times that of the present tank or to construct two or more addi-
tional settling tanks having a combined capacity equal to 4 times that of
the existing tank. In other words, it will require settling tanks having
a capacity of about 62,500 gallons to give a 6 hours' detention of sewage
contributed by a population of 2,500 persons, assuming a rate of water con-
sumption of 100 gallons per capita per day.
It will further be necessary for the city authorities, in order to comply
with the permit granted to them and thereby protect the water supply ot
Oswego, to increase the capacity of the existing sewage disposal plant in
accordance with the above suggestions and with plans to be approved by this
Department, before any sewage is discharged into the proposed sewer extension.
It appears that the construction of the sand filters may be deferred until
such time as in the judgment of the State Commissioner of Health a more
complete purification of the sewage of the city of Fulton may become necessary,
provided the settling tank now in operation be enlarged or extended so as to
give a proper time of detention of sewage to be contributed by 2,500 persons.
In conclusion, I would say that the plans before the Department are sat-
isfactory except as noted above, and they can easily be revised to meet the
requirements of the Department. The question of sewage disposal, however,
is an important one and has received careful consideration.
I would, therefore, recommend that the plans be approved and a permit be
issued allowing the discharge into the Oswego river of settling tank effluent,
and that the permit contain in addition to the usual revocation and modifi-
cation clauses the following provisions:
1. That the slope of all sections of six (6) inch sewers shown by the
plane shall be increased to at least 0.7 per cent.
404 State Department of Health
^. That no sewage shall be admitted to the proposed sewers until the
sewage disposal plant is enlarged in complete conformity with compete,
detailed plans satisfactory to this Department for the treatment of the
entire sanitary sewage of the West Side sewer district, which plans shall
first have been submitted to and approved by this Department.
3. That whenever required by the State Commissioner of Health com-
plete, detailed plans satisfactory to this Department for more complete
treatment of the sanitary sewage of the West Side sewer district shall
be submitted to the Department for approval, and any or all portions of
the sewage disposal works shown by said plans shall thereafter be con-
structed and put in operation when required by the State Commissioner
of Health.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer,
Albany, N. Y., November 2, 1910.
Eugene H. Porter, M.D., State Commissioner of Health, Albany, N, Y,:
Dear Sir: — I beg to submit the following report on an examination of
plans for a proposed extension to the sewage disposal plant of the city of
Pulton, Oswego county, submitted to this Department for approval by the
city engineer on behalf of the board of public works on October 25, 1910.
The records of the Department sht>w that plans for a sewage disposal plant,
consisting of a settling tank and sand filters, were approved on December 23,
1908. A provisional permit was issued in connection with these plans which
allowed the discharge into the Oswego river of effluent from the settling tank
to be cqnstructed as part of the sewage disposal plant to treat the sewage
collected by the West Side sewer system on the condition that whenever it
was deemed necessary by the State Commissioner of Health sand filters should
be constructed in accordance with the plans as approved and the effluent from
the settling tank should be passed through them. This permit also limited
the amount of sewage to be passed through such settling tank and subse-
quent sand filters to that contributed by 500 persons until the capacity of
such sewage disposal plant should be increased in accordance with plans to
be approved by this Department.
On September 30, 1910, plans for some 19 sewer extensions in the West
Side sewer district tributary to the sewage disposal plant were approved. It
was estimated by the city engineer that these sewer extensions, when com-
pleted, would ultimately serve about 2,500 persons.
In view of the condition of the permit issued on December 23, 1908, which
limited the number of persons to be served by the settling tank to 500, the
permit issued on September 30, 1910, in connection with the plans for sewer
extensions approved on that date contains in addition to the usual revocation
and modification clauses the condition that no sewage shall be admitted to
the proposed sewers until the present sewage disposal plant shall be enlarged
in full conformity with complete detailed plans satisfactory to this Depart-
ment for the treatment of the entire sanitary sewage of the West Side sewer
district, which plans shall first have been submitted to and approved by
this Department. This permit also contains the provision that the gradients
of all sections of 6-inch sewers shown by the plans should be at least .6 per
cent.
In connection with the plans for an extension to the sewage disposal plant
recently submitted for approval the city engineer, on behalf of the board of
{mblic works under date of October 24, 1910, requests that the board be re-
eased from the two conditions of the permit referred to above inasmuch as ( 1 )
two of the five sections 6" sewers with flat gradients could not be changed
owing to existing connections and location of other piping; and (2) that the
existing settling tank is giving a detention of ten and one-half hours at present
and will at least not be overtaxed before January 1, 1911 (when it is expected
Sewesaoe and Sewage Disposal 405
that the proposed extensions to the present settling tank will be completed),
since only 5 per cent, of the houses to oe connected with the sewers are provided
with plumbing. It was further pointed out that the people whose houses are
provided with proper plumbing fixtures are anxious to have them connected
with the sewers and that the work could be done more easily now than in
the spring owing to the conditions of the ground.
The plans before the Department and now under consideration show that it
is proposed to construct an additional settling tank with three equal com-
partments and one dosing tank. Each compartment is 12' x 24' x 10' deep,
giving a total capacity of the new tank of about 64,800 gallons, which is ade-
quate to give about six hours' detention of sewage contributed by a popula-
tion of some 2,600 persons. The total settling tank -capacity will therefore be
adequate to care for the sewage to be contributed by an ultimate population
of 3,100 persons and this population formed the basis of design with respect to
the necessary capacity of the sewage disposal plant when the original plans for
the West Side sewer system and sewage disposal plant were submitted to the
D^artment and approved in 1004.
The dosing tank, which is to be provided with two six-inch alternating
siphons, will have a capacity of about 15,000 gallons. It may be necessary to
add additional siphons to the dosing tank when supplementary treatment works
are constructed in order to properly distribute the effluent over the sand
filters.
The proposed settling tank, if properly constructed and operated, should
produce a satisfactory effluent for this type of plant and, in connection with
the present settling tank, should be adequate to give a satisfactory preliminary
treatment of sewage when serving a population of 3,100 persons on the usual
assumptions as to sewage contribution.
In view of the above, therefore, I beg to recommend that the plans for the
proposed settling tank to be constructed as part of the permanent sewage dis^
posal plant for the West Side sewer district be approved on condition that
detailed plans for more complete treatment of the sanitary sewage of the
West Side sewer district shall be submitted to this Department for approval
whenever required and that any or all portions of the sewage disposal works
shall be thereafter constructed when required by the State Commissioner of
Health and that such additional siphons and dosing apparatus shall be in-
stalled in the dosing tank shown by the plans when supplementary treatment
works are installed, as may be necessary to properly deliver the effluent from
the five settling tanks to the supplementary treatment works when such works
are required by this Department to be constructed.
Respecting the request made by the city engineer on behalf of the board of
public works that the city authorities be released from the provisions con-
tained in conditions III and IV of the permit issued on September 30, 1910,
I beg to recommend that with reference to condition III, this request be
granted since it appears that the gradients of three of the five sewers of which
criticism was made have been increased as required, while in the case of the
other two sewers of which criticism was made, existing connections are too
low or storm sewer and water pipes were encountered which made the in-
crease of gradient impracticable.
With respect to the application for permission to allow connections with pro-
posed sewers for which plans were approved on September 30. before the com-
pletion of the additional settling tanks, it is stated by the city engineer that
the bids for contracts for constructing the additional settling tanks for which
Slans are now before this Department for approval are to be received on
fovember 7, 1910, and their completion is to be asked for on or about Janu-
ary 1, 1911. It is further stated that gaugings of the flow to the two existing
tanks show that nearly 70 per cent, surplus capacity is available at present in
these tanks over that for which these tanks were designed and the plans ap-
proved, while it is estimated that only about twenty-five connections out of
500 would probably be made.
406 State Department of Health
In view of the foregoing, I would recommend that permission be given until
February I, 1911, for the discharge into Oswego river of such sewage as may
be c(^ lee ted by the proposed sewers shown by the plans approved on September
30, 1910, provided such sewage is passed through the existing settling tanks.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
Albany, N. Y., November 12, 1910.
Gbobge W. Hackett, City Engineer, Fulton, N, Y,:
Deab Sib: — I am sending you under separate cover the approved plans for
additional settling tanks for the preliminary treatment of sewage to be col-
lected by proposed extensions to the West Side sewer system for which plans
were approved on September 30, 1910, the submission of such plans for ap-
proval and the construction of the additional tanks in accordance with ap-
proved plans havine been required by the conditions of the permit granted on
September 30th before house connections should be mad^ with the proposed
sewers.
The permit issued on September 30, 1910, above referred to, allows the dis-
charge of effluent from the additional tanks into the Oswego river so that the
granting of an additional permit in connection with the approval of the plans
for additional settling tanks is not necessary, the conditions of approval of such
plans being contained in this communication.
In accordance with the recommendations of the report of the chief engineer
on an examination of the plans, a copy of which is herewith inclosed, I have
this day approved the plans, in response to the application for their approval
made by you under date of October 24, 1910, on behalf of the board of public
works of the city of Fulton, under the following conditions extending and con-
forming to the conditions of the permit granted on September 30, 1910:
(1) That whenever required by the State Commissioner of Health, com-
plete detailed plans satisfactory to this Department for more complete
treatment of the sanitary sewage of the West Side sewer district shall be
submitted to this Department for approval, and any or all portions of
the sewage disposal works shown by said plans shall thereafter be con-
structed and put into operation when required by the State Commissioner
of Health.
(2) That such additional siphon and dosing apparatus shall be installed
in the dosing tank shown by the plans, when supplementary treatment
works are installed, as may be necessary to properly deliver the effluent
from the five settling tanks to the supplementary treatment works when
such works are required by this Department to be constructed.
In your communication of October 24th you asked on behalf of the board
of public works that such board be released from conditions III and IV of the
permit granted on September 30, 1910, requiring an increase to 0.6 per cent,
of the gradient of all six-inch sewers shown by the plans and requiring that
no sewage should be admitted to the proposed new sewers imtil the additional
settling tanks should be constructed. Your communication stated the reasons
why release from these conditions was asked for and might reasonably be
granted and the advisability of granting such request is fully discussed in the
accompanying report of the chief engineer.
In accordance with the recommendations of said report, I hereby release
the board of public works from complying with that requirement of the per-
mit granted on September 30th which involved the increase of gradient of the
sewers on Worth and Wickham streets.
Furthermore, in accordance with the recommendations of the inclosed report,
permission is hereby granted to the board of public works until February 1,
1911, to discharge into the Oswego river, the sewage to be collected by the
Sewebage and Sewage Disposal 407
proposed sewer extensioiiB, provided such sewage shall be passed through the
existing settling tanks pending the completion of the additional settling tanks
for which plans are this day approved.
The permit embodied in this communication to become operative must first
be recorded in the county clerk's office of Oswego county.
Very respectfully,
EUGENE H. PORTER,
Commiesumer of Health
FULTONVILLE
On September 17, 1910, plans for an extension of the trunk sewer to a new
location of the settling tank near the easterly boundary line of the village
were submitted for approval. The plans were approved on September 19, 1910,
and a permit was issued allowing the discharge of effluent from proposed
settling tank into the Mohawk river.
This permit contains, in addition to the usual revocation and modification
clauses, the following conditions:
(1) That both the sewer system and the sewage disposal plant shall
be constructed in full conformity with the approved plans or such as
may hereafter be approved by this Department; and that all the sewage
to be collected by the proposed sewers shall be passed through the sewage
disposal plant.
(2) That whenever in the opinion of the State Commissioner of Health
an extension or enlargement of the proposed settling tank or supplementary
or additional treatment may become necessary, satisfactory detailed plans
for such enlargement or for supplementary or additional treatment shall be
submitted to the Department for approval, and upon approval of said plans
such aditional works shall be constructed within the time limit then
specified.
Albany, N. Y., September 19, 1910.
Eugene H. Pobter, M.D., State Commissioner of Health, Alhanyy N. Y.:
DcAB SiB: — I beg to submit the following report on an examination of
amended plans of the sewer system of the village of Fultonville, Montgomery
oounty, submitted to this Department for approval by the president of the
board of trustees on September 17, 1910.
The plans were sulmiitted in duplicate and show that it is proposed to change
the location of the sewage disposal plant to a site on the corporation line near
the river some 1,100 feet below that shown by the original plans for a sewer
system and sewage disposal plant approved by this Department on October 2,
1909.
According to the statement of the village authorities, the location of the
settling tank near the silk mill, as provided by these plans, is not a proper
location for a sewage disposal plant as it is presumably near the built-up sec-
tion of the village. It appears that the new location shown by the amended
plans is better inasmuch as it will place the disposal plant in a more isolated
position in regard to dwellings.
The only change in the sewer system provided by the plans now under con-
sideration is the extension of the 15-inch outfall sewer in River street to the
new site, a distance of 1,100 feet. This extension is to be of the same size
and to be laid on the same slope as that portion of the outfall sewer from
Franklin street east to the former site near the silk mill shown by the original
plans.
I therefore recommend that the plans be approved and a permit issued
allowing the discharge into the Mohawk river, in the town of Glen, near the
408 State Department of Health
easterly corporation line, of effluent from the proposed sewage disposal plant
and that the permit contain in addition to the usual revocation and modifica-
tion clauses, the same conditions as to future treatment of sewage as were
embodied in the permit issued on October 2, 1900.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
HASTINGS-ON-HUDSON
Plans for sewerage and sewage disposal for the Hudson Heights sewer dis-
trict in the village of Hastings-on-Hudson were submitted for approval by
Ward Carpenter & Co., civil engineers, on behalf of the board of trustees of
the village early in January, 1910.
After considerable correspondence and several conferences between this De-
partment and representatives of the owners of the Hudson Heights propertp*,
and after & number of revisions of the plans, they were finally approved on
September 22, 1910, and a permit was issued allowing the discharge into the
Saw Mill river of effluent from the proposed sewage disposal plant on condi-
tion that the amount of sewage to be passed through the sewage disposal plant
is hereby limited to that contributed by 100 persons until the capacity of such
sewage disposal plant shall be increased in accordance with plans approved by
this Department.
Albany, N. Y., January 19, 1910.
VVabd Carpenter & Co., Tarrytown, N. Y,:
Gentlemen: — In further reference to the plans for sewage and sewage dis-
posal plans for the section of the village of Hastings, known as ''Hudson
Heights," I beg to say that after carefully considering the plans we find that
they are not only defective in certain features, but that there are other
features concerning the Public Health Law and the requirements of this De-
partment for the submission of plans which require further consideration.
Under the Public Health Law there is no provision made whereby the State
Commissioner of Health can accept and approve plans submitted by individuals
or real estate corporations, and it has been my custom that plans for private
development areas be accepted by the village and be presented to the Depart-
ment by the village before any approval is given of them. In explanation of
this, I would point out that it is not practicable for this Department to deal
directly with such companies and that practically there is no responsibility
attached to any approved plans or a permit when issued to a private party or
company. In other words, as soon as a land company has sola its property to
various individuals, the company may cease to exist and it would be a very
difficult matter to hold the individual property owners responsible for any
failures on the part of said company.
If, however, the village will accept the plans of the private company and
will make application to the Department and take the responsibility of taking
over these sewers and maintaining the sewage disposal plant in the future,
this Department can then have some definite guarantee as to the proper con-
struction and operation of the proposed plant. I would, therefore, suggest
that you take this matter up at once with the president of the village or the
board of trustees and come to some agreement or arrangement whereby the
village may construct and operate the necessary sewers and sewage disposal
plant for this district of Hudson Heights.
In regard to the plans themselves, there are two general defects; one is
that they do not show all of the sewers which will ultimately contribute
sewerage to this disposal plant and consequently it will not be possible for me
SiEWEiRAQE AND SeWAGE DISPOSAL 409
to determine the suitability of the plant for this ultimate requirement. Further
than this no grades are shown upon the sewers as required in the rules and
r^pilations of this Department which have been furnished your engineers.
Further than this, the contact beds and the sand filter areas are entirely too
small for the population which you propose to connect this sewer within the
next few years; viz., 125 persons. This matter, as well as the former referred
to, were taken up in detail by our Chief Engineer, Mr. Horton, during his
recent visit to Hastings where he met one of your engineers, and looked over
the ground and pointed out to him the difficulties and desirable changes which
it would be necessary to make in the plans before they could be approved
by him.
Since I have already suggested that you take this matter up with the
village, I would suggest that it would be well for it individually or for them
and you jointly to consider not only one treatment by the means which are
shown upon the plans submitted by the engineers, Ward Carpenter &, Co., but
that other means of sewerage and disposal of this whole section lying in the
western portion of the village be considered and a sewage system and disposal
works, on a more comprehensive scale for this entire section, be considered
and developed.
I will therefore await further advice from you as to the success you have
had in reaching an agreement with the village board concerning either the
present plans or the more comprehensive plan as just referred to, and as soon
as such comprehensive plans or corrected plans for the individual plant now
under consideration are submitted, your plans will be at once considered and
examined.
Respectfully yours,
EUGENE H. PORTER,
Cotntniasioner of Health
Albany, N. Y., July 20, 1910.
£UGENE H. POBTEB, M.D., State Commissioner of Health, Albany, N. Y.:
Deab Sib: — I beg to submit the following report on the examination of
elans for sewerage and sewage dispoeal at Hudson Heights, Hastings-on-
[udson, in the county of Westchester, submitted to this Department for ap-
proval by the board of trustees of the village of Hastings-on -Hudson.
Hudson Heights is a large tract of land owned by the Hudson P. Rose Co.
in the village of Hastings-on -Hudson. There are at present five houses on
this property and it is expected that this number will be increased to fifteen
or twenty-five within the next two years.
Plans for sewerage and sewage disposal for this territory were submitted to
this Department for approval early in January, 1910, by the designing engi-
neers, but owing to the inadequate size of the sewage disposal plant and the
lack of proper application from village authorities these plans were returned
for amendment. As the result of an inspection of the proposed location of
the sewage disposal plant by me, several conferences and considerable corre-
spondence with the representatives of the H. P. Rose Co. and this Department,
amended plans, revised in general in accordance with the recommendations of
this Department were finally resubmitted for approval on July 8, 1910. An
application properly filled out and signed by the board of trustees of thp
village of Hastin&:s-on-Hudson, asking for the approval of these plans was
also received on June 10, 1910.
The revised plans now under consideration show that it is proposed to con-
struct some 3,000 feet of 8" sewers in Mount Hope boulevard and Stanley
avenue. This sewer is to have a slope of from 0.5 per cent, to 14 per cent.
and is to extend from a point some 200 feet west of Le Furgy avenue to a pro-
posed sewage disposal plant near Saw Mill river and about 400 feet from
the Mount Hope station on the Putnam division of the New York Central and
Hudson River railroad. This sewer is adequate as to size and capacity to
410 State Department of Health
meet the probable future demand for the conveyance of sanitary sewage that
may be made upon it in the future, provided that in construction the sewers
will be made sufficiently water-tight to prevent excessive infiltration of ground
water.
The proposed sewage disposal plant consists of a settling tank, a contact bod
and a sand filter. The sewage enters the settling tank through a submerged
inlet near the middle of the long side of the tank and is discharged into the
contact bed through a submerged outlet formed by connecting a riser pipe with
a collecting box placed across the end of the tank near the inlet pipe.
This arrangement requires modification inasmuch as the provision for the
sewage entering the tank so near the outlet will tend to cause the sewage to
flow directly from the inlet to the outlet, thus leaving a large portion of the
tank in a stagnant condition. In order to utilize the entire capacity of the
tank and thereby make it more efficient, the inlet should be located at the
opposite end from the outlet.
From the settling tank the sewage is to flow continuously into the contact
bed filled with two-inch broken stone to a depth of thirty-six inches laid upon
a layer of field stone varying in depth from six inches to eight inches. This
layer of large stone is intended to act as a system of underdrains. When the
contact bed is filled with sewage to a depth of about thirty-six inches, a three-
inch Miller siphon will discharge the contents to the distributing system of
the sand filter. Better results would undoubtedly be obtained if the contact
bed be divided into two units having a combined area and depth equal to
that of the proposed contact bed inasmuch as smaller and more frequent doses
would be delivered to the sand filters. Under the proposed arrangement only
one and one-half fillings of the contact bed would obtain per day for the
maximum contribution of sewage which the disposal plant is designed to treat
and a considerable period of the time would be consumed in discharging each
dose to the filter. Furthermore, each dose of contact bed effluent although
some time is required for its discharge, will be sufficient to flood the sand
filter to depth of one foot, which is undesirable inasmuch as too rapid a rate
of filtration will result.
It is important that a satisfactory effluent from the proposed sewage dis-
posal plant be obtained since a portion of the public water supply of the
city of Yonkers, although filtered, is taken from the Saw Mill river a few
miles below the point of discharge.
It appears therefore that while the plans have been designed in general
accordance with the suggestions of this Department, there are certain features
in the details of the design that require modification in order that the sewage
disposal plant may operate more satisfactorily and efficiently, viz., (1) placing
the inlet pipe of the sewer at the opposite end of the settling tank from the
outlet; (2) dividing the contact bed into two units having a depth and area
equal to that of the proposed bed.
I therefore beg to recommend that the plans be returned to the designing
engineers for amendment in accordance with the above suggestions.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
Albany, N. Y., September 16, 1910.
EuGEN^ H. POBTEB, M.D., State Commissioner of Health, Albany, N. Y,:
Dear Sir: — I heg to submit the following report on aji examination of
amended plans for sewage disposal at Hudson Heights, Has tings-on -Hudson,
in the county of Westchester, resubmitted to this Department for approval by
Ward Carpenter & Co., civil engineers, on behalf of the Hudson P. Rose Co.,
application for permit having been submitted by the board of trustees of the
village of Hastings-on-Hudson.
The plans have been before the Department since January, 1910, and have
been the subject of several conferences and considerable correspondence be-
Sewerage and Sewage Disposal 411
tween this Department and representatives of the owners of the Hudson
Heights property. The plans have finally been revised in accordance with the
recommendations embodied in my report on an examination of plans for sewage
disposal at Hudson Heights, dated July 20, 1910. Reference is made to this
report for a discussion of the sewer district plant and of the plans that have
been under consideration from time to time.
As noted in the last report, the proposed sewage disposal plant consists of a
settling tank, contact beds and a sand filter.
The settling tank has a capacity sufficient to give about ten hours' detention
of sewage contributed by a population of 100 persons assuming a rate of water
consumption of 100 gallons per capita per day. From the settling tank the
sewage passes through a submerged outlet controlled by the Merritt air-lock
inlet feeds into either of the two contact beds. These contact beds are filled
with broken stone to a depth of three feet and have a combined area of about
0.033 acres, which permits of a rate of operation of ^about 300,000 gallons per
acre per day on the above assumption as to population and water consumption.
The contact bed effluent is then to be discharged to the distributing system
of the sand filter by means of Merritt air-lock discharge siphons. The sand
filter is to be provided with two longitudinal lines of underdrains which con-
nect with a six-inch collecting drain and outlet pipe. The underdrains are to
be covered with a six-inch layer of one-half inch broken stone ; over the broken
stone are placed eighteen inches of coarse sand and a top layer of medium sand
twelve inches deep.
The sand filter has an area of about 0.026 acres and will be required to
treat the contact bed effluent at the rate of about 384,000 gallons per acre per
day when serving a population of 100 persons contributing sewage at a daily
rate of 100 gallons per capita.
In conclusion I would say that the proposed sewage disposal plant, if
properly constructed and operated, should produce a satisfactory effluent when
treating sewage contributed by a population up to 100 persons on the usual
assumptions as to water consumption. Whenever the population to be served
by the disposal works shall exceed 100 persons it will be necessary to in-
crease the plant in accordance with plans to be approved by this Department.
I therefore recommend that the plans be approved and a permit be issued
allowing the discharge into the Saw Mill river of effluent from the proposed
sewage disposal plant, and that the permit contain in addition to the usual
revocation and modification clauses, the provision:
That the amount of sewage to be passed through the sewage disposal
plant shall be limited to that contributed by 100 persons until the
capacity of such sewage disposal plant shall be increased in accordance
with plans approved by this Department.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
On October 1, 1910, plans for a sewer extension in Broadway in the village of
Hastings-on-Hudson were submitted for approval by the board of trustees.
These plans were approved on October 28, 1910, and a permit was issued allow-
ing the discharge into the Hudson river of sewage from the proposed sewer on
condition that whenever required by the State Commissioner of Health detailed
pians satisfactory to this Department for such intercepting sewers as may be
necessary to convey the entire sanitary sewage of the village to a suitable site
for sewage disposal works together with detailed plans for sewage disposal
works to treat the entire sanitary sewage of the village, accompanied by a
proper application from the village authorities for the approval of such plans,
shall be submitted to this Department for approval ; and that such intercepting
sewers and any or all portions of such sewage disposal works as may be
designated shall be constructed and put into operation whenever required by
the State Commissioner of Health.
412 State Depabtmbnt of Health
On November 2S, 19 10^ plans for proposed sewers in Warburton avenue and
in the '' Uniontown " sewer district were submitted for approval. These plans
were approved on December 23, 1910, and a permit was issued allowing the
discharge into the Hudson river of sewage from the proposed sewers. This
permit contains in addition to the usual revocation and modification clauses
the following conditions:
1. That on or before January 1, 1912, the village of Hastings-ou-
Hudson shall submit for approval detailed plans satisfactory to this
Department for intercepting sewer for collecting and conveying the entire
sanitary sewage of the village to a suitable eite or sites for sewage dis-
poeeU works.
2. That ofi or before January 1, 1912, the village of Hastings-on-
Hudson shall submit for approval detailed plans satisfactory to the De-
partment, providing for preliminary treatment of the entire sanitary
sewage of the village, comprising ecreening, sedimentation or septic action
or a combination of these methods, accompanied by general plans for addi-
tional and more complete treatment of the sewage.
3. That any or all portions of such intercepting sewers and sewage dis-
posal works shall be constructed and put in operation whenever required
oy the State Commissioner of Health.
Albany, N. Y., October 25, 1910.
Eugene H. Porteb, M.D., State Commissioner of Health, Albany, N, F.;
Deab Sib: — I beg to submit the following report on the examination of
plans for the proposed sewer extension in the village of Hastings-on -Hudson
recently submitted to this Department for approval by Ward Carpenter and
Company, Civil Engineers and Surveyors of Tarrytown, N. Y., on behalf of
the board of trustees.
The records of the Department show that plans for a comprehensive sewer
system for the village were approved on September 21, 1894, and that amended
plans were approved by the Department on January 25, 1895.
The plans now under consideration show that it is proposed to construct
some 1,863 feet of 10'' sewer in Broadway from the village line of Dobbs
Ferry to Edgar's lane. The sewer is to have a slope of from 0.53 per cent,
to 1.2i3 per cent, and is to discharge into the existing sewer at the intercep-
tion of Broadway and Edgar's lane. The sewage to be collected by the pro-
posed sewer is to be discharged into the Hudson river at the wharf near the
foot of Maple street extended.
The sewer which it is now proposed to construct is shown by the plans ap-
proved on October 4, 1894, referred to above.
The plans have been carefully examined in regard to grades, velocities,
capacities and other hydraulic and sanitary features in connection with the
proposed sewer, and it is found to be adequate to meet the future require-
ments for sanitary sewerage for the section to be sewered by it on the usual
assumption as to population and water consumption, and assuming that iti
construction the sewer will be made sufficiently water tight to prevent
excessive infiltration of ground water.
It should be kept in mind that the time is approaching when preliminary
treatment, at least, should be given the sewage from Hastings-on-Hudson be-
fore its discharge into the Hudson river. However, in view of the fact that
the proposed sewer is shown on the plans approved in 1894, and in order that
no unnecessary delay in constructing the sewer may result it would seem that
approval of the plans might be given, provided the permit issued includes a
clause requiring the submission of plans for intercepting sewers and sewage
disposal works when required by this Department.
I would, therefore, recommend that the plans be approved and a permit
for the discharge into the Hudson river of sewage to be collected by the pro-
posed sewer be issued which shall contain, in addition to the usual revoca-
Sewerage and Sewage Disposal 413
tiou and modification clauses, the provision that whenever required by the
State Commissioner of Health detailed plans be submitted to this Department
for intercepting sewers and sewage disposal works to treat the entire sewage
of the village, and that such intercepting sewers and sewage disposal works
shall thereafter be constructed and put into operation when required by the
State Commissioner of Health.
Respectfully submitted,
THEODORE NORTON,
Chief Engineer
Albany, N. Y., December 9, 1910.
Eugene H. Poster, M.D., 8tate Commissioner of Health, Albany, N, Y,:
Dear Sib: — I beg to submit the following report on an examination of
plans for proposed sewer extensions in the village of Hastings-on-Hudson,
Westchester county, submitted to this Department for approval by Ward Car-
penter and Company, Civil Engineers and Surveyors of Tarrytown, on behalf
of the board of trustees, on November 28, 1910.
The records of the Department show that original plans for a sewer system
for the village were approved on September 21, 1894, and amended plans were
approved on January 26, 1895. These plans provided for the discharge of
untreated sewage into the Hudson river at several points.
Plans for an extension to the sewer system in Broadway were approved
on October 28, 1910. The permit issued in connection with the approval of
these plans contains in addition to the usual revocation and modification
clauses the condition:
" That whenever required by the State Commissioner of Health detailed
plans satisfactory to this Department for such intercepting sewers as may
De necessary to conveiy the entire sanitary sewage of the village to a
suitable site for sewage disposal works, together with detailed plans for
sewage disposal works to treat the entire sanitary sewage of the village,
accompanied by a proper application from the village authorities for
the approval of such plans, shall be submitted to this Department for
approval; and that such intercepting sewer and any or all portions of
such sewage disposal works as may be designated shall be constructed
and put into operation whenever required by the State Commissioner of
Health."
The plans now before the Department and under consideration show that
it is proposed to construct some 1,600 feet of 8" and 10" sewer in Warburton
avenue in general accordance with the plans approved in 1894, except that
the proposed outlet into the Hudson river is to be located about 1,000 feet
south of one of the outlets provided for by the original plans. Although the
slope of the ground is such that the flow of sewage would be in the opposite
direction from that provided for by the plans the engineers state in their
report that it would be practically impossible to get a right-of-way for an
outfall sewer into the river at a point farther north and the outfall sewer
would also be longer at any other point than that shown by the plans. The
cut, however, does not exceed 15 feet and it is pointed out that a deep cut is
desirable inasmuch as the property on the westerly side of Warburton avenue
is considerably below the street level. The 8" sewer has a slope varying
from 0.75 per cent, to 1 per cent., and the 10" sewer is to be laid on a slope
of 0.36 per cent. About 200 feet of the proposed sewer is tributary to the
existing sewer in Warburton avenue. The proposed sewer extension should
be adequate as to size and capacity to satisfactorily care for the sewage of
the district to be served by it.
Plans are also presented which provide for sewers in the easterly section
of the village located on the Saw Mill river watershed, including the Union-
town and Hudson Heights sewer districts. These sewers are for sanitary
sewage only and vary in diameter from 8" to 15". It appears that the pro-
posed sewers are somewhat larger than would be required to care for the
ultimate contribution of sanitary sewage for the district to be served by them
414 State Depabtment of Health
on the UBual assumptions as to population and sewage contribution. Tliid«
however, is a good fault and will insure ample capacities for future needs,
provided that in the construction the sewers be made sufficiently water-
tight to prevent excessive infiltration of ground water.
The sewage to be collected by the proposed sewers is -to be conveyed by
gravity to a piunping station located near the Putnam Division of the New
York Central and Hudson River railroad at the foot of Farragut road from
which it will be pumped through a 6'' cast-iron force main to the existing
8" sewer in Farragut road near Merrill street, a distance of about 3,800 feet.
The sewage pumps, which are in duplicate, are to be operated by compressed
air similar to the Pries tman sewage ejector. According to the engineers the
pumping plant is designed to care for an average flow of 300 gallons per
minute or about 430,000 gallons per day, which is nearly equal to additional
quantity of sewage which can be cared for by the existing 8" sewer on a 1.0
per cent, slope in Farragut road. The proposed system should be adequate
to care for the district to be served by it for a reasonable period in the
future, inasmuch as the preseat population of the sewer district is only about
600, according to the engineer's report.
In view oi the fact that the plans under consideration provide for a
comprehensive sewer system in a new sewer district which will greatly in-
crease the amount of raw sewage discharged into the Hudson river, and In
view of your consistent policy of removing, as far as possible, the gp*oss pollu-
tion of the river by requiring at least screening or settling tank treatment
of sewage before it is discharged into the Hudson river, especially where new
sewer districts are involved, I believe that the village should be required at
an early date to provide for the interception and treatment of the entire
sanitary sewage of the village.
I, therefore, recommend that the plans be approved and a permit issued in
connection with the approval of the plans containing, in addition to the usual
revocation and modification clauses, the condition that detailed plans satis-
factory to this Departpaent for such intercepting sewers as mav be necessary
to convey the entire sanitary sewage of the village to a suitable site for dis
posal, together with detailed plans for sewage disposal works, providing for
at least screening or settling tank treatment, or both, of the entire sanitary
sewage of the village, be submitted to this Department for approval on or
before January 1, 1912.
Very respectfully submitted,
THEODORE HORTON,
Chief Engineer
HEMPSTEAD
On October 21, 1910, plans for a sewer system and for sewage disposal
works for the village of Hempstead were submitted for approval by the board
of trustees. These plans were examined and returned to the designing engineer
for revision as respecting the capacity and gradients of certain portions of
the sewer system and the arrangement of double compartments at the screen-
ing chambers.
The plans were revised and resubmitted for approval on November 22, 1910.
They were approved on December 2, 1910, and a permit was issued in con-
nection with the approval of the plans on condition that the amount of sew-
age to be treated in the disposal plant shall not exceed that contributed
by 5,000 persons unless the plant is enlarged in accordance with approved
plans.
Albany, N. Y., November 7, 1910.
Eugene H. Porter, M.D., State Commissioner of Health, Albany, N, Y,:
Dear Sir: — I beg to submit the following report on an examination of
plans for a proposed sewer system and sewage disposal works for the village of
Hempstead, Nassau county, submitted to this Department for approval by the
board of trustees on October 21, 1910.
Sewebage and Sewage Disposal 415
The plans were prepared by Cyril E. Marshall, civil and landscape engineer
of Hempstead, and comprise blue prints of the following in duplicate:
1. Plan of the village of Hempstead east of Franklin street.
2. Plan of the village of Hempstead west of Franklin street.
3. Filter beds and outfall sewer to disposal works.
4. Profiles of sewers and streets (two sets).
5. Manholes and flush tanks.
6. Profile of outfall sewer to disposal works.
7. Pumping station No. 1 at Franklin street and Mill road.
8. Pumping station No. 2 at disposal works.
9. Disposal works.
Specifications and report by the designing engineer were also submitted in
duplicate.
The report of the engineer states that the sewer system is designed on the
separate plan and that all storm water from roofs^ streets or other areas
are to be excluded from the sewers. It is understood and appears from the
plans that the system covers all portions of the built-up sections of the vil-
Lage, although only the northerly corporation line is shown on the plans.
The village of Hempstead is situated in the northern part of the town of
Hempstead, in the county of Nassau, and has a population, according to the
statement of the engineer, of about 5,000. The village is provided with a
water supply taken from wells. The total consumption is apparently 500,000
gallons per day, equivalent to a per capita rate of 100 gallons per day, as
this is the basis of design according to the engineer.
The village has had a somewhat erratic growth for the past twenty years,
according to the census figures, which are as follows: In 1890 it had a pop-
ulation of 4,831; in 1900, 3,582; in 1902, 3,653; in 1905, 4,145; and according
to the report of the engineer the population at present is estimated at 5,000
persons. Owing to its close proximity to New York city and the increasing
facilities for transportation in Long Island the village will probably have a
more rapid growth in the future, and it is stated by the engineer that there
is a possibility that the village limits will be extended in the course of a few
years, and that provisions for such extension have been made in the design
of the sewer system.
The area of the village to be served by the proposed sewer system shown
on the plans ia about 670 acres of which some 90 per cent, is tributary to the
pumping station located at Franklin street and Mill road, and the sewage
to be collected from the remainder of the area in the southeastern portion of
the village will reach the sewage disposal site directly by gravity flow through
the outfall sewer into which the pumps discharge.
Inasmuch as the corporation limits are not shown on the plans as they
should be, except on the north, it is impossible to determine from the plans
if the proposed sewer system covers all portions of the village. According
to the engineer the present population of the area covered by the proposed
system is nearly 5,000 persons and, on the usual assumption of twenty persons
per acre for nilly developed municipalities, the ultimate population to be
provided for is about 13,400. The populations which will in the immediate
future contribute sewage to the pumping station in the village and the outfall
sewer with corresponding flow in gallons per day based on 100 gallons (aver-
age rate of flow) and 300 gallons per capita, respectively, will be as follows:
1. Population, 4,500; flow at 100, 450,000 gallons; flow at 300, 1,350,000
gallons.
2. Population, 5.000; flow at 100, 500,000 gallons; flow at 300, 1,500,000
gallons.
The populations which will ultimately contribute sewage to the pumping
station and outfall sewer, respectively, with corresponding flows of 100 and
300 gallons per capita per day will be as follows:
1. Population, 12,000; flow at 100, 1,200,000 gallons; flow at 300,
3,600,000 gallons.
2. Population, 13,400; flow at 100, 1,340,000 gallons; flow at 300,
4,020,000 gallons.
416 State Depabtment of Health
The plans have been carefully examined with respect to the sewerage bys-
tem and sewage disposal works. In connection with the sewerage system the
design has been carefully studied with reference to alignments, sizes, grades,
capacities, facilities for cleaning, inspection and flushing, and other features
of a hydraulic or sanitary nature. In connection with means for sewage dis-
posal it has been studied with reference to general method and efficiency of
the sewage disposal as a whole, and of the capacities, efficiencies and practical
operation of individual structures, appurtenances and apparatus.
In reference to the sewer system, it appears that although the minimum
size of sewers used is 8^ there are a niraiber of flat grades and sections of
sewers, including the outfall sewer, which are inadequate as to capacity to
properly care for the ultimate maximum contribution of sewage on the usual
assumptions as to populations and sewage contribution.
The gradients of some of the S" sewers are as flat as 0.2, and the conse-
quent velocity of flow would be too low to induce a self-cleansing of the sewer
and prevent stoppage from occurring. Although automatic flush tanks are to
be placed at the upper ends of all sew^er lines that are not to be extended the
lengths of some of the 8" and ICT lines with flat gradients, especially of the
former, are too great to be materially affected or benefited by such means of
flushing except for comparatively short distances below the flush tanks.
The minima slopes of different size sewers which should not be decreased
except in extreme cases, even where ample facilities for regular flushing are
provided, are as follows:
0.35 per cent, for 8" sewers.
0.25 per cent, for 10" sewers.
0.18 per cent, for 12" sewers.
0.13 per cent, for 15" sewers.
0.10 per cent, for 18" sewers, etc.
On the usual assiunption as to population and sewage contribution, i. e.,
20 persons per acre at 300 gallons per capita per day, the ultimate maximum
rate of contribution of sewage tributary to the 8" sewer on a 0.4 per cent,
g^ade in Fulton %venue between Hilton avenue and Franklin street, assuming
that the sewer district shown on the plan be not extended in a westerly direc-
tion, will be about 1.35 cubic feet per second and the capacity of this sewer
on 0.4 per cent, grade flowing full is only about .66 cubic feet per second.
On the same assumption the proposed sewers in portions of Franklin, Front
and Clinton streets and Fulton avenue are not adequate to care for the prob-
able, ultimate, future contribution of sewage.
Using the same basis of computation and assuming also that the territory
covered by the proposed sewer system will not be extended the ultimate
maximum rate contribution of sewage to be cared for by the 18" outfall
sewer will be about 4,000,000, while the carrying capacity of this sewer on
a grade of 0.2 per cent, is only about 3,000,000 gallons per day when flowing
full. The size of this sewer should be increased, therefore, to at least 20**
in order to properly care for the probable maximum rate of sewage contribu-
tion when the territory to be served by the proposed sewer system is fully
developed.
It appears that the efficiency and capacity of the sewer system could be
increased and most of the flat grades of the small sewers eliminated by run-
ning a comparatively large sewer in the streets along the creek in the astern
section of the village to a point at or near Jackson street, and by having
smaller branches cross the creek at one or two points to connect with such
trunk sewer. This would tend to concentrate the sewage at the upper end of
the trunk sewer quickly, thus securing self-cleansing velocities by increasing
the depth of flow of the sewer. Such trunk sewer could possibly be provided
for in the western section of the village also.
As an alternative means for providing increased capacities of sewers, where
needed, and insuring a more nearly self-cleansing velocity of flow in some
of the lateral sewers, it is possible to increase the diameters of some of the
main trunk and more important lateral sewers, the gradients remaining the
same, and to increase the gradients of the upper sections of some of the lateral
Sewkrage and Sewage Disposal 417
sewers where an increase in diameter is not warranted by the amount of
flow to be provided for. If especial facilities for flushing are provided at the
head of such lateral sewers the danger of stoppage in these sewers will be
greatly lessened. Owing to the unusual conditions obtaining at Hemp»tead
with iWpect to the flatness of the area to be sewered and the height of ground
water near the pumping plant as compared to the invert elevation of the main
trunk sewer leading to the pumping plant, I believe that it may be found
necessary to construct some of the 8" lateral setwers on gradients of from
0.25 per cent, to 0.3 per cent.
Alao the grade of some of the sewers could be increased by better balancing
the available fall, viz. : the S'^ sewer in St. Paul road has a grade of 0.3 per cent,
in the upper half of the sewer and of 0.4 per cent, in the lower seotion. The
gradient could be changed so as to give a slope of 0.35 per cent, for its entire
length.
As noted by the engineer the portion of Long Island on which the village
of Hempstead is located is comparatively flat and has an average slope of
about fifteen feet to the mile toward the south. The problem, therefore, of
designing an efficient sewer system with adequate grades is difficult and has
evidently required a great deal of study.- This Department has neither the
time nor facilities to do more than offer the above suggestions for improving
the design as respecting capacity of the system and velocity of flow.
The alignment of all sewers are straight between manholes which are to be
placed at street and sewer line intersections and at all points of change of
grade and alignment. The manholes are spaced on an average of 300 feet
apart and the spacing rarely exceeds 400 feet.
Automatic flush tanks four feet in diameter are to be placed at all dead ends
exoept where sewers are to be extended. These tanks are to have a maximum
depth of 6'-0" and are provided with 5" siphons. According to the profiles
of the sewers and the detailed plans of flush tanks a break in the grade of
the sewer is to be made 10 feet from the center of the flush tank.
The sewage from about 90 per cent, of the village is tributary to a central
pumping station located near the intersection of Franklin street and Mill roao.
The sewage upon reaching the pumping station is discharged into a square
manhole 4'x4'xl0' deep placed adjacent to the receiving well. The sewage
flows into the receiving well through an opening IS'^ square after passing
through a vertical bar screen 4 feet wide placed in front of the outlet. The
screen is to consist of ^" bars spaced y^" apart in the clear. It appears
that the screen cannot readily be removed and no means or facilities are pro-
vided for cleaning the screen and handling and disposing of the screening.
Although the screens in thie case are primarily for the purpose of protect-
ing the pumps by removing the coarse floating material from the sewage
rather than as a means of preliminary treatment they should, nevertheless,
be installed in duplicate in separate chamber so that they may be more acces-
sible at times of dogging. Cleaning of the screens and the handling of the
screenings would also be facilitated if they were to be placed in an inclined
position wi4:h an operating platform slightly above the screens.
The pump well is divideii into two compartments consisting of a receiving
well and suction well having a combined capacity of about 18^000 gallons.
Although no connection is shown between the pump and suction wells this is
probably due to error in drafting. The pumps are placed in an adjacent dry
well which can be drained into the suction well when empty.
According to the plans and the report of the engineer it is proposed to
install at present two 6" vertical top suction volute centrifugal sewage pumps
of the Worthington type with a capacity of 750 gallons per minute each,
equivalent to about 2,160,000 gallons per day for the two pumps. It appears,
therefore, that the pumps have a capacity equal to about 1.6 times the es-
timated maximum rate of contribution for the present population. The plans
provide for the installation of two additional pumps whenever required.
Aach pump is to be driven by a direct connected 15-horsepower Wagner verti-
cal m<kor with a Cutler hammer float switch and self-starting control. Alter -
14
418 State Department of Health
nating single phase 60 cycle current of 220 volts is to be used far motive
power. The fetatic head under which the pumps will operate varies from 10
to 22 feet and the starting apparatus is designed to start the pump at dif-
ferent heads.
The pumps are to discharge the aewage through a 12'^ force main some
2,000 feet long to a manhole at the intersection of Greenwich and Grove streets
from which point it flows by gravity through an 18" sewer on a grade of
0.2 per cent, to a second pumping station at the disposal site some 7,400 feet
south of Grove street.
The disposal site is to be located in the sandy district to the south of the
village and consists of 41 acres of land. The disposal works are ultimately
to comprise four complete units each consisting of two pumping stations, u
septic tank, dosing ciiamber and 12 sand filter beds, two of which are to be
used as sludge beds. It is proposed to construct one pumping station and
one unit of the disposal works at present.
This pumping station is the same in design and capacity as the first both
as to arrangement and equipment. The pumps are to discharge the sewage
into the septic tank and will operate under a static head of from 16 to 22 feet.
The septic tank which is covered has but one compartment, 125'x30' with
6' depth of flow, giving a liquid capacity of some 168,000 gallons and is
sufficient to provide for about 8 hours' detention of sewage when serving a
population oi 5,000 persons on the usual assiunptions as to sewage contribu-
tions. The tank has submerged inlets and outlets and the average velocity
of flow through the tank will be about 3" per minute when treating sewage
at the rate of 500,000 gallons per day.
Two sludge pipes are located near the outlet end of the tank which are
provided with a blow-ofl* valve so that the sludge and supernatant liquid can
be discharged to the sludge beds by gravity when required. It appears that
the sludge outlets could be placed near the inlets to better advantage inas-
much as the greater portions of the sludge is usually deposited near inlet of
the tank.
From the septic tank the sewage passes into a small separate chamber 4'
wide through 15 submerged outlets. From this chamber the sewage flows into
a dosing chamber 50'x30'x4' deep, having a total capacity of about 45,000 gal-
lons. Five plural alternating 14" siphons of the Miller type are located in
a separate chamber 20'xl0'x4' deep which communicates with the main cham-
ber by means of four 18" openings. According to the report of the engineer
tbe siphon:* are designed to empty the dosing tank in about 15 minutes.
The siphons discharge through 15" and 18" vitrified pipes to the 10 sand
filter beds having a total area of 3.4 acres. These beds are provided with
distributing systems but are not underdrained, it being assumed that the
soil which consists of sand some 40 feet deep will be able to absorb the effluent.
Wlien treating sewage at the rate of 500,000 gallons per day the beds will
be required to operate at a rate of 145,000 gallons per acre per day. The
sewage disposal plant, if properly constructed and operated, should provide
for a satisfactory means of caring for the sewage for a population up to
about 5.000 persons on the usual assumption as to sewage contribution.
It appears, therefore, that the four units comprising the sewage dis]>0fiai
works to be constructed ultimately will care for a future population of some
20,000 persons.
In view of the results of our examination of these plans and after careful
consideration of the essential features of the design and of local and general
requirements with respect to proper methods for the disposal of sewage from
the proposed system of sewers it appears that the plans, with the exception
of the screening chamber plans, are well designed in this respect and provide
for a satisfactory means of sewage disposal.
With respect to the proposed sewer system, however, it appears that there
are a few features of the plans which should be revised before final approval
of the plans is given. There are, as indicated above, a few lines of sewers
with flat grades and the system, including the outfall sewer, is not entirely
adequate as to capacity, as noted above, to care for the probable future con-
tribution on the usual assumptions as to population and water consumption
J
Sewebage axd Sewage Disposal 419
winch gives rise to the sewage. I would recommend, therefore, that the plans
be returned for amendment in accordance with tlie suggestions embodied in thisf
report.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
Albany, N. Y., November 28, 1910.
Eugene H. Pobter, M.D., State Commissioner of Healthy Albany, N. y.;
De.\r Sib: — I beg to submit the following suplementary report on an ex-
amination of amended plans for a proposed sewer system and sewage disposal
plant for the village of Hempstead, Nassau county, resubmitted to this De-
partment for approval on November 22, 1910.
The plans have been carefully examined by the Engineering Division and
it appears that they have been revised in general accordance with the recom-
mendations embodied in my report of November 7, 1910, on the examination
of the original plans.
The tlat gradients of some of the sewers criticised in my last report have
been increased or the sizes of the sewers increased so as to give a minimum
slope of 0.3 per cent, for the 8" sewers, 0.2 per cent, for the 10" sewers and
0.16 per cent, for 12" sewers. While these gradients are rather flat to insure
self-cleansing velocities except when the sewers are flowing full or half-full,
clogging can be prevented by proper flushing and attention.
Ihe design of the system has been rearranged so that trunk sewers are to
be constructed in the streets along the creek which has permitted the use of
larger sewers on flatter grades than shown on the original plans.
The sizes of some of the main sewer lines tributary to the central pumping
plant at Franklin street and Mill road have been increased so as to better
care for the probable future contribution of sewage from the sections served
by them on the usual asbumptions as to population and water consumption
giving rise to the sewage.
The size of the 18" outfall sewer from the end of the force main in Green-
wich street to the sewage disposal works has also been increased to 20" so
that this sewer will now care for a population of some 13,000 persons con-
tributing sewage at a maximum rate of 300 gallons per day.
It appears, therefore, that the proposed sewer system should be adequate
to meet the needs of the village for a considerable period in the future, assum-
ing that in the construction the sewers be made sufficiently water-tight to
prevent excessive infiltration of ground water.
The receiving manholes or screen chambers in connection with the pump-
ing stations have been enlarged so as to form two compartments. Each com-
partment is provided with two inclined screens, 2'x4', composed of ^" rodb
spaced 1" apart on centers, giving a total screening area of 32 square feet at
each pumping plant.
Although each compartment of the screen chamber is provided with valves
at the inlet and outlet so that either one may be by-passed while cleaning, no
platforms, however, are provided to receive the screenings and for the operator
to stand on when raking the screens. It appears also that the screens are
rather fine and will tend to clog quickly and require frequent cleaning, thereby
increasing the cost of operation so that it may become necessary to replace
them with somewhat coarser screens before the sewer system is fully developed.
The design of tJie sewage disposal plant has not been changed from that
shown by the original plans.
It appears that the sewer system, pumping stations and sewage disposal
plant if properly constructed and operated should provide satisfactory sewage
facilities for the village of Hempstead for a reasonable period in the future
and I would therefore beg to recommend that the plans be approved.
Respectfully submitted,
THEODORE HORTON,
• Chief Engineer
420 State Depabtment of EDeialth
ILION
On October 31, 1910, plans for sewer extensions in the village of Ilion were
submitted for approval by the sewer commissioners. These plans were ap-
proved on December 2, 1910, and a permit was issued allowing the discharge
of sewage from the proposed sewers into the Mohawk river. This permit con-
tains in addition to the usual revocation and modification clauses the follow-
ing conditions:
1. That on or before January 1, 1912, detailed plans for settling, sedi-
mentation or septic tanks to treat the sanitary sewage of the village of
Ilion, which shall meet the requirements of this Department accompanied
by general plans for additional or supplementary works for more complete
treatment of the sewage, sftiall be submitted to this Department for
approvaL
2. That the said settling, sedimentation or septic tanks shall be con-
structed and put in operation by September 1, 1912.
3. That whenever required by the State Commissioner of Health detailed
plana for said additional works for more complete treatment of the sewage
of the village shall be submitted for approval and that any or all por-
tions of said additional or supplementary works for more complete treat-
ment of sewage shall be constructed and put in operation when required
by the State Commissioner of Health.
Albany, N. Y., Novemker 18, 1910.
Eugene H. Pobteb, M.D., State CommiaHoner of Health, Alhaa^y, N. Y,:
Deab Sib: — I beg to submit the following report of an examination of plans
for proposed sanitary sewer extensions in the village of Ilion, Herkimer county,
submitted to this Department for approval by the sewer commissioners on
October 31. 1910.
The records of the Department show that plans for a comprehensive sewer
system, pumping station and sewage disposal plant were approved on January
16, 1893. The plans showed that the proposed pumping station and sewage
disposal plant consisting of a chemical precipitation plant were to be located
near the West Shore railroad tracks and some 600 feet east of East street
extended. It appears that the pumping station and chemical precipitation
plant were never constructed.
On August 25, 1893, amended plans were approved showing ohangea of align-
ment of the outfall sewer and outlet and change of location of the sewage
disposal plant to a point near the intersection of East street extended and
the West Shore railroad, some 600 feet west of the location shown by the pre-
vious plane.
On January 16, 1894, amended plans for the sewer system for the village
were approved by the Department. These plans pro\'ided for a change in the
alignment, sizes and gradients of the sewers in the vicinity of River and Kail-
road streets and Brewery lane between the West Shore railroad and the Erie
oaoial so «« to eliminate the pumping plant at the intersection of Bailroad
and River streets and thereby change the entire sewer system of the village
into a gravity system.
On February 13, 1902, plans for extensions to the sewer system were
approved.
The report of the public sewer system made in accordance with section 79
of the Public Health Law, as amended by chapter 468 of the Laws of 1903,
together with a plan showing all sewers constructed to date, were not submitted
until April 15, 1904. This report shows that tlie total length of sewers in the
system at that time was 12.41 miles and the estimated population served by
the sewer system about 4,500. The population of the village in 1905, ac-
cording to the State census, was 5,924.
The plans now submitted were prepared by James D. Ringwood, civil engi-
neer of Ilion, and eomprise duplicate tracings of plans of proposed sewer
extension* and dapUcate tracings of profiles of proposed sewers and streets.
Sewerage and Sewage Disposal 421
These plans show that it is proposed to oonstmct eight-inch sewers on grades
Tarying from .34 per cent to 11.7 per cent, in Hakes road, Spring, Maple,
McCann, Elm and Gordon streets.
Manholes are to be placed at all points of change of grade and alignment
and flush tanks are to be located at the upper ends of Maple and Elm streets
and Hakes road. The spacing of the manholes vary from 75 feet to 500 feet,
but in no case are manholes to be placed at a greater distance than 500 feet
apart.
The plans have been carefully examined in reference to sizes, grades and
capacities in connection with the proposed sewers and it is found that the
sewer extensions should be adequate as to size and capacity to satisfactorily
care for the sanitary sewage of the 4iBtrict to be served by them on the usual
assiunptions as to population and to sewage contribution provided that in the
construction the sewers be made sufficiently water tight to prevent excessive
infiltration of groond water.
The urgent need lor sewage disposal was pointed out in the report of the
Consulting Engineer of the Depar^ent, dated October 27, 1892, on his exam-
ination of plans for sewerage for the village and in accordance with the resolu-
tion of the then State Board of Health revised plans including plans for the
chemical treatment of sewage before discharging into the Mohawk were sub-
sequently submitted for approval and reported upen under date of January 6,
1893. These revised plans were approved on January 11, 1893, but the sewage
disposal works were never constructed as noted above. The discharge into the
Mohawk river of untreated sewage from the village is therefore in direct vio-
lation of the Public Health Law and Village Laws.
The need for sewage disposal along the Mohawk river is becoming more and
more urgent, and in view of the policy of this Department to eventually re-
move, as far as possi'ble, all pollution of the waters of the State caused by
the direct discharge of raw sewage and inasmuch as no plans for sewerage are
being approved that do not provide for some means of sewage disposal,
especially where public water Bupplies are involved, the village of Ilion i^ould
at this time be required to provide for the treatment of its sanitary sewage at
an earlv date.
I am of the opinion, however, that the village should not be required to
construct the rather expensive and antedated chcmiical precipitation plant pro-
vided for by the plans approved on January 11« 1893^ inasmuch as a properly
eocistructed and operated settling, sedimentation m* septic tank will give prac-
tically as satisfactory results as those obtained by means of chemical precipita-
tion, and the cost of operation in the case of ch^nical precipitation is much
greater than by either of the other means of preliminary treatment owing to
the added cost of chemicals and the additional amount of sludge to be cared
for.
While it may not be necessary for the village to provide immediately lor
complete purification of the sewage that is now being discharged into the
Mohawk river, steps should be taken to provide for at least settling, sedimenta-
tion or septic tank treatment at an early date.
I would therefore recommend that the plans now before the Department be
approved and a permit issued allowing the discharge into the Mohawk river
of sewage to be collected by the proposed sewers and that the permit contain
in addition to the usual modification and revocation clauses, the following
provisions :
1. That only sanitary or domestic sewage and no surface or storm water
from streets, roofs or other areas shall be admitted to the proposed sewers.
2. That on or before January 1, 1912, detailed plans for settling, sedi-
mentation or septic tanks to treat the sanitary sewage of the village of
Ilion, which shall meet the requirements of this Department,- accompanied
by general plans for additional or supplementary works for more complete
treatment of the sewage, shall be submitted to this Department lor
approval.
3. That the said settling, sedimentation or septic tanks shall be con-
structed and put into operation by September I, 1912.
4i'22 State Depajkt3I£nt of Health
4. That whenever required by the State Commissioner of llealth de-
tailed plans for said additional works for more complete treatment of the
sewage of the village shall be submitted for approval and that any or all
portions of said additional or supplementary works for more complete
treatment of the sewage shall be constructed and put in operation when
required by the State Commissioner of Health.
Respectfully submitted,
THEODORE HORTOX,
Chief Engineer
JOHNSTOWN
On May 2, 1910, plans for a proposed intercepting sewer in the city of
Johnstown were submitted for approval by the city engineer on behalf of the
common council. These plans were approved on June 13, 1910, and a con-
ditional permit issued allowing the discharge, into Ca\*adutta creek, of sewaj^e
to be collected by the proposed sewer.
On June 29, 1910, plans for a proposed sewer extension in Grove street were
submitted for approval. The plans were approved on July 26, 1910, and a per>
mit was issued allowing the discharge of eewage from the proposed sewer into
Cayadutta creek.
Plans for a proposed sewer extension in East State street were approved on
August 20, 1910, and a permit issued allowing the discharge of sewage from
the proposed sewer in Cayadutta creek.
On August 23, 1910, plans for an extension of the intercepting sewer were
submitted for approval. These plans were not satisfactory inasmuch as the
capacity of the proposed sewer was considerably smaller than that portion of
the intercepting sewer above the proposed extension and the plans were there-
fore returned to the city engineer for amendment with the request that pre-
liminary plans be submitted showing a tentative location of the proposed
sewage disposal site together with a profile of proposed route of a sewer from
Montgomery street to such disposal site. These plans were amended in ac-
cordance with the recommendations of the Department and were resubmitted
for approval on November 21, 1910. The revised plans were approved on
December 2, 1910, and a conditional permit was issued allowing the dis-
charge into Cayadutta creek of sewage from the proposed sewer.
The permits issued to the common council of the city of Johnstown during
the past year contain the condition that on or before June 1, 1911, complete
detailed plans, satisfactory to this Department, for the purification of the
entire sanitary sewage of the city shall be submitted for approval; and that
the construction of any or all portions of the sewage disposal works ©hown by
said plans shall thereafter be undertaken when required by the State Com-
missioner of Health and be completed within the time limit set by said
Commissioner.
Albany, N. Y., June 15, 1910.
Eugene H. Porteb, M.D., State Commissioner of Health, Albany, N. V.:
Deab Sir: — I beg to submit the following report of the examination of
plans for a proposed intercepting sanitary trunk sewer in the city of Johns-
town, Fulton county, submitted to this Department for approval by the city
engineer on behalf of the common council on May 2, 1910.
The city of Johnstown has a population of about 10,000 and is located in
the south central part of Fulton county near the Montgomery county
boundary line. It is situated on both sides of Cayadutta creek, which
meanders through the city in a southerly direction and empties into the Mo-
hawk river at Fonda, a distance of about seven miles below Johnstown
measured along the stream. The creek has a fall of about 400 feet in that
distance.
Sewerage and Sewage Disposal 423
The water supply of the city is furnished by the municipality which owns
the entire watershed.
The records of the Department show that the construction of the sewer
system commenced in 1876 and although extensions of this system have been
made from time to time until at present practically the entire population is
served by sewers, none of these extensions have been submitted for approval
or approved by this Department. All but a small portion of the existing
sewers are constructed on the separate plan and discharge into Cayadutta
creek within the city limits.
The plans and documents now under consideration were submitted in per-
son by the city engineer and city attorney and consist of duplicate copies of
each of the following :
1. A eeneral plan showing the alignment of sewers constructed to date
in the city.
2. A general plan for a proposed intercepting sewer with discharge into
Cayadutta creek in the lower end of the city, comprising:
(a) A general plan of intercepting sewer.
(b) Profile of intercepting sewer.
3. Report and application signed by the city attorney.
4. One copy of specifications.
A duplicate set of blue-prints of plans for sewers recently constructed by
the city were later submitted in order to facilitate the examination of the
plans now before the Department.
The proposed intercepting and trunk sewer is to extend along Cayadutta
creek from the existing 24-inch sewer near Market street to Montgomery
street, a distance of 4J50 feet, and is to consist of 24-inch and 30-inch vitrified
tile and iron pipe sewers, the latter to be used where the sewers are to be laid
in trenches in the bottom of the creek. This precaution should tend to reduce
the infiltration of ground water or creek water to a minimum if proper care
is taken during construction to secure tight joints. Manholes are to be
located at intervals not exceeding 500 feet.
The proposed trunk sewer will intercept all but one of the sewers which now
discharge into Cayadutta creek and the outlet of this sewer as well as that of
the proposed trunk sewer is below the series of ponds in the western pare ot
the city which are at present polluted by sewage.
The plans have been carefully examined in regard to sizes, grades, velocities,
capacities and otlier hydraulic and sanitary features in connection with the
intercepting sewer and it is found to be sufficient to meet the probable future
requirements for sanitary sewage of the district to be served upon the usual
basis of population and water consumption, and assuming that in the con-
struction the sewers will be made suflBciently water tight to prevent excessive
infiltration of ground water. It appears, however, that considerable saving
could be eff'ected by reducing the size of the proposed sewer from 30" to 2^
between stations 24 -|- 04 and 29 -f- 29, a distance of 725 feet, inasmuch as 225
feet of this section is to be of iron pipe. This reduction in size can safely be
made since a 24" sewer on a 1.48 per cent, grade has a greater carrying
capacity than the sewer below this section which is to be 30" in diameter and
have a grade of 0.3 per cent.
It will be noticed that the plans make no provision for any method of sewage
purification, the contemplated improvements involving merely the interception
of the sewage and conveying it to a point below the city where no nuisance
will be created afl'ecting the citizens of Johnstown. In order to determine the
extent of pollution of Cay;idutta creek above and through the city as a
result of the discharge of sewage of not only Johnstown but the citj' of
Gloversville, and to secure other information that might have a bearing' upon
the requirements for sewage disposal in the case of Johnstown, I visited the
city on May 16, 1910, and made an examination of the creek through the
city.
It appears that above the discharge of the intercepting sewers just below
Market street Cayadutta creek is comparatively clean and apparently no
nuisance would be created in this section of the stream during any season.
Below the discharge point of this 24" sewer, however, the stream is seriously
424 State Department of Health
fouled and was not only a nuisance at the time of my visit bint unquestionably
would be one to a worse extent during the summer season.
Just below the Fonda, Johnstown and Gloversville railroad the oM canal
enters Cayadutta creek. This canal is covered for a portion of its diiFfcanee
through the city and into it is discharged the sewage of Gloversville some tmo
miles above. Consequently below the intersection of the canal with Cayadutta
creek the combined pollution of G-loversville and Johnstown produces a con-
dition of sewage pollution that is hardly if at all exceeded anywhere in the
State. It should be noted, however, in this connection that the city of Glover*
ville has authorized the construction of a sewage disposal plant and that when
the construction of this plant is completed the sewage pollution of this canal
water will be removed, thus leaving in Cayadutta creek the pollution from
Johnstown only.
It is therefore quite important for the city of Johnstown, owing to the
serious nuisance that exists along this stream on the greater portion of its
course through the city, that the sewage now discharged into the stream
should be intercepted and carried below the city. It is likewise important
that suitable provision should be made for sewage purification, either at the
present time or in the very near future. The city of Gloversville has already
imdertaken to purify its sewage for the benefit of the city of Johnstown and
riparian owners, and it appears that these plans will be executed within a
reasonably short time. There is no legitimate reason why the city of Johns-
town should not do the same thing for the benefit of riparian owners below
Johnstown. There is, however, an important difference between the condi-
tions below the city of Gloversville and those existing below the city of
Johnstown, namely: that below the city of Glovers\ille the health and comfort
of a very large community is immediately affected, whereas below the city of
Johnstown a relatively few riparian owners live along this stream between
the city and its junction with the Mohawk river.
In consideration of the important distinction above pointed out in regard
to the two cities, the further fact that a very necessary relief is immediately
needed in the city of Johnstown from the present sewage pollution of this
stream and the nuisance resulting from it; the limited funds available for
sewerage improvements at the present time by the city, that the construction
of disposal works for the purification of the sewage of the city might be
temporarily deferred under certain conditions cited below; although no special
study has been made by the city engineer or other person, to my knowledge, as
to the feasibility, type or proper location for disposal works below the city,
it appeared from my inspection of the land that there was sufficient fall and
the requisite area somewhere available below the city for the construction of
suitable methods of sewage disposal.
Since the plans for the proposed system of intercepting sewers are suitable
from an engineering standpoint as pointed out above, and notwithstanding the
lack of detail study as to the exact Uiethod and location of suitable works for
the disposal of the sewage, it is from my inspection, easily possible to design
these works for the economical and satisfactory disposal or purification of the
sewage from this system when necessary, I should recommend on the grounds of
immediate relief from present insanitary conditions in the city, that these plans
be approved and a permit be issued for the discharge of sewage at proposed
outlet upon the conditions: that, satisfactory plans be submitted by the city
within one year providing for the purification of the sewage of the entire
city and that whenever in the opinion of the Commissioner it shall become
necessary, the construction of any or all of said sewage disposal plant shall be
undertaken and completed within the time limit set by him.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
Sbwkraqe and Sewaob Disposai. 425
Aidant, N. Y., July 25, 1910.
EuoBTfE M. PoBTER, M.D., State Commieaioner of Health, Albany, N, Y.:
DiiiUK'SiB: — I beg to submit the following report on the examination of
plans for a proposed sewer extension in the city of Johnstown, Fulton county,
submitted to this Department for approval by the common council on June
29. 1910.
The plans show that it is proposed to construct an eight-inch sanitary sewer
in Grove street from Mill street 250 feet west. The topography of Grove
street is such that this sewer will probably never be extended and is therefore
adequate as to size and capacity ror future requirements for the conveyanc
of sanitary sewage provided that in construction the sewer is made sufficiently
water tight to prevent excessive infiltration of ground water.
Plans were recently approved by this Department for the construction uf an
intercepting sewer in the city of Johnstown and the permit issued by this
Department for the discharge into Cayadutta creek of sewage to be collected
by this sewer required that on or before June 1, 1911, complete detailed planS)
satisfactory to this Department, for the purification of the entire sanitary
sewage of tlie city shall be submitted for approvals
Therefore the question of the disposal oi sewage need not be considered in
connection with the plans now before the Department for approval inasmuch
as this matter was carefully considered in my report of June 15, 1910, on the
examination of plans for the construction of the intercepting sewer approved
by you on that date.
I beg to recommend that the plans be approved and a permit issued allowing
the discharge of sewage to be collected by the proposed sewer into Cayadutta
creek.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
ALBAI9T, N. Y., AMguat 19, 1910.
EvoBNE H. Poster, M.D., State Commissioner of Health, Alhany, N. Y.i
Deab Sib:— ^I beg to submit the following report on the eatamination of
plans for a proposed reconstruction and extension of the present sewer in
East State street in the city of Johnstown, Fulton county, submitted to this
Department for approval by the city engineer on behalf of the common council
on August 13, 1910.
The plans show that it is proposed to reconstruct some 250 feet sewer la
East State street easterly from Chase street on a slope of 0.5 and to extend
this sewer on the same slope for a distance of about 560 feet beyond the end
of the existing sewer. The total length of this sewer will be 810 feet and
owing to the topography of this street the proposed sewer will probably not
be extended in the future.
The sewer is found to be adequate as to size and capacity to meet the prob-
able future requirements for sanitary sewage for the district to be served by
it» assuming toat in the construction the sewer is made sufficiently water-
tight to prevent excessive infiltration of ground water.
The sewer, however, should be provided with an intermediate manhole in
order to facilitate cleaning and inspection. The distance between manholes
should not be greater than 500 feet and the proposed sewer is to be 810 feet
with no manholes except at the upper and lower ends of the sewer.
The question of sewage disposal for the cit^ was carefully considered in
my report of June 15, 1910, on the examination of plans for tlie proposed
intercepting sewer and need, therefore, not be taken up in connection with the
present plans.
I would recommend that the plans be approved and a permit be issued
allowing the discharge into Cayadutta creek of sewage to be collected by the
proposed sewer on the condition that an intermediate manhole be inserted on
426 State Department of Health
the line of this sewer. I would also recommend that the permit contains the
provision as to the future disposal of sewage of the city of Johnstown em-
Dodied in the permit issued to the common council, June 15, 1910.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
Albany, N. Y., September 28, 1910.
Eugene H. Pcateb, M.D., State Commissioner of Healthy Albany y N. Y.:
Dbab Sir: — I beg to submit the following report on an examination of
plans for a proposed extension of the intercepting sewer along Cayadutta
creek in the city of Johnstown, Fulton county, submitted to this Department
for approval by the city engineer on behalf of the common council on August
23, 1910.
Plans for a 30" intercepting sewer for the city were approved on June 15,
1910. This sewer extended from Market street to Montgomery street along
Cayadutta creek, a distance of some 4,600 feet. All but one of the outfall
sewers of the city which formerW discharged into the creek at various points
within the city limits are to be intercepted by this sewer. These plans also
provided for a tentative extension of this sewer on a 0.30 per cent, grade.
The plans now under consideration show that it is proposed to extend this
30" intercepting sewer from Montgomery street southerly along Cayadutta
creek for a distance of about 700 feet. This additional extension will inter-
cept a 12" sewer, known as the Madirfon avenue outfall sewer, below Mont-
gomery street.
According to the plans it is proposed to construct this sewer from station
46+30 to station 53-1-05 on a slope of 0.15 per cent. While this slope is ade-
quate to give self-cleansing velocities in a sewer of this size it does not appear
that the capacity of this sewer on a slope of 0.15 per cent, will be adequate
to care for the sewage of the city when fully developed on the usual assump-
tions as to population and sewage contribution and the basis of computation
used in passing upon the plans for that portion of the intercepting sewer above
Montgomery street, approved on June 15. 1910.
Although the proposed extension will be required to care for considerably
more sewage than the intercepting sewer above Montgomery street the capacity
of the former will be only two-thirds that of the latter.
It will be necessary, therefore, to either increase the size of the proposed
extension or to increase the slope to at least 0.30 per cent, so that the capacity
of this section will be at least equal to that of the intercepting sewer above
the proposed extension, thereby better balance the design of the intercepter
for the entire distance and make it more adequate and meet the probable
future requirements of the city. It may be possible to utilize a portion of
the 13.79 feet of head lost in the 51 feet of sewer between stations 45-1-79 and
46+30 to increase the slope of the section of the proposed extension now
under consideration as well as in the case of future extensions of this sewer.
It appears that at this time before any plans for extensions to the intercept-
ing sewer are approved by this Department tentative or preliminary plans
showing a profile and proposed route to the disposal plant site should be sub-
mitted in order to show the feasibility of further extending this sewer and
conveying the sewage to the proposed disposal plant by gravity.
I, therefore, beg to recommend that the plans be returned to the city engineer
for amendment, in accordance with the above sugsrcptions, and that he also
be requested to submit tentative or preliminary plans showing the probable
location of the sewage disposal plant, together with a profile of the proposed
route of the outfall sewer to such sewage disposal plant.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
Sewerage and Sewage Disposal 42T
Albany, N. Y., November 26, 1910.
EtJOENE H. Porter, M.D., State Commissioner of Healthy Albany, A\ Y.:
Dear Sir: — I beg to submit the following report on an examination of
amended plans for a proposed extension of the intercepting sewer aJong Cay-
adutta creek in the city of Johnstown, Fulton county, resubmitted to this
Department for approval by the city engineer on November 21, 1910.
The plans have been revised in accordance with the recommendations em-
bodied in my report of September 28, 1910, and show that it is proposed to
extend the 30" intercepting sewer on a slope of 0.3 per cent, along Cayadutta
creek southerly from Montgomery street to a temporary outlet into this creek,
a distance of some 700 feet.
A preliminary plan has also been submitted which shows that it is possible
to extend the intercepting sewer on a slope of .3 per cent, along the southerly
bank of Cayadutta creek to a proposed disposal site near the iron bridge
some 4,000 feet from the end of the sewer extension now under consideration
and, according to the city engineer, this site has an area of 4.6 acres, and the
elevation of the intercepting sewer at the disposal site is 20 feet above the
creek. It appears, therefore, that it is possible to convey by gravity How the
entire sanitary sewage of the city of Johnstown to a suitable site for disposal
works about three-quarters of a mile beyond the city limits.
In view of the above I would recommend that the plans be approved and
a permit be issued allowing the temporary discharge of sewage into Cayadutta
creek about 700 feet below Montgomery street and that the permit contain in
addition to the usual revocation and modification clauses the following
provisions :
1. That the proposed sewer extension shall be constructed in complete
accordance with the plans approved this day.
2. That on or before June 1, 1911, complete detailed plans satisfactory
to this Department for the purification of the entire sanitary sewage of
the city shall be submitted for approval; and that the construction of
any or all portions of the sewage disposal works shown by said plans
shall thereafter be undertaken when required by the State Commissioner
of Health and be completed within the time limit set by said Commissioner.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
LESTERSHIRE
On July 14, 1910, plans for sanitary sewer extensions in Lewis street and
Jenison avenue were submitted for approval. Application made by the board
of trustees of the village for the approval of these plans was received on
July 18, 1910. The plans were approved on August 16, 1910, and a permit was
issued allowing the discharge into the Susquehanna river of sewage from the
proposed sewers.
On September 29, 1910, application was made by the board of trustees for
the approval of plans for a proposed sewer in Main street. These plans were
approved on October 21, 1910, and a permit was issued allowing the discharge
into the Susquehana river of sewage from this sewer.
Albany, N. Y., August 12, 1910.
EuoE?JE H. Porter, MID., State Commissioner of Health, Albany, N, Y.:
Dear Sir: — ^I beg to submit the following report on the examination of plans
for sanitary sewer extensions in the village of Lestershire, Broome county, sub-
mitted to this Department for approval by the board of trustees on Julv 14,
1910.
The records of the Department show that original plans for a comprehen-
428 State Department of Health
sive sewer system and sewage disposal plant were approved on February 27,
1903, and amended plans were approved on October 4, 1904. Permits for
extensions to the sewer system have been issued from time to time since the
year 1904. On February 7, 1906, a permit was issued on the condition that
the sewage disposal plant be put in operation within two years of that date.
On April 10, 1908, this permit and the one issued on October 30, 1907, were
extended until such time as the State Commissioner of &alth shall require
the construction of the sewage disposal plant.
The plans now under consideration ^ow that it is proposed to construct
some 700 feet of 6" and 8" sanitary sewers in Jenison avenue and Lewis
street which are to discharge into the existing sewer in Willow street at the
intersection of this street and Lewis street. The plans also riiow that it is
proposed to construct the sewer in Lewis street on a straight alignment from
a manhole in Jenison avenue to a manhole on the east line of Willow street
at which point the alignment changes so as to connect with the sewer in Wil-
low street on a steep grade at right angles to this sewer.
This is not a good arrangement and in order to facilitate cleaning and
inspection the oewer in Lewis street should be continued on a straight align-
ment from the proposed manhole at the intersection of Jenison avenue and
Lewis street to the present sewer in Willow street where a drop manhole oould
be constructed on the line of this sewer. Such an arrangement would eost
b«it very little more, if any, than that shown on the plans now before the
Department.
Tbe proposed sewer extensions have been carefully examined as ia sices,
grades and capacities, and it is found that they are adequate, if properly eon-
structed, to meet any probable demand that may be made upon them in the
future.
I, therefore, recommend that the plans be approved and a permit issued
blowing the discharge of sewage to be collected by the proposed sewers into
the Susquehanna river through the existing outlet on condition that a man-
hole be constructed at the intersection of the proposed sewer and the existing
sewer in Willow street.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
Albany, N. Y., October 18, 1910.
Eugene II. Porter, M.D., State Commissioner of Health, Albany, N. Y.:
Dear Sir: — I beg to submit the following report on an examination of
plans for a proposed amendment to plans for the sewer system of the village
of Lestershire, Broome county, submitted to this Department for approval
by Mr. S. Foster Jaques, consulting engineer of the city of Bingham ton, on
behalf of the board of trustees, on September 29, 1909.
The question of sewerage and sewage disposal of the village was dlscusfled
in my report on an examination of plans dated August 12, 1910, to which ref-
erence is made, and this matter will, therefore, not be considered at this time.
The plans for sewerage and sewage disposal for Lestershire, approved by this
Department on February 27, 1903, provided for an 8" and 10" sewer in
Main street that would drain west from Baldwin street.
The plans now under consideration show that it is proposed to construct
this sewer in Main street so that it will drain east from St. Charles street
to Baldwin street, a distance of some 800 feet, and beyond Baldwin to Arch
street. The sewer is to have a slope of from 0.3 per cent, to .35 per cent.
It is stated in the report of the designing engineer that the section of Main
street west of St. Charles street is sparsely settled and will not require sew-
erage facilities for years, but that it is desired to lay a sewer in that portion
of Main street east' of St. Charles street before paying Main street, which is
the business street of the village.
The plans hare been carefully examined in reference to sizes, slopes, capaci-
ties and other hydraulic and sanitary features, and it is found that the pro-
Sewerage and Sewage Disposal 429
posed sewer is adequate for fitture requirements for sanitary sewage for the
section to be served by it, assuming that in construction the sewer will be
made sufficiently water-tight to prevent excessive infiltration t)f ground water.
In conclusion, I would state that the proposed change in the direction of
flow of sewage in the section of Main street under consideration does not
materially change the original design, and in view of this and the adequacy
of the proposed sewer I l^g to recommend that the plans be approved arid a
permit issued allowing the discharge of sewage to be collected by this sewer
into the Susquehanna river.
Very respectfully,
THEODORE HORTON,
Chief Engineer
LETCHWORTH VILLAGE
On July 22, 1910, plans for water supply, sewerage and sewage disposal for
Letchworth village were submitted to the Department for approval by the
State Architect, in accordance with the provisions of section 14 of chapter
49 of the Laws of 1909, the " Public Health Law," constituting chapter 45
of the Consolidated Laws. These plans were approved on July 27, 1910.
Albany, N. Y., July 26, 1910.
EtroENE H. Porter, M.D., State Commissioner of Health, Albany, N. Y.:
Dear Sir: — I beg to submit the following report on the examination of
plans for water supply, sewerage and sewage disposal for Letchworth Village,
Thiells Station, Rockland county, submitted to the Department for approval
by the State Architect on July 22, 1910.
According to the State Architect the institution is to be established for the
purpose of caring for feeble-minded and idiots and will provide for an ulti-
mate population of 3,000 persons, consisting of about 2,500 patients and 500
employees. The daily per capita water consumption is estimated at 125 gal-
lons based upon water consumption of similar institutions, making a total of
375,000 gallons per day to be provided for.
The water supnly is to be taken from the middle branch of Minisceongo
creek. This supply was recommended to the commission appointed to select
a site for the institution by Mr. Emil Kuichling who, together with Mr. G.
C. WTiipple, went over the watershed of that part of Minisceongo creek which
lies above the proposed site.
According to Mr. Kuiehling's report to the chairman of the Commission,
" various samples of water were closely examined in the field, and three were-
taken to Mr. Whipple's lalx>ratory f»>r chemical and bacteriological analysis.**^
Mr. Whipple, in liis report to Mr. Kuichling, dated October 30, 1907, on the
result of their inspection and analyses, states that "the water of the middle
branch would not need filtration, as the color is low and the watershed almost
uninhabited. If properly stored, it would make an excellent supply. One of
its most attractive qualities is its extreme softness."
Mr. Kuichling also states in his report that by constructing an impounding
reservoir of about 25,000.000 gallons storage capacity at an elevation of about
700 feet above tide level the institution "would secure an abundant supply
of pure and very soft water, delivered by gravity at a sufficient pressure or
head to throw copious streams for fire service directly from the hydrants
over any of the buildings." A storage capacity of 25,000,000 gallons is equiva-
lent to a uniform daily supply of 250,000 gallons during 100 consecutive days
of absolute droujrht.
According to the report of the State Architect and plans now before the
Department for approval it is proposed to construct a dam to intercept the
middle branch of Minisceongo creek so as to give a total drainage of about
three square miles and form an impounding reservoir of some 21,000,000 gal-
lons capacity. The elevation of the crest of the spillway is 682 feet above tide-
water level.
430 State Department of Health
The dam has been designed under the direction of the Deputy State Engi-
neer and Surveyor. The bottom of the reservoir, which is composed largely
of rock and clay, is to be cleared and grubbed together with whatever strip-
ping of loams may be found necessary.
A 12'' distributing pipe will be carried under the dam from the gatehouse
to manhole below the dam where this pipe will be divided into two 8" dis-
tributing pipes which are to be provided with blowoff valves, air valves at
different intervals along the lines. These two 8" water pipes which will have
a capacity of 600.000 gallons per day, each with a pressure head of about 150
feet at the buildings, loop the central portion of the institution grounds.
The plans show that it is proposed to construct only the trunk sewers
at present. Tlie system of sewers also inchides two pipe siphons, 8" and
10" in diameter across the creek, which are provided with screens and flush-
ing connections with the water supply system. The plans have been carefully
examined with respect to sizes, capacities, grades and other hydraulic features
in connection with the proposed sewers and it is found that they are adequate
to care for the sanitary sewage for the institution on the basis of population
and water consumption used, and assuming that in the construction the sewers
will be made sufficiently watertight to prevent excessive infiltration of ground
water.
The sewage will be conveyed by gravity to the proposed sewage disposal
plant, consisting of settling tanks, sprinkling filters, settling basins, and
sludge tank and sludge bed.
The ultimate design provided for seven settling tanks with hopper shaped
bottoms for the depositing and collection of sludge. The settling tanks have
a combined capacity to give about six hours* detention of sewage for the ulti-
mate conditions for which the plant is designed. It is proposed to install
about one-half of this plant at present.
Each hopper of the settling tank is provided with a force pipe and valve bv
means of which the accumulated sludge is discharged into a sludge tank
where the heavier materials tend to settle to the bottom and the liquid is dis-
charged through a siphon to sludge beds. The heavy sludge in the sludge
tank is conveyed to trenches at the sludge disposal field.
There are two dosing tanks connected with the settling tanks, the smaller
one is provided with a 6" discharge siphon and the larger tank, which has a
capacity equal to two times the smaller tank, is provided with a 10" siphon.
Although both of the dosing tanks are to be constructed with the first instal-
lation the larger tank will not be used until whole plant is constructed.
Under the average contribution of sewage for the ultimate population the
large dosing tank will be filled about every twelve minutes, and it will take
about one minutes to discharge each dose.
The effluent from the settling tanks are to be discharged to a sprinkling
filter filled with broken stone to a depth of 5' 6" and designed to operate at
a rate of about 1,900,000 per acre per day. The filtrate is to be collected by
underdrains which discharge into settling basins and then into Minisceongo
creek through a submerged outlet. The ends of the underdrains are connected
with riser pipes for the purpose of ventilation.
A uniform distribution of the settling tank effluent is effected by means
of nozzles of the square distribution type in connection with dosing tanks
having a varying cross section.
The sewage disposal plant, if properly constructed and operated, should pro-
duce a satisfactory effluent.
It appears from a careful examination of the plans, in connection with the
data furnished by the State Architect's report and the report of the CJommis-
sion appointed to select a site, that the plans provide for an adequate and
satisfactory water supply, sewer system and sewage disposal works for the
future requirements of the institution on the basis of population and water
consumption used in the design.
I, therefore, recommend that the plans be approved.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
Seweselage and Sewage Disposal 431
LONG BEACH
On January 31, 19 10, plans for a proposed sewer system and sewage disposal
plant for Long Beach were submitted for approval. The plans were returned
for amendment and additional information and were finally resubmitted for
approval on February 15, 1910. The plans were approved on March 16, 1910,
and a permit issued allowing the discharge into Broad or Long Beach chan-
nel of eflSuent from the proposed sewage disposal plant. This permit con-
tains, in addition to the usual revocation and modification clauses, the con-
ditions that the effluent shall be discharged into the channel only during
the periods of ebb tide but not within two hours of the time of low tide ; that no
sowage sludge shall be discharged into Broad or Long Beach channel; and
that whenever required by the State Commissioner of Health arrangements
shall be made to effectually sterilize or disinfect the effluent or additional
works shall be constructed for more complete treatment of the sewage than
that provided for by the proposed plans.
Aidant, N. Y., March 7. 1910.
Eugene H. Porteb, M.D., State Commissioner of Health, Albany , N. Y.:
Dear Sir: — I beg to submit the following report on an examination of
plans for the proposed sewer system and sewage disposal plant for Long Beach,
Long Island, suomitted to this Department for approval by Charles W.
Leavitt, Jr.
These plans were first submitted for approval on January 31, 1910, but
owing to deficiencies in certain features of design and a lack of sufficient and
definite data as to the methods of operation, the plans were returned for
amendment and additional information on February 5th. Revised plans^ to-
gether with a supplementary report, were resubmitted for approval on Feb-
ruarv L*?. 1910.
Long Beach is an island located in the town of Hempstead, south of Long
Beach channel, and has an area of about 2,000 acres. About 600 acres of the
western portion of this island is being developed as a summer resort, and
this constitutes about one-half of the entire area to be improved in the near
future for the use of the proposed summer colony.
The plans show that it is proposed at present to provide sewerage facilities
for the central and eastern portion of the section undergoing development,
and the report of the designing engineer states that the future population of
this area is estimated at 5,000 persons. The lateral sewers are to be 8"
in diameter in the east and west streets, draining through alternate north
and south streets by gravity through 8 and 10" sewers. to the main sewer
which is to have a diameter of from 20 to 30". Flush tanks are to be in-
stalled at the ends of all lateral sewers. Owing to the level surface of the
ground pumping stations are to be located at difi'erent points along the line
of the main intercepting sewer for the purpose of raising the sewage to differ-
ent levels and allow it to flow by gravity from one station to the next.
The plans have been carefully examined by the engineering division , in
regard to grades, sizes, velocities, capacities and other hydraulic and sanitary
features in connection with proposed sewers, and they are found to be suffi-
cient to meet the future requirements of this district upon the basis of popu-
lation used, and assuming that in the construction the sewers shall be made
sufficiently watertight to prevent excess leakage. The plans for the trunk
and lateral sewers provide for sanitary sewage only and, it is understood,
in the development of all branch and lateral sewers, which will discharge
into this interceptor in the future, that additional plans for this shall be sub-
mitted for approval by this Department.
According to the plans the sewage disposal plant is to consist of a settling
tank and storage tank. The settling tank is divided into three compartments
and the 6ewage is to flow from one compartment to the other through sub-
nierged orifices. The total capacity of the settling tank is sufficient to give
about six hours' detention of sewage on the basis of 5,000 persons and an
average rate of water consumption of 100 gallons per capita per day.
43^ State Depabtment of Health
From the last compartment of the settling tank the sewage is to pass into
a storage tank large enough to retain the maximum contribution of sewage
for a period of eight hours, on the assumption that three-fourths of the sewage
will reach the disposal plant in twelve hours.
It appears from the report of the designing engineer that it is proposed
to discharge the effluent from the storage tank at high tide and allow a
continuous flow to within two hours of low tide when the outlet valve will
be closed and the effluent stored for eight hours until the next high tide. The
effluent pipe extends into the channel some 100 feet to deep water where it
is divided into several branches in order to better facilitate dispersion. Sludge
from the settling tank is to be disposed of in sand pits adjacent to the dis-
posal works.
There has been considerable correspondence between the designing engineer
and this Department since the plans were first received as to a possible cnange
of location of the disposal plant to a more suitable site to the west, embrac-
ing: a more complete purification of the sewage owing to the location of im-
portant oyster beds in the waters wherein it is proposed to discharge the
effluent from the disposal works. It was suggested that on account of the
possibility of the settling tank effluent returning to the inner harbor on the
flood tide due to improper operation of the disposal works or other causes
the effluent should either receive supplementary purification on natural sand
filter beds following treatment in contact or sprinkling filters, or be treated
on sand filters without the use of preliminary filters.
It was learned, however, from the designing engineer that the land to the
westward is in litigation and, therefore, not available for this purpose at
present. It was further pointed out that the proposed installation of the
sewage disposal plant as designed is to be used for two or three years only
or imtil such time as it will be possible to secure land and extend the sewers
to the west end of the island, where it could be more efficiently treated, or to
provide other satisfactory means of purification. Permission was, therefore,
asked to allow the temporary discharge of settling tank effluent from the
proposed sewage disposal plant at the point shown upon the plans.
In view of the above and of the apparent urgent need for sewerage facili-
ties, I beg to recommend that the plans be approved and a permit be issued
allowing the temporary discharge of effluent from the proposed sewage dis-
posal plant containing, in addition to the usual modification and revocation
clauses, the following conditions:
1. That whenever required by the State Commissioner of Health, and
upon due notice from him, arrangements shall be made to effectually ster-
ilize or disinfect the effluent to be discharged from the sewage disposal
plant, or additional works shall be constructed for more complete treat-
ment of the sewage than that provided by the plans; such sterilization
or more complete treatment to be accomplished in accordance with plans
which shall be submitted to and approved by the State Commissioner of
Health.
2. That the length of time after due notice of revocation, as specified
. by section 79 of the Public Health Law, within which the discharge of
sewage effluent shall cease shall be two months, imless otherwise stated
in such notice.
3. That the effluent from the proposed disposal plant shall be discharged
into the channel only during the period of ebb tide, but no such discharge
shall be caused during these periods within two hours of the time of low
tide.
4. That no sewage sludge shall be discharged either into the waters of
Broad or Long Beach channels or where they may pollute the same or
other waters tributary thereto or connected therewith, but shall be dis-
posed of by burying in trenches as specified in the designing engineer's
report accompanying the plans or by other means or methods approved
by this Department.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
Sewerage anb Sewage Disposal 433
MEDINA
On Jaouanr 4, 1910, application was received from the board of sewer com-
inissioners oi the village for the approval of a proposed amendment to the
plans for sewers in the West Side sewer district. These plans were approved
on January 8, 1910.
Albany, N. Y., January 8, 1910.
To the Board of Sewer Commi88ioner8f Medina^ N, Y,:
Gentlemen : — In response to the application, contained in a resolution
adopted by your board on December 30, 1909, for my approval of a proposed
amendment to the plans for proposed sewers in the West Side sewer district
in the village of Medina, approved on November 15, 1909, I hereby approve
such amendment and change, to wit:
A change in the diameter and gradient of the trunk sewer in said sewer
district from Center street to Prospect avenue from a diameter of 20 inches
and a gradient of 0.4 per cent., as shown on the approved plans, to a
diameter of 22 inches and a gradient of 0.275 per cent., as shown on a profile
sheet submitted to this Department on December 31, 1909.
The above approval is duly given this 8th day of January, 1910, in ac-
cordance with section 260, article 11 of chapter 64 of the Consolidated Laws,
the Village Law, subject to the provisions of a permit issued on November 15,
1909.
ALEC H. SEYMOUR,
Acting Commissioner of Health
MONROE COUNTY TUBERCULOSIS HOSPITAL
On January 24, 1910, plans for a sewage disposal plant for the proposed
Monroe County Tuberculosis Hospital were submitted for approval by the
board of supervisors of Monroe county. These plans were approved on March
1, 1910.
Albany, N. Y., January 26, 1910.
Eugene H. Porter, M.D., State Commissioner of Health, Albany, N. Y.:
Dear Sir : — I beg to submit the following report on an examination of
plans for the proposed sewage disposal plant for the Monroe County Tuber-
culosis Hospital submitted to this Department for approval on January 24,
1910.
The proposed hospital is to be located just outside the city limits of
Rochester and the report of the designing engineer states that it is designed
to accommodate 100 persons, including patients, attendants and officers. A
per capita rate of water consumption of 100 gallons per day is assumed in
the design, based upon the rates used in similar institutions in the State.
The sewage disposal works consists of a settling tank, three sand filters
and a sludge bed. The settling tank is divided into three compartments by
transverse division walls forming a grit and screen chamber, sedimentation
compartment and dosing chamber. The settling tank has a sedimentation
capacity equivalent to about ten hours' detention of sewage for an average
daily contribution of 10,000 gallons.
The sedimentation compartment is to be built with a double hopper bottom
for the accumulation of sludge which can be discharged to an adjacent sludge
filter through two 4-inch blow-off pipes extending to within three inches of the
bottom of the hoppers. The grit and dosing chambers are also provided with
434 State Department of Health
similar blow-off pipes leading to the sludge bed so that the entire tank can be
cleaned without emptying.
The settling tank effluent passes into the dosing chamber provided with
three 6-inch alternating dosing siphons for discharging the contents of the
chamber upon three intermittent sand filters in rotation. These filters are
three feet deep, properly underdrained, and have a combined average area of
about 0.1 acres. At the assumed rate of contribution the beds have suffi-
cient area to treat settled sewage at the rate of 100,000 gallons per acre
daily.
The plans have been carefully examined by the Engineering Division and the
sewage disposal plant is found to be well balanced and shows evidence of
careful study and design. A satisfactory and nonputrescible effluent should
be produced by this plant if properly constructed and operated. The capacity,
moreover, is adequate to meet the present needs of the institution and allow
for a reasonable increase in the future.
Respecting the design of the vitrified sewer to convey sewage from the
hospital to the disposal plant, however, it should be noted that the final
section, 350 feet long, is designed to act as an inverted siphon from manhole
Xo. 4 to the screening chamber.
This feature of the design is likely to prove unsatisfactory, owing to the
probability of grease deposits induced by fluctuations of the elevation of
sewage in the settling tank and in this siphon and owing to the usual ten-
dency to deposition of solid matters in siphons and the consequent stoppage
of the sewer.
If this entire section of sewer were located to the southward, the gradients
of the last two sections of sewer flattened so that the inlet to the tank should
enter at elevation 529 or above and connect with a tee or a cross with a
vertical pipe from this tee or cross reaching nearly to the bottom of the
screening chamber, the result would be that the unsatisfactory section of in-
verted siphon would be eliminated, ready access for inspection and cleaning
of the portion of the inlet pipe below the elevation of sewage in the tank
would be had and a comparatively small amount of embankment over the
sewer would be required.
I, therefore, beg to recommend that the plans be approved on condition
that the inverted siphon be eliminated in a manner similar to that de<
scribed above.
Respectfully submitted,
THEODORE HORTON
Chief Engineer
MONTICELLO
On June 1, 1910, plans for an amendment to the plans for sewage disposal
for the village of Monticello, which were approved on December 16, 1909,
were submitted for approval by the board of sewer commissioners. These
plans were approved on June 15, 1910, and a permit was issued allowing the
discharge into Cold Spring brook of effluent from the proposed sewage dis-
posal plant.
Albany, N. Y., June 13, 1910.
EuoEXE H. PoBTEB, M.D., State Gommiasioner of Health, Albany, 2V. F.:
Deab Sib: — I beg to submit the following report on the examination of
amended plans for sewage disposal for the village of Monticello, Sullivan
county, submitted to this Department for approval on June 1, 1910.
According to the records of the Department, plans for sewerage and sewage
disposal for Monticello were approved on December 16, 1909. The proposed
sewage disposal plant was to consist of settling tank, contact beds and natural
irrigation or filter beds.
Sewerage and Sewage Disposal 435
The amended plans and dociunenta recently submitted comprise the
following:
1. Duplicate reports and specifications.
Tracings and prints of:
2. Topographical map showing alignment of a portion of the sewer
system and the new location of the sewage disposal plant.
3. Amended plan of sewage disposal works.
4. Plan of former sewage disposal plant to be superseded.
5. Profile of main outfall sewer.
The plans now under consideration show that it is. proposed to change the
location of the sewage disposal plant to a site some 1,200 feet to the south-
west and up-stream on Cold Spring brook from the site shown upon the plans
approved last December. It is stated in the application for the approval of
the amended plans that the change in location of the plant is necessitated by
the inability to secure a site at the point shown by the approved plans.
While the general arrangement of the difTerent parts of the disposal plant
has been changed to suit the new conditions of topography of the changed
location, the capacity of the plant is the same as that shown by the former
plans.
The approved plans proposed to divide the irrigation field into three unitsi
one having a superficial area of two acres and two units of about one acre
each. The present plans show that it is proposed to divide the field iiito
four units of about one acre each. The amended plans also provide for a
somewhat different method of applying the sewage to the contact beds as
well as a field for the disposal of sludge adjacent to the proposed irrigation
field.
The new location of the proposed disposal plant seems to be more suitable
for a disposal site than the former, inasmuch as it will be necessary to divert
the flow of only one stream around the plant, whereas two streams flow
through the former site.
After a careful examination of the amended plans, I beg to recommend that
they be approved and a permit issued allowing the discharge of effluent from
the proposed sewage disposal plant into Cold Spring brook, a tributary of
the Neversink river.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
NEW ROCHELLE
On March 17, 1910, application was made by the board of public works for
the approval of plans for sewers in North avenue. Beech mont drive and
Montgomery circle. These plans were approved on March 25, 1910, and a
conditional permit was issued allowing the discharge, into Long Island sound,
of sewage from the proposed sewers.
On March 22, 1910, an application was also made by the board of public
works of New Rochelle asking for an extension of the time for filing plans
for a clarification of the sewage discharged through the Bailey's Rock out-
let, as was required by the permit issued on May 4, 1909, to be done within
one year. The time for filing such plans was extended to February 1, 1911,
as noted in a letter to the chief engineer of the board of public works dated
March 25, 1910. A copy of this letter is printed below.
The permit issued on March 25, 1910, contains in addition to the usual
revocation and modification clauses the following conditions:
1. That on or before February 1, 1911, satisfactory detailed plans shall be
submitted to the Department providing for a clarification by means of
effieient screening or sedimentation, or both, of the portion of the sewage of
the city not treated in the sewage disposal plant at the foot of Morgan street;
and that such plans shall also show in detail suitable works for supplementary,
complete treatment of sewage.
436 State Department of Health
2. That whenever required by the State Commiesioner of Health the clarifi-
cation works shown by the approved plans shall be constructed within the
time then specified; and that whenever deemed necessary or desirable by the
State Commissioner of Health suitable extensions to such clarification works
shall be made or supplementary works shall 'be constructed for more complete
treatment of sewage within the time specified by said Commissioner.
Albany, N. Y., March 22, 1910.
Eugene H. Porteb, M.D., State Commissioner of Health, Albany, N. Y.:
Deab Sib: — I beg to submit the following report on an examination of
plans for proposed sewer extensions and for proposed alterations to the sewer
system of the city of New Rochelle, Westchester county, submitted in person
to this Department for approval on March 4, 1910, by Mj. J. K. Wilkes,
chief engineer of the board of public works.
Several conferences have been held during the past year between the city
officials and this Department in regard to extending the sewer system and
providing sewerage facilitie^i for a large territory that is being rapidly de-
veloped and built up north and northeast of Eastchester road.
Tlie plans under consideration show that it is proposed to change the align-
ment, size and grade of the sewer in North avenue between Brookside place
and Eastchester road; to extend the sewer in North avenue from Eastchester
road to Broadview; also to change the alignment of sewers in Beechmont
drive and Montgomery circle.
Plans were approved by this Department on March 22, 1904, providing for
a 24-inch sewer running north from Brookside place in North avenue and
through private land to Eastchester road. The portion of tlie sewer through
private land was to follow, approximately, the course of a stream presumably
to avpid deep rock cutting during construction. This sewer, however, has
not been constnictod.
It is stated in the rejwrt by the designing engineer that in order to " avoid
certain physical difliculties of construction and also the usual delays and
complications arising from acquiring the necessary rights of way," it is now
proi)osiHl to abandon the route along the creek between Brookside place and
Eastchester road and to construct a 27-inch sewer entirely in North avenue
from Brookside place to Broadview, about 2,100 feet north of Eastchester road.
This change will iioee.-isitate a cut of twenty feet in depth far a considerable
distance in order that this sewer may at some future time intercept sewers to
be constructed to serve streets in the low area to the west of the Inter-Urban
Company's reservoir. Tlie dilTerence in the cost of the two routes is prob-
ably not great since it will be necessarv' to lay a small sewer in North avenue
parallel to the intercepting sewer for a distance of some 900 feet, if the
trunk sewer is constructed along the stream.
The plans also show that it is proposed, eventually, to extend this trunk
sewer from Broadview in a northerly direction to Quaker Ridge road, a dis-
tance of some 6.400 feet, but since the present plans show only the probable
location of such sewer, detailed plans for the extension of the proposed trunk
sewer in North avenue should be submitted to this Department for ap-
proval before any extensions are made.
The territory that will ultimately be tributary to the new sewer is about
850 acres. Plans for sewers in a portion of this territory, known as Halcyon
park, Becclimont and part of Sunsetview park, including about 200 acres of
land, were approved on May 4, 1009. Tliese sewers were tributary to the
main intoreej)ting sewer between Brookside place and Fifth avenue.
It is now proposed to change the alignment of sewers in parts of Beech-
mont drive and Montgomery circle in this section so as to discharge into the
proposed trunk sewer at the intersection of Montgomery circle and North ave-
nue, and not, as originally planned, into the existing trunk sewer between
Brookside place and Fifth avenue. Both designs make these sewers tributary
to the same outfall but at dilTerent points.
Sewkbage and Sewage Disposai. '4r37
•
The plans have been carefully examined by the engineering division in
regard to grades, sizes, velocities, capacities and other hydraulic and sanitary
features concerning the proposed sewers and they are found to be properly
designed to meet the future requirements of this district upon the usual basis
of population and per capita consumption, and assuming that in the con-
struotion the sewers be made sufficiently watertight to prevent excess infiltra-
tion. A considerable saving could be made by reducing the size of the pro-
posed 27" sewer between Beechmout drive and Brookside place, a distance of
1,055 feet. In any. case of reducing the size of a main trunk sewer for a
section having a steeper grade than the section above precaution should be
taken to prevent any accidental stoppage which is more probable at such
points of reduction in size than at other points in a sewer.
The plans for the sewage under consideration provide for sanitary sewage
only, and it is understood that in the development of all branch and lateral
sewers which will discharge into this interceptor in the future or in the ex-
tension of this sewer plans for such sewers shall be submitted for approval by
this Department.
The existing outfall sewer, with outlet into Long Island sound at a point
some 800 feet beyond Bailey's Rock to which the proposed sewer extensions
are tributary, has been examined aa to capacity to care for additional sewa^.
It is found 'that it is adequate for reasonable service in the future, but that
it will probably be necessary to relieve that portion of the outfall sewer be-
tween Fifth avenue and the New York Central right of way before the addi-
tional territory made tributary to this sewer by the proposed sewer extensions
ia fully developed.
The general questions of extensions to the sewer system for the city of
New Bochellfi and the effect upon the waters of Long Island sound and the
oyster beds in such waters of additional pollution from the discliarge of sew-
age from the sewer system of the city were discussed at length in my report
to you of April 14th on the examination of plans approved on May 4, 1900,
and at that time it was advised that:
"Owing to the comparative remoteness of any oyster beds from the
existing outlet of the system of which the pxx>poBed sewers will be an
extension, I am of the opinion that it will not be necessary to require
at the present time a thorough purification of the sewage now discharged
into this outlet from the existing sewers and the proposed extensions. I
do believe, however, that with the rapid development that has taken place
along this shore of Long Island sound, the importance of the oyster in-
dustry which must be protected, the desirability of curtailing visual pol-
lution and possible offense in these waters and your consistent policy
with the municipalities along this shore, it is necessary to require clari-
fication of this sewage in the immediate future and to require that suit-
abje provision be made to increase the efficiency of this purification at
such a time or times in the future as local conditions nwiy in your opinion
demand/'
The proposed extensions are tributary to the same outfall to which the
extensions made the subject of the report quoted above were tributary. The
permit granted for the discharge of sewage from sewers for which plans were
approved on May 4, 1909, required that within one year satisfactory, detailed
plans be submitted to the Department providing for a clarification of the sew-
age by efficient screening or sedimentation, or a combination of both, and that
such plans shall show in detail also suitable works for the complete purifica-
tion of the sewage.
From conferences which Iiave been held with the members and oflicers of
the board of public works of tlie city of New Bochelle during the past year
conserning the preparation of these plans for treatment of sewage, it is seen
that for various reasons, some of which are not under the control of the
board of public works, it has not been possible for such board to prepare
the plans as required for submission by May 4, 1910. Further, the Depart-
ment is this day in receipt of an application from the chairman of the board
of public works for an extension of tne time within which plans for treatment
of sewage were to be submitted to this Department for approval.
438 State Department of Health
In view of the forgoing I would, therefore, recommend that the plans
for a change in the alignment, size and grade of the sewer in North avenue
between Brookside and Eastchester road; for the construction of a sewer
in jNorth avenue from Eastchester road to Broadview; and a change in the
alignment of sewers in Beechmont drive and Montgomery circle be approved
as submitted, and that the provisions requiring that plans for sewage treat-
ment as embodied in the permit granted May 4, 1909, be included in the
permit granted for discharge from the sewers proposed at this time, the
terms of such requirement being substantially as were stated in the per-
mit granted May 4, 1900, except that the time for filing said plans be extended
to February 1, 1911.
Respectfully submitted,
THEODORE HORTOX.
Chief Engineer
Albany, K. Y., March 25, 1910.
Mr. J. K. Wilkes, Chief Engineer Board of PuhHo Works, New Rochelle,
N, y.;
Deab Sir: — I am sending you, under separate cover, by American Express,
the approved plans for sewer extensions in North avenue, Beechmont drive
and Montgomery circle, and am enclosing herewith a permit allowing the
discharge into Long Island sound of sewage to be collected by the proposed
sewers.
You will note that this permit to become operative must first be recorded
in the county clerk's oflSce of Westchester county.
In response to the application from the board of public works of New
Rochelle, received on March 22d, asking for an extension of the time for filing
plans for a clarification of the sewage discharged through the Bailey's Rock
outlet, as was required by the permit issued on May 4, 1909, to be done
within one year, I have extended the time for filing such plans to Februarv
1, 1911.
I would at this time call your attention to the desirability of carefully
considering in any proposed plans providing for treatment of sewage of the
city of New Rochelle some provision for permanent treatment of the sewage
now treated in the disposal plant at the foot of Morgan street. A study of
this portion of the system and of the question of sewage disposal for this
section may show that, on account of the comparatively obsolete type of
this plant and the fact that the plant is overtaxed at the present time, it
might be found advisable to arrange for treatment of sewage from this sec-
tion in the same plant to be designed for treatment of the sewage now dis-
charged through the Bailey's Rock outlet.
These matters, I presume, will be carefully considered 'by your Board in
studies you are making of plans for sewage disposal for the city.
Very respectfully,
ALEC H. SEYMOUR,
Acting Commissioner of Health
NORTH TONA WANDA
Application was made by the board of public works, under date of March
16, 1910, for permission to discharge sewage into the Niagara river from
proposed sewers in Cramer, Robinson and other streets, and plans cover-
ing these sewers were submitted for approval on April 8, 1910. These plans
were approved on April 25, 1910, and a permit was issued allowing the dis-
charge of sewage to be collected by the proposed sewers into Niagara river, on
condition that whenever required by the State Commissioner of Health com-
Sewebaoe and Sewage Disposal 439
plet« plans satisfactory to this Department for the interception and treat-
ment of the entire sanitary sewage of the city shall be submitted to this
Department for approval; and that any or all portions of the works shown
by such plans shall be constructed thereafter when required, and within the
time limit set by the State Commissioner of Health.
Albany, N. Y., April 25, 1910.
Eugene H. Pobteb, M.D., State Commissioner of Health, Albany, N, Y,:
Deab Sib: — I beg to submit the following report on the examination of
plans for proposed sanitary sewer extensions in the city of North Tonawanda,
Niagara county, submitted to this Department for approval on April 8, 1010,
by the city engineer.
The plans and documents submitted connist of:
1. One copy of report of city engineer.
2. One copy of specifications.
3. Application.
Tracing and blue print of:
4. Plan of pumphouse building.
5. Plan of pumping plant.
6. Two sheets of protiles of proposed sewers.
7. Plan of sewer district to be served by the proposed sew^ers.
The general plan of the city, recently submitted to the Department for filing,
shows that although sewers have been constructed from time to time since
1889, no plans for sewers or sewer extensions have been submitted to or ap-
proved by this Department.
The plans now under consideration show that it is proposed to construct
sewers in Cramer, Robinson, Rombolt and Zimmerman streets and Hagen ave-
nue. These sewers are to carry sanitary sewage only and vary from 10" to
12," in diameter.
The plans of the proposed sewers have been carefully examined as to grades,
sizes, velocities, capacities and other hydraulic and sanitary features, and all
but the proposed extension in Hagen avenue are found to be satisfactory and
adequate to meet the future requirements of the district to be served by them
upon the usual assumed basis of population and water consumption, and
assuming that in the construction the sewers will be made sufficiently water-
tight to nrevent excessive infiltration of ground water.
The plans show that the proposed 10'' sewer in Hagon avenue is to be
constructed on a .25 per cent, grade except for the last fifty feet near the
manhole at Rombolt street where the grade suddenly changes to about 8
per cent. The slope of this sewer should be made at least .3 per cent, for
the entire length in order to hotter insure self-cleansing velocities which
will probably not be obtained under the proposed conditions even though a
flush tank is placed at the upper end of a sewer, since the sewer is some
2,200 feet long. The vertical alignment should also be made straight between
manholes so as to. facilitate cleaning and inspection. This can be done by
installing a drop manhole at the intersection of Rombolt street and Hagen
avenue or by installing an additional manhole at the change of grade.
It also appears from the examination of the plans that the invert elevation
of the sewer at the upper end of Cramer street should be 508.46 instead of
563.46, this evidently being an error made in marking elevations on the map
and profile.
The sewage to be collected by the proposed sewers is to be conveyed
by gravity to a pumping station to be located near the intersection
of Rombolt and Division streets. Two automatic and electrically operated 4"
centrifugal piunps are to be installed at the pumping station which will
raise the sewage some fifteen feet and discharge it into the existing sewer
system.
According to the city engineer's report each pump is to have a capacity
of 470 gallons per minute which should be adequate to care for the sanitary
sewage contributed by tlie prr posed sewers.
440 State Dbpabtment of Heai^th
Respecting the advieability of allowing the temporary discharge of an in-
creased amount of sanitary sewage from North Tonftwanda into the Niai^ara
river it may be stated that at present no municipality derives its water sup-
ply from the river below North Tonawanda, or from Lake Ontario near the
mouth of the river, except Niagara Falls. The city of Niagara Falls is
planning to improve its water supply, and while my report on an investiga-
tion of proposed water supply for Niagara Falls, dated December 26, 1907,
was transmitted by you to the city authorities, it is not known if the city
intends to follow the recommendations contained in said report.
The seriously contaminated condition of a supply taken from the Ameri-
can channel was pointed out in the report above referred to, and in this
report it was shown that a relatively pure water could be secured from the
Canadian channel which would avoid the pollution from North Tonawanda.
Even if the present sewage of North Tonawanda were excluded from
the river the discharge of sewage from Buffalo and Tonawanda would make
it just as imperative for Niagara Falls to extend its intake to the Canadian
channel in order to obtain a supply relatively free from ooniamination.
It would seem, therefore, that since the purification of the sewage of North
Tonawanda would not materially lessen the desirability of an extension of
the Niagara Falls intake to the Canadian channel the adoption of any re-
quirement for the purification of such sewage may reasonably be deferred
until some comprehensive plan has been adopted looking toward the removal
of other and greater amounts of sewage from the river.
Since the volume of the flow in the river is great and the currents of the
river are swift there will be abundant opportunity for aeration and disper-
sion, and as a result there will be no danger that the additional discharge of
sewage proposed will have any effect in causing a nuisance in or along the
river below the city.
In view of the foregoing, I beg to recommend that the plans be approved
and a permit be issued allowing the discharge into Niagara river of sewage
to be collected by the proposed sewers, such permit to contain the usual revo-
cation and modification clauses, together with a stipulation tiiat the gradient
of the Hagen avenue sewer be increased to 0.3 per cent, and that the ver-
tical alignment of the sewer be made straight betweeen manholes.
I would further recommend that the permit reqiiire the submission of com-
plete plans for interception and treatment of the sanitary sewage ol the
city and tlie construction of any or all portions of the works shown by Uie
plans when required by the State Commissioner of Health.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
OGDENSBURG
On May 26, 1910. application was made by the board of public works for
the approval of plans for proposed sewer extensions in Market, Brown and
Jiickson streets. These plans were approved on June 15,. 1910, and a pennit
was issued allowing the discharge into the Oswegatchie river of sewage to be
colleote<i by the proposed sewers.
On August 12, 1910, application was also made for the approval of plana
for sewer extensions in Rensselaer avenue and Oak sti*eet. These plans were
approved on August 20. 1910. and a permit was issued allowing the discharge
into the Oswegatohie river of sewage from the proposed sewers.
Albany, N. Y., June 8, 1910.
Ei'GENE H. roRTKR. M.D., Stiitv Cotfimissit>tier of lieaith, Albany, N. T.:
Dear Sir: — I bog to submit the following report on the examination of
plans for proposed siinitary sower extensions in the city of Ogdensburg, St.
Lawrent^ county, suhmittwi t«» this Department for approval by tha board of
public works on May 2«>, HMO.
Sewekage anb Sewage Disposal, 441
The plans show that it is proposed to construct some 4S0 feet of 10" and
12" sewers in Market street from the intersection of Jackson sjid Market
streets to tke upper end of the existing stone sewer which commenees at Com-
merce street and discharges into the raceway tributary to the Oswegatchie
river through outlet No. 12. It is also proposed to construct two short sec-
tions of 8" sewers in Jackson and Brown streets between Main and Market
streets and tributary to the proposed Market street sewer.
Owing to the necessarily flat grade of the proposed sewer in Market street
it is proposed U> tap the existing sewer in Main street at Jackson street so
as to obtain a greater depth of flow of sewage in this sewer at all times.
In addition to increasing the flow by diverting some of the sewage from the
Main street sewer a more uniform flow through the entire length of the
proposed sewer in Market street would result if the invert elevation of the
manhole at Brown street be lowered somewhat so as to obtain a slightly
greater srlope of the 10" sewer and at the same time decrease the grade of the
12" sedtion of this sewer. More satisfactory results could pro^bly be ob-
tained by making the proposed sewer 12" in diameter for the entire distance.
The sewer will probably require cleaning occasionally no matter which one of
the two alternative changes is adopted. The sewer is, however, adequate as
to size and capacity if properly constructed to meet the future requirement
of the section to be served by it.
I would, therefore, recommend that the plans be approved and a permit
issued allowing the discharge of sewage from the proposed seMcr into the
raceway tributary to the Oswegatchie river through outlet No. 12.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
Albany, N. Y., Avffust 25, 1910.
Eugene H. Porter, M.D., State Commiasioner of Health, Albany, A^. Y,:
Dear Sir: — I beg to submit the following report on the examination of
plans for sanitary sewer extensions in the city of Ogdensburg, St. Lawrence
county, submitted to this Department for approval by the city clerk on behalf
of the board of public works, on August 12, 1910.
These plans, as first submitted for approval, did not contain suflicient data
to enable the engineering division to pass upon the plans and they were,
therefore, returned to the city engineer for additional information. Amended
plans were resubmitted for approval on August 23, 1910.
The plans now under consideration show that it is proposed to construct
sewer ^tensions in Rensselaer avenue and Oak street. The proposed sewer in
Rensselaer avenue is to be laid on a slope of 3.5 per cent, for a distance of
400 feet between Adams and Jefferson avenue and is to have a slope of 1.23
per cent, for a distance of 200 feet westerly from Jefferson avenue. A man-
hole is to be installed at the intersection of Jefferson avenue and Rensselaer
avenue and a lamphole is to be located at the upper end of this sewer. Owing
to the short length of this section of the proposed extension it appears that
a lamphole should afford adequate facilities for cleaning and inspection.
The proposed sewer in Oak street is to be constructed on a slope of 0.4 per
cent, for a distance of 180 feet easterly from Ford avenue, and is to be pro^
vided with a lamphole at the upper end of the sewer which should be ade-
quate for purposes of cleaning and inspection^ inasmuch as the section of
sewer is comparatively short.
These sewers will probably never be extended inasmuch as the proposed sewer
in Rensselaer avenue is to extend to the limit of the watershed in that
avenue, and in the case of Oak street extension there is at present a sewer in
New York avenue which is the next street east of Ford avenue and will pre-
vent any extension of the proposed sew^er in Oak street.
The phuis for the proposed sewer extensions have been carefully examined
and it is found that the sewers are adequate for future requirements of the
districts to be served by them, if properly constructed.
442 State Department of Health
I, therefore, recommend that the plans be approved and a permit be issued
allowing the discharge of sewage to be collected by the proposed sanitary
sewer extension into the Oswegatchie river through the existing outlet No. 4
which empties into the raceway crossing, Main street.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
ONEONTA
On June 18, 1910, plans for sewer extensions in London avenue, Henry and
other streets were submitted for approval by the board of public works of the
city of Oneonta. These plans were approved on July 20, 1910, and a condi-
tional permit was issued allowing the discharge into the Susquehanna river
of sewage to be collected by the proposed sewers.
On August 11, 1910, plans for a proposed sewer extension in West street
were submitted for approval. These plans were approved on August 17, 1910,
and a permit was issued allowing the discharge of sewage from the proposed
sewer into the Susquehanna river, on condition that on or before April 1,
1911, plans satisfactory to this Department for complete sewage disposal
works to treat the entire sanitary sewage of the city of Oneonta, accompanied
by a proper application for the approval thereof, shall be submitted to this
Department for approval, together with plans for such intercepting and out-
fall sewers as may be necessary to convey the sanitary sewage of the city
to the site or sites selected for such sewage disposal works, and that, when-
ever in the opinion of the State Commissioner of Health it is deemed neces-
sary or desirable, any designated portion, or all of, said sewage disposal
works shall be constructed within the time limit there specified.
Albany, N. Y., July 20, 1910.
Eugene H. Porter, M.D., State Commissioner of Health, Albany, N. Y.:
Dear Sir:— I beg to submit the following report on the examination of
plans for sanitary sewer extensions in the city of Oneonta, Otsego county,
submitted to this Department for approval by the board of public works on
June 18, 1910.
The plans show that it is proposed to construct 8" sewer extensions in
London avenue between River and Henry streets, in Henry street between
London and Burnside avenues, and in Bumside avenue between Henry and
Luther streets, all of which will discharge into the Susquehanna river through
the present outlet at the foot of Main street; also 8" sewers in Norton avenue
between Third and Fourth streets, and in Fourth street between Norton ave-
nue and Main street with outlet into the Susquehanna river at the foot of
Hunt street; also an 8" sewer extension in Spruce street east of East street
for some 240 feet, with an outlet into the river through the existing outlet
at the foot of Hunt street.
Tliese plans have been carefully examined in regard to grades, velocities,
capacities and other hydraulic and sanitary features in connection with the
proposed sewer extensions, and with some exceptions noted later it is found
that they are adequate to satisfactorily meet the future requirements for
sanitary sewage of the sections to be served by them on the usual assumptions
as to population and water consumption, and assuming that in the construc-
tion the sewers will be made sufficiently watertight to prevent excess infiltra-
tion of ground water.
However, the gradient or slope of the proposed sewer extension in Norton
avenue is too fiat and should be increstsed to at least 0.4 per cent., so as to
Sewerage and Sewage Disposal 435
The amended plans and documents recently submitted comprise the
following:
1. Duplicate reports and specifications.
Tracings and prints of:
2. Topographical map showing alignment of a portion of the sewer
system and the new location of the sewage disposal plant.
* 3. Amended plan of sewage disposal works.
4. Plan of former sewage disposal plant to be superseded.
5. Profile of main outfall sewer.
The plans now under consideration show that it is proposed to change the
location of the sewage disposal plant to a site some 1,200 feet to the south-
west and up-stream on Cold Spring brook from the site shown upon the plans
approved last December. It is stated in the application for the approval of
the amended plans that the change in location of the plant is necessitated by
the inability to secure a site at the point shown by the approved plans.
While the general arrangement of the different parts of the disposal plant
has been changed to suit the new conditions of topography of the changed
location, the capacity of the plant is the same as that shown by the former
plans.
The approved plans proposed to divide the irrigation field into three units,
one having a superficial area of two acres and two units of about one acre
each. The present plans show that it is proposed to divide the field iiito
four units of about one acre each. The amended plans also provide for a
somewhat different method of applying the sewage to the contact beds as
well as a field for the disposal of sludge adjacent to the proposed irrigation
field.
The new location of the proposed disposal plant seems to be more suitable
for a disposal site than the former, inasmuch as it will be necessary to divert
the flow of only one stream around the plant, whereas two streams flow
through the former site.
After a careful examination of the amended plans, I beg to recommend that
they be approved and a permit issued allowing the discharge of effluent from
the proposed sewaa^e disposal plant into Ck)la Spring brook, a tributary of
the Xeversink river.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
NEW ROCHELLE
On March 17, 1910, application was made by the board of public works for
the approval of plans for sewers in North avenue. Beechmont drive and
Montgomery circle. These plans were approved on March 25, 1910, and a
conditional permit was issued allowing the discharge, into Long Island sound,
of sewage from the proposed sewers.
On March 22, 1010, an application was also made by the board of public
works of New Rochelle asking for an extension of the time for filing plans
for a clarification of the sewage discharged through the Bailey's Rock out-
let, as was required by the permit issued on May 4, 1909, to be done within
one year. The time for filing such plans was extended to February 1, 1911,
as noted in a letter to the chief engineer of the board of public works dated
March 26, 1910. A copy of this letter is printed below.
The permit issued on March 25, 1910, contains in addition to the usual
revocation and modification clauses the following conditions:
1. That on or before February 1, 1911, satisfactory detailed plans shall be
submitted to the Department providing for a clarification by means of
efficient screening or sedimentation, or both, of the portion of the sewage of
the city not treated in the sewage disposal plant at the foot of Morgan street;
and that such plans shall also show in detail suitable works for supplementary,
complete treatment of sewage.
436 State Department of Health
2, That whenever required by the State Commissioner of Health the clarifi-
cation works shown by the approved plans shall be constructed within the
time then specified; and that whenever deemed necessary or desirable by the
State Commissioner of Health suitable extensions to such clarification works
shall be made or supplementary works shall be constructed for more complete
treatment of sewage within the time specified by said Commissioner.
Albany, N. Y., March 22, 1910.
Eugene H. PoRTsa, M.D., State Commiesioner of Health, Albany, N, Y,:
Dear Sir: — I beg to submit the following report on an examination of
plans for proposed sewer extensions and for proposed alterations to the sewer
system of the city of New Kochelle, Westchester county, submitted in person
to this Department for approval on March 4, 1910, by Mr. J. K. Wilkes,
chief engineer of the board of public works.
Several conferences have been held during the past year between the city
officials and this Department in regard to extending the sewer system and
providing sewerage facilitie«i for a large territory that is being rapidly de-
veloped and built up north and northeast of Eastchester road.
Tlie plans under consideration show that it is proposed to change the align-
ment, size and grade of the sewer in North avenue between Brookside place
and Eastchester road; to extend the sewer in North avenue from Eastchester
road to Broadview; also to change the alignment of sewers in Beechmont
drive and Montgomery circle.
Plans were approved by this Department on March 22, 1904, providing for
a 24-inch sewer running north from Brookside place in North avenue and
through private land to Eastchester road. The portion of the sewer through
private land was to follow, approximately, the course of a stream presumably
to avoid deep rock cutting during construction. This sewer, however, has
not been constructed.
It is stated in the rcjwrt by the designing engineer that in order to "avoid
certain physical difliculties of construction and also the usual delays and
complications arising from acquiring the necessary rights of way," it is now
proposed to abandon the route along the creek between Brookside place and
Eastcliestor road and to conntruct a 27-inch sewer entirely in North avenue
from Brookside place to Broadview, about 2,100 feet north of Eastchester road.
This change will necessitate a cut of twenty feet in depth for a considerable
distance in order that this sewer may at some future time intercept sewers to
be constructed to serve streets in the low area to tlie west of the Inter-Urban
Company's reservoir. The dilTerence in the cost of the two routes is prob-
ably not great since it will be necessary to lay a small sewer in North avenue
parallel to the intercepting sewer for a distance of some 900 feet, if the
trunk sewer is constructed along the stream.
The plans also sliow that it is proposed, eventually, to extend this trunk
sewer from Broadview in a northerly direction to Quaker Ridge road, a dis-
tance of some 6,400 feet, but since the present plans show only the probable
location of such sewer, detailed plans for the extension of the proposed trunk
sewer in North avenue should be submitted to tliis Department for ap-
proval before any extensions are made.
The territory that will ultimately be tributary to the new sewer is about
850 acres. Plans for sewers in a portion of this territory, known as Halcyon
park, Beechmont and part of Sunsetview park, including about 200 acres of
land, were approved on May 4, 1909. These sewers were tributary to the
main intercepting sewer between Brookside place and Fifth avenue.
It is now proposed to change the alignment of sewers in parts of Beech-
mont drive and Montgomery' circle in this section so as to discharge into the
proposed trunk sewer at the intersection of Montgomery circle and North ave-
nue, and not, as originally planned, into the existing trunk sewer between
Brookside place and Fifth avenue. Both designs make these sewers tributary
to the same outfall but at difTerent points.
Sbwebaoe and Sewage Disposal '4r37
The plans have been carefully examined by the engineering division in
regard to grades, sizes, velocities, capacities and other hydraulic and sanitary
features concerning the proposed sewers and they are found to be properly
designed to meet the future requirements of this district upon the usual basis
of population and per capita consumption, and assuming that in the con-
struotion the sewers be made sufficiently watertight to prevent excess infiltra-
tion. A considerable saving could be made by reducing the size of the pro-
posed 27" sewer between Beechmont drive and Brookside place, a distance of
1,055 feet. In any case of reducing the size of a main trunk sewer for a
section having a steeper grade than the section above precaution should be
taken to prevent any accidental stoppage which is more probable at such
points of reduction in size than at other points in a sewer.
The plans for the sewage under consideration provide for sanitary sewage
only, and it is understood that in the development of all branch and lateral
sewers which will discharge into this interceptor in the future or in the ex-
tension of this sewer plans for such sewers sliall 'be submitted for approval by
this Department.
The existing outfall sewer, with outlet into Long Island sound at a point
some 800 feet beyond Bailey's Rock to which the proposed sewer extensions
are tributary, has been examined as to capacity to care for additional sewage.
It is found 'that it is adequate for reasonable service in the future, but thai;
it will probably be necessary to relieve that portion of the outfall sewer be-
tween Fii'th avenue and the New York Central right of way before the addi-
tional tf^rritory made tributary to this sewer by the proposed sewer extensions
is fully developed.
The general questions of extensions to the sewer system for the city of
New Bochellfi and the effect upon the waters of Long Island sound and the
oyster beds in such waters of additional pollution from the discharge of sew-
age from the sewer system of the city were discussed at length in my report
to you of April Hth on the examination of plans approved on May 4, 1900,
and at that time it was advised that:
" Owing to the comparative remoteness of any oyster beds from the
existing outlet of the system of which the proposed sewers will be an
extension, I am of the opinion that it will not be necessary to require
at the present time a thorough purification of the sewage now discharged
into this outlet from the existing sewers and the proposed extensions. I
do believe, however, that with the rapid development that has taken place
along this shore of Long Island sound, the importance of the oyster in-
dustry which must be protected, the desirability of curtailing visual pol-
lution and possible ofi'ense in these waters and your consistent policy
with the municipalities along this shore, it is necessary to require clari-
fication of this sewage in the immediate future and to require that suit-
able provision be made to increase the efiiciency of this purification at
such a time or times in the future as local conditions may in your opinion
demand."
The proposed extensions are tributary to the same outfall to which the
extensions made the subject of the report quoted above were tributary. The
permit granted for the discharge of sewage from sewers for which plans were
approved on May 4, 1909, required that within one year satisfactory, detailed
plans be submitted to the Department providing for a clarification of the sew-
age by efficient screening or sedimentation, or a combination of both, and that
such plans shall show in detail also suitable works for the complete purifica-
tion of the sewage.
From conferences which have been held with the members and officers of
the hoard of public works of the city of New Bochelle during the past year
coneernlng the preparation of these plans for treatment of sewage, it is seen
that for various reasons, some of which are not under the control of the
board of public works, it has not been possible for such board to prepare
the plans as required for submission by May 4, 1910. Further, the Depart-
ment is this day in receipt of an application from the chairman of the board
of public works for an extension of tne time within which plans for treatment
of sewage were to be submitted to this Department for approval.
438 State Department of Health
In view of the foregoing I would, therefore, recommend that the plans
for a change in the alignment, size and grade of the sewer in North avenue
between Brookside and Eastohester road; for the construction of a sewef
in North avenue from Eastehester road to Broadview; and a change in the
alignment of sewers in Beechmont drive and Montgomery circle be approved
as submitted, and that the provisions requiring that plans for sewage treat-
ment as embodied in the permit granted May 4, 1909, be included in the
permit granted for discharge from the sewers proposed at this time, the
terms of such requirement being substantially as were stated in the per-
mit granted May 4, 1909, except that the time for filing said plans be extended
to February 1, 1911.
Respectfully submitted,
THEODORE HORTON.
Chief Engineer
Albany, N. Y., March 25, 1910.
Mr. J. K. Wilkes, Chief Engineer Board of Public Works, New Hochelle,
N, Y.:
Deab Sib: — I am sending you, under separate cover, by American Express,
the approved plans for sewer extensions in North avenue, Beechmont drive
and Montgomery circle, and am enclosing herewith a permit allowing the
discharge into Long Island sound of sewage to be collected by the proposed
sewers.
You will note that this permit to become operative must first be recorded
in the county clerk's office of Westchester county.
In response to the application from the board of public works of New
Rochelle, received on March 22d, asking for an extension of the time for filing
plans for a clarification of the sewage discharged through the Bailey's Rock
outlet, as was required by the permit issued on May 4, 1909, to be done
within one year, I have extended the time for filing such plans to February
1, 1911.
I would at this time call your attention to the desirability of carefully
considering in any proposed plans providing for treatment of sewage of the
city of New Rochelle some provision for permanent treatment of the sewage
now treated in the disposal plant at the foot of Morgan street. A study of
this portion of the system and of the question of sewage disposal for this
section may show that, on account of the comparatively obsolete type of
this plant and the fact that the plant is overtaxed at the present time, it
might be found advisable to arrange for treatment of sewage from this sec-
tion in the same plant to be designed for treatment of the sewage now dis-
charged through the Bailey's Rock outlet.
These matters, I presume, will be carefully considered <by your Board in
studies you are making of plans for sewage disposal for the city.
Very respectfully,
ALEC H. SEYMOUR,
Acting Commissioner of Health
NORTH TONAWANDA
Application was made by the board of public works, under date of March
16, 1910, for permission to discharge sewage into the Niagara river from
proposed sewers in Cramer, Robinson and other streets, and plans cover-
ing these sewers were submitted for approval on April 8, 1910. These plans
were approved on April 25, 1910, and a permit was issued allowing the dis-
charge of sewage to be collected by the proposed sewers into Niagara river, on
condition that whenever required by the State Commissioner of Health com-
Seweraok and Sewage U
plete plans sutisfactory to this Department for
ment of the entire sanitary aewage of the city
Department for approval; and that any or all pi
by such plans shall be constructed thereafter whi
time limit net by the State Commissioner of Heal
ALBjI
EUQENE H. PORTEB, M.D., Stale Com mission cr 0/ J
Deab Sib; — I beg to submit the following re|
plana for proposed sanitary sewer extensions in th
Niagara county, submitted to this Department for
by the city engineer.
The plans and documents submitted ronsist of:
1. One copy of report of city engineer.
2. Une copy of specifications.
3. Application.
Tracinjc and blue print of:
4. Plan of pumphouse building.
5. Plan of pumping ^lant.
6. Two sheets of prohles of proposed sewers.
7. Plan of sewer district to be served by tl
The general plan of the city, recently submitted t
shows that although sewers have been constructe
18X9, no plans for sewers or fewer extensions hai
proved by this Department.
The plans now under cousideribtion show that
■ewers in Cramer, Robinson, Rombolt and Zimmen
nue. The^^e sewers are to oarrv sanitary sewage
12" in diameter.
The plans of the proposed sewers have been carel
sizes, velocities, capacities and other hydraulic am
but the proposed extension in Hagen avenue are fi
adequate to meet the future requirements of the di
upon the usual assumed basis of population an
assuming that in the construction the sewers will
tight to Tirevent e.xccBsive infiltration of ground ws
The plans show that the proposed 10" eewer
constructed on a .25 per cent, grade except for 1
manhole at Rombolt street where the grade sue
per cent. Tlie slope of this sewer should be mai
the entire length in order to better insure sell
will probably not be obtaineil under the proposoi
flush tank is placed at the upper end of a sewc
2,200 feel long. The vertical alignment should als
manholes so as to facilitate cleaning and insjiecl
installing a drop manhole at the intersection of
■venue or by instnlling an aililitional manhole at
It also appears from the examination of the pla
of the sewer at the upper end of Cramer street 1
563.18, this evidently being an error made in mar
and profile.
The sewage to be collected hy the proposed
by gravity to a pumping station to be loca
of Rombolt and Division streets. Two automatic .
eentrifugal pumps are to be installed at the p'
raisi' the "ewage some fifteen feet and discharge
Acpording to the city engineer's report each p
of 470 gallons per minute which should be adequi
•ewige eontributeit by the prrno^ed sewers.
440 State Dbpabtment of Health
Baspecting the adyiBability of allowing the temporary diadtarge of an in-
creased amount of sanitary sewage from North Tonawanda into the Niaj^ra
river it may be stated that at present no municipality derives its water sup-
ply from the river below North Tonawanda^ or from Lake Ontario near the
mouth of the river, except Niagara Falls. The city of Niagara Falls is
planning to improve its water supply, and while my report on an investiga-
tion of proposed water supply for Niagara Falls, dated December 26, 1907,
was transmitted by you to the city authorities, it is not known if the city
intends to follow the recommendations contained in said report.
The seriously contaminated condition of a supply taken from the Ameri-
can channel was pointed out in the report above referred to, and in this
report it was shown tliat a relatively pure water could be secured from the
Canadian channel which would avoid the pollution from North Tonawanda.
Ev«n if the present sewage of North Tonawanda were excluded from
the river the discharge of sewage from Buffalo and Tonawanda would make
it just as imperative for Niagara Falls to extend its intake to the Canadian
channel in order to obtain a supply relatively free from contamination.
It would seem, therefore, that since the purification of the sewage of North
Tonawanda would not materially lessen the desirability of an extension of
the Niagara Falls intake to the Canadian channel the adoption of any re-
quirement for the purification of such sewage may reasonably be deferred
until some comprehensive plan has been adopted looking toward the removal
of other and greater amounts of sewage from the river.
Since the volume of the flow in the river is great and the currents of the
river are swift there will be abundant opportunity for aeration and disper-
sion, and as a result there will be no danger that the additional discharge of
sewage proposed will have any effect in causing a nuisance in or along the
river below the city.
In view of the foregoing, I beg to recommend that the plans be approved
and a permit be issued allowing the discharge into Niagara river of sewage
to be collected by the proposed sewers, such permit to contain the usual revo-
cation and modification clauses, together with a stipulation that the gradient
of the Hagen avenue sewer be increased to 0.3 per cent., and that the ver-
tical alignment of the sewer be made straight betweeen manholes.
I would further recommend that the permit require the submission of com-
plete plans for interception and treatment of the sanitary sewage ol the
city and the construction of any or all portions of the works shown by tiie
plans when required by the State Commissioner of Health.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
OGDENSBURG
On May 26, 1910, application was made by the board of public works for
the approval of plans for proposed sewer extensions in Market, Brown and
Jackson streets. These plans were approved on June 15,. 1910, and a permit
was issued allowing the discharge into the Oswegatchie river of sewage to be
collected by the proposed sewers.
On Augiist 12, 1910, application was also made for the approval of plans
for sewer extensions in Rensselaer avenue and Oak street. These plans were
approved on August 20. 1910, and a permit was issued allowing the discharge
into the Oswegatchie river of sewage from the proposed sewers.
Albany, N. Y., June 8, 1910.
Eugene H. Porter, M,D., ^tate Commissioner of Health, Alb<my, N, T,:
Dear Sir: — I beg to submit the following report on the examination «f
plans for proposed siinitary sewer extensions in the city of Ogdenaburg, St.
Ldiwrence county, submitted to this Department for approval by the board of
public works on May 26, 1910.
Sewbkaoe and Sewage Disposal
The plans ibow that it ia propoaei to construct some 460 feet c
12' Mwers in Market atreet from the intersection of Jackaon ai
«tr«eta to t^ upp«r end of the existing sttme seircr which commenM
merce street and diBcbargea into the racewaj tribntary to the Oi
river through outlet No. 12. It is also proposed to construct two
tioita of 8" sewers in Jackson and Brown strecta between Main ai
streets and tribntaiy to tlie proposed Market street sewer.
Owing to the necessarily tiat grade of the proposed sewer in Mai
it is proposed to tap the existing sewer in Main street at Jackson
as to obtain a greater depth of flow of sewage in this sewer at
In addition to increasing the How by diverting some of the sewage
Mkin street sewer a more uniform flow through the entire leng
proposed sewer In Market street wonld result if the invert elevat:
manhole at Brown street be lowered somewhat so as to obtain
grefttor riope of the 10" sewer and at the same time decrease the gr
12* section of this sewer. More satisfactory results could probal
tained by making the proposed sewer 12" in diameter for the entiri
The sewer will probably require cleaning occasionaM3' no matter wh
the two alternative changca is adopted. The sewer is, however, at
to tite and capacity if properly constructed to meet the future re
of the section to be served by it.
I would, therefore, recommend that the plana be approved and
issued allowing the discharge of sewage from the proposed aewei
raceway tributary to the Oswegatehie riyer through outlet No. 12.
Respectfully submitted,
THEODORE HORTO>
CMef E
Alsakt, N. Y., Augvit 2
EuoEXE H. POBTEB, M.D., Blale Commissioner of Heallh, Albany, .V.
Deab SiB: — I beg to submit the following report on the exam
plans for sanitary sewer extensionB in the city of Ogdensburg, St.
coun^, submitted to this Department for approval by the city clerk
of the board of public works, on August 12, 1010.
These plans, as tirst submitted for approval, did not contain siiffi'
to enable the engineering division to pass upon the plans and t
therefore, returned to the city engineer for additional information,
plans were resubmitted for approval on August 23, 1010,
The plans now under consideration show that it is proposed to
sewer exIcnsionB in Rensselaer avenue and Oak street. The propose)
it«is0»laer avenne is to be laid on a slope of 3.6 per cent, for a d
WO feet between Adams and Jelferson avenue and is to have a slo
Er cent, for a distance of 2O0 feet westerly from Jeflerson avenue.
le ii to be installed at the intersection of Jefferson avenue and 1
avenue and a lamphole is to be located at the upper end of this sewt
to the short length of this section of the proposed extensioD it ap]
a lABphole should afford adequate facilities for cleaning and inspect!
The proposed sewer in Oak street is to be constructed on a slope
cent, for a distance of ISO feet easterly from Ford avenue, and is
vidad with a lamphole at the upper end of the sewer which shoul
foatc for purposee of cleaning and inspection, inasmuch as the
•ewer ia oomparatively abort.
These sewers will probably never be extended inasmuch as the prop<
■a Renisolaer aventie is to extend to the limit of the watersbei
avestie, artd in the case of Oak street extension there is at present t
)»ew York avenne which is the next street east of Ford avenue and
vent any extension of the proposed sewer in Oak street.
The plans for the proposed sewer extensions have been carefully
•■d it !■ found that the sewers are adequate for futare reqnlreme
dtslTicls to be served by them, if properly constructed.
442 State Department of Health
I, therefore, recommend that the plans be approved and a permit be issued
allowing the discharge of sewage to be collected by the proposed sanitary
sewer extension into the Oswegatchie river through the existing outlet No. 4
which empties into the raceway crossing, Main street.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
ONEONTA
On June 18, 1910, plans for sewer extensions in London avenue, Henry and
other streets were submitted for approval by the board of public works of the
city of Oneonta. These plans were approved on July 20, 1910, and a condi-
tional permit was issued allowing the discharge into the Susquehanna river
of sewage to be collected by the proposed sewers.
On August 11, 1910, plans for a proposed sewer extension in West street
were submitted for approval. These plans were approved on August 17, 1910,
and a permit was issued allowing the discharge of sewage from the proposed
sewer into the Susquehanna river, on condition that on or before April 1,
1911, plans satisfactory to this Department for complete sewage disposal
works to treat the entire sanitary sewage of the city of Oneonta, accompanied
by a proper application for the approval thereof, shall be submitted to this
Department for approval, together with plans for such intercepting and out-
fall sewers as may be necessary to convey the sanitary sewage of the city
to the site or sites selected for such sewage disposal works, and that, when-
ever in the opinion of the State Commissioner of Health it is deemed neces-
sary or desirable, any designated portion, or all of, said sewage disposal
works shall be constructed within the time limit there specified.
Albany, N. Y., July 20, 1910.
Eugene H. Porter, M.D., State Commissioner of UeaXth, Albany, 'N. r.;
Dear Sir:-^I beg to submit the following report on the examination of
plans for sanitary sewer extensions in the city of Oneonta, Otsego county,
submitted to this Department for approval by the board of public works on
June 18, 1910.
The plans show that it is proposed to construct 8" sewer extensions in
London avenue between River and Henry streets, in Henry street between
London and Burnside avenues, and in Bumside avenue between Henry and
Luther streets, all of which will discharge into the Susquehanna river through
the present outlet at the foot of Main street; also 8" sewers in Norton avenue
between Third and Fourth streets, and in Fourth street between Norton ave-
nue and Main street with outlet into the Susquehanna river at the foot of
Hunt street; also an 8" sewer extension in Spruce street east of East street
for some 240 feet, with an outlet into the river through the existing outlet
at the foot of Hunt street.
These plans have been carefully examined in regard to grades, velocities,
capacities and other hydraulic and sanitary features in connection with the
proposed sewer extensions, and with some exceptions noted later it is found
that they are adequate to satisfactorily meet the future requirements for
sanitary sewage of the sections to be served by them on the usual assumptions
as to population and water consumption, and assuming that in the construc-
tion the sewers will be made sufficiently watertight to prevent excess infiltra-
tion of ground water.
However, the gradient or slope of the proposed sewer extension in Norton
avenue is too flat and should be increased to at least 0.4 per cent., so as to
Sewekage and Sewage Disposal 443
insure eecuring self -cleansing velocities, inasmuch as no facilities for systematio
flushin&r -are provided, and this sewer will probably seldom, if ever, flow more
than h&lf full.
The plans also show two changes of grade or vertical alignment in the
prpoposed sewer in Fourth street, with no manholes at these points. As was
pointed out in my former report on the examination of plans for sewer ex-
tensions in the city of Oneonta, dated September 14, 1909, manholes should
be installed at all points of change of grade or alignment in order to facili-
tate cleaning and inspection.
Reference is also made to my report of September 14, 1909, for a review
of the present status of sewerage in the city, as well as for a discussion aa
lo the condition of pollution of the Susquehanna river, in which report these
matters were carefully considered.
I beg to recommend that the plans be approved and a permit issued allowing
the discharge into the Susquehanna river of sewage to be collected by the
proposed sewers, on condition that the gradient of the proposed sewer in
Aorton avenue be increased to at least 0.4 per cent., and that manholes be
inserted at all changes of grade or alignment in connection with the proposed
sewer in Fourth street. I would also recommend that the permit contaip
the provisions, as to the future disposal of the sewage of the city of Oneonta,
embodied in the permit issued to the board of public works on September 22,
1909.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
Albany, N. Y., August 17, 1910.
Eugene H. Porter, M.D., State Commissioner of Healthy Albany, N. Y,:
Dear Sir: — I beg to submit the following report oh the examination of
plans for sanitary sewer extension in West street in the city of Oneonta. Otsego
county, submitted to this Department for approval by the board of public
works, on Aufmst 11, 1910.
The plans show that it is proposed to construct 600 feet of 8" sewers on a
grade of 6.2 per cent., between Cherry and Center streets. According to the
statements made by the city engineer this sewer extension is for the pur-
pose of improving the sanitary conditions of one house now located on this
section of West street by providing sewerage facilities for it.
Inasmuch as this sewer will probably not be extended it should be adequate
as to size and capacity to meet the probable demand that may be made upon
it in the future.
I beg to recommend that plans be approved and a permit issued allowing
the discharge into the Susquehanna river of sewage to be collected by the
proposed sewer extension, and would also recommend that this permit con-
tain provisions, as to the future disposal of the sewage of the city of Oneonta,
embodied in the permits issued to the board of public works on September 22,
1909. and July 20, 1910.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
OSWEGO
On No^'ember 29, 1910, plans for combined sewer extensions to the East
Eleventh street trunk sewer in the city of Oswego were submitted for ap-
proval by the commissioner of works. These plans were approved on Decem-
ber 20, 1910, and a permit was issued allowing the discharge 'into Lake On*
tario of sewage to be collected by the proposed sewers. This permit contains.
444 State Department of Health
in addition to the usual revocation and modification clausee, the following
conditions :
(1) That on or before March 1, 1911, detailed plans for settling sedineifta-
tion or septic tanks to treat the dry weather flow of sewage tributary to the
East Eleventh street trunk sewer in the city of Oswego, which shall meet
the requirements of this Department, accompanied by general plans for addi-
tional or supplementary works for more complete treatment of such sewage,
shall be submitted to this Department for approval.
(2) That the said settling, sedimentation or septic tanks shall be con-
structed and put in operation by September 1, 1911.
(3) That whenever required by the State Commissioner of Health detailed
plans for said additional works for more complete treatment of the dry weather
flow of sewage, conveyed by the East Eleventh street trunk sewer, shall be
submitted for approval; and that any or all portions of said additional or
supplementary works for more complete treatment of sewage shall be con-
structed and put in operation when required by the State Commissioner of
Health.
On December 6, 1910, plans for a sanitary sewer extension in West Seneca
street were submitted for approval. These plans were examined and returned
to the city engineer for revision and additional data. Revised plans were sub-
mitted for approval on December 16, 1910, and were approved on Deceniber
23, 1910, and a conditional permit was issued allowing the discharge into Lake
Ontario of sewage from the proposed sewer.
Albany, N. Y., December 5, 1910.
Eugene H. Porter, M.D., State Commissioner of Health, Alhant/, y. Y,:
Dear Sir: — I beg to submit the fallowing report on an examination of
plans for sewer extensions to the combined sewer system in the East Side
sewer district of Oswego, Oswego countj', submitted to this Department for
approval by the city engineer, on November 29, 1910:
The records of the Department show that plans for a trunk sewer in Bast
Eleventh and other streets in this district showing also a proposed location
of a sewage disposal plant were approved on May 21, 1909. This Bewer is
on the combined plan and discharges into the lake at the foot of East Eleventh
street.
The permit issued in connection with the approval of these plans contains,
in addition to the usual revocation and modification clauses^ the following
conditions :
That whenever required by the State Commissioner of Health:
1. Detailed plans satisfactory to this Department shall be submitted
for approval, showing settling or septic tanss to treat the dry weather
flow of sewage to be collected by the proposed sewers.
2. Plans for further treatment of such sewage, in addition to settling
tank or septic tank treatment shall be submitted for approval.
3. Within the period specified at such time such sewage disposal works
as may be required shall be constructed and put in operation.
Tlie plans now before the Department and under consideration provide for
a comprehensive system of lateral sewer extensions tributary to the East Elev-
enth street trunk sewer and are designed to carry both storm water and sani-
tary sewage. These sewers vary in diameter from 10" to 30" and inasmuch
as most of the extensions are comparatively short and the gradients rather
steep it appears that they should be adequate as to capacities to meet the
requirement of the district to be served by them for a reasonable period in
the future, provided that the sewers be properly constructed. While the pro-
posed sewers appear to be adequate both as to sizes and capacities to meet Uie
requirements for sanitary sewerage, no attempt has been made, however, to
determine closely the adequacy of these lateral sewers to satisfaotorily care
for the storm water when the district to be served by them is fully developed.
The question of the future disposal of the sewage to be collected by the
Sewerage and Sewage Disposal 445
proposed sewer and the effect on the proposed water supply of the city of the
discbarge into Lake Ontario of untreated sewage was discussed in my report
of'May 12, 1909, on the examination of the plans for the trunk sewer.
In view of the fact that the plans under consideration provide for an ex-
tension of the sewer system in this section of the city to cover, practically,
the entire developed area east of the Oswego river, I believe that the city au-
thorities should he required to provide at an early date for at least settling
or septic tank treatment of the dry weather flow of sewage from this diatrict.
I, therefore, recommend that the plans be approved and that the permit,
to be issued in connection with the approval of the plana, contain in addition
to the usual revocation and modification clauses, the condition that detailed
plans for settling or for septic tanks to treat the dry weather flow of sewage
tributary to the East Eleventh street trunk sewer accompanied by general
plans for more complete treatment of sewage shall be submitted to this De-
partment for approval on or before March 1, 1911, and that such settling or
septic tanks shall be constructed and put in operation by September 1, 1911.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
Albany, N. Y., December 13, 1910.
£coK2«K H« PoRTEB, MJ)., State Commissioner of Health, Albany, N. Y.:
Dbab Sib: — I beg to submit the following report on an examination of
plana for a sanitary sewer extension in the city of Oswego, Oswego county,
sobmitted to this Department fc^ approval by the city engineer on behalf of
the commissioner of works on December 6, 1910.
The plans submitted show a general plan of the proposed sanitary' sewer
system covering a portion of the northwesterly section of Oswego and show
also plans and profiles of proposed sanitary and storm water sewers in West
Seneca and other streets. Owing to the proposed improvement by the State
Highway Commissioner of West Seneca street immediate consideration and
approval of plans for the proposed 8" sanitary sewer in this street only be-
tmea First and Seventh avenues is asked for at this time. According to the
engineer, no house connections are to be made with this sewer until the con-
struetion of the trunk sewer.
Tfae plans have been carefully examined and it is found that there is not
saAcient data submitted nor on file with the Department to permit a proper
consideration of the plans relative to their approval.
No plans are submitted to show the area to be served and no statement is
made as to the uUiaiate contribution of sewage to be carried by the proposed
sewer in West Seneca street, and it is, therefore, impossible to reach a de-
cision as to the adequacy of this sewer to properly care for sanitary sewage of
tbe district to be served by it. It appears also that the gradient of the lower
seetioa of this sewer as designed is too flat to give self cleansing velocities
and prevent clogging.
Tke plana, moreover, indicate that the sanitary sewer in West Seneca street
is to discharge directly into the storm water sewer in First or Hillside
or is to be provided with an overflow into this storm sewer. Sanitary
rage should not be allowed to discharge into the storm water system and
BO connections should be made between this system and the sanitary sewer
system.
It appears alao that the plans as submitted cannot be finally passed upon at
ibis time or until more complete plans or additional data are submitted as
ta tbe area to be served by the proposed sanitary sewers in the entire district,
inasBUch as the approval of these plans for the sanitary sewer in West
8e»cc> street would predetermine the elevation of one of the trunk sewers in
ffillside or First aventie.
In view of the above I wouM recommend that the plans be returned and the
eity engineer informed that the approval of the plans cannot be considered
446 State Department of Health
until plans of the proposed sewer, revised in accordance with the suggestions
embodied in this report so as to eliminate the objectionable features referred
to, be submitted for approval accompanied by a short report giving:
1. The basis of design.
2. The areas to be served by the proposed sewer and trunk sewer in
Hillside or First avenue.
3. The estimated ultimate population tributary to these sewers and the
maximum per capita rate of contribution of sewage.
4. A statement as to whether the design of the trunk sewers in Hill-
side and First avenues is the result of and is consistent with studies made
as to the feasibility of delivering by gravity at the disposal plant site the
sewage to be conveyed by these sewers at such an elevation as to permit
the operation of such works by gravity flow as far as possible.
Respectfully submitted,
THEODORE HORTOX,
Chief Engineer
Albany, N. Y., December 20, 1910.
Eugene H. Pobteb, M.D., State Commissioner of Health, Alhant/y y. Y.:
Dear Sir: — I beg to submit the following report on a re-examination of
plans for a proposed sewer extension in the city of Oswego, Oswego county,
resubmitted to this Department for approval by the city engineer, in person,
on December 16, 1910.
It appears from the supplementary report of the city engineer and state-
ments made by him at the conference in this office on December 10, 1910, that
the area of the territory tributary to the proposed 8" sanitary sewer in West
Seneca street is 24.7 acres and that the design is based on an ultimate future
population of thirty persons per acre contributing sewage at a maximum rate
of 240 gallons per capita per day. On this basis the proposed sewer which is
to have a grade of from 0.25 per cent, to 6.4 per cent, is adequate as to size
and capacity to meet the future requirements of the territory to be served by
it, provided that in the construction the sewer be made sufficiently water-
tight to prevent excessive infiltration of ground water.
The gradient of 0.25 per cent, of the lower section of this sewer consisting
of about 360' is, however, too flat to prevent clogging. This is especially true
where no facilities for regular flushing can readily be installed at an inter-
mediate point on a sewer line as in the case of this sewer. The diameter of
the sewer should, therefore, be increased to 10" or the gradient increased to at
least .35 per cent. The latter can be done either by raising the invert ele-
vation of the first manhole above First avenue or by slightly lowering the
sewer in First avenue. The latter alternative would probably be practicable
since, in any event, it may be necessary to pump the sewage at the proposed
disposal plant to operate complete treatment works owing to the small head
available under the proposed design. The additional cost would in either case
be slight owing to the comparatively short section of the sewer involved.
It was also pointed out by the city engineer that it is not proposed to pro-
vide an overflow from the sanitarv sewer in West Seneca street into the storm
sewer in First avenue and that the line shown upon the plans connecting the
sanitary sewer in West Seneca street with the storm sewer in First avenue is
simply a transit line shown upon the original tracing in red.
Although the city engineer stated in his letter of transmittal dated De-
cember 5, 1910, that no house connections would be made with the proposed
sewer until the construction of the trunk sewer, the commissioner of
works at the conference referred to above, asked permission to be allowed to
temporarily discharge sewage directly into a small stream tributary to Lake
Ontario in order that advantage might be taken of the provision of the city
charter which allows an assessment, for the cost of sewers, against the prop-
erty owners. He stated that he feared that if the abutting property owners
did not have the use of these sewers, it would be difficult to collect any as-
Besements from them and the construction of the sewers would be delayed.
SEWEEifiE AXD Sewage Disposal 44T
I sm of the i^inion that, in order to protect th« water supply of tlw ritv.
no additional rav E«va^ should even tenporirilj be Jisfhai^nvi int'i l^kr
Ootario. The prohibition of tLe use of these sewers until tite ivajij^e dispoMil
plant i» rauBtmeted will be eonsiglent with your diKapprtiral nf plans for
fewer eitensions in We«t Scborler street. Seventh. West. Oneida and other
■treetg. pending the BuhmiBsion of plaqs for interesting $evi«r» and Fewagie
dispoBal works in the district.
Id view of the above I would reeonmend that the plans be approved and a
permit be issued which shall contain in addition to the usnal rev<y-aTion and
modification clauses, the following provisions;
1. That no house connectinns shall be made with the propo<eil feuer
until the completion of the trunk sewer and s*H-a(re disposal pl»nt and
that the sewage to be collrcled by the propof«( sescer shall first be passcii
through the proposed sewage disposal plant before it be dischsrpcd iiilo
the Cfewego river.
2. That either the size of the lower swtion of the sewer shall be in-
creased to 10" or the gradient be increased to 0.35 per cent.
Respectfully submitted,
THEODORE HORTOK.
Chirf Enflinr-'
PELHAM
On November II, 1910, application was received from the board of trusti-es
of the village of Pelham in reference to plans for a projwsed oulfull sewor
for the villages of Pelham and North Pelham, to connect with the »ewnRi'
disposal plant of the town of Pelbam. The plana, however, did not nhow
sufficient details and there wag not sufficient data at hand to permit of nn in-
telligent esainination of them. The plans were, therefore, retiirni'd to the
desicning enftineer for additional details and information.
On November 30, 1910, the plans were resubmitted for approval and were
approved on December 2, 1910.
^\i.B\NV, N. v., .Voirmtcr 21. linn.
EcuEsE H. PoBTEB, M.D., Stoic Commwsroncr of Ilfiitlh, Albany, Tf. Y.:
Deab SiBt — I beg to submit the following rejHirt on an ciiiminnli.in «f
plans for a proposed outfall sewer for PcDiam and North Pelhnm. in tin'
town of Pelham. Westchester county, submitlei) to this Urptirtnient for up-
proval by Harold B. Roberts, consulting engineer for the village of relliiim,
on behalf of the board of trustees, on November 11. IDIO.
The records of the Department in reference to plnns and nmendmentu In
plans for sewerage and sewage disposal for North Pelhnm and Pelham Miinor
show that plans for these municipalities have been approved from time to
time and the dates of approval of the difTerent selt of plans were tiiveti in my
reports on the examinations of plans for sewnge dispoHnl for the town of
Pelham, dated .Tuly 20, 1D09, and May 26. lOIO. which plans proviiled for
sewage disposal for the three villages in the town of Pelham. vu.: Pellmni.
Pelham Manor and North Pelham. Plans for m'wers in the viltnire of ivnmm
have not been approved by the Department, however, except in cinm-i'ii"" niiK
the plans for sewage disposal in the town of Pelham.
The first set of plans for sewage disposal for tlie town sliow
proposed to intercept the sewers of Pelham ami North Pelhnn
section of Colonial avenue and Wolf's lane and to enrry the •>'<
point to the disposal plant, a distance of some l.Nlin feet thrr
pipe. The sewers of Pelham Manor were to be intercepted a
conveyed from Esplanade to the disposal site by means of a 24
The amended plans tor sewage disposal for the town of Pe
on June I, 1910, did not show the siiCB of the proposed sewe
448 State Department of Health
latter plans merely prorided for a modifieation of the sewage diapoaal works.
The question of capacities of the sewers tributary to the proposed sewage dis-
posal plant was not considered in detail, however, in eonneotion with these
plans, inasmuch as the matter of sewerage for the three Tillages was pre-
sented jointly by these villages in a general way and the legislative enactment
which created the Pelham £)ard of sewage disposal works simply authorized
the commissioners to construct and maintain sewage disposal works for the
town of Pelham, and provided that plans for the sewage disposal works pre-
pared by them or by their engineer should show a plan for connecting there-
with the sewer system of each of the villages of said town.
The amended plans for the proposed sewer system for the village of North
Pelham approved on December 21, 1900, provided for an 18" trunk sewer in
Wolf's lane and Iden avenue to Park place, some 300 feet from the disposal
site.
The plans now under consideration show that it is proposed to intercept the
sewers of North Pelham and Pelham at the intersection of Colonial avenue
and Wolf's lane a^d to convey the sewage collected by the sewers in these
villages to the disposal works by means of a 24" sewer, which sewer, according
to the letter of the engineer transmitting the plans, is to be built jointly by
North Pelham and Pelham. The plans also provide for the interception of the
sewage from Pelham Manor in Esplanade and Daniels street.
It is, however, impossible to examine these plans intelligently, inasmuch
as there are not sufficient details shown on the plans and not suSo^ient data
submitted with the plans nor on file in this Department to pass upon them.
The plans should show the sizes of all sewers and, in addition to the invert
elevaticm of the manholes, the rate of slope of the proposed sewers between
manholes. Profiles ol all outfall sewers should also be submitted in accord-
ance with the requirements of this Department.
The plans should also be accompanied by a report by the designing engi-
neer and such report should give the basis of design, i. e., the area to he
served by the proposed outfaU sewers, the present and estimated future popu-
lation and the maximum per capita rate of contribution of sewage to be cared
for by the sewers. A statement should also be submitted as to the reaaon
for changing the size of the outfaU sewer for Pelham and North Pelham from
36" to 24" in diameter, as the capacity of the former is from two to five times
that of the latter, taking into consideration the gradients of the two sewers.
In view of the above, I would beg to recommend that the plans be re-
turned and the designing engineer be* asked to submit additional plans and
data in accordance with the suggestions embodied in this report.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
Albany, N. Y., Deeemher 1, 1910.
Eugene H. Porter, M.D., State C<nnfnis8ioner of Health, Albany, N. Y.:
Dear Sir: — I beg to submit the following supplementary report on a re-
examination of plans for a proposed outfall sewer for the villages of Pelham
and North Pelham, Westchester county, resubmitted to this Department for
approval by Harold B. Roberts, consulting engineer of New York city, on be-
half of the board of trustees of the village of Pelham, on November 30, 1910.
These plans were first submitted for approval on November 11, 1910, but
inasmuch as they did not show sufficient (tetails and sufficient data were not
submitted with them to enable the Department to pass upon the plans at that
time, they were returned to the designing engineer with the request that
additional data be submitted in accordance with my report on an examination
of these plans dated November 21, 1910.
The plans were resubmitted for approval on November 30th, as noted above,
and were accompanied by profiles and report by the designing engineer. The
plans show that it is proposed to intercept the existing 10 and 15" sewer
Sewerage and Sewage Disposal 440
wrvinpf the village of Pelbani niu\ tl.e proposed 18" sewer from North IMham
at the intersection of Colonial avenue and Wolf's lane and to convej^ the
sewage collected by these sewers to the sewage disposal works by means of a
24" sewer laid on a grade of .2 per cent. The proposed sewer has a capacity
somewhat in excess of the combined capacities of the three sewers to be inter-
cepted.
According to the report of the engineer, the area of the village of Pelham
tributary to the proposed sewer is about 250 acres and that of the village of
North Felham about 230 acres.
On the usual assumptions as to population and sewage contribution, the
proposed sewer should Ihj adequate as to capacity to care for the ultimate
contribution of sewage from the two villages, provided that in the construc-
tion, the sewer be made sufficiently water tight to prevent excessive infiltration
of ground water and I would, therefore, recommend that the plans be ap-
proved.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
PELHAM (Town)
On May 23, 1910, plans for proposed sewage disposal works for the town of
Pelham were submitted for approval by the Pelham board of sewage disposal
works. These plans were approved on June 1, 1910, and a permit was issued
allowing the discharge, into Hutchinson river, of effluent from the proposed ,
sewage disposal plant.
Albany, X. Y., May 26, 1910.
Eugene H. Porteb, M.D., State Commissioner of Health, Albany, N. Y.:
Dear Stb: — I beg to submit the following report on the examination of
plans for the proposed sewage disposal works for the town of Pelham, West-
chester county, submitted to this Department for approval on May 23, 1910,
by the Pelham board of sewage disposal works.
The Pelham board of sewage disposal works was constituted by legislative
enactment which became effective May 28, 1909, and known as chapter 544
of the Laws of 1909. llie law provides that the board shall be composed of
three members, to be called the Pelham sewage disposal works commissioners,
consisting of the presidents of the three villages in the town of Pelham,
namely. North Pelham, Pelham and Pelham Manor.
The board is authorized and empowered to construct and maintain sewage
diftposal works for the town of Pelham, and the law further provides that the
plans for the disposal works shall show a plan for connecting therewith the
sewer system of each of the villages of said town.
The records of the Department show that plans for a comprehensive sew^er
system for North Pelham were approved on August 18, 190S, and on De-
cember 21, 1909, revised plans, providing for minor changes in alignment of
the sewers in this village, were approved by this Department. Original plans
for a sewer system and sewage disposal works for Pelham Manor were ap-
proved on June 29. 1894. and on April 12, 1895. plans for a chanpre in the
fewer system of Pelham Manor were approved. On September 17, 1896. plans
for a change in the location of the outlet sewer were approved by the De-
partment.
Some time after the passage of the le2ri^lative enactment which created the
Pelham board of sewage disjiosal works, plans for a sewage disposal plant for
the town of Pelham were submitted to this Department for approval and
were approved on July 27, 1909. This disposal plant was designed on the
concentric plan and provided for detritus tanks, septic tanks and sprinkling
filter. AH of the above plans for sewage disposal works were to be located in
15
450 State Department of IIealtu
the vicinity of the plant shown in the present plans and provided for the dis-
charge of effluent into Hutchinson river.
The plans recently submitted for approval and now under consideration
show that the proposed disposal plant is to be located on the bank of Hutchin-
son river at the intersection of Park place and Esplanade and meet the
requirements of the law above referred to, t. e., chapter 544 of the Laws of
1909, inasmuch as the plans show a plan for connecting the sewers of the
three villages in the town of Pelham with the proposed sewage disposal works.
These disposal works are to consist of a screen cnamber, four settling tanks,
two storage tanks, pump chamber, three dosing tanks and a sprinkling filter
bed consisting of three units. The plant is designed to care for the sanitary
sewage contributed by a future population of 8,000 persons assuming a rate
of water consumption of 100 gallons per capita per day and is designed in
substantial accordance with the recommendations of this Department embodied
in several communications with the designing engineer.
According to the report of the designing engineer the present population is
estimated at 2,500, and although the entire plant is to be constructed only
two sedimentation tanks, two storage tanks, two dosing tanks and two units
of the filter beds will be put in operation at present.
The sewage upon reaching the disposal works passes through a screen
chamber provided with two inclined bar screens each having an available
screening area of forty square feet. The bars of the first screen are spaced
1% inches apart in the clear and the bars of the second screen are spaced one-
half inch apart. From the screen chamber the sewage is carried in channels
to the outside ends of the settling tanks where the amount of sewage to be
discharged into each tank is regulated by weirs placed in the partitions
between the channels and the settling tank.
Each settling tank is 16 feet wide by 48 feet long and is to be constructed
with a triple hopper bottom for the reception of sludge. A 4-inch blow-
off pipe is provided in each hopper and connected with a pump through which
sludge may be discharged at any time to the adjacent sludge disposal field
without emptying the tank.
The total capacity of the four settling tanks is about 190,000 gallons, which
is equivalent to six hours' fiow of sewage on the basis of 8%,000 gallons
daily fiow.
From the sedimentation tanks the sewage passes over adjustable weirs to
channels leading to the storage tanks having a combined capacity of some
1,800 cubic feet. It appears that only one of these tanks is to be used at a
time and the effluent from the sedimentation tanks can be diverted into
either of the two tanks by means of flash boards. The storage tanks are to
be provided with an automatic float arrangements for starting and stopping
the two 5-inch centrifugal pumps located in an adjacent dry pump well. The
pumps are designed to discharge 600 gallons per minute each, which is equal
to the estimated maximum flow of sewage for which the plant is designed to
treat and are to be operated by induction motors connected with the current
from the municipal lighting plant. An auxiliary power plant consisting of a
gasoline engine and generator will supply the electric current for the motors
to drive the pumps in case of emergency.
The sewage from the storage tanks will be discharged to an overhead feed
trough leading to three truncated pyramidal-shaped dosing tanks located
directly above the storage tanks. The sewage is to pass into these dosing
tanks simultaneously over adjustable weirs. Each tank has a capacity oi
about 5,700 gallons and is provided with an 8" automatic siphon which dis-
charges into the distributing system of the sprinkline filter. One dosing tank
supplies one of the three units of the sprinkling filter.
llie filter has a total area of about .55 acres and is to be filled to a depth of
six feet with broken stone varying in diameter from 2 to 2^^ inches. At a
daily rate of contribution of 800,000 the sprinkling filter will be required to
treat settling tank effluent at the rate of 1,500,000 gallons per acre per day.
The sewage or effluent is to be applied to each unit of the filter by means
of seventy-two spraying nozzles spaced 10.4 feet on centers and designed to
^i^e a square distribution. These nozzles, being supplied by a gravity flow
Sewerage and Sewage Disposal 451
from the dosing tanks, will tend to give a uniform distribution of sewage over
the surface of the filter area under a dropping head. The net pressure head
at the nozzles will vary from about 0.5 to 6.5 feet, and under these con-
ditions each nozzle is to have an average rate of discharge of about fifteen
gallons per minute. At this rate of discharge each dose will be applied to
the filter in about six to seven minutes and allow a period of rest of about
twenty-seven minutes for an average rate of contribution of 800,000 gallons
per day, which is the amount of sewage the plant is designed to treat properly.
The sprinkling filter is to be thoroughly underdrain^ by means of 8-inch
horseshoe tile, and 8-inch tile vents spaced five feet on centers are to be
placed along the east side of the filter for the purpose of ventilation. The
effluent collected by the underdrains is to be discharged into Hutchinson river.
In conclusion, I beg to state that the plans have been carefully examined
and show that the proposed sewage disposal works are well balanced as to
design and should produce a satisfactory effluent if properly constructed and
operated*
I therefore recommend that the plans be approved and a permit be issued
allowing the discharge into Hutchinson river of effluent from the proposed
sewage disposal works.
Hespectfully submitted,
THEODORE HORTON,
Chief Engineer
POUGHKEEPSIE
On February 7, 1910, application was received from the board of public
works of the city asking for the approval of plans for sewer extensions in
Innis avenue, Dwight, South Wliite and Cherry streets, and Pox terrace.
These plans were approved on February 8, 1910, and a permit issued allowing
the discharge, into the Hudson river, of sewage from the proposed sewers.
On October 25, 1910, plans for a proposed sewer extension in North Clinton
■treet were submitted for approval by the board of public works. These plana
were approved on October 31, 1910, and a permit was issued allowing the
discharge of sewage into the Hudson river from the proposed sewer.
Albany, N. Y., January 31, 1910.
EUOEXE H. PoBTER, M.D., State Commissioner of Healthy Albany, N. Y.:
Deab Sib: — I beg to submit the following report on an examination of
plans for sewer extensions in the city of Poughkeepsie, Dutchess county, sub-
mitted to this Department for approval on January 18, 1910.
The records of the Department show that plans for combined sewers within
the present sewer districts of the city have been approved from time to time
during the past two years. The plans now under consideration show about
4,000 feet of 12-inch sewer extensions in Dwight street, Innis avenue. South
White street. Fox terrace and Cherry street.
The plans show that the sewer in Innis' avenue is to be a sanitary sewer,
while the proposed sewers in Dwight street, South White street, Fox terrace
and Cherry street are to be constructed on the combined plan with provisions
for future separation of sanitary sewage and storm water in Cherry streets
The proposed sewers have sufficient grades to produce self-cleansing veloc-
ities and are satisfactory as to other engineering features, and I would,
therefore, recommend that the plans be approved and a permit be issued
allowing the discharge of sewage into the Iludson river.
Respectfully submitted,
THEODORE HORTON,
Chief Engineep
452 Statk Department of Health
Albany, K. Y., October 31, 1910.
Eugene H. Porter, M.D., State Commissioner of Health, Albany, N. Y.:
Dear Sir: — I beg to submit the following report on an examination of
plans for a proposed sewer extension in Poughkeepsie, DirtchesH county, sub-
mitted to this Department for approval by the board of public works on
October 25, 1910.
The plans show that it is proposed to construct a 12" and 15" sewer in
North Clinton street from a point about 375 feet north of the C. H. Park en-
trance to the railroad crossing under Clinton street between Cottage and
Oakley streets. From this point two routes are shown, one across private
property to Hamilton street; the other (which, according to the Superin-
tendent of Public Works, is the one to be constructed) under the tracKs of
the Central New England railroad to the existing se^er in Cottage street at
the intersection of Clinton street.
The sewer is to be carried under the tracks by means of an inverted siphon
which is to consist of 75 feet of 20" vitrified tile pipe with a manhole at each
end. The difference in elevation of the inverts of the sewer at the manholes at
the banning and end of the siphon is about 2.2 feet.
The plans have been carefully examined by the engineering division and
found to be satisfactory and adequate for future requirements for sanitary
sewage of the district to be served by the proposed sewer, provided the sewer
is carefully constructed especially with reference to the inverted siphon.
I, therefore, beg to recommend that the plans be approved and a permit is-
sued allowing the discharge into the Hudson river of sewage to be collected by
the proposed sewer.
Respectfully submitted,
THEODORE UORTON,
Chief Engineer
ROCHESTER
On March 1, 1910, plans for proposed intercepting and outfall sewers and
for sewage disposal works for the city of Rochester were submitted for approval
by the city engineer.
These plans were, however, not approved and were returned to the city engi-
neer for amendments and modifications with respect to time of detention and
arrangement of outlet, on July 26, 1910. The plans were resubmitted for
approval on August 20, 1910, after having been revised in general accordance
with the recommendations embodied in the report, dated July 18, 1910, on
an examination of the first plans presented.
The revised plans were approved on September 22, 1910, and a permit was
issued allowing the discharge into Lake Ontario of effluent from the proposed
sewage disposal works.
Albany, X. Y.. July 18, 1910.
Eugene H. Porter, M.D., State Commissioner of Health, Albany, \. Y.:
Dear Sir: — I beg to submit th^ following report covering my examination
of the plans for proposed intercepting and outfall sewers and for sewage dis-
posal works for the city of Rochester, Monroe county, submitted for your ap-
proval on March 1, 1910:
The plans submitted comprise duplicate copies of the following:
1. Map of Rochester and vicinity.
2. Proposed intercepting sewer and main sewer outlets from Central
avenue to Driving Park avenue.
3. Proposed intercepting sewer from Driving Park avenue to Strong
and Hollenbeck streets, showing connection with Lake avenue outlet.
4. Profile of intercepting sewer from North Water street to Hollenbeck
Btreei.
Sewebage and Sewage Disposai. 453
5. Profile of proposed connections from the West Side Trunk sewer to
Avenue B.
6. Profile of proposed connection with Lake avenue outlet sewer.
7. Profile of Main Trunk sewer from Norton and Hollenbeck streets to
sewage disposal works and of outfall sewer from sewage disposal works to
terminal crib in Lake Ontario.
8. Topographic plan showing Main Trunk sewer, disposal works and
farm of Edward Harris and lands adjacent thereto.
i). Plan and sections of disposal works.
10. Special Rochester sheet of United States Geological Survey, showing
location of proposed outfall sewer.
11. Plan and sections of overflow chamber at north end of Mill street
tunnel.
12. Plan and section of terminal crib on discharge pipe in Lake Ontario.
The following reports and documents were also submitted:
1. The report of Emil Kuichling, consulting engineer on the proposed
Trunk sewer for the east side of the city of Rochester, dated April 29,
1889.
2. The report of Emil Kuichling, consulting engineer on the disposal
of the sewage of the city of Rochester, dated February, 1907.
3. Notes on sewage disposal, supplementing the report on the disposal
of the sewage of the city of Rochester, made on February 1, 1907, by
Emil Kuichling, consulting engineer, dated March 21, 1910.
Rochester is a city of the first class, situated in the northern central por-
tion of Monroe county on the Genesee river, the northerly boundary of the
oi^ being five miles from Lake Ontario, and the southerly boundary about
eleven miles from the lake.
The population of the city, as given by the United States and New York
State census from 1875 to 1905. is as follows:
1875 1880 1890 1900 1905
81,722 89,366 133,896 162,608 181,666
Mr. Kuichling estimates that in 1925 the population of the city will be
260,000, and to this he adds a population of 15,000 in the districts of the
towns of Gates and Greece, adjoining the westerly city line, which will nat-
urally be served by the city sewer system and will probably ultimately be in-
cluded within the city limits. This gives a total population of 275,000 as the
ba«i» for the design of the intercepting sewer and disposal works.
A study of the population statistics for the city shows that the rate of
growth has been comparatively uniform, and the estimated population of
275,000 in 1925, given by Mr. Kuichling, appears to be a reasonable and proper
one. If the above estimate for 1925 be extended ten years with a correspond-
ing rate of increase, but with a somewhat greater allowance for density of
population in the section west of the city, which would naturally be tributary
to the city sewer system, the population of the city in 1935 would be ap-
proximately 325,000.
The total area within the prcfeent city limits is 12,627 acres, of which
1,313 acres are parks, cemeteries, rivers, canals, etc., and 794 acres comprise
the new portion of the city, formerly the village of Brighton. This latter
section is provided with a separate sewer system, plans for which were ap-
E roved by this Department on October 24, 1907, the sewage being collected
I a system of separate sewers and pumped into the east side trunk sewer
at University avenue. Since the natural slope of this district is toward Iron-
dequoit bay it is proposed to treat the sewage from this district in a separate
lewage disposal plant having an outlet into Irondequoit bay.
Prom the above statement as to areas it will be seen that the habitable
area lying within the city limits tributary to the proposed intercepting sewer
is 10,520 acres. Outside of the city limits there are also tributary to the
intercepting sewer system about 5,500 acres in the town of Gates, and some
300 acres in the town of Greece. These give a total of some 16,000 acres as
tnbntary to, and to be served by, the proposed intereeptiujr sewer.
454 State -Depabtment of Health
The city water supply is derived from Hemlock lake which lies 26 miles
due south of Rochester and has a catchment area of 43 square miles, with
a lake surface of about 3 square miles. The construction of the water-works
was commenced in 1873. There is one storage reservoir 9 miles south of
the city and two diistributing reservoirs near the southerly city line. Two
conduits, the last one completed in 1894, convey the water to the distributing
reservoirs whence it is distributed to the consumers. It is expected in the
future that the present source of water supply will have to be supplemented
by additional sources and it is possible that the city may be forced to secure
a supply from Lake Ontario, m which case the intake would probably be
selected at some point west of Manitou Point.
Sewer construction in the city of Rochester dates back as far as 1829. Many
of the sewers are, therefore, quite old and, with the exception of those re-
cently laid in the Brighton district, practically all are constructed on the
combined plan. At the present time there are some eight different outfall
sewers which discharge into the Genesee river north of the upper falls, two
of which discharge immediately below the upper falls, and the remaining six
at various points between the upper falls and the northerly city line. These
outfall sewers consist of vertical shafts and short tunnels, or steel pipes
leading down the sides of the river gorge, through which the sewage is dis-
charged into the river. The two more important of these outlet sewers are
on the east side and west side trunk sewers. The former, completed in 1893,
and receiving the sewage from the east side sewer district, discharges into
the river opposite Norton street; and the latter, receiving sewage from the
town of Gates, discharges into the river just below the lower falls.
The Genesee river rises in Potter county, Pennsylvania, and after entering
New York State flows through and between the counties of Allegany, Wyoming,
Livingston and Monroe to Lake Ontario. The river has an average fall of
14 feet per mile from its source to its mouth and drops 264 feet in passing
through the city of Rochester. There are three falls within the city limits,
the upper, 100 feet in height, being located at about the middle point of the
city, and the middle and lower falls being located VA and 1^ miles north-
erly, with heights of 30 feet and 100 feet, respectively. The drainage area
of the river is about 2,500 square miles. Based on the 1905 census the aver-
age population per square mile, Rochester excluded, is 55, and if Rochester is
included the average population per square mile is 128.
The minimum monthly flow of the Genesee river at Rochester during ordi-
nary years, according to Mr. Kuichling's report, is 300 cubic feet per second
or 0.127 second feet per square mile of drainage area. This flow is based
on records of discharge at the Court street dam in the city of Rochester, kept
by the city engineer since 1893, a few gaugings made by the United States
Geological Survey in 1903, and other gaugings. It is also stated in this
report that for several weeks during severe droughts the average flow will
not exceed 200 cubic feet per second or about .085 second feet per square mile.
Gaugings made by the State Engineer, in co-operation with the United States
Geological Survey at the Elmwood avenue bridge at the southerly city line,
commenced in March, 1904, show the lowest mean monthly runoff to be 0.156
second feet per square mile during the years 1904 to 1907, inclusive. This
corresponds to a flow of about 360 cubic feet per second.
It is evident, therefore, that the average flow in the Genesee river, at
Rochester, during the di-y season, is ordinarily not greater than 300 cubic
feet per second. This is equivalent to a flow of 1.5 cubic feet per second per
1,000 persons for the present population, and a flow of slightly less than 1
cubic foot per second per 1,000 persons for the estimated population of 325,000
in 1935. Without entering into a detailed discussion, it is evident that this
flow is insuflicient, according to accepted standards, to prevent a nuisance in
the river even at the present time, a fact that is borne out by observation
of the condition of the river at almost any time during the summer season.
The plans now before the Department comprise a system of intercepting
and main trunk sewers for the collection of the sewage of the city and its
conveyance to the proposed sewage disposal works; sewage disposal works
consisting of detritus tanks and revolving: scrci'ns located alnjut i^ mile
Sewerage and Sewage Disposal 455
south of Lake Ontario and about 3 miles northerly from the northerly city
line; and an outfall sewer extending from the sewage disposal works into
Lake Ontario to a point 7,000 feet from shore.
The proposed intercepting and main trunk sewers, some sections of which
are in tunnels, some in open trenches, and others inverted siphons, extend
from the intersection of North Water street and Central avenue to the sewage
disposal plant near Lake Ontario, a total distance along the line of these
sewers of about 7.5 miles.
The first tunnel begins at a shaft at the intersection of North Water street
and Central avenue and crosses the Genesee river under Central to Mill street,
whence it passes through Mill street and thence through property of the
Rome, Watertown and Ogdensburg railroad and Cliff street to a manhole at
the top of the west bank of the Genesee river near the Rome, Watertown and
Ogdensburg railroad bridge. This tunnel has a total length of about 5,600
feet and is provided with 12 shafts, located at intervals of from 100 to 700
feet.
At the intersection of North Water street and Central avenue the tunnel
18 to intercept the outlet sewers of the two Central avenue sewer districts,
and the outlet sewers of three additional sewer districts are to be intercepted
by the tunnel as follows: The Front street district at Central avenue near
Front street; the Genesee Valley canal district at the intersection of Mill and
Factory streets and the Spencer, Lyell and Saxton streets districts at the
intersection of Spencer and Cliff streets. All but about 400 feet of this tunnel
section is to be constructed through rock. Along this section of the inter-
cepting sewer there will be located five storm water overflows into the Genesee
river.
From the manhole near the Rome, Watertown and Ogdensburg railroad
bridge the sewage will be carried through two iron pipe inverted siphons, car-
ried down the west bank of the river under the river, and along the east bank
of the river to a manhole near the intersection of Park driveway and Avenue
6. This inverted siphon is some 3,200 feet long and is provided with a blow-
off at the water's edge at the east bank of the river.
From the end of this inverted siphon the intercepting sewer will be con-
structed in a second tunnel, some 3,100 feet in length, provided with five
shafts. It is proposed to extend the West Side Trunk sewer across the river
through two iron pipe inverted siphons and to discharge the sewage carried
by this sewer into the tunnel section of the intercepting sewer at Avenue 6,
at which point the outlet sewer from the Avenue B sewer district is also
intercepted. An overflow sewer into the river is also to be located at this
point.
The final section of what has been considered for clearness, the intercepting
•ewer, extends from the tunnel to the Main Trunk sewer at the intersection
of Strong and Hollenbeck streets. The length of this section is about 2,900
feet and will be five feet in diameter constructed in open cut.
The Main Trunk sewer, which will extend from Norton street to the dis-
posal plant, will begin at the intersection of Norton and Hollenbeck streets
where the East Side Trunk sewer is to be intercepted, and will extend to the
sewage disposal works located about ^ mile from the lake and nearly 5
miles from Norton street, measured along the line of the sewer. Although
this section is designated for convenience, the Main Trunk sewer, it does in
fact intercept the sewage from the Lake avenue sewer district, which is car-
ried across the river through an iron pipe siphon to a pumping station located
on the east bank of the river and discharged into the Main Trunk sewer at
St. Paul street near the city line. The Main Trunk sewer varies in diameter
from y Q"* to 6' and follows an irregular route through public highways
and private property to the disposal plant, discharging at an elevation of
68 feet above high water level of the lake.
The water consumption in 1890 was 63 gallons per capita. After the new
conduit was laid in 1894 the water consumption increased to 77 gallons per
capita in 1895, and gradually increased from that time to 87 gallons per
capita in 1904. The present design assumes a water consumption of 100 gallons
per capita.
456 State Department of HEALtH
The Main Trunk sewer below the last proposed intercepting sewer ranges
in diameter from 4' 3" to 6', with slopes ranging from 1.18 per cent, to 0.186
per cent., and velocities ranging from 11 feet to 6.5 feet per second when
running full. Although the different sections of the trunk sewer vary some-
what in capacity this sewer will carry 100,000,000 gallons per day when flow-
ing full. Ihis capaoity is adequate to convey sewage to the disposal works
at a rate of about 500 gallons per capita for the estimated present population
of about 200,000 persons; 360 gallons per capita for 275,000 persons, and 308
gallons per capita for 325,000 persons, the two latter populations being the
estimated populations which will contribute sewage in the years 1925 and
1936, respectively.
It is assumed, as stated above, that the average daily contribution of domes-
tic sewage will be 100 gallons per capita, ordinarily. During certain seasons
of the year and during wet weather this average daily flow may be increased
to from 125 to 150 gallons per capita. On this basis the trunk sewer lead-
ing to the sewage disposal works will have a surplus capacity for t)ie convey-
ance ot a portion of the storm wa/ter flow to the extent of from 150 to 175
gallons per capita when the population is 325,000.
The outfall sewer leading from the sewage disposal plant will consist of a
steel pipe 5 feet in diameter and about 9,400 feet long, 7,000 of which will be
laid in a trench on the bottom of the lake. The last 50 feet of the 5-foot steel
outfall sewer terminates at a crib 60 feet by 30 feet in plan and 20 feet deep,
designed to protect the end of the pipe from injury by ships, anchors, etc.
The bottom of this crib will thus be some 8 feet below the bed of the lake
and 68 feet below the water surface of the lake, and will be fllled with stone
to hold the crib and inclosed outlet section of the steel pipe firmly in place.
This outfall sewer will terminate at the crib in a vertical reversed curve
which will bring the invert of the end of the pipe about 5 feet above the lake
bottom and about 45 feet below the surface of the waiter.
The sewage disposal works comprise six detritus tanks, each provided with
two screens, one a flat iron bar screen placed at the inlet end of each tank,
and the other a revolving screen placed in the outlet channel from each tank.
The flow from the trunk sewer leading to the plant is to be carried by
two diverging channels constructed in concrete across the ends of the six
detritus tanks. From these two main channels, separate channels 2' 6"
wide and 7' deep lead to each tank. At the entrance to each tank each of
these separate cnannels subdivides into three outlets, two of which are 24"
pipes, one leading from each side of the channel to carry the flow from the
bottom of the channel around to the quarter points of the end of each tank,
while the third outlet has its bottom raised about two feet and discharges
liquid from the upper part of the channel.
About flve feet from (the entrance end of the tank a flat iron bar screen extends
across the tank. This screen is set at an angle of about 20 degrees from the
vertical, and the lower edge rests on a concrete bench extending from the end
of the tank ten feet below the top of the tank and eight feet below the flow
line of the tank.
Each tank is 57 feet long, 16 feet wide at the top and 6 feet wide at the
bottom and has a bottom slope of about 1" per foot of length toward the
sludge pipe inlet. The side walls are vertical for a depth of 4 feet below
the flow line (6 feet below the top of tank), and the depth of flow in the
tank ranges from 11 feet near the outlet end to 14 feet over the valve of
the sludge pipe situated 12 feet from the inlet end.
An 18" sludge pipe with hand operated stop valve leads from a point at the
bottom of each tank on the center line and 12 feet from the inlet end to a
sludge sump built in >the end wall of the tank, the bottom of this sump being
4 feet below the bottom of the tank.
The plans show a revolving screen in the outlet channel from each detritus
tank. This channel is 8 feet wide and the bottom is 4 feet below the flow
line except for a curved depression of 18" under the revolving screen. The
revolving screen is placed wi-th its axlp about 8 foot fnmi the drtritus tank and
oonsists of a pair of circular on«l franio.s 12' S" in dianiotor, connected by
5 radial blades of wire cloth having approximatoly I/IO" openings and ex-
Skweraop: and Skwage Disposal 457
tending across the channel. The screen is to rotate so that its blades revolve
against the flow of sewage, and appliances are to be provided for auto-
matically removing the materials caught and retained on these screens.
The capacity of each tank is about 9,000 cubic feet, or about 67,500 gallons,
giving a total capacity for the six tanks of about 400,000 gallons. The time
of d^ention of sewage in the detritus tanks, on the basis of 100 gallons per
capita daily from a population of 210,000 (slightly more than the present
estimated population), is about 28 minutes. On the same basis of sewage
contribution per capita the time of detention in the tanks of sewage from a
population of 275,000, as estimated for 1025, will be 21 minutes, and for a
population of 325,000, estimated for 1935, the time of detention will be 18
minutes. Based on a daily flow of 100,000,000 gallons, or the capacity of
the lower section of the Main Trunk sewer, the period of detention in the
detritus tanks, as proposed by the design, is about 5 minutes, and the average
velocity of flow through the tanks will be about 1/6 foot per second.
It is evident, therefore, that the time of detention in the detritus tanks
during times of storm, when the flow in the trunk sewer approaches a ra/te
of 100,000,000 gallons daily, will be only about one-fifth the time of deten-
tion which occurs during periods of no rainfall. When the flow in this trunk
sewer would exceed 100,0.00,000 gallons per day as a result of storms raw sew-
age will be discharged into the Genesee river, and the relative amount of such
sewage overflow will depend largely upon the excess rainfall at such times.
Having thus outlined somewhat in detail the proposed works for intercept-
ing and disposing of the sewage of Rochester, let us now inquire into the
question of adequacy and efficiency of these methods in fulfilling the require-
ments of a satisfactory and safe collection and disposal of this sewage, |iot
alone in relation to meeting the requirements of the oity of Rochester, but
to the general welfare of the other municipalities situated along Lake On-
tario that may in any way be afl'ected. Since this is one of the first instances
of the presentation of a comprehensive plan for disposal of any considerable
volume of sewage into Lake Ontario that has been submitted for your ap-
proval, and owing to the relatively large population and volume of sewage
to be discharged into the lake tlie ease constitutes an important, if not a
leading one, at this time, and con&equently a most careful consideration should
be given the many factors and interests that are necessarily involved.
To do this fairly, and to keep clearly before us only the important principles
and factors involved, it will be well, even at the cost of slight repetition,
to state briefly the esisential features of the design, viz.:
1. The collection of the sanitary sewage, together with a limited amount
of the storm water, in a system of intercepting sewers, and the convey-
ance thereof through a trunk sewer to disposal works situated about 3
miles north of the city and about ^^ mile irom the lake front.
2. The treatment of this sewage by passing it through a series of set-
tling tanks having capacities surticient to retain the sewage in them for
periods ranging from 5 to 28 minutes and with velocities ranging from
1/0 to 1/33 foot per second, whereby opportunity will be given for a set-
tlement or precipitation of portions of the heavier grit and suspended
particles in the sewage, and the removal of portions of grease and floating
matter.
3. The passage of the effluent from these tanks through fine screens
having openings of 1/10", for the purpose of removing all coarse and
fine suspended matters not previously removed by settlement, which will
be caught or retained by screens of this mesh.
4. The conveyance of this partially clarified sewage from the settling
and screening plant through a long outfall sewer 5 feet in diameter, laid
beneath the bed of the lake to a point of discharge some 7,000 feet from
shore and in 50 feet of water where, through combined physical agen-
cies of dilution, sedimentation and dispersion, and through natural chemi-
cal and biological changes induced by bacteria and other and higher
aquatic organisms, the final purification of the sewage will take place.
It will be seen, first, that the plans propose an interception of only a
458 State Department op Health
portion of the sewage which now discharges into the Genesee river in MTfar
as that during storms, which exceed a certain rate, a portion of the sewttge*
diluted with varying proportions of rainfall, depending upon its intensity,
will overflow into the Genesee river. Upon strictly sanitary grounds this
overflowing of sewage is, in general, an oojectionable feature, but since most
of the sewers of Rochester were constructed many years ago before a sepa-
ration of sewage from surface water was practiced to any considerable extent,
and before the advantages of this separation were realized, it would be very
costly, if not almost impracticable, to change this system at this time.
Again, the raw river water below Rochester cannot be considered potable
and a suitable source of water supply. With the question of water supply
thus eliminated it is very unlikely that any nuisance of a serious nature
would ever be experienced by the overflow of highly diluted sewage during
times of storms if these overflow pipes are properly extended out into the
channel of the river and submerged at their points of discharge. Occasion-
ally, during short rain storms in the summer months, overflowing may occur
before the increased flow in the river resulting from the rainfall has been
felt, and at such rare and short intervals it is possible that objectionable
conditions might be noticeable.
Whereas, then, the existence of these combined sewers, involving necessarily
an overflow of sewage into the Genesee river during storms, must be considered
in general an unavoidable objection in connection with any method of dis-
posal of the sewage of Rochester, it is in my opinion not a serious one, for it
is highly improbable that any local nuisance will occur at any time even in
the immediate vicinity of these outlets. I do believe, however, that all future
extensions to the Rochester sewage system in new outlying districts, espe-
cially where independent sewage disposal plans have to be installed and main<
tained, with outfalls into smaller streams, should, for sanitary, as well as
economical reasons, be constructed on the separate plan.
Considering the other main features of this project outlined above under
(2) to (4) inclusive, relating to the more specific question of the treatment
or purification of the sanitary sewage, it will be well to first discuss gener-
ally, but briefly, the essential factors and requirements of any system of
sewage purification; for it is only following a thorough knowledge of such
requirements and a comparison with experience in other cases that a satisfac-
tory opinion concerning the efficiency or adequacy of a method of sewage
disposal for any particular community can be reached.
Generally speaking, when the discharge of sewage upon land or into water
becomes objectionable or dangerous it is a result of the following important
ingredients or characteristics, viz.:
1. The suspended matter, especially the grosser solid, which may, under
certain conditions, cause deposits near the point of discharge, offending
not only sense of sight but possibly of smell; and under other conditions
may be carried considerable distances from point of discharge, and cause
offense in other ways. Owing to this tendency of being more easily car-
ried greater distances by wind and water action, these grosser solids which
harbor and protect the life of dangerous organisms contained within and
upon them must consequently be regarded not only an offensive, but a
dangerous ingredient of sewage.
2. The dissolved ami colloidal matter, especially the more quickly de-
composable portion which, under certain conditions of supply of oxygen,
become putrefactive and give off noxious gases, and thus b^ome offensive
to sense of smell.
3. The bacteria, a large percentage of which are of intestinal origin,
and many of which may be pathogenic, which may be the vehicles of
transmission of disease and oause of epidemics. These bacteria may
travel considerable distances from the point of discharge under \infavor-
able conditions of winds, wave action and water currents, and at such
times a menace or actual danger may result, if the distance of travel
comes within range of some unprotected water supply or other influence,
whereby infection may be transmitted to people.
Sewkraoe and Skwaok Disposal 459
Whereas the above characteristics are by no means a complete list of objec-
tionable qualities of sewage discharged, under such conditions, they do rep-
resent the more important ones in so lar as they relate to the case of Rochester.
It !Sy therefore, essential to consider more closely the effects or the efficiency
of the successive means or stages of the purification process proposed in the
removal of these objectionable conditions.
According to the plans it is proposed to give the sewage first a preliminary
treatment by passing it through a series of tanks provided with screens and
skimming biDards, in order to settle out the grosser and heavier solids, to
skim off the lighter floating grease or oils and to screen out the floating and
suspended grosser solids. The effect of this treatment will be to remove from
the sewage one of its most objectionable features, i. e., the floating or depos-
iting solids which offend the sense of sight and smell, and which under imfavor-
able conditions of wind and wave action may become dangerous as a result
of the relatively greater distance to which these grosser and, at times germ-
laden, solids may be transported.
It is evident, however, that this treatment will not accomplish a complete
removal of objectionable matter in the sewage, and that there will remain
in the effluent from these settling and screening chambers:
1. The finer and less visible suspended matter which does not of itself
settle, or which is not entrained with coarser matters which settle in the
tanks; or is not removed by entrainment of coarser solids in passii^
through the screens.
2. Practically all of the soluble and colloidal organic matter, and that
portion of the suspended organic matter not removed by settlement and
screening.
3. A very large percentage of the original bacteria and disease germs
not attached or contained in the removed solids, or not removed by en-
trainment with these solids during settlement or screening.
After treating the sewage in these settling tanks it is then proposed to
finally dispose of the effluent, which will contain these residual but still some-
what objectionable ingredients referred to above, by conveying it through a
long outfall pipe out into Lake Ontario, and discharge it into the waters of
the lake 7,000 feet from shore, at the bed of the lake, some 50 feet below the
surface, where it will be subjected to the natural processes or agencies of purifi-
cation that will take place under such conditions. The nature of these pro-
cesses and their effects in purifying the sewage effluent thus discharged are
unquestionably many and complex, are variable as a result of changeable con-
ditions of wind, temperature and other atmospheric factors, and the volume
and character of the effluent; and owing to these variable influences, and
the limited information concerning the experiences of other municipalities
similarly situated, are somewhat difficult and uncertain of close formulation
or estimation. The general principles of engineering, chemistry and biology
in regard to these phenomena are, in my opinion, sufficiently and definitely
known and established, and a sufficient number of similar or analogous cases
in practice are, in my opinion, available to enable one to judge approximately,
or at least to estimate, within sufficiently close limits, the probable effects
that will be produced by the discharge of this partially treated sewage into
the lake under the conditions proposed.
There is little doubt in my mind that the following phenomena or changes
will take place following the discharge of the sewage effluent from the pro-
posed disposal works in^ the waters of the lake 7,000 feet from shore in 50
feet of water:
1. A settlement of a portion of the fine, suspended and possibly colloidal
solids upon the bed of the lake around the outlet for a varying but lim-
ited distance, due to the relatively greater specific gravity resulting from
a dilution with the lighter lake water and the lowering of temperature
while passing through the outfall pipe.
2. A general diffusion and dispersion of the portion of the liquid sewage
through the lake waters surrounding the outfall, due to currents induced:
(a) By differences in specific gravity of the sewage and lake water;
4CiO State Dkpartmkxt of TIkalth
the sewage being, by reason of its dissolved matters, of greater spe-
cific gravity than lake water; but, owing to the relatively higher tem-
perature which it may possess at times, due to unusual changes in
temperature of lake water and to relative loss of heat of sewage pass-
ing through the outfall (which would vary at times according to its
volume and the time consumed in passing through the outfall),
lighter than lake water.
(6) Through wind action which at times will stir the lake to a
considerable depth, although this agitation may not ordinarily ex-
tend to the depth of the outfall pipe.
(c) By currents of lake water along and over the pipe line, in re-
verse direction to the flow of fiewage in the pipe, due to the heat of
sewage transmitted through the pipe, and covering of earth, to the
lake water immediately over the pipe line.
(d) Rising gas bubbles due to septic action of solids deposited
around outfall.
3. A gradual diffusion and dispersion, throughout the body of lake
water surrounding the outfall, of the fine suspended and colloidal matter
whose net specific gravity (t. c, the natural, corrected for changes due
to temperature and dilution of sewage in lake water) is about equal to the
mixture of lake water and sewage.
4. A rising to the surface of fine suspended and colloidal matter whose
net specific gravity (». ei, the natural, corrected for changes due to tem-
perature and dilution of sewage with lake water) is less than that of the
mixture of lake water and sewage.
5. A transporting of the sewage and any suspended matters which have
diffused or risen to the surface of the lake from the outfall to varying
distances therefrom as a result of natural lake currents or currents in-
duced by wind action. This transportation, or travel, will be generally
oscillatory, governed almost entirely by direction of the wind, since cur-
rents of translation through lake are relatively insignificant and the dis-
tance of travel will depend upon the intensity and duration of wind from
any one direction.
6. A slow but progressive decomposition due to septic, or anaerobic
bacterial action, of any solid materials deposited around the outfall.
7. A slow but progressive oxidation of the liquid organic matter either
contained in the sewage effluent as it is discharged from the outfall, or
derived from a liquefaction of the solids surrounding the outlet as a re-
sult of anaerobic bacterial life in the presence of sufficient oxygen carried
in the lake water and replenished continuously from the atmosphere above
as it is exhausted.
8. The consumption as food of the suspended organic matter, both
living and dead, by small aquatic organisms which are, in turn, succes-
sively 'devoured by larger ones.
9. A gradual destruction of the original bacterial and disease germs
contained in the sewage resulting from adverse environment, antagonism
of species, settlement upon bottom of lake and consumption as food by
higher forms of living organisms.
Although the above may not be a complete statement of the complex
phenomena that take place from a physical, chemical and biological stand-
point, it includes nevertheless the more important phenomena upon which
judgment as to the efficiency of this proposed means of disposal can be
adequately based. These phenomena, complex and variable as they are, show
what is daily being clearly demonstrated by experience, and what we are daily
learning better to understand, that purification does take place when sewage
IB discharged under favorable conditions into large bodies of water.
The prime and ultimate aims of any method of purification are the re-
moval of objectionable suspended matters, the oxidation of the organic
matters, and the destruction of bacteria. This purification is accomplished on
land where sewage is allowed to filter or percolate over or through soil or sand
in the presence of a sufficient supply of oxygen and the nitrifying organisms
.3-
Sewerage and Sewage Disposal 461
which harbor upon the soil grains. It is accomplished more economically,
but no less positively nor, under favorable conditions, less completely though
perhaps less rapidly, when sewage is discharged into sufficiently large bodies
of water charged, and replenished, with dissolved oxygen. Indeed, just as
artificial means of purification on land, by means of sand filters, contact beds
and sprinkling filters, are able to remove large portions of suspended matters
in the sewage, oxidize and make stable the organic matters and destroy a
relatively large number of original bacteria, leaving portions 'of each unre-
moved or unoxidized; so is the method of purification by means of discharge
into large bodies of fresh water supplied with oxygen and organisms of
nitrification, able to accomplish a similar removal of suspended matters,
nitrification of organic matter and destruction of bacteria, through the agencies
of sedimentation, septic action, oxidation and the consumption as food by
hifi:her forms of aquatic life.
The significant and important question in any case is whether local or
artificial conditions of purification are favorable, and whether they are such
that these processes of elimination and oxidation can be attained without the
production of nuisance and without danger to public health; and since these
conditions may vary considerably in difl'erent cases, especially if the purifica-
tion is a natural one, it follows that each case represents a local problem in
itself, and must be considered and judged individually and independently.
In the case before us of the discharge of a sewage partially clarified by
settlement and screening into a vast body of pure water practically saturated
with oxygen, with ample opportunity for replenishment as this dissolved
oxygen is absorbed and utilized for the nitrification of the organic matter, we
have in principle, and in relation to the local conditions which exist, a method
of disposal that may be considered most favorable. That is, as to adequacy,
the method and disposal proposed will leave no coarse suspended matter to
carry offense and danger to distant shores through wind and wave action;
the finer suspended and colloidal matters will be so minute that if deposited
on the bottom of lake or outlet will be readily disintegrated or hydrolized by
septic action, or, if dispersed into the body of water around the outlet, will be
attacked by the aerobic bacteria and even higher forms of life and be either
nitrified or consumed as food; the outlet will be so far distant from shore
that large quantities of oxygen will be supplied from the vast volumes of
fresh lake water which will pass progressively or oscillate back and forth over
the outfall, the spent dissolved oxygen carried by the lake waters being
replenished by absorption from the air at the water surface.
That the purification by this method of disposal will not be complete, even
within a considerable distance of the outlet unless important modifications and
changes are made in accordance with recommendations which will be given
later, there can be little question in my opinion. Indeed, there may be, and
possibly will be at times, notwithstanding these important changes, some dis-
coloration or other slight ofi'ense in the immediate neighborhood of the outfall.
That any such nuisance will after these recommended changes in the pro-
posed plans are carried out ever extend to any appreciable distance from the
outfall, or that any traces of sewage will be noticeable along the shores of
Lake Ontario, is in my opinion very unlikely.
It is improbable that with the modifications in plans later recoRunended,
even under refined methods of testing, any chemical traces would ever be de-
tected along the shores of the lake even under unfavorable conditions of wind
and wave action. That biological traces would ever be detected is quite pos-
sible and even probable. That any such traces would be less discernible along
the shores of the lake after these works were in operation than are discern-
ible now, with the crude sewage of the city discharged into the river and
thence into the lake, is, in my opinion, almost certain.
There are, however, certain local considerations such as the possible con-
tamination of the water supplies of the Rochester and Ontario water com-
panies and of the Charlotte waterworks, which is taken from the lake a short
distance west of the mouth of the Genesee river, and the possible danger to
health of bathers along the shores of the lake, which must not be overlooked.
Without going into a detailed di8c^ls^ion of these questions, it may be said
462 State Department of Health
first, in reference to the safety of these two supplies, that the sewage now
carried by the Genesee river and discharged into the lake near the intake
carries more pollution to these intakes than will be taken there after the
sewage now discharged into the river and in turn into the lake is diverted
from it and discharged at a point in the lake further removed, where the
river currents freed from sewage will tend to create a barrier against any
pollution crossing these currents, and after the sewage has been treated in
accordance with the proposed plans and the recommended changes and modifi-
cations made later in this report. Futhermore, with satisfactory maintenance
and operation and with suitable extensions to the present water filters,
especially in view of the lessened pollution of the water reaching the intake
after the sewage is diverted from the Genesee river, it is my opinion that
this supply will be adequately protected against danger from sewage dis-
charged from the proposed outlet in the lake.
In regard to health of bathers along the shores of the lake, it must be borne
in mind that there will be other dangers to the health of these bathers than
from the sewage from the proposed outlet in the lake, such, for instance, from
the local contamination resulting from the washings and the occasional acci-
dental or wilful discharge of excreta from the bathers themselves. Further,
it must be remembered that any pollution that may reach the shores under
adverse conditions of wind and wave action would occur at a time when
people would be unlikely to be bathing. In all probability any danger to
health of bathers resulting from sewage from outfall would, if the recom-
mendations for changes in these plans are carried out, be no greater and in
all probability less than that for arising from the washing from the bathers,
and it is, therefore, my opinion that the possibility of danger from this
source is, from a practical standpoint, so remote as to be nesfligible.
In regard to the water supply of Oswego there can he little question that
after the consummation of the proposed project traces of sewage will be
carried to a greater distance in the direction of Oswego's new intake than
now occurs. It is highly improbable, however, that even traces of sewage
will ever reach this intake following the discharge of sewage into the lake.
If it ever did reach this intake, it is my opinion again that its relative in-
tensity will be negligible compared with the sewage pollution resulting from
the sewer outfalls of the city of Oswego, or from the pollution carried by the
Oswego river which flows into the lake only a relatively short distance from
its water supply intake and which, as shown by the reports of their con-
sulting engineers, will reach the intake during certain unfavorable periods of
wind action.
There are three features in connection with this plan which are of especial
importance and which should not be overlooked. One is the relatively brief
period of detention of the sewage in the settling and screening chamber,
another the lack of provision for discharging the sewage in the lake at more
than one point, and the third the lack of provision for extending the outlet
further out into the lake.
Concerning the first of these omissions it appears that the detention period
for the sewage during the early years following the completion of the works
will range from one-half to one-third of an hour. This period is much shorter
than that which conservative practice has established in the design of sewage
purification works of this character, and it is my opinion that in the present
case it is entirely too brief. It is true that there is a compensating relation
that exists between settling capacity and fineness of mesh of screens, and that
if the screens be very fine the settling capacity need not be so great, and
vice versa. It is also true that by increasing the time of settlement a
relatively greater amount of sludge, difficult and costly to dispose of, is pro-
duced, but it is important to remember that this additional sludge means
additional purification, and that this is an essential and fundamentally im-
portant matter in the present case and cannot be overlooked by this Depart-
ment, which is charged with the responsibility of conserving the purity of the
waters of the State.
I am of the opinion, therefore, that notwithstanding the relatively fine mesh
•creens which It is proposed to adopt, the detention period in the lettling
Sewebaoe and Sewage Disposal 468
tankB should be increased. It should not be increased to such an extent as to
place any considerable or unreasonable burden of expense in the cost of
operation upon the city, and if the period was increased to twice that pro-
vided a much safer and conservative requirement would be imposed. This
means that the tanks have to be of double the proposed capacity and also that
the difficulty and cost of sludge disposal will be considerably greater. The
increased cost in construction and maintenance due to these changes will not
in my opinion be great, nor unwarranted, in view of the increased purification
and security of freedom from objectionable results from the method of disposal.
In regard to the lack of provision for discharging the effluent at more than
one point in the lake, I would suggest that this is likewise an important
omission and one that should be supplied. The most objectionable condition
to be feared from such a method of sewage disposal as here contemplated is
that of possible local nuisance in the immediate neighborhood of the point of
discharge. Such nuisances, when they occur, most generally result from an
attempt to discharge too large a volume of sewage at one point, or to discharge
it a/t a point too near shore, and the nuisa^e is usually directly proportional
Ut the volume of sewage. Conversely it is possible to reduce and usually
eliminate these local nuisances by extending the outlets or providing two or
more distinct, and more or less widely separated, outlets, thus reducing the
volume of sewage discharged at any one point.
Whereas, then, no nuisance may be created in the immediate neighborhood
of the proposed outlet, with the changes in the disposal plant recommended
below, during the early period immediately following the completion of these
works, I am of the opinion that such local nuisances would be likely to occur
at times with only a single outlet during later years as the volume of
sewage increased. To provide against this future contingency the plans should
be modified to the extent of inserting branches at or near the end of the
proposed outfall sewer, or otherwise making provision which will permit the
flow to be divided and be discharged at two or more outlets.
As a further security or protection against any nuisance or danger to health
which may in the future be shown from experience to arise from the dis-
charge of the effluent into Lake Ontario, provision should be made at the end
of the outfall sewer for extending it further out into the lake.
The report of Mr. Kuichling shows that it is perfectly feasible, and in my
opinion, within reasonable cost, to disinfect the sewage effluent from the pro-
posed settling and screening works before its discharge into the lake and
thereby destroy all pathogenic bacteria that may be carried to and might be
shown to endan&rer the water supplies taken now, or in the future, from the
lake. Disinfection of sewage though not in any way prohibitory as to ex-
pense, is, nevertheless, costly, as pointed out above, and if changes and modifi-
cations are made in accordance with the recommendations later given which
will provide increased capacity and more efficient facilities for discharging the
sewage into the lake, there appears to be no reasonable grounds for requiring
this great expense at the present time. Should Rochester ever turn to Lake
Ontario for a supplementary supply, or should other conditions arise, or
should it be found from experience that public health is in any way affected
by the discharge of this settled and screened sewage into the lake, the question
of disinfection could then be considered and applied.
I wish to point out, finally, that if after the extensive changes and pro-
visions are made or embodied in the plans in accordance with the recom-
mendations given below and the works have been constructed and put in
operation, it be found from experience that any question affecting the public
health or a local nuisance in the vicinity of the intake or at more distant
points arises due to the suspended matters in the sewage, or to putrescibility
of the organic matter contained therein, the report of Mr. Kuichling further
shows that it would be possible, even though relatively more expensive than
disinfection, to further clarifv the sewage by sedimentation, or to produce
even a higher degree of purification by treatment in rapid filters, land for
which might be available or easily secured in the vicinity of the propoged sita
for the diipoial works.
464 State Depabtment of Health
To summarize briefly my opinions and conclnsions concerning these plana,
following a careful examination and study of tlera, I would state:
1. Ibat the proposed system of intercepting and outfall sewers will
remove from the Genesee river practically all of the sewage now dis-
charged into this river by the city of Rochester at all times, except during
heavy rainfalls when the sewage will be discharged through overflows in
a highly diluted state.
2. That the diversion of this sewage will remove practically all offense
and nuisance along the river in and below the city and along the shores
of Lake Ontario near the outlet of the river.
3. That during heavy rainfalls when overflowing of sewage will occur,
the dilution of the sewage will be so great as to prevent any appreciable
nuisance in and along the river below the points of overflow.
4. That whereas the method of sewage disposal proposed, viz., by pre-
liminary treatment in settling and screening tanks and flnal treatment by
dilution, oxidation and digestion in Lake Ontario, is in principle a suit-
able and appropriate one for the city of Rochester, the plans are insuffi-
cient and inadequate as to capacity and important details and should be
so modified and corrected as to provide:
a. Settling tanks of twice the capacity shown by the plans.
h. Skimming boards or other means for removing objectionable
grease and oils.
o. Branch connections near the end of the outfall sewer in the
lake to permit the flow to be divided and discharged at two or more
outlets in the lake, whenever such provision may become necessary.
d. Suitable means at the end of the outfall sewer which will permit
of its being extended further out into the lake if, or whenever, such
provision may become necessary.
5. That the proposed method of preliminary treatment, if modiflcations
in the plans are made in accordance with the above recommendations,
will eliminate from the sewage all of the grosser, and a large percentage
of the finer, suspended matters, which, on account of their relative in-
solubility and difficulty of segregation, and their off'ensive and dangerous
nature, are easily transported by winds and induced surface currents, to
considerable distances.
6. That if the changes abov3 recommended are made in the plans, the
finer susnended solids remaining in the partially clarified effluent, after
passing through the settlincr and screening tanks and after their dis-
charge into Lake Ontario 7,000 feet from shore in over fifty feet of water,
will be subject to combined action of sedimentation, dilution and dis-
persion to such an extent that no traces of sewage will be discernible to
the senses along the shores of the lake or at any considerable distance
from the outlet.
7. That at times, under unfavorable conditions of wind and wave
action, pollution from the effluent of the proposed settling and screening
plant discharged into the lake 7,000 feet from shore will even with modifi-
cations in plans above recommended, be carried to the intakes o-f the
water supplies of the Rochester and Ontario Water Company, and of the
village of Charlotte. This pollution will, on the whole, be much less in
amount than occurs under existing conditions with the sewage of Rochester
discharged into the river, and in turn into the lake near these intakes,
and it will occur in such small amounts, at such infrequent intervals and
be 80 diluted and attenuated, that with properly installed water purifica-
tion plants the health of the communities using those supplies will be
amply protected atrainst any danger of infection.
8. That the possibility of any traces of sewage from the proposed out-
fall ever reaching the intake of the Oswego water supply, some fifty miles
distant, ie too remote for practical consideration. Even if traces were
ever carried to this intake under unfavorable conditions they would be in
such minute amounts and so attenuated as to have no appreciable efl"ect on
the public health of the citizens of Oswego, and entirely negligible as
Sewerage and Sewage Disposal 465
compared with the pollution of this water supply by the polluted waters
of Oswego river which now enters the lake only a short distance from said
intake.
9. That if it be found in the future, after these works have been put
in operation and after practical opportunity has been afforded to observe
and study the effects ot the discharge of effluent from the proposed plant
into the water of the lake, that the health or comfort of the people who
reside along the shores of Lake Ontario, or who may use the water for
drinkine, bathing or other purposes, is in any way deleteriously affected,
it will oe easily possible, and within reasonable cost, to increase the de-
gree of purification by providing increased or additional sedimentation,
supplementary treatment in biological filters or the application of dis-
infectants, or all.
In view of the foregoing conclusions, and of the expressed policy of this
Department of preventing the discharge of raw or insufficiently treated sewage
into the waters of this State, I beg to recommend that these plans be dis-
approved in their present form, and that they be returned for corrections and
modifications in accordance with the suggestions and recommendations out-
lined above.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
Albany, N. Y., July 26, 1910.
Mr. E. A. FiSHEB, City Engineer, Rochester, y, Y.:
DcAB SiB: — I am returning to you, by express, the plans of the intercepting
8€fwer system and sewage disposal plant for the city of Rochester, submitted
for my approval March 1, 1910.
Realizing the importance of the questions involved, and that the decision of
the Department in this matter is one of vital interest to the city of Rochester,
a careful study of the plans was made by our engineers. Desiring to get all
possible information on the questions involved, I held a public hearing in the
city of Rochester on June 9, 1910, where the matter of the plans was dis-
cussed and anyone who desired to do so might be heard in reference to them.
Believing that the city of Rochester should have the best advice on this
matter that the Department could inve it. I submitted the matter of the
approval of these plans to three of the leading experts in sanitary engineering
in this country, Messrs. Allen Hazen, New York city; X. H. Goodnoiigh, of
Boston, Mass.. and P. Herbert Snow, of Harrisburg, Pa. A number of ques-
tions were submitted to each of these gentl^nen and the matter was gone
over with them carefully by our chief engineer.
The questions regarding which they were requested to express an opinion are
as follows:
1. Will the system of intercepting sewers removing from the Genesee
river the raw sewage of Rochester except during time of storm, eliminate
praotically all nuisance from the river in and below the city of Rochester?
2. Will the overflow of sewage during storms after proposed plans are
executed, produce any nuisance along the river in or below the city?
3. Will the effluent from the proposed sedimentation and screening
plant, after discharge into lake 7,000 feet from shore in fifty-five feiet of
water, produce any nuisance in the lake sJt the point of discharire or be-
yond a very limited zone immediately surrounding such point of outlet?
4. Will pollution affecting in any way the senses occur along the lake
shore as a result of discharge of the effluent from the proposed sedimenta-
tion and screening plant, under adverse conditions of wind or wave action ?
5. Will any chemical or biological traces of sewage ever be found so far
distant from the outlet as along the shores of the lake?
6. Will the sewage effluent from the proposed sedimentation and screen-
ing plant, discharged at a point 7.000 feet from shore in fifty five feet of
466 State Department of Health
water result in less pollution along the shores of Lake Ontario, east or
west of the mouth of the Genesee river, than now occurs from the raw
sewage discharged into the Genesee river, and in turn into the lake at
the mouth of the river?
7. Will any pollution from the discharge of effluent from proposed
settling and screening plant reach the shores of Lake Ontario in amounts
and under conditions that will injuriously affect bathing along these
shores or appreciably menace the health of bathers?
8. Will the organic matter remaining in the sewage effluent after treat-
ment in the proposed sedimenta;tion and screening plant be ultimately
completely oxidized before any such organic matter haB*traveIed any con-
siderable distance from the outlet, especially before it could travel as
far distant as 7,000 feet, to the nearest shore of the lake?
9. Will the discharge of the effluent from the sedimentation and screen-
ing plant under the proposed conditions affect the potability of the filtered
water supply of Rochester & Ontario Water Works, west of the mouth
of the Genesee river and some three miles from this proposed outlet?
a. More deleteriously than under existing conditions of discharge
of raw sewage into the Genesee river?
h. In general to such an extent, assuming ordinary operations of
the filter plant, so as to be a menace to this supply?
10. Will any pollution derived from the discharge of the effluent of the
proposed disposal works —
a. Ever reach the water intake of the Oswego supply, taken from
the lake some fifty miles distant, just west of the mouth of the Oswego
river?
h. If it should ever reach the intake under unfavorable conditions
of wind, would the pollution be
1. Less in amount and frequency than would occur from pol-
lution carried from the polluted Oswego river and the sewers of
the oMy of Oswego?
2. In such amounts and with such frequency that, independent
of other pollution, it would appreciably affect the potability of
the Oswego supply?
H. If the proposed plans are insufficient, should additional purification
be accomplished —
o. By removing danger to health by disinfection or sterilization?
b. By increased oxidation or nitrification through biological filtra-
tion ?
c. By double protection obtained by biological filtration and dis-
infection?
12. In view of the fact that the Genesee river below Rochester will not
be potable after the execution of the proposed plans, and cannot be made
so because of the pollution which must directly or indirectly reach the
river durin&: its course, should only such purification be required as Will
guarantee freedom from any nuisance or any effect upon the senses?
13. Judged in the light of the broader prc^lem of Great Lake pollution,
and the establishing of a general policy concerning the requirement for
fiewage purification, in connection with not only the city of Rochester but
of other cities and municipalities along the entire Great Lake system, are
the proposed plans in their present form, or a somewhat modified form,
sufficient and appropriate; and in your opinion should they be approved
by the Department unconditionally, or upon certain conditions and what?
A copy of the written report of each one of the engineers is being trans-
mitted to you, together with the copy of the report of the Chief Engineer of
the Department.
After a careful consideration of the questions involved. I am unable to
approve these plans in their present form, and they are, therefore, returned
to you without my approval. The changes which will be required are fttlly
outlined in the report and are, briefly, as follows:
1. Settling tanks of twioe the capacity shown by the plans.
Sewerage and Sewage Disposal 467
2. Skimming boards or other means for removing objectionable grease
and oile.
3. Branch connections near the end of the outfall sewer in the lake to
X>ermit the eflSuent to be divided and discharged at two or more outlets,
whenever such provision may become necessary.
4. Special means at the end of the outfall sewer which will permit of
it being extended further out into the lake, if, or whenever, such a pro-
vision may become neoessarj-.
In any event, the approval of these plans and permit granted in connection
with them, will be conditional and will explicitly provide that if it be found
after these works have been put in operation and after practical opportunity
has been afforded to observe and study the effects of the discharge of effluent
from the proposed plant into the waters of the lake, that the health or the
comfort of the people who reside along the shores of Lake Ontario or who
may use the water for drinking, bathing or other purposes, is in any way
deleteriously affected, that there be such increase in the degree of purification
by providing increased or additional sedimentation, supplemental treatment in
biological filters, or other additional method of disposal as may be necessary
to properly protect the public health and prevent a public nuisance.
As soon as the changes and modifications have been made in these plans in
accordance with the recommendations contained in the report of our Chief
Engineer, and they are returned to me -for approval, they will again be
promptly considered.
Very respectfully,
EUGENE H. PORTER,
Commissioner of Health
Albany, N. Y., September 22, 1910.
EuoEME H. PoBTER, M.D., State CommAssioner of Health, Albany^ N, Y.:
DCAB Snt: — I beg to submit the following report of my examination of the
revised plans for a system of intercepting sewers and sewage disposal works
for the city of Rochester which were resubmitted for vour approval August 20,
1910.
These plans were first submitted for approval by the city authorities on
March 1, 1910, and after a careful examination of them by the Engineering
Division a report was submitted to you under date of July 18, 1910, setting
forth the results of this examination and making recommendations for certain
changes and revisions before the final acceptance of them. In order to safe-
guard the interests of the citizens of Rochester in this matter a public hearing
was held in Rochester on June 9, 1910, where an opportunity was given for
full discussion of the plans. In order to secure a disinterested and scientific
decision in regard to not only the essential features of the design but as to the
general and important larger questions involving the sufficiency and appro-
priateness of the method of disposal proposed, the plans were, further, sub-
mitted individually to three eminent sanitary engineers of the country for
their professional opinions.
These plans were accordingly returned by you to the city authorities on
July 26, 1910, for modifications and additions in the following respects:
1. That the settling tanks be made of twice the capacity shown oh the
plans.
2. That skimming boards or other means of removing the objectionable
grease or oils be provided.
3. That branch connections be made near the end of the outfall sewer
in the lake to permit the sewage effluent to be divided and discharged at
two or more outlets whenever such provision may become necessary.
4. That special means be provided at the end of the outfall sewer to
permit of its being extended further into the lake if or whenever suoh
extension may become necessary.
468 State Department of Health
After a careful examination of the rerised plans I find that they have in
general been modified and corrected in accordance with all the abore re-
quirements. I find, however, that the provision for doubling the capacity of
the settling tanks has been accomplished not by increasing the size of the
settling or detritus tanks but by adding to these settling or detritus tanks
six additional supplementary tanks having a total capacity of twice the
capacity of the settling or detritus tanks shown on the original plans.
It is evident, then, that although the modifications recommended have been
carried out in general conform itv with the recommendations and that the re-
quired increas^ capacity has been secured l>y the new plans it has been
accomplished in a somewhat difl'erent manner than was contemplated and
recommended in my previous report to you. The manner of securing in-
creased capacity of tanks proposed by the revised plans is, however, in my
opinion an improvement over the original plana, since it gives an opportunity*
for a separation of the solids which will be retained in these tanks and will
undoubtedly simplify the handling and disposition of sludge.
I note in the report of the consulting engineer that it is proposed to regu-
larly operate the detritus tanks with only three of the supplementary sedi-
mentation tanks which it is claimed, by him will give the necessary increased
capacity called for. This method of operation, however, is not in accordance
with the recommendations made in regard to increasing the capacity of the
settling or detritus tanks, since any' general results obtained by passing sewage
through two independent tanks of a given size is not the same as that ob-
tained by passing the sewage through a single tank having a total capacity of
the two independent tanks. In view, however, of the improved means of
separation of sludge provided by the revised plans as well as the total surplus
capacity also provided, I would recommend that four of these supplementary
tanks instead of three as recommended by the consulting engineer be used
with the settling or detritus tanks in the daily operation of this plant.
In view of the foregoing I beg to recommend, therefore, that the revised
plans as now submitted be approved and a permit be issued to the city of
Rochester for the discharge into Lake Ontario of the effluent from the pro-
posed sewage disposal works which shall provide in addition to the usual
modification and revocation clauses the following requirements or conditions:
1. That all portions of the sewage disposal works shall be fully con-
structed in complete conformity with the plans as approved or with such
detailed plans as may hereafter be called for and approved by this De-
partment; and the general methods of operating such works shall at all
times conform to the requirements of the State Commissioner of Health.
2. That multiple outlets shall be constructed and the outfall sewer shall
be extended when in the judgment of the State Commissioner of Health
such construction and extension shall become necessary or desirable.
3. That no sludge shall be discharged into Lake Ontario.
4. That whenever required by the State Commissioner of Health com-
plete detailed plans satisfactory to this Department for more complete
treatment of the sewage of the city of Rochester shall be submitted to the
Department for approval and any or all portions of the sewage disposal
works shown by said plans shall be thereafter constructed and put in
operation when required by the State Commissioner of Health.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
ROCKAWAY BEACH
On January 28, 1910. plans for sewerage and sewage disposal for Rockaway
Beach were submitted for approval by Mr. A. J. Provost, Jr.. civil engineer of
New York city, on behalf of the NeponsJt Realty Company. These plans were
approved on March IC, 1910, and a permit was issued allowing the discharge,
Skwkraoe and Sewage Disposal 469
into the Rockaway inlet, of effluent from the proposed sewage disposal plant
on condition that no sewage sludge shall be discharged into Rockawoy Inlet
or other adjacent bavs or channels; that whenever required by the State
Comittiasioner of Health plans satisfactory to this Department for treating
the effluent by sterilization or disinfection, or for other and more complefte
treatn»ent of sewage shall be submitted for approval; that whenever required
bj the State Conunissioner of Health the sewage disposal plant shall be so
operated as to discharge effluent from the settling tank only during the first
four hours of ebb tide; and that whenever deemed necessary or desirable
additional tank capacity sliall be provided in order to secure such discharge on
ebb tide.
Albany, N. Y., March 0, 1910.
KUOENE H. PoRTEK, M.D., kltate Commissioner of Health, Albany, N. Y.:
Deab Sib: — I beg to submit the following report on an examination of
plans for sewerage and sewage disposal works for a proposed realty develop-
ment at Rockaway Beach recently submitted to this Department for approval.
This undeveloped section of Rockaway Beach consisting of about 100 acres
of land is located opposite Barren Island and is being laid out into streets
and developed as a site for a summer colony by the Neponsit Realty Company.
The ultimate population is estimated by the designing engineer at 5,000 per-
sons which is a somewhat liberal allowance at this time for an area of this
size, but may be reached in the future. The water is to be supplied by the
Queens County Water Company of Far Rockaway and the daily consumption
18 estimated at sixty gallons per capita.
The plans show that it is proposed to construct sewers in all streets. The
sewage is to be collected by means of 8 and 10-inch cast-iron and vitrified
pipe sewers and conveyed by gravity to the pumping station to be located near
the bay at the intersection of Delta street and Newport avenue, from which
it 18 to be discharged into the proposed settling tank through a 10-inch force
main. Flush tanks are to be installed at the ends of all lateral sewers.
It is said that special efforts will be made to exclude ground water from
the system as far as possible inasmuch as cast-iron pipes with lead joints are
to be used below elevation -2.5 (datum being mean high tide).
The plans have been carefully examined by the Engineering Division in
regard to grades, sizto, velocities, capacities and other hydraulic and sanitary
features concerning the proposed sewers, and they are found to be sufficient
to meet the future requirements of this district upon the basis of population
used, and assuming that in the construction the sewers will be made suffi-
ciently watertight to prevent excess leakage.
According to the plans the sewage disposal plant is to consist of a settling
tank divid^ into three compartments and so arranged that one, two or all
three of the compartments can be operated at a time. The total capacity of
the tank is sufficient to give about nine hours* detention of sewage on the
basis of 5,000 persons and an average rate of water consumption of 100
gallons per capita per day. It would appear, therefore, that for the proposed
method of treatment the settling tank is suitable and adequate for reasonable
service in the future and of sufficient capacity to care for a considerable
quantity of ground water infiltration that may unavoidably find access to the
sewer system. The effluent is to be discharged continuously into Jamaica Bay
through a 12-inch pipe.
Each compartment of the settling tank is provided with a sump to facilitate
the accumulation and discharge of sludge and toward which tlie bottom of the
compartment slopes. A 10-inch cast-iron pipe is to convey the sludge by
gravity from the sump to the sludge pump well provided with a centrifugal
pump having an 8-inch suction. It is proposed to pump the sludge into a
scow which IS to be towed to sea and dumped whenever it shall become neces-
sary to dean the tank.
The sewage disposal plant is designed so as to give flexibility of operation
and, if properly constructed and operated, should produce an effluent that
will not create a local nuisance inasmuch as a large percentage of the solids
470 State Bkpartmkxt of ITealtji
in suspension will be retained in the settling tank and the volume of water
into which it is proposed to locate the discharge pipe and the flow of the
tides should give an adequate dilution and rapid dispersion.
As respecting the manner of discharging effluent from the plant, it would
seem desirable, as in the case of certain other disposal plants on tidal waters,
to arrange either for the present or for the future to discharge such effluent
during ebb tide.
The arrangement of the proposed settling tank with its division into three
compartments lends itself very readily to such a method of discharging effluent
and with very little change in the plans as submitted, provision may be made
for discharging effluent during the first four or five hours of ebb tide, first
by using one chamber as a storage tank and later, when the sewage flow has
increased beyond a certain limit, by using two of the chambers as storage
tanks. Then, finally, when such method of operation would result in too
short a time of detention in the remaining compartment in use as a settling
tank, an additional storage tank might be constructed if deemed necessary.
With respect to the extent of purification of sewage which should be required
at this point and considering the question with reference to the possible
pollution of the waters over shellfish grounds leased in Jamaica Bay, it
would seem from the results of the investigation of the pollution of such waters
carried on by this Department in 1908 that the effect of the discharge of
effluent from the proposed plant as affecting the sanitary quality of the
waters would be inconsiderable as compared to the effect of the direct dis-
charge of sewage into Beach Channel and Jamaica Bay that now occurs
during the siunmer season along the entire Hockaway Beach district to the
east of the proposed disposal plant site.
In view of the above and since a vastly greater discharge of sewage into
Jamaica Bay occurs at several points other than along Rockaway Beach and
where the possibility that such discharge will injuriously affect shellfish
grounds is much greater than in the case of the discharge of effluent from the
proposed plant, I believe that a permit to discharge effluent from the proposed
plant may reasonably be granted, provided a proper provision is made for
discharge during ebb tide and for more complete treatment or sterilization of
the effluent if this is later deemed necessary or desirable.
I would, therefore, recommend that the plans be approved and a permit
for the discharge into Rockaway Inlet of effluent from the proposed settling
tank be granted which shall embody, in addition to the usual modification and
revocation clauses, the provision that whenever deemed necessary by the State
Commissioner of Health, and upon due notice, plans satisfactory to this
Department for sterilization of the effluent from the settling tank or for more
complete treatment of sewage shall be submitted to this Department for
approval and that such works for the sterilization of the effluent or for more
complete treatment of sewage shall be constructed and put in operation
within the time limit then specified.
I would further recommend that the permit require that whenever deemed
necessary or desirable by the State Commissioner of Health, the disposal plant
shall thereafter be so operated as to discharge effluent from the settling tank
during the first four hours of ebb tide, only; and that when the amount of
sewage received by the plant shall, by reason of such manner of regulating
the discharge of effluent, necessitate the construction of an additional storage
tank in order that proper settlement of sewage may occur before discharge,
that such additional storage tank shall be constructed.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
Sewerage and Skwaoe Disposal 471
ROME
On NoTember 3, 1910, application was received from the Board of Water
and Sewer Commissioners for the approval of plans for proposed sewer exten-
sions in Fourth, Park and other streets in the City of Rome, plans having been
submitted on Octoi)er 24, 1910.
These plans were approved on December 2, 1910, and a permit was issued
alknrin^ the discharge, into Wood Creek, of sewage to be collected by the
proposed sewers. This permit contains in addition to the usual revocation
and modification clauses the following conditions:
1. That on or before February 1, 1911, detailed plans for settling,
sedimentation or septic tanks to treat the sanitary sewage of the city of
Rome, which shall meet the requirements of this Department, accom-
panied by general plans for additional or supplementary works for more
complete treatment of the sewage, shall be submitted to this Department
for approval.
2. That the said settling, sedimentation or septic tanks shall be con-
structed and put in operation by September 1, 1911.
3. That whenever required by the State Commissioner of Health detailed
plana for said additional works for more complete treatment of the sewage
of the city shall be submitted for approval and that any or all portions
of said additional or supplementary works for more complete treatment
of the sewage shall be constructed and put into operation when required
by the State Commissioner of Health.
Albany, X. Y., November 23, 1910.
ExTOENC H. PoBTEB, M.D., State Commiasioner of Health, Albany, N, Y,:
DcAA SiB: — •! beg to submit the following report on an examination of
plana for proposed sanitary sewer extensions in the city of Rome, Oneida
county, sulnnitted to this Department for approval by the superintendent of
tbe city water works in behalf of the Board of Water and Sewer Commis-
sioners, on October 24« 1910.
The plans show profiles of proposed sewer extensions to be constructed
aa follows:
1. About 230 feet of 8-inch sewers on a grade of 2.5 per cent, in Fourth
street to discharge into the existing manhole in Dominick street. The
plana show no manhole at the upper end of this sewer.
2. About 300 feet of 6-inch sewers on a grade of 0.8 per cent, in Park
atreet of which 219 feet are already constructed. This sewer is tributary
to tbe existing sewer in Jay street and is to be provided with a flush tank
at the upper end.
3. About 250 feet of 8-inch sewers on a grade of .3 per cent, in Linden
street to discharge into the existing manhole at its intersection with
George street. There is no manhole shown at the upper end of this sewer.
4. About 250 feet of 8- inch sewers on a grade of 0.8 per cent, in Elm
street and Aahland avenue. One hundred and twenty-eight feet of this
sewer haa already been constructed and is tributary to the existing sewer
in Croton street. No manhole is shown at the upper end. Ashland avenue
is not shown on the general plan on file in this office.
5. About 100 feet of 6-inch sewers on a grade of 2.0 per cent, in Dean
street tributary to the existing sewer in ** Alley." Dean street is not
shown on general plan.
6. About 450 feet of 6- inch sewers on a grade of 1.5 per cent, tributary
to tbe existing sewer in Dominick street. This sewer is to be provided
with an intermediate lamp hole and a fiush tank at the upper end.
The proposed sewer extensions if properly constructed should be adequate
as to size and capacity to meet the future requirements for sanitary sewerage
for the district to be served by them on the usual assumptions as to population
472 State Department of Health
and sewage contribution. The gradient of the proposed sewer in Linden street,
however, is too flat to insure self-cleansing velocities with a low flow of
sewage and should be increased to about .4 per cent, in order to decrease the
cost of maintenance.
As noted above not all of the streets in which it is proposed to construct
sewers are shown on the general sewer plan of 1904 of the city or, if shown,
are not marked on this plan. The plans now before the Department and under
consideration, however, can he passed upon inasmuch as the proposed exten-
sions are all tributary to the existing sewer system. In order, however, to
facilitate the examination of plans that may be submitted for approval in
the future, the sewer commissioners should be requested to submit a copy of a
general sewer plan showing all sewers and streets constructed to date.
The question of sewage disposal for the city of Rome has been before the
city authorities for j^ome time in the form of injunction suits now pending
in the local courts. A preliminary report on the sewage disposal problem of
the city containing estimates of costs of several difl'erent methods of sewage
disposal including settling or septic tank treatment followed by sand filtration,
broad irrigation and sprinkling filter was prepared by Knight and Hopkins,
Civil Engineers, and submitted to the Board of Water and Sewer Commia-
sioners. A copy of this report was left with this Department for consideration
at a conference in this oflice with Mayor Kissenger, city attorney and some
other gentlemen on June 22, 1910.
At the time of my conference with the city officials and inspection of the
proposed sewage disposal sites on November 21, 1910, I was informed by them
that it was the intention of the city to present final plans for sewage disposal
at the earliest possible time. It has not been definitely decided, however, as to
which of the proposed methods of sewaee disposal reported upon by Messrs.
Knight and Hopkins will be adopted altnough it appeared to be a feeling in
the city that the method of purification by settling tanks followed by sprinkling
filters would be the more satisfactory.
There appears to be urgent need for sewage disposal especially in view of
the gross pollution of Wood Creek which now receives from ninety to ninety-
five per cent, of the sewage of the city and while it may be diflicult for the
city to construct complete purification works at this time owing to the fact
that its debt limit has nearly been reached, steps should, however, be taken
to provide for at least settling or septic tank treatment at an early date.
I would recommend therefore that the city be required to submit detailed
plans for settling, sedimentation or septic tank treatment and general plans
for supplementary treatment as soon as possible.
I would further beg to recommend that the plans be approved and a permit
issued allowing the discharge into Wood Creek of sewage to be collected by
the proposed sewers and that the permit contain in addition to the usual
modification and revocation clauses, the following conditions:
1. That on or before February 1, 1911, detailed plans for settling,
sedimentation or septic tanks to treat the sanitary sewage of the city of
Rome, which shall meet tlie requirements of this Department, accom-
panied by general plans for additional or supplementary works for more
complete treatment of sewage, shall be submitted to this Department for
approval.
2. That the said settling, sedimentation or septic tanks shall be con-
structed and put into operation by September 1, 1911.
3. That whenever required by the State Commissioner of Health detailed
plans for said additional works for more complete treatment of the sewage
of the city shall be submitted for approval and that any or all portions
of said additional or supplementary works for more complete treatment
of the sewage shall be constructed and put into operation when required
by the State Commissioner of Health.
Very respectfully.
THEODORE HORlOX,
Chief Enffineer
Sewebaoe Amy Sewage Disposal 473
SONYEA (Craig Colony for Epileptics)
On July 26, 1910, plans for proposed alterations and additions to the exist-
ing sewage disposal plant at the Craig Colony for Epileptics, Sonyea, N. Y.,
were submitted for approval by the State Architect. These plans were ap-
proved on Auipist 1A« 1910.
Albany, N. Y., August 15, 1»10.
EUOEITE H. POETEB, M.D., State Commissioner of Health, Alhany, 2V. Y.:
Dear Sib: — I beg to submit the following report on the examination of
plans for alteration and additions to the existing sewage disposal plant at
Craig Colony for Epileptics, Sonyea, N. Y., submitted to this Department for
approval on July 20, 1910.
According to the report of the State Arcliitect the present population of the
institution is about^ 1,500 and the daily water consumption is e^stimated at 100
gallons per capita. It appears that there will probably be no material in-
crease in the population in the future inasmuch as similar institutions for
this class of patients are being erected in other parts of the State. The exist-
ing sewage disposal plant consists of a screen chamber, dosing tank and
three natural underdrained sand and gravel filter beds having a combined area
of about three acres. It appears that the existing dosing tank and filter beds
are inadequate as to size and capacity to properly care for the sewage from
the institution under the present method of operation.
The plans now under consideration show that it is proposed to install a
new settling tank and dosing chamber, and to regrade the three existing filter
beds and subdivide them into 12 beds of .25 acres each. Two of these beds
are to be used as sludge beds and for treating sewage while siphons are being
cleaned.
The proposed alterations and additions to the sewage disposal plant are
in general accordance with the recommendations of Professor Ogden for in-
creasing the capacity of the disposal works.
The settling tank is divided into two compartments, one of which is to be
constructed with four hoppers constituting the bottom of this compartment
for the collection and depositing of sludge. These hoppers are provided
with blow-off pipes and valves for discharging the sludge to the sludge beds
without emptying or drawing off the liquid in the tank.
The screened sewage enters the settling tank through submerged inlets and
fiows over a weir into the second compartment from which it is discharged
through a submerged effluent pipe collector into the dosing chamber. The
capacity of the settling tank is sufficient to give five hours* detention of
sewage for the sewage contributed by the present population, and fhis time
of detention is increased to about six hours by the use of the old dosing tank
located near the screen chamber which is to be reconstructed.
The dosing chamber is to be provided with three 8" alternating siphons
and so arranged as to draw off about 3'' of sewage from the first compartment
of the settling tank and 9^ from the other compartment at each dose and
discharge into central manholes located in the center of the reconstructed
filter bed areas. These manholes are each provided with 4 shear gates so
that one dose from the dosing chamber can be discharged into the distribut-
ing system of any one of the 4 smaller beds into which each of the old
filter bed areas is subdivided. One dose is sufficient to cover each unit of the
filter to a depth of about .1 of a foot.
The filter beds are to be formed by building up new embankments so as to
fonn 4 units of .25 acres each from each one of the 3 old filter beds, making
12 in all. The existing system of underdrains is to be left intact and it was
learned from the designing engineer that these drains are laid about 3.5 feet
below the surface of the filters. The old filters were constructed by grading
the natural soil. compofe<) largely of sand and gravel, and by laying under-
drains.
474 State DepabtMent of Health
At the present rate of sewage contributioD the filter beds will be required
to treat settling tank effluent at the rate of about 60,000 gallons per acre per
day. The effluent from the filters is to discharge through the present outlet
Into Kushsana creek, a tributary of the Genesee river.
If properly constructed and operated the reconstructed sewage disposal
works should produce a satisfactory effluent, and I, therefore, recommend that
the plans be approved.
Respectfully submitted,
THEODORE HORTON,
• Chief Engineer
SPRING VALLEY (Salvation Army Orphanage)
On April 22, 1910, plans for sewage disposal for the Salvation Army Orphan-
age (Cheriy Free Home) near Spring Valley, in the town of Ramapo, were
submitted for approval. Alternate plans were submitted on May 8, 1910,
and on May 23d the designing engineers were advised that the approval of
either of the two alternate methods of disposal would be considered favor-
ably as soon as such plans were submitted in proper form.
On June 2, 1910, plans for the second or alternation plan of pumping
sewage direct to the distributing system of the disposal field were submitted
for approval. These plans were approved on June 8, 1910, but no permit
was issued since, as the plans do not provide for the discharge of sewage or
sewage effluent into any of the waters of this State.
ALBA19T, N. Y., June 8, 1910.
Eugene H. Porter, MD., State Commissioner of UecUth, Albany, N. Y.:
Dear Snt: — I beg to spubmit the foHowing report on the examination of
plans for a proposed sewage disposal plant at the Salvation Army's Orphanage,
near Spring Valley, Rockland county, submitted to this Department for ap-
proval on April 22, 1910.
Plans for sewage disposal for this institution were prepared by the Ashley
House Sewage Disposal Company and submitted to this Department for ap-
proval early in June, 1909, but were returned for certain corrections and
modifications with reference to the septic tank and nitrification beds on June
21, 1909. Subsequent to this date an inspection was made by one of our
assistant engineers, in accordance with your direction, of the method of
sewage disposal at the orphanage, inasmuch as a complaint had been received
b^ the Department of the pollution of a tributary of the Saddle and Passaic
rivers by the discharge of wastes from this institution. The result of this
inspection was submitted to you in a report dated December 30, 1909, to
which reference is made for a detailed account of the location, population,
water supply and present method of sewage disposal of the Salvation Army
Orphanage.
On April 22, 1010, the following plans were submitted in duplicate, together
with duplicate report of the designing engineers:
1. General plan of the sewage disposal system.
2. Plan and section of dosing tank and discharge siphon.
3. Plan and section of receiving well, showing screens and pumping
system.
According to the report of the designing engineers the present and normal
population of the institution consists of 60 children and 25 adults, giving a
total of 85 persons, and it is stated that the maximum cannot at any time
exceed 100, with an estimated water consumption of 3,500 gallons per day.
At the time of the inspection above referred to, however, the population was
100. consisting of 75 children and 25 adults, and it was learned from the
official in charge that the capacity of tlie institution may at some future time
be increased so as to care for a total population of 150 persons, including
officials and attendants.
Sewerage and Sewage Disposax 475
The plana show that it is proposed to dispose of the sewage from the insti-
tution by means of screening and ''broad irrigation." The existing cesspool
which is about 14 feet in diameter will be utilized as a receiving well from
which the sewage will be pumped either to a dosing chamber located above
the disposal field, about 400 feet from the well or reservoir, or pumped direct
to the outlets at the disposal field.
The cesspool will be reconstructed so that the sewage will pass through
two screens before reaching the suction of the pump. The first screen is
to consist of %"x%" bars, spaced %" apart in the clear, and arranged so
that the screenings may be raked upon a platform placed at about the same
elevation as the top of the screen. The second screen is to be made of heavy
galvanized wire and to be placed in a vertical position back of the bar screen
and arranged so as to be rennyvable for cleaning.
The screened sewage will be pumped to the dosing chamber throu^^h a 2^"
force main by means of a 2" submerged centrifugal pump to be driven by a
3-horsepower vertical electric motor. The motor is to be controlled by an
automatic starting and stopping device connected with a float and adjusted
so that about 2,500 gallons will be pumped at one operation. The pump is
to have a capacity of from 60 to 70 gallons per minute and, if properly in-
staJled and operated, should be adequate to satisfactorily handle the sanitary
sewage contributed by the institution.
It was proposed to deliver the sewage from the pump to the disposal field
in one of two ways. In the first arrangement the force main from the pump
is connected with a dosing chamber located about 45 feet above and at a dis-
tance of some 400 feet from the cesspool or pump well. This dosing chamber
has a capacity of about 2,000 gallons and is connected with a siphon cham-
ber provided with a 5" siphon. The chamber has three 5" outlets, each pro-
vided with a shear gate valve, and connected with 5" cast-iron distributing
pipes placed at right angles to the main distributors. The three distributing
pipes are each provided with 14r-5"x2" branches for outlets, spaced IT apart
on centers. In front of each outlet is to be placed a concrete apron for the
purpose of facilitating the distribution of the sewage over the surface of the
ground.
The alternate plan, submitted to the Department on May 3, 1910, proposes
to omit the use of the dosing chamber and provides for pumping the sewage
direct from the cesspool to the outlets of the disposal field. The location
and the general arrangement of the distributing pipes is practically the same
as that shown on the first plan except that the outlets are to be vertical
instead of horizontal. These outlet pipes, spaced IT apart on centers are
to be 2^ in diameter, terminating about Q** above the level of the ground
and made adjustable as to elevation above the top of the pipe so that each
can be made to discharge the proper proportion of the quantity pumped.
A concrete splash plate, 12" in diameter, is to be placed on the ground,
each outlet pipe to break the fall of the sewage and protect the ground.
As in the first arrangement about 2,500 gallons of sewage is to be pumped
at each running of the pump and this quantity will be discharged to the
disposal field in some 30 minutes.
li is understood that the surface of the ground which is sloping will be
graded and a growth of grass maintained upon it.
It is stated in the report by the designing engineers that the ground to
be used for disposal is composed of a permeable and drv loamy soil, and
asfluming that the sewage will fiow down the slope for a distance of 100 feet
before it is completely absort>ed by the soil the area over which the sewage
will be distributed by either method is equal to about one acre. The disposal
area will, therefore, be required to care for sewage at the rate of 10,000 gal-
lons per acre per day, assuming that a population of 100 persons will con-
tribute sewage at the rate of 100 gallons per capita per day. The actual con-
tribution of sewage will probably not exceed one-half this amount, but owing
to the greater strength it will perhaps be as difficult to dispose of as a more
dilute sewage from the same population.
Owing to the probability of this ground becoming frozen during the winter
and thereby preventing the sewage from percolating through the soil freely
476 State Depabtment of Health
it may be found necessary to prepare the disposal fields for cold weather, pos-
sibly by furrowing and ridging, or some other method so as to facilitate
the absorption of the liquid by the ground and at the same time prevent the
sewage from freezing.
With this provision it appeared that either one of the two proposed methods
of caring for the sewage should be adequate and satisfactory if the disposal
plant is properly constructed and operated.
The designing engineers were, therefore, advised by you, in a letter dated
May 23, 1910, that while it would be impossible to pass upon these plans until
complete duplicate plans for one or the other of these alternate methods of
disposal were submitted for approval, you would consider favorablv the ap-
proval of plans for either of the two methods as soon as such plans were
submitted in proper form.
Accordingly, duplicate plans for the second or alternation plan of pump-
ing the sewage direct to the distributing system of the disposal field were
submitted to the Department for approval on June 2, 1910, ana after a careful
review of these plans, I beg to recommend that they be approved.
Respectfully submitted,
THEODORE HORTONy
Chief Engineer
STAMFORD
On April 8, 1910, certified copies of resolutions were received from the board
of health and board of trustees of the village of Stamford in reference to the
extension of a sanitarv sewer in River street. The certification was approved
on April 16, 1910.
Albany, N. Y., April 16, 1910.
BOABD OF Trustees, Stamford, N. Y.:
Gentlemen: — In response to the application made to me by your board
in accordance with a resolution adopted on April 6, 1910, as provided for
by section 21 of the Public Health Law. asking for toy approval of the certi-
fied recommendation of the board of health to your board to construct 2,700
feet of sanitary sewer extension in River street, plans for which were approved
by this Department on June 17, 1892, as a part of the sewer system of the
village of Stamford, I hereby approve the recommendation to construct the
proposed sewer in River street.
The above approval is duly given this 16th day of April, 1910, in accordance
with section 21, chapter 45 of the Consolidated Laws (Public Health Law).
ALEC H. SEYMOUR,
AcUng Commissioner of Health
TICONDEROGA
On June 25, 1909, an inspection of the sewerage conditions of the village
of Ticonderoga was made by the engineering division, and as a result of
this inspection it was recommended that sewer extensions in the village should
be carried along permanent and comprehensive lines. A copy of the report
on the inspection is printed in the Thirtieth Annual Report (1909), page
213, to which reference is made.
On July 2, 1910, application was made by the board of trustees of the
village for permission to discharge sewage into Ticonderoga creek from a pro-
posed sewer in West Exchange street and vicinity.
A permit was issued on August 1. 1910, which contains the provision that
Sewerage and Sewage Disposal 477
on or before February 1, 1011, complete plans, satUfactory to the Department,
for a sanitary sewer system for the village of Ticonderoga, together with gen-
eral plans for a sewage disposal plant to treat the entire sanitary sewage of
the village, shall be submitted to this Department for approval.
Albany, K. Y., August 1, 1910.
Mr. T. E. Harvey, Village President, Ticonderoga, N. Y,:
Deab Sib: — I am enclosing a permit granted to the board of trustees of the
village of Ticonderoga which allows the discharge into Ticonderoga creek of
sewage to be collected by a proposed sanitary sewer from a point near Pros-
pect street, thence across Prospect street and private property to West Ex-
change street and thence to Ticonderoga creek.
You will note that this permit to become operative must first be recorded
in the county clerk's office of Essex county.
At the time of my communication to you of July 6, 1909, it was expected
that before this time complete plans for sewerage for Ticonderoga would be
submitted to this Department for approval, and upon the approval of such
plans it was expected that application would be made for permission to defer
the construction of portions of the system, as provided for by the Village
Law, and to construct certain necessary portion^ of the system, notably the
sewer from Prospect street to West Exchange street.
Such general plans have not as yet been submitted in shape for approval,
and it is only on account of the urgent need for an improvement in sanitary
conditions near West Exchange street that I am granting a permit for the
discharge of sewage into Ticonderoga creek from the proposed sewer in advance
of the submission of such plans.
However, you will note that the permit requires that such complete plans
for sewerage, together with general plans for sewage disposal, shall be sub-
mitted for approval on or before February 1, 1911, and I trust that the plans
will be submitted as soon as possible. In this manner opportunity will be
afforded to construct other necessary portions of the village sewer system in
accordance with the Village Law relating to sewer construction and the gen-
eral insanitarj' conditions now existing at various points in the village may
be remedied.
Very respectfully,
WM. A. HOWE, M.D.,
Acting Commissioner of Health
TUCKAHOE
See IJronxvilie and Tuckahoe. on page 388.
UTICA
On April 9, 1910, plans for a proposed sewer extension in Leeds street were
submitted for approval by the board of contract and supply of the city of
Utica. Thes© plaiw were approved on April 13, 1910, and a permit was
isMied allowing the discharge of sewage from the proposed sewer into a
tributary of the Mohawk river, 'fliis permit contains in addition to the
usual revocation and modification clauses the following conditions:
1. That on or before May 1, 1911, the authorities having by law charge
of sewer construction in the city of Utica shall submit to this Depart-
ment for approval satisfactory plans as follows:
a. Plans for intercepting or outfall sewers to convey the entire
sanitary sewage of the city to a suitable site for disposal.
478 State Department of TTealth
6. Detailed plans providing for a partial treatment of the entire
sanitary sewage of the city by sedimentation and screening.
c. Plans showing the location, general arrangement and type of
works for complete treatment of the sewage.
2. That whenever required by the State Commissioner of Health the
intercepting or outfall sewer and the works for partial treatment of
sewage shall be constructed within a time limit then specified.
3. That whenever required by the State Commissioner of Health,
satisfactory, detailed plans for complete treatment of sewage shall be
submitted to this Department for approval; and such works shall be
constructed and completed within such time thereafter as may be
specified by the State Commissioner of Health.
Albant, N. Y., April 13, 1910.
Eugene H. Pobteb, M.D., State Commissioner of Health, Alhany, N, Y,:
Dear Sib: — I beg to sumbit the following report on the examination of
plans for a proposed combined sewer extension in Leeds street in the city of
Utica, Oneida county, submitted to this Department for approval on April 9,
1910, by the commissioner of public works.
Prior to the submission of plans now under consideration, no plans for
sewer system or sewer extensions have ever been approved by the Depart-
ment. The sewer system of the city is constructed on the combined sewer
plan, there being eight separate outfalls into the Mohawk river. A trunk
sewer was constructed in recent years along the river front from Division
street to a point opposite Kossuth street. This trunk sewer intercepted some
six separate outfall sewers and its construction was made necessary by
reason of the abandonment of a portion of the old river channel north of
the city.
The proposed 12-inch sewer extension in Leeds street is to extend from the
intersection of Leeds and Eagle streets to the existing 15-iuch sewer in Leeds
street, a distance of some 480 feet. This sewer extension lies within the
present combined sewer district and is to discharge into an arm of the
Mohawk river at the foot of Jefferson street extended and north of the New
York Central and Hudson River railroad tracks. The plans of the proposed
sewer have been examined by the engineering division and found to be
adequate to care for the sanitary sewage in that portion of Leeds street in
which this sewer is to be constructed.
It seems advisable at this time that the attention of the city authorities
should be called to the need of arranging for future treatment of the sanitary
sewage of the city before its discharge into the Mohawk river and that some
requirement should be made in this respect.
Not only the present condition of pollution of the Mohawk river but the
inevitable increase in such pollution that will occur in the future, coupled
with the facts that the city of Utica is located near the headwaters of the
river and that the river is now being canalized, demand that arrangements
be made for at least a partial treatment of the sanitary sewage of the city
in the near future.
I, therefore, recommend that the plans be approved and that, under the
provisions of section 77 of the Public Health Law, a permit be issued allow-
ing the discharge into the Mohawk river of sewage to be collected by the pro-
posed sewer, such permit to contain in addition to the usual revocation and
modification clauses the provision that within, say, one year, plans for an
intercepting sewer and for works for partial treatment of sewage by screen-
ing and sedimentation shall be submitted to this Department for approval,
together with plans showing the general location, arrangement and type of
works for the complete treatment of sewage.
I would further recommend that the permit contain provisions requiring
that detail plans of works for complete treatment of sewage be submitted for
approval by the city authorities on proper notification by the State Com*
Sewerage and Sewage Disposal 479
missioner of Health and that any or all works for both the partial and com-
plete treatment of sewM^e shall be constructed whenever required by the
State Commissioner of Health.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
WATERTOWN
During the past year, plans for sewer extension in the streets listed below
have been approved and permits containing the usual revocation and modifi-
cation clauses have been issued in connection with such plans:
Date of Stream receiving
approval Description or location of sewers sewage
February 11, 1910. Emmett, Boon and Sand streets Black river
March 15, 1910. Sherman street Black river
March 28, 1910. Coffeen street Black river
June 15, 1910. Arsenal street Black river
June 16, 1910. Morrison street Cowen's creek
WESTFIELD
Under date of January 14, 1910, application was made by the board of
trustees of the village of Westfield asking for the approval of plans for a
proposed sewer system and sewage disposal plant. Although the plans showed
careful study and design, the sewage disposal plant as a whole was not well
balanced, inasmuch as the capacity of the contact filters was somewhat small
and the sludge bed was not well arranged. The plans were, therefore, re-
turned for amendment on Januarr 25, 1910.
The plans were revised and resubmitted for approval on February 17, 1910.
They were approved on February 10, 1910, and a permit issued allowing the
discharge into Chautauqua creek of effluent from the sewage disposal plant
to be constructed in connection with the proposed sewer system.
On June 20, 1910, application was made by the board of trustees of the
village asking for the approval of a proposition to construct the sewage dis-
posal plant and certain portions of the permanent general sewer system.
The proposition was approved on June 20, 1910, as noted below.
Albany, N. Y., January 15, 1910.
Eugene H. Porter, M.D., State Commissioner of Health, Albany, N, Y,:
Dear Sir: — I beg to submit the following report on an examination of
plans for a proposed sewer system and sewage disposal plant for the village
of Westfield, Chautauqua county, submitted to this Department for approval
on December 27, 1909.
The plans and documents consist of single copies of report and specifica-
tions by the designing engineer, together with tracings and prints of the
following:
1. General topographical map of the village showing location of pro-
posed sewers and sewage disposal plant.
2. Eight sheets of profiles of sewers and streets.
3. General layout and wall sections of disposal plant.
4. Details of septic tank.
5. Location plan of disposal plant.
6. Details of distributing and valve chambers.
7. Duplicate prints of manhole sections.
8. Section of automatic flush tank.
480 State Dkpaktmkxt of Health
The village of Webtlield is located in the northern part of ChautAuqaA
county and about one roile from Lake Erie. The village has had a slow but
steady growth during th^ past twenty years, amounting to about 2-6 per cent.
a year. In 1890 it had a population of 1,983; in 1900, 2,430, and the present
population is estimated at 3,144.
The proposed sewer system is comprehensive and adequate as to sizes,
grades and capacities to meet any probable demand that may be made upon
it for a considerable period in the future, provided that the sewers are
properly constructed and no cellar drainage or storm water from roofs,
streets or other areas is admitted to the system. The slopes of all sewers are
sufficiently steep to protluce self -cleansing velocities when flowing full or
half full, and the upper or so-called "dead ends" of all sewers are pro-
vided with automatic flush tanks for the purpose of keeping these sewers
clean. The plans show that it is proposed to collect and carry the entire
sewage of the village to a point of disposal near the northwestern comer of
the cori)oration on the east bank of Chautauqua creek, which flows in a
northerly direction through the western portion of the village.
The sewage disposal plant consists of septic tank and contact beds. The
septic tank is divided into two compartments which have a combined capacity
of about 125,000 gallons. The sewage, upon reaching the disposal plant can
be either by-passed or discharged into either one or both of the grit chambers.
From the grit chamber it flows into the septic tank through submerged inlets
after passing through coarse screens placed directly in front of the openings.
The oiutlets from the septic tank are also submerged, inasmuch as they are con-
nected with a slotted, submerged collector box across the end of the tank by
means of riser pipes.
The septic tank has a capacity sufficient to give about ten hours' detention
of sewage that would be contributed by the present population of 3,144 per-
sons at a rate of 100 gallons per capita per day, and about six hours' de<
tention for a population of 5,000 persons on the above assumption. At the
present rate of growth this population should obtain in about twenty years.
The plans show that it is proposed to oarry the sludge pipes from sumps
in the septic tank to a point near the water line of Chautauqua creek, but
no area is provided for the disposal of sludge and no sludge beds are shown.
This omission should not be allowed, since the discharge of sludge directly
into a stream as small as Chautauqua creek could probably not be done
without creating a local nuisance. The additional cost of preparing beds for
the proper disposal of sludge would be comparatively slight and in my
opinion it would avoid the probability, or at least the possibility, of creating
a nuisance.
From the septic tank the sewage is conveyed to a distributing chamber
through a 12-inch vitrified pipe located in the division wall between contact
beds Nos. 1 and 4. This distributing chamber at the center of the contact
bed area is provided with the air-lock system for controlling the flow into the
contact beds, the time of contact and the time of emptying the beds.
The contact beds are four in number, of equal capacity and have a com-
bined area of about 0.4 acres with a 4-foot depth of broken stone. The beds
are provided with distributors and underdrains.
Although the details of the sewage disposal plant show careful study and
design, the plant as a whole is not well balanced. As noted above, the septic
tank is adequate as to capacity for present needs and for reasonable service
in the future. The contact beds, however, do not have a sufficient capacity
to properly treat the septic tank effluent for the present population, assuming
a per capita rate of contribution of 100 gallons per day. In practice it is
found that contact beds of this depth have a capacity of not more than
400,000 gallons per acre per day when the sewage is of a strength equal to
that furnished by a per capita rate of water consumption of 100 gallons per
day and when the plant is under careful maintenance and operation. While
no definite data is submitted as to the w^ater consumption of the village, the
design seems to be based on a contribution of sewage varying from 50 to 100
gallons per capita per day. and the report mentions an assumed flow of 50
gallons per capita for a future population of 5,000 persons. As stated, how-
Sewt:rage and Sewage Disposal 481
ever, 100 gallons per capita is the basis which should be used, since the
capacity of contact beds depends not only upon the volume of sewage to be
treated but also upon the strength of the sewage.
In order, therefore, to more properly balance the sewage disposal plant and
to make it more efficient for present and future needs, the depth of the
contact beds should either be increased to six feet, retaining the present area,
or, better, to make the depth Ave feet and increase the area some 20 per cent.
In conclusion, I would say that, while the sewer system and sewage dis-
posal works have, in general, been carefully designed, the capacity of the
contact beds should be increased and sludge beds should be added in order to
make the plant thoroughly adequate, efficient and economical. I would,
(therefore, beg to reoommend that the plans be returned for amendment in
accordance with the above suggestions.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
Albany, N. Y., February 10, 1910.
Eugene II. Pobteb, M.D., State Commissioner of Health, Alhani/y N, Y,:
Dear Sir: — I beg to report that revised plans for sewerage and sewage
disposal for the village of Westfield, Chautauqua county, were resubmitted to
the Department for approval on February 7, 1910.
The plans have been revised in substantial accordance with the recommenda-
tions embodied in the report of January 15, 1910, insofar as the total area
of the contact beds is concerned and show that, although the four feet depth
of the beds is to be retained, the area of the beds has been increased by some
fifty per cent. The contact beds are now of ample capacity, if properly con-
structed and operated, to satisfactorily treat effluent from the septic tank
resulting from the sewage which would be contributed by the present total
population.
In regard to the disposal of sludge, the plans as revised, although providing
for a sludge bed, are not satisfactory. It was stated in the report above
referred to that a sludge bed should be provided for by the plans, '' since the
discharge of sludge directly into a stream as small as Chautauqua Creek
could probably not be done without creating a local nuisance." The revised
plans, however, do not provide for a sludge bed of sufficient capacity to
prevent a direct discharge of sludge into the stream owing to the relative
capacity of the septic tank and sludge bed and the unsuitable location of the
bed with reference to the elevation of the bottom of the septic tank which is
only 1.8 feet above the bottom of the sludge bed. Further, the location of .the
sludge bed and the limitations arising from probable ground water level and
the elevation of water in the stream do not allow a sufficient grade for the
sludge outlet pipe. Since the sludge from a greater portion of the bottom of
the tank must be discharged by gravity flow, the grade of the outlet pipe
should be preferably 1.0 per cent, in order that the pipe may be properly
flushed after the tank has been drained.
The area or capacity of the sludge bed should, therefore, be increased and
in this connection it might be suggested that in order to have a smaller
quantity of tankage to provide for, contact beds No. 1 and No. 4 could be
connected with each compartment of the septic tank by means of pipes and
valves located some three feet below the flow line of the tanks, so that the
sewage level in the tanks might be drawn down somewhat preparatory to
discharging onto the sludge beds.
Owing to the peculiar topography of the proposed location, it may be neces-
sary to place the sludge bed at some point down-stream from the site of the
disposal works in order to arrange for adequate gradient for the outlet pipe,
to provide a depth of at least one foot of sand over the underdrains, should
16
483 State Departaiext of Health
such iinderdrains be found necessary, and to provide sufficient capacity to care
for the voliuue of effluent and sludge drained from the tank during cleaning.
According to the plans, it is proposed to provide for an emergency by-pass
for the septic tank. Since no untreated sewage should be discharged into
the stream, if a by-pass is deemed necessary it should discharge onto one of
the contact beds, since temporary discharge of sewage onto the contact beds
would not seriously interfere with their x)peration and such provision would
prevent any discharge of raw sewage into the stream. It would seem, how-
ever, that a by-pass were unnecessary, since both the grit chamber and the
septic tank arc divided into two compartments each of which may be operated
separately.
I would conclude that in order to make the design of the sewage disposal
plant complete and thoroughly efficient and in conformity with the require-
ments of this Department, sludge beds should be provided to adequately dis-
pose of the sludge and arrangements should be made to obviate entirely the
discharge into the stream of untreated sewage or sewage sludge.
I beg, therefore, to recommend that the plans be approved and a permit be
issued allowing the discharge into Chautauqua creek of effluent from the pro-
posed sewage disposal plant on condition that no untreated sewage or sewage
sludge shall be discharged into the stream and no direct outlets shall be con-
structed from the septic tank or from the sludge bed to the stream; and
that if the sludge bed is underdrained, at least one foot of sand shall be
placed over the collecting drains.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
Albany, X. Y., July 20, 1910.
Board of Trustees, Westfield, N. Y.:
Gentlemen: — In response to the application made to me by your board
and dated June 20, 1910, asking for my approval of a proposition to con-
struct certain portions of the permanent general system of sewers for the
village of VVestfield, plans for which were appro\'ed by this Department on
February 10, 1910, and which application constitutes an application to tem-
porarily omit or defer the construction of the remaining portions of the per-
manent general sewer system not named in the application, I hereby certify
my determination to approve and do approve of such temporary omission
from construction, until in the judgment of the State Commissioner of Health
or of the trustees of the village of Westfield the construction of such por-
tions may be necessary, of all the remaining portions of the sewer system not
named in the application, the portions to be constructed being as follows:
Beginning at the intersection of Main and Portage streets; thence east
on Main street to Pearl; thence north along Pearl and East Pearl to the
intersection of the sewer along English street; thence east to the junction
of English street sewer and the sewer from Cass street; thence north
across Lake Shore & Michigan Southern railroad to Bourne street; east
on Bourne to Lake street; north on Lake street to village line; thence
northwest to Nichols street; thence westerly on Nichols to North Portage
street; thence westerly to disposal plant. Also on Main street from
Pearl street easterly to first flush tank; thence on Main from second
flush tank easterly to Cass street; north on Cass to junction south of
the N. Y., C. & St. L. R. R. ; thence across said railroad to the junction
of the English street sewer. Another sewer beginning on Coburn street
north of Main street; thence north to Jefferson street; west on JefTerson
to Cass street; all the sewer on West Pearl street; all Jefferson street
from Portage street to Holt street; all the sewer on Holt street; Frank-
lin street from flush tank north of Clinton street to Jefferson street and
from point a little north of the N. Y., C. & St. L. R. R. to English street;
on English street from Franklin to East Pearl; on Washington street
Sewerage and Sewage Disposal 483
from Maple to Pearl; all of Clinton street; North Portage from Main
to Jefferson; South Portage from Main to first manhole south of Bliss;
Elm street from Main to Third; Kent street; Union street to Davis;
Union street from >lain to Tliird; Davis street, Kent to Nixon; all
Cottage and Bank streets; all of Pleasant, Riley, Ash and Wells streets;
Spring street, Academy to fifth manhole; Academy street from Main to
manhole with elevation 188.35; all of Main street from Water street east
4o0 feet (this is not shown on map on file in your office) ; South Water
street from Main southerly to a point 200 feet south of the fourth man-
hole; North Water street from Main street north to disposal plant;
Chestnut street south from Main street 1,050 feet; Oak street from Main
street northerly to junction with North River street on the south side of
the L. S. & M. S. R. R. ; West Main street from Oak street to Gale street ;
all of Clark street, together with the sewage disposal plant.
The ahove approval is duly given this 20th day of July, 1910, in accordance
with the provisions of section 260, article 11 of chapter 64 of the Consolidated
Laws, the Village Law.
Respectfully,
ALEC H. SEYMOUR,
Acting Commissioner of Health
YORKVILLE
On August 6, 1910, plans for a proposed sewer system in the village of
Yorkville were submitted for approval by the lx)ard of trustees. These plans
were returned to the designing engineer for amendment, inasmuch as they
did not provide for sewage disposal and did not provide for the interception
of the existing sewers in the village. The plans were revised and resubmitted
for approval on September 14, 1910. After a conference and some corre-
spondence with the engineer the plans were approved on October 7, 1910, and
a permit was issued allowing the discharge, into the Mohawk river, of
effluent from the proposed sewage disposal plant to be constructed in con-
nection with the proposed sewer system on condition that whenever required
by the State Commissioner of Health, complete, detailed plans satisfactory
to this Department and showing works for additional treatment of sewage to
that provided for by the plans for sewage disposal approved this day shall be
submitted to this Department for approval; and any or all portions of such
additional sewage disposal works shall be constructed and put in operation
whenever required by the State Commissioner of Health.
Albany, N. Y., October 3, 1910.
EtOEXE IT. Porter, M.D., State Commissiofier of Healthy Albany, N. Y.:
Dear Sir: — I beg to submit the following report on the examination of
plans for a proposed sewer system and sewage disposal plant for the village
of Yorkville, Oneida county, recently submitted to this Department for ap-
proval by the designing engineer, Mr. W. (J. Stone, C. E., of Utica, on behalf
of thft Ikoard of trustees.
The vilhige of Yorkville is located on Sauqr.oit crfck, the Erie t^nal and the
main line of the New York Central railroad and near the confluence of
Sauquoit creek and tlie Moliawk river. It is bounded on the ea.st by the city
of Ltica.
The village was incorporated in 1903 when it had a population of 504.
The population in 1905 was 524 and the present population is estimated at
some 7<^0 persons.
Plana for a comprehensive sewer svi^tem for the village were first sub-
mitted to this Department for approval on August 6, 1910, but they were not
484 State Department of Health
entirely satisfactory inasmuch as they did not provide for sewage disposal
nor for the interception of existing sewers. The slope of the outfall sewer
was also too flat to insure securing self-cleansing velocities and the plans
furthermore contemplated the interception of a portion of the flow of Martin
brook. Although this latter provision would tend to keep the sewers flushed
by increasing the depth of flow, it was undesirable inasmuch as it would in-
crease the amount of liquid to be cared for by the disposal works.
At a conference held in this Department in reference to the plans for York-
ville with members of the engineering division on September 1, 1910, the
designing engineer was informed that the Commissioner would undoubtedly
require some form of sewage purification and that provision be made in the
plans for intercepting the existing sewers even though the construction of
such intercepting sewer might not be required at this time. He was, there-
fore, advised to revise the plans in accordance with these suggestions so as
to at least provide for settling tank treatment at present, the settling tank
to be so placed with reference to elevation and location as to permit of
supplementary treatment works should such additional purification of sewage
be required at some future time. He was also requested to increase the scope
of the outfall sewer to at least 0.15 per cent., to show on the plans an ad-
ditional sewer line for intercepting the existing sewers which now discharge
into Sauquoit creek and to exclude from the proposed sewers the water from
Martin brook. The plans were resubmitted on September 14, 1910, revised in
general accordance with the above suggestions but the arrangement of the
screen and screen chamber was not entirely satisfactory inasmuch as no pro-
vision was made for closing ofi" the screen chamber from the remainder of the
settling tank while cleaning the rather fine, removable mesh screens. After
another conference with the designing engineer revised plans satisfactory to
this Department have been resubmitted for approval.
The plans and documents submitted comprise:
Tracing and blue print of the following:
1. Topographical map and plan of existing and proposed sewers and
sewage disposal plant.
2. Profiles of streets and seAvers.
3. Details of canal crossing.
4. Details of appurtenances.
5. Plan and sections of settling tank.
6. Details of screens.
7. Details of gates, collecting hoods and breeches pipes for inlets and
outlets of settling tank. Specifications, report and estimates by the
designing engineer.
According to these revised plans and report of the designing engineer,
sewers were constructed in certain streets in a portion of the village south of
the Erie canal by private individuals in the year 1901. While it is not pro-
posed to intercept these sewers at present, the plans show that they can be
intercepted and that the sewage collected by them can be carried across the
canal to the proposed sewer in Whitesboro street by a sewer having a slope
of 0.96 per cent.
Although the plans provide for a comprehensive sewer system covering
practically all of the built up portions within the corporation lines, it is
proposed at present to construct only the sewage disposal plant and a portion
of the sewer system. Under date of August 4, 1910, the board of trustees of
the village submitted a petition to tliis Department asking permission to
omit, for the present, the construction of all portions of the sewer system
except the proposed sewers in WTiitesboro street, Coventry avenue and outfall
sewer, Elmwood and Oatley avenues, Main street and special.
The plans have been carefully examined in reference to sizes, slopes,
capacities and other engineering and hydraulic features in connection with
the proposed sewers and they are found to be adequate to meet the future re-
quirements for sanitary sewage for the territory to be served by them on
the usual assumptions as to population and water consumption and assuming
that in the construction, the sewers will be made sufficiently watertight to
prevent excess infiltration of ground water.
Sewerage and Sewage Disposal 485
The plans for sewage disposal show a detailed design for a settling tank
to be constructed immediately and provide for additional area to be reserved
for supplementary treatment works whenever additional purification of sewage
shall be required. The tanks are to be covered with a building to be used
as a pumping station when such additional purification works shall be con-
structed. The settling tank is divided into two compartments which are
practically square in plan, and provide for a depth of sewage of about eight
feet. Bach compartment is adequate to give about eight hours' detention of
sewage contributed by a population of 500 persons assuming a rate of water
consumption of 100 gallons per capita per day, and about six hours' detention
of sewage when serving a population of 700 on the same assumption.
The sewage upon reaching the settling tank can be discharged into either
one of the two equal compartments after passing through small screen
chambers which occupy a space 6' x 8' in adjacent corners of the compart-
ments. The screens are to be composed of 2" x %" bars spaced %" in the clear.
These screens are inclined at an angle of 20° with the vertical and sup-
ported at the top by the cleaning platform and rests on a 3"x3" recess in
the outer edge of a concrete sill 12" wide placed about 4' from the bottom
of the screen chamber. This 'is not a good arrangement for supporting the
bottom of the screen inasmuch as they can easily be misplaced and pushed
from this narrow recess of the ledge or sill into the screen chamber during
cleaning or by floating material from the sewers and when once removed it
will be difficult to replace them in their proper position while the tank is in
operation.
In order, therefore, to better prevent the screens from being disturbed and
to facilitate replacing them when removed a projection should be constructed
on the sill to prevent the bottom of the screen from slipping from the end
of the sill, or a groove or channel iron could be placed in the side walls of
each screen chamber extending from the top of these walls to the sill so as
to guide the screens in placing them and to support them when in place.
After the sewage passes through the screens it is discharged from the
screen chamber into the settling tank through a submerged outlet 8'x2', with
the bottom of the outlet 16" from the bottom of the settling tank. The out-
let pipe is protected by collecting hoods which act as baffles and prevent the
scum from entering the outlet pipe. Tlie effluent from the settling tank
is to be discharged into the Mohawk river at the low-water mark through a
15" outlet sewer laid on a grade of 0.151 per cent.
In conclusion, I would say that the plans provide adequate sewerage facili-
ties for the village for a considerable period in the future, and the sewage
disposal plant, if properly constructed and operated, should produce a satis-
factory effluent for this type of plant.
I, therefore, beg to recommend that the plans be approved and a permit
issued allowing the discharge into the Mohawk river of effluent from the pro-
posed settling tank, and that the permit contain, in addition to the usual
revocation and modification clauses and the provision as to future purification
of sewage, the condition that the screens shall be set in accordance with the
suggestions embodied in this report.
KeHppctfully submitted,
THEODORE HORTON,
Chief Engineer
Albany, N. Y., October 7, 1910.
BoABO OF Tbustees, VILLAGE OF YoRKViLLE, Oneida County, N. Y.:
Gentlemen: — In response to the application made to me by your board
under date of August 4, 1910, asking for my approval of the temporary
omiseion from construction of certain portions of the permanent general sys-
tem of sewers and sewage disposal for the village of Yorkville, plans ifor
which have this day been approved by this Department, I hereby certify my
determination to approve and do approve of such temporary omission from
486 State Department of Health
construction until, in the judgment of the State Commissioner of Health or
of the trustees of the village of Yorkville, such portions may be necessarj',
of all portions of said system of sewers and sewage disposal except the sewage
disposal plant, the sewers in Whitesboro street, Ck)ventry avenue, and Out-
fall sewer, Elmwood and Oatley avenue, Main street and " special sewer."
The above approval is duly given this 7th day of October, 1910, in accord-
ance with section 260, article 11, chapter 64 of the Consolidated Laws, the
Village Law.
Very respectfully,
EUGENE H.* PORTER, M.D.,
Commissioner of Health.
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GENERAL INVESTIGATIONS RELATING TO
SEWERAGE AND SEWAGE DISPOSAL
In addition to tho routine of examining and reporting upon
plans for sewerage systems and extensions, time-consuming as this
work must necessarily be, there is still much work of an educa-
tional and advisory nature to be done in connection with it. This
educational work is considerable in amount and varied in its
nature, and includes numerous conferences with local boards or
committees, lectures and talks in connection with sewerage sys-
tems and sewage disposal plants, and advice and reports concern-
ing specific local problems. The municipalities where work of
this nature has been performed by the Engineering Division dur-
ing 1910, are as follows:.
AKRON
Several complaints having been received by the Department in reference to
nuisances caused by the overflow of cessnools in the village of Akron, an in-
spection was made of the sanitary conditions of the village by one of the in-
specting engineers of this Department on June 15, 1910. The findings of this
inspection are discussed in the following report, copies of which were sent to
the health officer and board of trustees of the village on June 24, 1910.
Albany, N. Y., June 20, 1910.
Eugene H. Porter, M.D., State Cotnmi^sion^r of Health, Albany, N. Y,:
Dear Sir: — I beg to submit the following report of an investigation of the
sanitary conditions of the village of Akron, Erie county.
Several complaints have been received in regard to nuisances caused by
overflowing cesspools, and in accordance with your instructions, an inspection
of local conditions was made on June 15th by Mr. F. M. Arnolt, inspecting
engineer in this division.
The village of Akron, incorporated in 1850, is located northeast of the
center of Erie county on the West Shore and the New York Central and
Hudson River railroads. It is on the north and east bank of Murder creek, a
tributary to Tonawanda creek, which flows into the Niagara. Its population
at present is about 1,800. and it is a slowly growing village.
The principal industrial plants are the Akron Manufacturing Company, em-
ploying sixty men, Wheat's Ice Cream Company, employing twelve men, a
stone crushing plant and Newman's cement works and flouring mill. There
are twenty-two stores, two banks and eight hotels iii^ the village.
The water supply is furnished by the munioi])ality and is obtained from
a spring. The village owns the land upon which the spring is located and
has erected upon it a pumping plant containing two 6-horsepower boilers,
one Snow duplex compound pump and one Deniinrj triplex power pump. A
[488]
Sewerage and Sewage J)isposal 480
standpipe has been erected by the village about a mile from the pumping sta-
tion which has a capacity of 100,000 gallons. About 7^ miles of mains, vary-
ing between 10" and 4" in diameter have been laid.
Most of the streets are well paved and for the greater portion of the vil-
lage the natural slope affords satisfactory drainage. At Buell and Chestnut
streets, however, the drainage is very poor. Natural sullies collect the rain
water from a large section of country and this is led by ditches terminating
in short lengths of tile drain to a catch pit located on the northeast comer
of Buell and Chestnut streets. A single drain leads from the catch pit to
Murder creek. This drain is entirely inadequate to handle the surface wash
from heavy rain storms. As a consequence the drainage overflows on the
adjacent property owned and tenanted by Mrs. E. M. Cox.
A cesspool on the property of Mrs. Ganyo on the west side of Buell street
opposite the premises of Mrs. Cox discharges into an open drain leading to
the catch pit mentioned. A well used as a cesspool on the property of Mrs.
S. J. Wiltse, located on the southeast comer of Buell and Chestnut streets,
discharges into an open drain on the south side of Chestnut street opposite
the premises of Mrs. Cox. This is piped under Chestnut street to an open drain
on the north side of Chestnut street adjacent to the property of Mrs. E. M.
Cox leading to the catch pit mentioned. This cesspool effluent, consisting of
sink wastes, remains often for weeks stagnant in the open drains. Putrefac-
tion ensues, giving rise to intensely disagreeable odors. During heavy rain
storms the drainage overflows on the property and into the cellar of Mrs. £.
M. Cox, carrying with it a large amount of this sink waste which is in a
very highly putrefactive state, giving rise to extremely disagreeable and un-
liealthy conditions.
The village board of health has served notices to abate these nuisances but
has failed to press the matter.
Murder creek, running along the southern and western sides of Akron,
receives a considerable amount of pollution. Tweaty-one drains from cesspoolB
and flush closets on the south side of Main street between Mechanic and
Church streets lead directly into the stream. A large number of privies are
located on a high bank on the south side of Main street about 100 feet from
Murder creek. These are in an extremely insanitary condition. Most of the
excreta is washed by the rains into Murder creek.
The general sanitary condition of the village is poor. The favorable loca-
tion of the village and a water supply which is almost free from possible con-
tamination have prevented any serious results from the existing insanitary
conditions. At the time of the inspection over a dozen cesspools were found
which were overflowing into open drains or directly into the street gutters.
This situation is to be deplored and forms a constant menace to the health of
the community. These pools of sewage, one of which was fromf a foot and a
half to two feet deep, two feet wide and over fifty feet long, besides giving
rise to disagreeable odors as the sewage undergoes putrefaction, furnish very
attractive feeding grounds for flies. The danger from these pests cannot be
minimized. Walking over and feeding on the sewage they collect on their
feet filth and disease germs and then fly to the kitchen, pantry or table, walk
over the articles of food, giving opportunity for infection of food. It is very
generally believed that a great deal of the residual typhoid results through
the agencies of these pests, aided by the insanitary practices of exposing
food and allowing such stagnant pools of sewage to accumulate.
One of the conditions in Akron that most needs remedying arises from the
use of wells as cesspools. This practice has become very prevalent. The
owner of one property having obtained water from the public supply turns
bis well into a cesspool. The owner of the next property is still using his
well for drinking water with the firm conviction that his supply is as good
as that of the municipality's or even better. Akron is in a limestone region
and one well almost invariably has a connection through fissures or cracks
with those about it. Sewage from the cesspool may find its way into adja-
cent wells making them deadly sources of infection.
The number of overflowing cessfools in Akron has constantly increased.
The unhealthy conditions arising from this makes the construction of a ccon-
prehensive sewerage system for the village of Akron a pressing necessity.
490 State Department of Health
A good map of the village showing the streets and houses has already been
prepared. Profiles of the streets must be obtained but with the data at hand,
the design of a complete sanitary sewerage system and sewage disposal works
would be comparatively inexpensive.
The village has a bonded debt of $39,000 and an assessed valuation of
$625,525. This leaves over $23,000 available for the purpose at hand, on the
basis of the limitation of bonded indebtedness to 10 per cent, of the assessed
valuation, available for the purpose at hand.
In conclusion it is evident from the foregoing that the insanitary conditions
in Akron are becoming so grave and the need of a sewerage system so urgent
that immediate consideration of sewage by the village authorities should not
be longer delayed.
The village of Akron should inunediately consider the drawing up of plans
for a comprehensive and modern system of sewerage with the view of dis-
posing of the same in the most approved manner, these plans to be submitted
to the Department for approval. It will be possible and feasible to build at
present, subject to the approval of the State Commissioner of Health, only that
portion of the works which is necessary from the standpoint of health and
economy.
I would, therefore, recommend that the board of trustees of the village of
Akron be urged to take up the question of sewerage and cause a compre-
hensive plan of sewerage and sewage di8{>o8al for the entire village to be pre-
pared and submitted for approval. With an approved plan on file such por-
tions of the system as might be found advisable to construct from time to
time could be added with the assurance that all expenditures would be in
harmony with a permanent general plan.
Respectfully submitted,
'HIEODORE HORTOX,
Chief Engineer
CENTRAL ISLIP (State Hospital)
A number of complaints of the insanitary conditions arising from the opera-
tion of the Central Islip State Hospital having been made to this Department,
an inspection of the disposal plant of tlie hospital was made by this Depart-
ment in conjunction with Mr. James H. Fuertes, Consulting Engineer of the
Central Islip Protective Association, which was one of the complainants. The
inspection was made on October 5. 1909. and a copy of the report of Mr. Fuertes,
together with a copy of the letter of transmittal of the Department to the
superintendent of the institution, is given below.
New York dry, December 6. 1909.
Mr. John H. Vail, Chairm<in Islip Protective Asaooiationy Islip, N. Y.:
SiB: — In response to your invitation I visited the Manhattan State Hos-
pital at Central Islip on October 15th, in company with yourself, Mr. B.
Welles, Mr. Eugene R. Smith, C. E., and Mr. C. A. Holmquist, Assistant Engi-
neer of the State Department of Health, to make an inspection of the sewage
disposal plant at the hospital and to observe its methods of operation.
Dr. G. A. Smith, the superintendent, being absent, we were accompanied on
our trip of inspection of the works by Dr. M. B. Heyman, who, on behalf
of the superintendent, tendered every courtesy and supplied us with all the
information in his possession. We were also accompanied by Senator Hubbs
and by the superintendent of the sewerage works.
After a general discussion of the situation with Dr. He\Tnan, in his office,
we visited the sewage pumping station of the North Colony, then passed
through the North Colony disposal fields to those of the South Colony, exam-
ifiing on the way the condition of these areas and the methods of distribut-
ing the sewage over the ground, and concluding our inspections by a visit to
the South Colony pumping station and sewage storage tank.
Sewkeaoe and Sewage Disposal 491
Description of Seioagc Disposal Plant
The State Hospital for the Insane at Central Islip is made up of two sets
of buildings, the original group, which houses about 1,5(10 patients, being
known as the North Colony, while the newer group, housing over 4,000
patients, is known as the South Colony. In addition to the patients there
are attached to each colony numerous physicians, attendants, foremen, servants
and laborers.
For several years the sewage from the buildings of the North Colony was
collected in an underground tank whence it was pumped to a pond covering
about an acre and allowed to soak into the ground. In 11)02 this pond was
done awav with by the construction of works, planned bv the late Mr. (leorge
VV. Rafter, C. K.
At the present time the quantity of sewage from the North Colony is esti-
mated by the superintendent of sewers to be about 75,000 to 100,000 gallons
per day. Ihis is disposed of by pumping it out to fields hating an area of
approximately 100 acres and scattering it over the area through some 40 2"
hydrants located at convenient places. A large part of the area receiving the
North Colony sewage is cleared and cultivated and readily absorbs the sewage.
All the sewage from the buildings reaches the pumping station in a fresh
condition, the sewers being relatively short; and, after passing through the
settling tanks, which holds al>out one day's flow of sewage is pumped by two
duplex double-acting steam pumps through a 10" force main to the irrigation
held. The sewage evidently* undergoes a degree of septic action in the tanks,
though the process is not pushed far. The tanks are cleaned out about once
every two weeks, the sludge being buried in trenches in the fields and plowed
under. The larger tank has screens which are cleaned oflf daily. No odors
are noticeable about the pumping station.
After reaching the irrigation fields 0" vitrified pipe distributors branch
from the force main, each distributor having connected therewith 2" hydrants
standing about 2% feet high above the ground, with a quarter-bend, on top,
from which the sewage discharges horizontally. Each hydrant has a control
valve and a nipple on the end of the quarter-bend threaded for 2" hose.
The sewage from the South Colony, from 200,000 to 3(10,000 gallons daily,
flows from the main mitfall sewer into a receiving or storage tank, about
lK)'x75' and 10' deep, situated at the edge of the swamp southwest of the hos-
pital buildings, at the headwaters of Winganhauppauge brook, which flows
into Great South bay just east of Islip. As it enters the tank the sewage
flows through ineflicient, unsatisfactory screens. The tank will hold nearly
two days* flow of sewage at the present time. Two 6" steam driven direct-
connected centrifugal pumps, in a small brick building by the side of the
tank, pump the sewage through a 12" force main to the disposal fields about
one-third of a mile to the enst.
The di8pf^Hal area for the J^outh Colony extends half a mile to the east of
Carlton avenue and is about one mile long from north to south. Its area
ifl approximately 300 acres. This, together with the disposal area for the
North Colony, which adjoins it on the north, gives a total area of 400 acres
available for sewage disposal.
The sewage is delivered upon the area through 2" hydrants, as in the
North Colony field, but instead of being cultivated the land is covered with
rather open timber much groiin up with underbrush, coarse grasses and ground
vine**. No great eff"ort is made to secure a proper distribution of the sewage
over this area, short ditches, perhaps ,50 to 7.> feet long, usually leading the
sewage to some depression from w^hich it can, in time, soak away. The hy-
drants are arranged along 6 lines of 6" pipe, running north and south from
the 12" force main, there being about 7 hydrants on each line to the south
and 5 on each branch to the north of the 12" force main. The arrangement
is irregular to correspond with the topography of tiie area. The land chosen
for the disposal area is particularly well suited to tbe purpose, being of
a sandy, gravelly nature and capable, if properly cared for, of receiving large
quantities of sewage. The disposal area is not artificially underdrained, the
Nnall quantity of sewage, and the porous nature <rf the soil, rendering this
unneeessary.
492 State Department of Health
The Method of Operation
The sewerage works are operated under the direction of a superintendent,
assisted by paid employees to run the pumps, at both the North and South
colonies, and a few of the bettor and more tractable patients. At the North
Colony pumping station the suction pipe of the pumps only extends down to
within about 8" of the bottom of the storage tank so that the sludge accu-
mulating therein has to be cleaned out about twice a year. The accumula-
tions when removed are. buried in trenches in the nearby fields. The larger
receiving tank is about 30 feet wide by 50 feet long and 10 feet deep and is
provided with a screen at the point where the sewage enters. The screenings
are buried. The small tank which is only about 3 feet by 5 feet by 20 feet
Jon^ is provided with screens. The pumps are in duplicate and are 7%" by
8^" by 10" duplex Worthington pumps. They are usually in operation
about 6 hours daily. The quantity of sewage received at this station is esti-
mated to be from 75,000 to 100,000 gallons daily, this estimate being based
on the amount of water supplied to the colony. The main delivery pipe to the
disposal field is 10" in diameter and the branches 6" in diameter. As ordi-
narily operated the sewage is discharged upon the ground for about a week
from half the total number of hydrants and is then turned on for a week
through those previously skipped, in this way giving the ground a chance to
rest &tween doses. As practiced, therefore, the sewage is discharged upon
the ground continuously for about 6 hours out of the 24 for 7 or 8 days in
succession, the land then being allowed to rest for a week before receiving a
further dose of sewage.
The writer understands that no trouble has been experienced with the
disposal area of the North Colony. This area is largely under cultivation
and the sewage is easily distributed so as to avoid nuisances.
The sewage from the South Colony enters the storage tank through screens
in a manhole at the center of the north side of the tank. The tank is in-
tended only for storage purposes and is pumped out once a day. The pumps,
of which there are two, are of the steam-driven centrifugal type with 6" dis-
charge. They are used alternately. The suction pipes extend down into a
sump to a level lower than the bottom of the storage tank; twice a month the
lank is pumped out completely and the sides and bottom washed clean with
a hose, the wash water being pumped to the disposal field in the same man-
ner as the sewage. Ordinarily it takes about three hours each day to pump
the sewage from the tank to the disposal field. This field is operated simi-
larly to the north field excepting that no attempt is made to secure proper
distribution of the sewage over the ground. The surface being more or l^ss
irregular and being covered in places with grasses, vines, underbrush, as well
as with saplings and large trees, makes an even distribution practically impos-
sible unless at considerable expense for superiiitendence ana labor. Pouring
sewage on the ground three or four hours a day for a week at a time, where
it collects in pools or lies stagnant upon the surface under the grass and
brush is not conducive to its proper, odorless absorption. At some of the
hydrants, undoubtedly, satisfactory disposal takes place, but at others dis-
tinct nuisances existed on the day of my inspection. It is easy to conceive
that in hot, humid summer weather, with an easterly breeze, disgusting odors
would be noticeable on Carlton avenue, while passing through the grounds
of the hospital.
I am informed that the screenings removed from the manhole at the storage
tank are disposed of by burial.
Causes of Unsatisfactory Conditions and Complaints
The complaints which h^ve been made against sewerage conditions at the
hospital have related to the foul odors, noticeable along Carlton avenue in
the summer time, and to the possibility that the prevalence of typhoid fever
in portions of Islip and the adjacent villages was attributable in some way to
the insanitary condition of the disposal fields.
The odors, as made apparent by an inspection of the disposal area, are
due to the improper operation of the works. It would be difficult to find more
Sewerage and Sewage Disposal 493
suitable conditions for the satisfactory disposal of sewage by broad irrigation
than exist at the Manhattan State Hospital at Central Islip. The ground
is sufficiently rolling to permit of the spreading of the sewage out over the
entire area, and yet not sufficiently steep to favor the washing of the sewage
into nearby water courses during rain storms; and the soil is particularly
favorable for the reception of moderately large quantities of sewage. The
total quantity of sewage pumped to the disposal area per annum would cover
it to a depth of about one foot. The average annual rainfall on the same
area is nearly four times this depth. There is no doubt, therefore, not only
that ample land is available but that the difficulty arises from the improper
distribution of the sewage. In some places the confinement of the sewage to
relatively small areas resulted in its putrefaction and the evolution of foul
and disgusting odors. This condition was in some localities much aggravated
by the presence of dense underbrush and close growing vegetation.
Fresh sewage has practically no odor. If the hospital sewage be J)roperly
spread out over the extensive area provided for it there will be neither odors
nor unfavorable consequences to fear.
It is stated that odors coming from the storage tank at the pumping station
have sometimes been noticed along Carlton avenue. I hardly believe that
this can be true if no improper practices are followed in regard to the manage-
ment of the tank. Objectionable odors may possibly be noticed when wash-
ing out the tank as a considerable amount of decomposition will have taken
place in the sludge upon the bottom and with the wind in the proper direc-
tion odors from tliis might be carried as far as Carlton avenue.
There seems very little probability that the waters of Winganhauppauge
brook have ever been directly polluted by the washing of sewage from the dis-
posal area into the brook during heavy rains in the summer time, or over
frozen ground in the- winter. The only avenue through which contamination
could take place directly from the disposal area would be through a very
gently sloping depression leading toward the swamp at the head of the brook.
In order to reach the brook by this channel of communication, however, the
surface water would have to cross Carlton avenue, and there- being no cul-
verts or bridges providing for drainage thereunder it is pretty certain that
direct pollution of Winganhauppauge brook from the irrigation fields is
impossible.
Faults in Management and Carelessness of Employees
Although I was informed that the screenings from the storage tank at the
South Colony pumping station were disposed of by burial on land, my personal
inspections revealed practices which should be stopped immediately. I observed
that it was the habit of the employees to rake the floating matter from the
surface of the sewage in the tank occasionally ; and marks where these rakings
bad been dragged over the top of the walls of the tank recently were plainly
to be seen. Eividentlv on some occasions tlie collections were sufficient in
amount to necessitate an attempt at more efficient disposal than letting them
drop on the ground outside the wall of the tank. In following paths around
throiJgh the trees and underbrush in the swamp, to the west of the tank,
numerous piles were found where this material had been dumped from wheel-
barrows. Several pits were also found in these wet bottoms where offensive
materials had been buried. Whether or not all the screenings were disposed
of in this manner I am not informed. I observed also that it is the custom
apparently to wash the screens across a ditch with a hose, the wash water
from the screen finding its way through the ditch directly into the head-
waters of Winganhauppauge brook. This practice, as well as the practice of
burying the screenings and rakings from the surface of the tank in the
swamp at the headwaters of the brook is reprehensible.
It is possible, although it cannot be proven, that some of the typhoid cases
in the vicinity of Islip may have resulted from this practice. Winganhaup-
pauge brook, within three or four miles of its source, empties into an estuary
of Great South bay at Islip. and I am informed that a considerable propor-
tion of the milk supplied to Islip comes from a dair>' farm on its bank. While
there is no direct evidence that the typhoid cases of last summer could be
494 State DKrARTMEXX of IIkaltii
traced to the use of the luilk from this farm the situation is sr.ffifieiitly sus-
picious to require that the State Hospital authorities exercise the greatest
caution to prevent the pollution of the hrook at its headwaters by the screen-
ings, washings from the screens and rakings from the surface of the sewage
storage tank, as well as from other direct sewage pollution.
Tlie typhoid fever cases in question occurred last August, there having been
several cases scattered about principally through the eastern district. Tlie
records of the hosjiital do not show any t>'phoid cases there just prior to that
time, although two cases developed during the first week in September. This,
however, is not conclusive one way or the other, as a comparatively large
number of typhoid cases in every locality are mild and are not detected. Such
patients, being only slightly sick, are in a conditi<m to spread the disease
through carelessness. In many of tlie typhoid epidemics that I have been
called upon to investigate the suspicion of an origin of this sort has been
strongly indicated. Hence, although no cases of typhoid were recognized
among the hospital employees or patients early enough to have accounted for
the cases in Islip, it may be possible that the cases which were finally iden-
tified in September may have resulted from an infection acquired from a
"walking case" at the hospital.
Milk epidemics are sometimes diflicult to run down, particularly where the
infection has been caused by the washing of the milk containers in slightly
polluted water. From such a cause general epidemics are not usual, a bottle
containing tj^lioid bacilli might, for instance, be left at one house, whereas
that left at the next, or at several succeeding houses, might contain no in-
fection whatever. Outbreaks due to the contamination of the milk directly
by polluted water are of an entirely ditFerent nature: these usually leave a
trail so plain that it can be followed without difficulty. The means by
which a mild milk epidemic might be started are various. Cases might result
from the washing of the cans or bottles with water that had been subject
to pollution; possibly a slight infection might result from the wading or
wallowing of tue cows in infected water, and the subsequent brushing of in-
fected dust from their bodies into the milk cans, by the swishing of their
tails, or by other indirect means.
Recommendations and Huygestiona
Mr. Rafter's report, which probably contained the principles of his design
and the method by which the disposal works at the hospital should be con-
structed and maintained, has not come imder my notice, but I feel quite sure
that the works have not been laid out and constructed, and especially not
maintained, in accordance with his original plans. He undoubtedly intended
to have the beds properly cleared and the surface properly prepared to receive
the sewage on the broad irrigation plan, or on the natural sand filtration
plan, eitber of which would have been successful, if properly maintained. In-
stead, however, the field was never even cleared, there being a growth of brush
upon it with pooling of the sewage and consequent occasional nuisances.
The present objectionable conditions can be overcome by properly preparing
the land and properly maintaining it.
This preparation of the land can be done by removing all brush and vege-
tation to prepare it:
a. For sewage farming, so-called.
b. For sand filtration proper, laying the surface out in beds with divi-
sion embankments and proper appurtenances for distribution.
Since the present area is large (if properly laid out, as above, a much
less area could be safely utilized) it would be wise to:
c. Discontinue the use of the present area nearest the rotidway and
confine the application of sewage to the j>ortion of the present disposal
field more remote therefrom.
There is necessity for greater cure in regard to the operation of the settling
tanks. There is no piirticular objection to oi)erating the tanks as eombination
settling and storage tanks, pro\'iding no opportimity is had for discharging any
of the sludge that would settle in the tanks to the disposal field as is now
yannnwK .til All JUkBCllkCSflm i^l^iilUlCaill] if tltt •gprnn^ 7f llltt )«fUfe. WlUIlL lUl|XiC
iii Cila- tifiii£ -wart d^itMiii :&i> iir^L TWi> *Liciita> nmfuil ic ijih g -wnuiL Ik
j^mniii'w 'Ui jnm^t mH- -flfiiuflic ('.an^niuiniti'^ ij< tin dififr'inn 7t(Trtiuiit> in ttu
■difigimmi imiL 3 Ihuh"^ iouc utuiiiH ouiii^ wnuii i*enii i ir h niiivt imrriiTiii
•iiaush 3uC «<«eiL )Hitrtiimt vI^llnul d-''ic.;uc liu iv^umn tiait*^ -m "Uuc oih onuiL
lit Ji iipwi-Xiiir VI. »t "UiM iiLinr i^u* imiitc ti4ei.ii*»L '.ti iiiit v'liuti. 3 an. n.
iirvur ic mmmxmmidm^ "lih dvmiia it: ciit iuih:* nm* m' i*tiiiniurxiiimt& itn
iji* jurniuw of CHJKXLiui: *ir. :: -llh- i;iii. nm »h amie *t: ir-nt-idmc: h t^jnrnef^
-to* iiuc *ia*r itPvi^R 1'OL.iL iH }Mntxi*i*L tlvwru^} ii- iiiH liiUL :iir "I^m mum "tnnt
a»«mifflO-^ "ti »ii»:iii lilt )re««in "Luiii^,. Ti.h- tilnn xnm ir uiiiiiicttLun of raw
■'.tut in.ii*n imu^iarDm 3*h.T>ii't ic ~i« }i"-t»«nn iUHn":iini if Tiit lI^^l01Ui.^ df
■i*»Tjdt «nm uiiL )»(H^iii 7 fiiuupt C.-^^'S '^ m xm su-num in ^m ^nmiL ihsot
Uk li«ut*v ut^ir*- iif ^"iU£ri-UAA-i'Jn»uu£H iirmit tutt tiimuiL lun »« iMnnmi't,
tiic tii«*t nuatTiuH' -hiiiiuu »« irtiiH*'*^ ^rvta ixiun "LUt ^iiinn ir mnw-pt ii*
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"VTU, ~in )i!***»«n ^Mnuiu'LMii i: -Liit iM»H]r-,i.. i.'Kwnir tut t "miui»'-ia< iiiii"^«M*t
11 "Lilt ii»^uT ticu'*- r nutratr 1*1 m *ut jtiwr. i.i*r. n-^ tc lat uititriudii. imwfvi** .
m » nifi in'oiowiIuH xiui iih imnnHi*-!- ir iH~M^n* uhl un^'iiuuiiTt- niw^ n 1
4*w T •ju'^ iii'r*nw*t TV'i ir ii.'^t**-ntiL Siunm tkh- ih -li»< riwf iih T^n<'* n-
id ini:K*»n lia-': iih irfwjin fn rfitm ir **"v m/» t^iiiuwi. v 1 im iiibjiiwiunn'^
iiic i*»".:uiw*^ ti* i'.r'' n*ii»»v»n": cm*'*'-':* 11 'Lif* r^'t<:vii jr iu"i ir -rtiifittM^ii" uti 01
vij'n 'VI tiw)M>t*t ir iiH -»'v lur?. lun mn*-* -.-jm *jm liifiii'i.tr' «r ■rtt»:'ii"nif, iniU'n
llw}fuift. ir #vv wift :: n- iit^'.'t*-^u~T n i;i vt ^ nii'iUiir^in uiu nun imim t'lu•*^
"* «in»»r'niv*niCi'!ii'**- •^"irir nfiri*"*: v.l tuniHmnH**- '^♦•iki*'' bi miH'-'V'h^f flfiit't*»ii:
liiBJiC iir.i 7 ii»*»fij'.;i*nT t.iit fin'Mr^ n iiwc- 1 iiumuirf, Ti^j*- h> iiu'^iruui"'*
"ini» vri r»Hri#»f«': ii !• n-:*' ir t;-}»»*^ "vi.i"! rfHii;.-* tin dwiM**^un ir tiH -sh^im*^
ifw** it.*ij* tj-*'ut- u' iT'ouiiL \iiiiiKnr')iitt- um. *ut":i*nur*HTrT dmiM»Ki. tr tih -rtpw
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\r' juMiT ir* t i.iiTii^ frntH "iiii:i n- It iw iinnit ii'-diiui''>7 " «**^'tiiiL innucii^
V 111* jpnj»**i '•; u.Kt iiTijt *'tii': .iiuouh iititrf^ 11 tin vii**t v'in"i. xim^ iiT<-
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tr.ut « ti+ iv' '-in ^*'n "4 iira *v i ^»»~- uiL \n.^ut*. 4. -hh ir sirMii. :nir t.M<»*v laiL
^ Kiv ■ •' ^miiijt'ii;. H^r*i'»] '»» piin.i ^1H ***•- ».h **{^v lu/t n in t^ir'inLhiLC l..iifi*is.
TutM** 1 IV''> V .ti.ii 'iHiN.'" <r tM';;*' iT "iJi '•»< <M)ii"^ TJtnii*— it' ;ii' -Hixt o'-diuu'^i'T
u«»H :i •n»u'-*'i* ' n» u^u^ i»»':iti "*>" i^< n I'M J**i'" 11 n")t:i. u«MH»iu:nvr in»m
ittKV.f^'A til* l»"»i.»-l h: ntHh ' ii» H"V .^r# >r ♦■Mmw"! Ii -|m i..' 11 y \«»-' XKH.
l.in. iiiit '.»»♦ 'i.i ' ti*-.*** t»' Mi*^ iri:Ki !• na**"' u '.m ri*'v i^lm ir "iikiu?**( nr xtun
^*v^ J*:!'" iJt Ml* 1 .*" f r: t- iiir n 1 riuiu 'un ii iiiiu«'~ir» **xiit.*M(,iH.|^ inim-
Iti'-.i^i. *>ii'i «i t'ftiiiMii: "ini I ih »,)-.**• mn^'f n"«r. -|,, ^,-«»^,jn- t:t-*iii»>j u""«fc
T rM in (Ulli'n *' ' I • *|j*"» V n -: Im irt .:K*ijn»(u ii" * h« t^'u K"i.n <r ui-***
^3w»n-i«i» u'ivt'p n»" • • ini * !•• tn " nir.viri.iiK )ti>--iiii.. -' i»"nir ^lli;^ c u*
iviv.4n ;i * t i*^" I ^#vn. ' in *iK e.ii-*;n"t ur ui '' '•.niiiu»"'-t.iiH i*««-i lu fni"! itdnh-
496 State Depaktmext of Health
Since the art of sewage purification is in a state of development, there being
yet much room for improvements over known tried methods, it is possible
that some process may come to light which would be more satisfactory than
the suggested sprinkling filters for the future treatment of the hospital sewage.
I may say, in a general way, that no method of chemical treatment, barring
perhaps some future development in sterilization and disinfection, would be
applicable in the case under consideration.
My recommendations, in brief, therefore, are:
As TO Changes and Improvements in the Works to Provuie for a Reason-
able Increase in the Population at the Hospital
1. Abandon the use of the hydrants in the two lines of distributing pipes
nearest to and parallel with Carlton avenue.
2. Prepare about ten acren of the disposal field for sand filtration by
laying out the surface in beds, with embankments between, locating these
beds where the character of the soil is most suitable and where the topog-
raphy lends itself properly to such treatment, in order to provide for
proper winter disposal.
3. Clear the balance of the area of the disposal field, except the portion
to be abandoned, by the removal of all brush and vegetation except the
trees, which need not be disturbed.
4. Divide, the sewage storage tank at the South Colony works into two
parts to better facilitate the handling of the sewage and the cleaning of
the tanks.
5. It is my understanding that plans for the necessary works would
be prepared by the State Department of Health; if not, then the hospital
authorities should have the preparation of the disposal fields, and the
other alterations sugirested, carried out from the plans, and under the
general supervision of an expert in sewage disposal matters.
As to Improvements That Mny Be Required in the Future
6. If it be found that the changes and improvements above suggested
prove to be in sufficient in the future, further additions should be made
to the plant so as to secure a nonputrescible effluent to pump to the dis-
posal field. The installation of sprinkling filters would secure this end.
As to the MainteTiance and Operation of the Plant
7. Have the expert who prepares the plans for the suggested changes
give proper and detailed written instructions to the superintendent of the
hospital as to the proper method of operating the works, and give his per-
sonal attention to its operation until the employees are sufficiently skilled
to manage the works. Allow this expert to keep in touch with the opera-
tion of the plant, through the medium of occasional visits, for such time
as may be necessary to insure their proper management.
8. To meet the immediate necessities, the practices with regard to the
disposal of scum, sludge and screenings must be changed to avoid any pos-
sible contamination of the neighboring streams.
9. Any available labor should be utilized in clearing out underbrush
and weeds, and an effort should be made to get a better distribution of
the sewage over the ground than now obtains, pending securing appro-
priations for the permanent improvement of the works.
Trusting that the foregoing suggestions will be of value to your association.
Respectfully,
JAMES H. FUERTES
Sewerage and Sewage Disposal 497
Albany, N. Y., January 15, 1910.
G. A. Smith, M.D., Superintendent Central lalip State Hospital, Central lalip,
N. v.:
Deab SiB: — ^I beg to call to your attention and to take up with you the <jues-
tion of securing some relief from the present insanitary conditions arising
from inadequate means and operation of the sewage disposal plants of the
Central Islip (Manhattan) State Hospital at Central Islip.
These plants have at times, and especially during the recent past, been the
cause of a number of complaints of the residents of Central Islip and of other
persons who have to use the highways which pass in the vicinity of these
plants. The conditions surrounding these plants and the methods employed
in their management and operation have been carefully inspected not only
by engineering representatives of this Department, but also by an expert
engineer employed by the Central Islip Protective Association, the members
of which are particularly affected by the insanitary conditions arising from
these plants and which are especially interested in having these conditions
improved.
The inclosed report. of Mr. James H. Fuertes, consulting engineer for this
association, covering a careful investigation made by him of the construc-
tion and maintenance of these disposal plants is accordingly submitted for
your careful consideration. The inspections made by Mr. Fuertes were made
in company with one of the engineers of this Department, and during the
preparation of his report and before expressing the conclusions and recom-
mendations contained therein he conferred with this Department in order
that these conclusions and recommendations might be in acc6rdance with the
views and opinions of the Department.
This report has been carefully reviewed by our chief engineer, and since
the recommendations concerning the changes and improvements which should
be carried out in order to remove the insanitary conditions surrounding these
sewage disposal plants are in full accord with his views, based upon the in-
spections and investigations made independently under his immediate direc-
tion, I wish to express my approval of it and refer it to you for your careful
consideration and action. You will note that the report calls attention to
certain defects in the construction of the septic tanks and in the layout of the
filtration fields, which make it difficult, if not impossible, to operate the
plant efficiently or without producing at times a nuisance in proximity to
them. The changes or modifications in construction and arrangement of these
plants necessary to remove these difficulties and permit of the efficient and
sanitary operation of them are embodied in the recommendations contained
on pages 18 and 19 of the report, and it is to these recommendations that I
would call your particular attention and consideration, and ask that your
board of managers take suitable action to secure the necessary funds to
carry out the changes and modifications recommended.
I wish in closing to call attention to a slight misunderstanding concerning
the suggestion made in recommendation No. 5, page 18, of the report, that
plans lor the necessary improvements be prepared by the State Department
of Health. As you probably well know, this Department is not in a position,
nor has it the funds, to undertake the preparation of such plans. Plans for
such work are now prepared by the State Architect, and 1 would, therefore,
suggest that when suitable action has been taken, authorizing this work of
construction, that he be requested to prepare the necessary plans.
Trusting that this matter will receive prompt consideration and action
by you and the board of managers of your institution, and that you will
kinaly advise me of the action taken, I beg to remain.
Very respectfully,
EUGENE H. PORTER,
Commissioner of Health
498 Statk Department of Health
CHEEKTOWAGA
Complaint having been made to this Department of the insanitary condi-
tions existing in the town of Clieektowaga, ne«r William and Kennedy road,
due to improper sewerage facilities, an inspection was made by the engineer-
ing division on SeptemSer 15, 1910. The findings of this inspection are dis-
cussed in the following letter, copies of which were also sent to the
complainants.
Albany, N. Y., September 20, 1910.
Dr. Fbancis E. Fbonczak, Health Officer, Town of Cheek towaga, 806 Fillmore
Avenue, Buffalo, X. Y,:
DcAB Sir: — In reference to the insanitary conditions existing in the town
of Cheektowaga, near William and Kennedy road, I beg to state that through
the recent inspection of this district made by Mr. H. B. Cleveland, Principal
Assistant Engineer in this Department, I learn that urgent need exist* for
the immediate construction of a sewer system in this section of the town either
or for prompt action by the town board in abating the extremely insanitary
conditions now existing and menacing the health of the residents of the town.
The members of the town board and the board of health will recall that
this matter has heretofore been the subject of investigation by this Depart-
ment, and that a previous communication has been addressed to the board
outlining the steps which should be taken to secure proper sewerage facilities
for this district.
It appears that the overflow from the cesspools on the grounds of the
Felician Sisters' Asylum — an institution accommodating 400, and at times
800 persons — finds its way into the gutters and road ditches and from these
ditches overflows onto private property in the neighborhood, thereby creating
a decided condition of nuisance and setting up a menace to public nealth.
I understand that the town board are intending to at once take the proper
steps leading to an abatement of the present conditions, and wish, therefore,
to point out the procedure to be employed.
It is evident from an inspection of the territory aflfected that the conditions
as to the character of the soil and the high ground water level render the
disposal of sewage by cesspools unsatisfactory and insanitary luiless the
town board of health is compelled by the gravity of the situation, due to
the present insanitary conditions, to take action in correcting these condi-
tions that will virtually proliibit the use of inside flush closets in a district
enjoying a public water supply, arrangements must be made for, and the
residents and taxpayers must unite in, the construction of a public sewer
system.
It is apparent tliat a sewer district should be established in this section
of the town since the furnishing of sewerage facilities is the only feasible
and economical means for elTecting an improvement in sanitary conditions.
Such a district may be established by the town board under the authority
granted by article 24 of chapter 62 of the Consolidated Laws or under the
provisions of article XI of said chapter, and I consider it advisable in every
way for the board of health and the town board to at once take steps for the
establishment of such sewer district.
The engineer employed to draw up plans for sewerage and sewage disposal
will, of course, miike the necessary surveys and secure data as to elevations
and available routes for main trunk sewers and a site for sewage disposal
works in order that plans may be prepared and presented to this Department
for approval.
The plans for sewerage should be accompanied by plans for sewage disposal
and, while such sewage disposal plans should show complete treatment works,
it is possible when the local conditions have been studied and presented in
the report of the designing engineer, that approval would be given to such
plans with the understanding that only a portion of the disposal works need
i>e constructed at first.
Skwekagk and Sewage Disposal 499
Further, while the plan for sewerage should include sewers in all developed
streets in the sewer district to be formed, it would probably be desirable to
construct only the main trunk sewers and more important laterals at first.
In this manner the first cost of construction may be reduced to a minimum
and at the same time assurance will be had that such sewers as are con-
structed will form a part of a comprehensive sewer system for the sewer
district as ostablishetl.
Trusting? that early action will be taken by the town authorities and assur-
ing the board of the co-operation of this Department in any way possible, I am,
Very respectfully,
ELGENE H.PORTER,
Vommisaioticr
CORNWALL-ON- HUDSON
C^omplalnt having been made to this Department of insanitary conditions
duo to improper aewage facilities at Cornwall-on Hudson, a representa-
tive of the engijieering division visited the village on August 3. IIHO. The
findings of the investigation made by him are discust^ed in the following report,
a copy of which was sent to the village authorities on August 27. 1010.
Albaxy, X. Y., August 27. 1910.
Eugene H. Pokter, M.D., iitate Commiasioner of Health, Alhani/, X. Y.:
Dear Sir: — 1 l)eg to report on an inspectitm made by the engineering divi-
sion in the matter of insanitary conditions in the village of Cornwall-on-Hud-
son, with special reference to the needs of the village for sewerage.
On August 3, 1910, in accordance with your orders, I caused an inspection
to be made uf the insanitary cmiditions which obtain in the village.
This inspection was made by Mr. A. 0. True, assistant engineer of this De-
partment, who was accompanied by Mr. L. S. Ooodenough, the president of
the local board of health, and Dr. P. R. Bowdish, the health oihcer.
As stated in the report of this divi^sion, under date of February 3, 1908.
Cornwall is furnished with water from a public supply obtained from moun-
tain brooks. There is, however, no system of sewerage in the village, and the
sewage, consisting mainly of sink wastes, is diM'hargod into cesspools on the
premixs. Outdoor privies with iMTraanent vaults are provided on most of
the premises, though some have water-closets. Due to the nature of the
ground in the center of the village, which consists of on an average of seven
or eight feet of soil underlaid with rock, and the proximity of the cess-
pools, of which there arc many in the center of the village, the soil has
become p(dluted and in ^^ome places saturated with the leachings from these
pits. The result is these cesspools Jill ra]>i(lly and overilow and re<iuire fre-
quent cleaning.
In the center of the village wlere tlie premises are small and the houses
built closely together the privies are of necessity close to the dwellings. In
many instances the privies are in an insanitary condition. Inking unprotected
from (lies, and show evidence of neglect and infrequent cleanin'?.
I have been convinced for M>nie time ]>ast of the urgent ntH'd of a system
of sewerage for the village of roruwaIl-on-Hu<ls<m, antl tlie detailed report
of the assistant engineer on the condition.s above (mtlined indicates the neces-
sity for eliminating tlie undesirable methods now in use in that village for
the disposal of dangerous wastes. Tlie (|uehti(ni of ])roper and adecpiate sewer-
ago is very essential to the future welfare of the village on l)oth sanitary
and Oi'onomic grounds, and should not, therefore, be neglect<'d.
Plans for a coujorehensive system of si-wera^e for (ornwall have already
been approved by this Department, which would provide a modern sanitary
and economic method for the disjMJsal of the sewage of the community.
500 State Department of Health
In conclusion, I recommend that copies of thk report be transmitted to the
board of health and the trustees of the village of Cornwall-on-Hudson, and
that the latter be urged to consider this matter and take definite action with
view to constructing a sewer system which will undoubtedly be an asset to
the village from the standpoint of health and economy.
Very respectfully,
THEODORE HORTON,
Chief Engineer
EAST SYRACUSE
Albany, N. Y., October 27, 1910.
Eugene H. Porteb, M.D., State Commissioner of Health, Albany, N, Y.:
Deab Sib: — I beg to submit the following report on an examination of
amended plans for sewerage and sewage disposal for the village of East Syra-
cuse, Onondaga county, submitted to this Department for approval by the vil-
lage clerk on behalf of the sewer commissioners on October 3, 1910.
The records of the Department show that plans for sewerage and sewage dis-
posal for the village were approved on December 21, 1900, and that amended
plans for sewage disposal were approved on November 11, 1904. Both of
these plans provided for pumping and final disposal of effluent into Butter-
nut creek to the east of the village. The sewer system, sewage disposal plant
and pumping station were constructed but, owing to the large amount of infil-
tration of ground water into the system and the consequent excessive cost of
pumping, it was deemed necessary by the village authorities to provide for
some other means of disposal.
An application was submitted, therefore, to this Department by the sewer
commissioners of the village on February 19, 1908, for a permit to discharge
sewage into Marcey creek which flows through the western section of the
village. On March 7, 1908, the engineering division made an inspection of
the construction and operation of the sewerage system and as a result of this
inspection recommended the construction of a gravity system with disposal
into Marcey creek, also pointing out that this procedure would involve the
construction of an intercepting sewer in the southern portion of the village.
Plans for sewerage and sewage disposal, prepared in substantial accordance
with the recommendations of this Department were approved on February 18,
1909. These plans provided for a permanent sewage disposal plant to be
located near the intersection of James and Manlius streets and beyond the
northerly corporation line, and provided also for the construction of a tem-
porary settling tank near the freight branch of the New York Central and
Hudson River railroad, with temporary discharge of effluent into Marcey creek.
The permit issued in connection with the temporary settling tank provided
that the permanent sewage disposal plant, shown by the plans approved on
February 18, 1909, shall have been constructed and put into operation on
or before March 1, 1914.
The amended plans recently submitted for approval and now under consid-
eration show that it is proposed to construct two permanent settling tanks
near the intersection of Elm and Maple streets with a temporary outlet into
Marcey creek above its confluence with Headson creek and some 800 feet above
the proposed location of the temporary settling tank which it is understood
has not been constructed. These plans also provide for the ultimate extension
of the effluent pipes from the proposed settling tanks to the contact and filter
beds to be located north of the village.
The plans as presented are not satisfactory either from a sanitary or eco-
nomical point of view inasmuch as the proposed point of discharge is into
Headson creek above its confluence with Marcey creek where a smaller degree
of dilution would be obtained and therefore be more liable to create a local
nuisance in the stream below the proposed settling tanks and, since where a
gravity flow can be obtained, two disposal plants are more expensive both to
eoBstruet and to operate than otxe jilaui, Tliff iw^ jy/tlioiiv ^ i^u^'it }M*r
^■*«r^«^ 4i^KMa] plant, i. «.« k^liuif iaiik* «t>/i IIHw U'^Jr. »# ^fvwWJ i*^
by Ibese plaju, will \>t* m* trid^'Jv' »*»'}/tiniU»d «« to »1))J fiiHlt**r /imm-ha*' ilu
eort -of operatioD and «jIJ at tl>«' taiAi*' tiiiM' f>'o<J Vt /wju*-^ ih*' t'fti< mih^ «/f ^I^a-
plant.
It appears, thendor**. iliat ai/v <Kirtj*-1 nn'l *«*ii </f u |>^#*jii5»«*iii iit*»ii»i »l*«/*-I'l
be in aooordaiMe vitb ihit piaii* Jipi^rw*^ ity Hu iM-yutimi^iti t^t i i'hru»tf )>■
1909, JB Tiew <rf tlie car*^tij wtudy tlutl >ftti# BtwU- vf u**- j*M>oii'in i*</*i) *» <»**
tune «f tbe iiutpeelMiii of the ii*-«»-r KttfU^i^ </( tit*' tjn»>;» uu<\ v^ (ti* < uii* </f
mtHMm i4 tbt; aypr<n«i<J yljiii* yM*'ff*yl to.
L. tbereiore. Iit^r tu r43*?uiuHkHuc ii;<t lu^ vn^ii'^'^l ymut i^*- <!i«4i)/|rtv^'^<^ ift««'l
tamed to tbe iHiaj^f «irtlM/rrt>*^,
iUsKy^fi* til ■ r<J*iJl ^ >'
la acBBB daii*3tr ■» iti tii*- ♦«;*wtiin>-iiOi*'ivt * *y 't If ♦•-)>'/*'* *i»* j/»«'fu' r***« ''u-
GEXEVA
Tl^ •^•♦*«t*!» •^n.' ' /<««* »r.»-'* #</•*; '-' «f*.»-' * «.♦ a i r • t'.*<^ • 'f *f ' ^ w *'
ff* pnstti* »• ''!,*■ .a'A 1/-' *' u jj^*. ' i ♦ «.* .j' ' » •' * • ,*!.>' .'^ .*'v*f
r,hvrii';wA
-5* '
•r -^1 ' - . .- -
50^ State Department of Health
•
sary for the realty company to arrange with the village whereby application
for the approval of plans would be asked for by the village so that some guar-
antee be given to the 8tate Department of Health that the proposed system
of sewers and sewage disposal plant would ultimately come under the super-
vision of the village and be properly maintained by it.
Ihe inadequate capacity of the proposed contact beds and sand filters to
properly care for the future contribution of sewage was also discussed with
the engineer. Amended plans and application by board of trustees of the vil-
lage, asking for the approval of such plans for sewerage and sewage disposal
for Hudson Heights, were subsequently submitted for approval and approved
on September 22, 1910.
Plans for sewerage and sewage disposal for this sewer district, prepared
by the Starr-Patterson Engineering Company, were also submitted for ap-
proval, but owing to certain defects the plans were returned to the designing
engineers for , revision. These plans had not been resubmitted by the end of
the vear.
LONG BEACH
Request having been made by the engineer for the Long Beach estates that
the Department make an inspection of Long Beach, in reference to the pro-
posed sewerage and sewage disposal system, and to advise him in the mat-
ter, the Chief Engineer of the Department visited Long Beach on January 7,
1910, and in company with the local engineer inspected the conditions of the
new channel on the north side of the island and conditions of the surrounding
beaches.
It was suggested to the engineer that an investigation be made concerning
tidal flows to show the feasibility of disposing of sewage intermittently at
high tide and determine if the sewage would be carried out to sea so as not
to return on the incoming tide.
Plans for sewerage and sewage disposal for Long Beach were later sub-
mitted for approval and were approved on March 16, 1910.
MARTVILLE
On May 3, 1910, application was received by this Department from George
L. Gove, president of the Martville Dairy Products Company, asking for a
permit to discharge waste from the creamery of such company at Martville
into Little Sodus creek. This application was denied on June 30, 1910, pend-
ing the submission of plans for treatment of the wastes. Xo plans had been
received by December 31, 1010.
MORRISTOWN
On June 23, 1910, application was made to this Department by Frank L.
Scott, village clerk of Morristown, for the approval of plans for two pro-
pased private sewers in tlie village, j'his application was denied on June 28,
1910, on the ground that the ])lHns did not provide for a compreliensive sewer
system to be constructed l)y tlie proper municipal authorities as contemplated
by the provisions of the Village Law. The village authorities were urged
to have prepared a comprehensive plan for sewerage and sewage disposal, and
it was pointed out that the construction of a pu])lic sewer system would afford
the best solution of the prohlcui of abating tlie insanitary conditions caused
by the use of cesspools.
Sewerage and Sewage Disposal 503
On July 11, 1910, application was made to this Department by Alexander
I/. Lyman, general attorney of the New York Central and Hudson River Rail-
road Company, asking for permission to discharge sewage into the St. Law-
rence river from the railroad station of said company at Morristown. This
application was denied on July 13, 1910, on the same ground as that sub-
mitted by the village referred to above.
NEW PALTZ
Requej^t having been made by the local health officer that the Department
inspect the sewerage conditions of the village, a representative of the engi-
neering division visited New Paltz on September 13, 1910. The findings of
this inspection are discussed in the following letter.
Albany, N. Y., October 4, 1010.
Mr. William Kaiser, ticcretary Board of Health, AVtr Paltz, N. Y.:
Deab Sir: — I am addressing the board of health of the village of New
Paltz for the purpose of bringing to the attention of the village autliorities
and of the citizens of Xew Paltz the urgent need that exists for the con-
struction of a modern system of sewerage and sewage disposal for tlie village
in order that much needed improvement in the general sanitary conditions of
the village may result and the pollution of the ground water, forming the
source of supply for many wells in the village, may be lessened.
It appears from the results of the inspections made on September Ist by
Mr. L. M. Wachter, Chief Sanitary Chemist in this Department, and on Sep-
tember 13th by Mr. H. B. Cleveland, Principal Assistant Engineer in this
Department, that many instances of insanitary conditions exist in the village
which would be entirely removed by the proper development of the sewer sys-
tem of the village.
Laundry and sink wastes are now discharged into gutters at several points
and decided conditions of nuisance are created. Furthermore, from the evi-
dence afforded by the analyses of well waters made by the State Hygienic
Laboratory in connection with the recent prevalence of typhoid fever in Xew
Paltz, and from a study of the topographical and geological conditions in
the Tillage it appears that the present insanitary method of disposing of sew-
age and household wastes over a large portion of the village results in seri-
ously polluting many of the private wells on which the owners depend for
water supply. This menace to health would be greatly lessened if proper
sewerage facilities were afforded throughout the village.
Plans for sewerage for the village of New Paltz were approved in 1892 by
the then State Board of Health. These plans showed sewers in nearly all
the developed streets in the village, but provided for two separate outlets into
the Wallkill river, one at the Alain street bridge, and one opjwsite the old
Normal School site. While this system of sewerage was not constructed, three
separate sewers have been built from time to time, one in Main street dis-
charging into the river at the Main street bridge, a second, the Hasbrouck
sewer, being an extension of the old Normal School sewer, and third, serving
a section south of Main street.
It would be necessarj' at the present time to slightly revise the plans
for sewerage in order that all sewage might be carried to one point favorable
aa a site for sewage disposal works, but the cost of having plans prepared
would be comparatively slight and \*ith a general plan prepared, incorporating
such of the present sewers as misrht be found feasible, advantage might be
taken of the provisions uf the Village Law relating to sewerage to construct
only the more necessary extensions to the sewer system. In this way the
expense to the taxpayers involved in a proposition for the construction of
sewers, which must be submitted for their ratification, would be reduced to
504r State DEPAEXArENT of Health
a miuimum, although vast improvement iu sanitar}' conditions would result
from the construction of the sewers and assurance would be had that what
sewers were constructed would eventually form a part of a comprehensive
system for the entire village.
I trust that your board will at once recommend to the board of trustees
that they take this matter up and arrange to submit to the taxpayers a plan
for providing better sewage facilities in the village of New Paltz, thereby
eliminating as far as possible the present insanitary and oostly means for
disposing of sewage and household wastes and placing the village in better
sanitary condition.
Assuring your board and the board of trustees of every assistance within
the power of this Department in bringing about this important and necessary
public improvement, I am
Very respectfully,
EUCrENE H. PORTER,
Commissioner of Health
NYACK
Albany, N. Y., August 26, 1910.
Eugene H. Pobteb, M.D., State Commissioner of Healthy Alha^ny, N. Y,:
Deab Sib: — I beg to report on an investigation made by the engineering divi-
sion in the matter of certain insanitary conditions existing in the village of
Nyaxjk, Rockland county, which were brought to the attention of this Depart-
ment by the local health officer, and two of which were the subjects of com-
plaints by citizens of the village.
On August 3, 1910, I caused an inspection to be made of the several locali-
ties in question by one of the assistant engineers of this Department. In
this inspection he was assisted by the health officer of the village of Nyack.
These places are designated in the report of the assistant engineer as follows:
Privy on premises on Liberty street, occupied by a tenant by the name
of Kittle. The cause of complaint made by Mr. George Gates.
Privy on Depew*s property on the west side of Mill street, corner of
Depew avenue. The cause of complaint of Mr. W. B. Coleman.
Five bungalows, located on unaccepted street on north side of Sixth ave-
nue, west of Broadway on the hill, and owned by Townsend Brothers.
Brook which flows from Burk's pond through the village to the Hud-
son, a distance of about one and one-half miles. Privy on premises at 151
Cedar Hill avenue.
The privy on the Kittle property on Liberty street is located in the rear
boundary of the property some 30 feet from the house and about 30 to 60
feet from the neighboring houses. The vault was, as far as could be seen,
built of brick rather loosely laid. There was considerable odor and it ap-
peared as if no care had been exercised in either cleaning the vault or apply-
ing any earth, ashes, or other deodorizer.
The privy on Depew's property was found to have been abandoned, and at
the time of inspection was filled in with coal ashes. The place was some-
what unsightly in appearance, but there was no appreciable odor in the
vicinity.
Insanitary conditions were found to exist upon and in the vicinity of the
premises of the five aforesaid bungalows, located on the hill west of Broad-
way. The village sewerage, though serving the noighlx>ring streets, does
not extend up as far as the five bungalows. They are supplied with the
village water, but they have no water-closets. In each building the sink
water is conducted by water pipes to the privy vaults located some thirty feet
from the houses. Several of these waste pipes apparently are not provided
with any traps. The privy vaults are in an insanitary condition. They are
not watertight nor properly inclosed with brick or stone. They fill with
Seweiuoe and Sewage Disposal 505
water from the sinks and overflow, carrying the excremental matter in a
stream near the surface and onto the adjacent property. This condition ob-
tained at one of these buildings at the time of inspection. These insanitary
vaults are not protected from flies.
The brook from Burk's pond was examined for several hundred feet in the
rear of the premises bordering on Main street. Along this section of the
stream many waste pipes are discharged directly into it, and its bed is foul
from deposits of rubbish, ashes and garbage thrown from the adjacent prem-
ises. The water is thereby polluted, foul-smelling and unsightly.
Examination was made of the privy vault on the premises at 151 Cedar
Hill avenue. South Nyack. This vault is built of brick, laid in cement, and
was in a sanitary condition at the time of the inspection.
In conclusion, I recommend that a copy of this report be transmitted to
the board of health of Nyack and that their attention be called to these in-
sanitary conditions here existing, and the urgent necessity of immediate action
for their abatement.
Very respectfully,
THEODORE HORTON,
Chief Engineer
On August 26, 1910, a letter, inclosing a copy of this report was addressed
to the president of the board of health of Nyack, urging them to take immedi-
ate action to eliminate the unhealthy conditions descrilJd therein.
PHELPS
On June 13, 1910, an application made to this Department on November 30,
1909, by the Empire State Pickling Company, of Phelps, for a permit to dis-
chartre wastes from the sauerkraut factory of said company into the waters
of Flint creek, was denied, on the ground that the most effectual way of
solving the problem of properly disposing of the wastes from the factory
would be by the construction of a modem system of sewerage and sewage
disposal by the proper village authorities.
It was pointed out that whereas, under the Village Law, it is necessary
that the plans for sewerage should provide for sewers in all streets of the
village the same law provides that the construction of certain portions of
the system may be deferred on the approval of the State Commissioner of
Health, and that in this manner the initial outlay in the development of a
comprehensive sewer system may be reduced to a minimum, while by the
construction of necessary portions of the system many problems relating to
the proper disposal of sewage and wastes now confronting alike the board of
health, the manufacturinj? concerns, and private property-owners in the village
mav be satisfactorily solved.
On June 13, 1910, the application made to this Department by the Phelps
Dairy Association for a permit to discharge wastes from the Phelps Creamery
i»to Flint creek was d€»nied for the same reason that the application by the
Empire State Pickling Company was denied.
PORT JEFFERSON
Request having been made by the local board of health that the Department
make an investiaration of the insanitarv conditions existing at Port Jefferson,
due to the unsatisfactory sewerace facilities, and to advise them in this mat-
ter, a representative of the engineering division visited the village on June
30. 1910, and looked over the sewerage conditions with the town health officer
and the chairman of a committee of citizens.
The provisions of the law relatinir to the establishment of sewer systems out-
side incorporated villages were explained to the committee, and it was pointed
506 State Department of Health
out to them that after the establishment of a sewer district and sewer com-
mission by a petition to the town board and the approval of plans by the
^tate Department of Health the commission could make application to the
State Commissioner of Health to temporarily defer the construction of por-
tions of both the Fewer system and sewage disposal plans shown by such
approved plans.
The need for a sewer system wa^ pointetl out to the committee and they
were urged to take up the circulation of a petition for the establishment of a
sewer district.
RAVENA
At the request of the local board of health the Chief Engineer of the De-
j)artment visited Ravena on April 12, 1910, and looked over the sewerage con-
ditions of Ravena and Coc\vmans with the town board. He also gave aji ad-
dress before the taxpayers in the community on the general question of
sewerage, its needs, functions, etc. The local problem was discussed and a
general estimate was made as to the probable cost of a sewerage and sewage
disposal system.
RAY BROOK
Ketjuest having been made by the superintendent of the State Hospital for
Incinient Tuberculosis at Ray Brook that this Department make an inspection
of the operation of tlie sewage disposal plant installed at this hospital, a
representative of tlie Engineering Division visited Ray Brook on October 6.
1910. The findings of this inspection are discussed in the following report,
copies of which were sent to the superintendent of the Ray Brook hospital
and to the Fiscal Supervisor of State Charities on October 31, 1910.
Aldaxy, X. Y., Ocioher 31, 1910.
EiGE-NE 11. PouTHR, ^LD., State Commiasiotter of Health, Albany, N, Y.:
Dear Sib: — I beg to submit the following report on the operation and
efficiency of the sewage disjiosal plant at the State Hospital for Incipient
Tuberculosi?* located at Ray Brook, X. Y., this plant having been carefully
inspected bv Mr. Fritz X. Arnolt, Inspecting Kngineer with this Department,
on Octolwr'U, lUlO.
Plans were approved by this Department on October 20, 1903, for a settling
tank as a preliminary part of a complete sewage disposal system. The tank
was built as plannetl, the effluent discliarging into lines of sewer tile drain
placed a few inches below the surface of the ground. This system proved in-
efficient, and the conclusion was reached that the conditi(ms arising at the
plant were offensive and prejudicial to the hospital inmates. On June 25,
1906, plans for the exterusiun and improvement of the system by the con-
struction of a dosing chamber with automatic and intermittent siphons and
two sand filter beds of about % acre each were submitted to this Department
and approved by it. An additional settling tank and another filter bed of
about Mi acre were constructed about a year ago. Xew siphons and two new
filter beds of about % acre each have been installed and constructed this
siunmer. At the time of the inspection the two new filter beds although com-
pleted were not yet in operation. Xo plans for the improvements and ex-
tensions put in since 1906 have been submitted for approval to this Depart-
ment as required by section 14 of the Public Health Law.
The original settling tank is the only one used at present. This has a
working capacity of about 10,125 gallons. The present population at the
hospital is about 250. Allowing 100 gallons per capita per day as the water
consump^tion, the daily quantity of sewage entering the plant is about 25,000
gallons. This allows a detention ])eriod in the tank of about nine and one-
Sewerage and -Sewage Disposal 507
fourth lK)ur.«». The effluent from the nettling tank pa>*seii into the dosing cham-
ber, which has two biphouB discharging into a gatebox, tlie gates of which
opening to the different bedft are oj*e rated by hand.
'J liree sand lilter \>eds were in o|>eratiou at the time of the in^^pection. The
two new \H-iU. the KUf>erintendeijt fetated. wouhl be put in operation very
•shortly. Ihe .sand in the original two Ijcds apjH^ar*. to contain a good deal of
loam. Ihene bedb were covered with a film of dark, sewage fungi growth.
Pools of sewage remain on the bedh for extended periods. The Ijedh are raked
oecahionally. The rate of operation on the beds is about 60,0<MJ gallons i>er
acre per day when the three bed^ are in ojjeration. With such a light dose
the beds should not pool or clog if the sand were of suitable size and quality
and the surface film forming on the beds were removed at frequent intervals.
To make the two original beds work properly, enough of the present unsuit-
able sand should be removed and sand of ^uitabIe size and quality replaced to
remedy the present unsatihf actor)- conditions and secure efficient operation.
It i& probable that removing the upper twelve inclies of sand on the two
original lied-s, that which has been placed there and appears to l>e of un-
^uitable size and quality and replacing it witli sand of suitable size and good
quality, would improve the efficiency. Tlie K'ds should aiM> Ix' frequently
raked and the surface film accumulating on the ImmI^ removed. The sand on
the third bed and on the two just conftruct+^l, app<'ars to be of good quality.
N^Hwith&tanding the alwve unsatisfactory conditionh tlje effluent appears to
be clear and no *>lfen*ive <»dor could l>e dete<'ted at the outlet wJiere the M^wage
jp difccharged into a small hr <j<jk.
Summarized briefly I would conclude with re^^ard to tlje con^tiuction and
operation of this sewage dJ•^I>Ofcal p'ant:
1. That the <-on^truction of the a<l'Jilional wttling tank and of t|ie one
filter l>ed couNtrudcd in ]\H\\i and the two filter U'*!** in 1910 were in violation
of the Public Health Law, whieh re<]uire-. tlmt pla/H for the construction of
all sewerage h_\ '-terns and di^JK>*^al \%ork^ ^hall liint U^ Nubniitt4'd to and ap-
proved by tlie State Comnjji^*;oner of Health l>4^fore they are constructed.
'I. That the twelve inehes t/i han*! re<-ently placed V'\Hjn one of the filters
above referral to i*; too tine and re^iilt^ in undue clf>gging of this fiHx^r. 'This
sand hhouhl l>e removed and a more mitahle ^and of coar'^«'r grain substituted,
3. That notw itli'^tan'Jiiij: an aj»jjar«'nt!y satii-fa^-tory effluent U-ing delivered
by the-»e lilter J*e<!>'. wjuie <lini'ii!ty i» ex|>«'rien<-efi, due to insufliiiejjt scraping
of bcwage slufV** whiftj a<<'unnjiate-> on tlie hurfa^e ajnl which tend"* to reduce
the cana^'ity of the )m«1 ami "f it^ pr^ij^-r aeration, TIm'M' U^dn should be
scraped regularly and th«»r«iu;/iiJy laKed and at fn*<picnt interval- and jK^riod-
icallv a tliin lavei of "Hji'! rerno\eij afi'i r«'!>laeed with san<l of a suitable
character,
I b<-g. tlicrefore, to reconiiiiejid that a ••o]>y of thih rej>*>/t )jt^ tran'.rnitt4-d to
the suj»er Jntendent of tiie liny Hrf^A liO'-j^ital un<\ to the Fiscal >ijp<'j \ iH(>r of
State i itarjtier for ti «'ir i-*>r.'-i<U't sX'.*<]i aiid •^•Jjlable a<'tion to earrv out the
re<"omnieniJation^ cojjtair-»<l tljcr«^/n.
\'er\ r^-i-rM^tfulh .
THh<>LK>KK JIORTOV.
i'hiff Enfiiu**r
RIVERHEAD
At the ^e.pJe^t of tjie hxdl U»ard of h< ■tlth a re;.ji--i-jit.iti\e of the t'li'/uw^'T-
ing d)vi*»j"T! \iKitefl Hivwtnn'i on .f«irie lU. I'M". a)i<l \*fftV*'^\ o\er the •«*>'wera;£e
condition*- of tiie \jl-';';!e witfi meJ/Hx r*- of t*-*" \y>{ii<i.
1 lie n»-«'i of a sewer »-y*tef;i w ah (>*>]jitt*fi mit to th'i'i and t)ie provi-ion^
of 111** l.i\* c' ;p; t iif'd reli^.'i;; to tie t<M*j'.ii.ly of con»'iri *tiij(*: oij'y hU'h
porti'if**- *'i Ufji tie t>*Mer ^■\^tefr^ aj.il -^w.i^'e <iii«;^**a) plant a- nj:;.')it l*e
rtMpiir^-d for jin'r « "'-•♦e u-^' aJt**r pi; ^ - f«n "^ )- ti *• -♦efu imve iK-en a[.j»rove<i
bv tht '^tatt < oniun"-,.oii*'i ot \S* . '•ii
508 State Department of Health
ROME
The Chief Engineer of the Department visited Rome on November 21, 1910,
and in compainr with the city engineer and the superintendent of water works
and sewers looked over the proposed location for the sewage disposal worics to
be constructed, and also inspected the outlet of the present sewerage system
of ^'le city.
THERESA
Bequest having been made by the local board of health that the Department
make an inspection of the sewerage facilities and advise them in the matter,
a representative of the engineering division visited Theresa on June 4, 1910.
The findings of this inspection are discussed in the following report, copies of
which were sent to the village authorities on June 17, 1910, urging them to
comply with the recommendations embodied in this report.
Albany. N. Y., June 10, 1910.
Eugene H. Pobter, M.D., State Commissioner of Health, Albany, N, Y,:
Deab Sir: — In accordance with your instructions and at the request of the
local board of healthy I have inquired into the question of sewerage for the
village of Theresa, and bejf to report thereon as follows :
Theresa is an incorporated village in the northern part of Jefferson county
on the left bank of the Indian river, and is on the Rome, Watertown and
Ogdensburg division of the New York Central and Hudson River railroad,
twenty-three miles north of Watertown, N. Y. The population of the village
is about 1,000 and has shown no considerable variation from this number for
several years.
The principal industrial plants of the village are a silk mill employing
about forty hands, two grist mills, a foundry, a cheese factory, a milk station,
a sawmill and a novelty works.
The town has excellent water power facilities. The Indian river has a total
fall of about seventy feet in the two falls about 1,000 feet apart, directly
opposite the town. At the lower and greater of the two falls a recent de-
velopment of the water power has been made and is being utilized to generate
light and electric power for corporate and private purposes.
The water supply is taken from the Indian river at the middle dam, and
pumped to a standpipe in the southern end of the village. The average daily
pumpage is about 65,000 gallons. There are 284 taps on the water system and
as all the inhabitants of the village are not on the system it is somewhat
problematical as to the per capita consumption of water supplied. As near
as can be estimated the consumption is about seventy-five gallons per capita
per day of those supplied. The bonded indebtedness of the water system is
about $19,000.
The general sanitary condition of the village is good. There are 3 to 4
miles of wide macadamized, well lighted streets, and the greater part of the
village is on high ground, most of the streets being from 60 to 80 feet above
the river. All the main streets in the territory lying between the river and
the railroad station have an almost unbroken inclination toward the low land
bordering the river below and north of the village. The grades are mostly
steep, some few being about 10 per cent.
On June 4, 1910, Mr. A. O. True, assistant engineer of this Department,
made a thorough preliminary inspection of the town relative to the question
of sewerage urged by the local board of health to eliminate certain insanitary
conditions alleged to exist in the lower part of the town.
There are at present some 3,000 feet of sewer which serves the main business
streets and part of the upper residential section of the village. The exact
alignment and size of this sewer is somewhat uncertain, but it is nowhere
greater than 8" in diameter. It was built in the first instance by a few
Sewerage and Sewage Disposal 509
individuals to serve their property and extended from time to time as other
houses were permitted to be connected. At present it discharges through
several outfalls into the river some distance below the lower dam.
The lower part of the village has no sewers. This portion of the village is
chiefly residential, but comprises the town school occupied by about 200
pupils, the railroad station, a milk station and a small hospital. Most of the'
houses have the public water supply and water closets. The sewage from these
houses is either discharged into cesspools ou the premises or directly into a
drainage ditch running through the lowest part of the territory and finally
reaching the low groimd along the river before mentioned. In many in-
stances the cesspools are said to have overflowed into this ditch. In the
lower part of the territory in question the water table is high and the ground
unsuitable for the construction of safe or satisfactory cesspools. At the time
of the inspection conditions along the drainage ditch were not ofl'ensive, but
the local authorities state that the place is a nuisance in dry and hot
weather. Much rain had fallen at the time of the inspection.
The railroad station, in the low part of this area, maintains a wooden
vault banked up with cinders into which the sewage from the water-closets is
discharged. The schoolhouse has no water-closets, but maintains two large
privies with masonry open-back vaults ou the top of a steep, sandy bank some
thirty feet above the road. The milk station is located a few hundred feet
south of the railroad station. From this plant considerable waste has been
discharged into several cesspools in the low ground near the railroad track.
No information was available as to the average character and quantity of
this waste. It is said to consist of a certain amount of whey, and principally
washings from milk receptacles. The cesspools are apparently in unsuitable
ground and have overflowed into a well-defined ditch leading down through
the low land. Though no nuisance was apparent when the inspection was
made, complaints have been made of nuisance caused by the waste during hot
weather. Complaints have been made by two residents in the vicinity of the
railroad station that their well water has been afl'ected, presumably by
sewage having been washed into the wells.
Several houses in the southeastern part of the town, located on the high,
precipitous bank of the river gorge, discharge sewage from water-closets and
drains directly over into the river and in places upstream from the intake
crib of the water works.
In consideration of the conditions as outlined above, and shown by the
recent inspection to exist in the unsewered portions of the town, I am of the
opinion that the village is in need of a modern system of sewerage, designed
with a view of serving future as well as present needs.
The existence of drainage in the river from houses on the river bank just
above the intake of the water works is a serious menace to the health of the
village. Many of the inhabitants of the village consider the water supplied
to the town unfit for drinking purposes, and although without a more search-
ing inspection of the condition of the water reaching the intake and in the
distributing system it is not possible to state the effect of the above-mentioned
pollution, it is obvious that there is an ever-present possibility under favor-
able conditions of sewage reaching the water supply.
There is a demand among many of the residents in the lower part of the
tovm for a more sanitary method of sewage disposal than \s afl'orded at present
by cesspools and open drains. As before mentioned, many of the cesspools are
in wet, unsuitable ground and if not frequently cleaned will overflow, the
sewage reaching the open drain. Even where the ground is of such a
character as to absorb the contents of the cesspools and for a time to satis-
factorily dispose of the sewage and house wastes there results a gradual
pollution of the surrounding soil.
Disposal of household wastes in cesspools, while being permissible and not
necessarily dangerous in a spareely populated community, are considered by
sanitarians as insanitary and uneconomical in a closely populated village.
The schoolhouse and the privies connected with it are located near the center
of the village, and are used by some 200 pupils during the school terms. They
are unprotected from flies, and I consider them insanitary and inefficient for
tL community of this size.
510 State Departmext of Health
The question of sewerage for the villafj;e of Thertsa shouUI l>e euiisidered
immediately by the corporation of that village, and plans drawn up for a
comprehensive and modern system of sewerage with a view to disposing of the
sewage of the village in the most ap^iroved manner, these plans to be sub-
mitted to this Department for approval. Such procedure is in accordance with
the Village I^w relating to sewerage, and whereas, ajiy system pro}>osed
should make proper jjrovision for all parts of the village ultimately to be
sewered, it will be possible and feasible to build at present, subject to tlui
approval of the State C'onmiis*sioner of Health, only that portion of tlie works
which are necessary from the standpoint of health and economy.
In conclusion 1 recommend that the village take such steps as are necessary
to carr\' out the plans as above outlined for the improvement of the siuiiUiry
conditions of the communitv.
Respectfully submitted,
THEODORE HORTOX.
Chief Engineer
VICTOR
Request having been made by the local board of health that the Depart-
ment make an inspection of insanitary conditions existing at Victor, Ontario
county, due to improper sewerage facilities, and to advise them in the matter,
a represt»ntative of the engineering division visited Victor on May 19, 1910,
and conferred with the local board of health.
A general inspection of the village was made and it was found that at
many points the insanitary conditions due to overflow of cesspools and sew-
age discharge were l)ecoming serious, especially at several business blocks
along the main street where, owing to tlie crowded conditions, there are prac-
tically no available sites for cesspo<ds to dispose of the fewage.
The village board of health wa.s urged to take up with the board of trustees
the question of establishing a sewer system. The provision of the Ihiblic
Health Law, in reference to tlie establishment of sewer systems, was ex-
plained to them and it was j)ointcd out to them that, although the law
requires that the plans jirepared must be com])rehensive and cover all por-
tions of the village, the village may construct the whole of the said system, or
may temporarily omit any j>ortions thereof until such portions may be nec-
essarv, subject to the api>roval of Mich omissions bv tlie State Commissioner
of Health.
WARWICK
On October 21, 1910. this Department was requested by the local board
of health to make an investigation of tlie insanitary contlitions arising from
the discharge of sewage into \Vawayan<la creek. One of the inspecting engi-
neers of the l>epartment visited NVarwick on November 14, 1910, and the
findings of tlie inspei4i<m mude by him are found in the following report.
A copy of this report was sent to health ofticer on November 29. 1910. with
a rcijuest to urge the lo<*al board of health to take up with the Ixiard of
trustees the matter of the preparation of plans for sewerage and sewa;»e dis-
posal for the villaj^e.
Albany. N. V.. Xoremhcr 17, liHO.
ErcEXE H. PoRTKR. M.D., State <'omruissioner of Health, Mhany, "W V. .♦
Dear Sir: — I Wg to submit the following report on an investigation made
at Warwick, Orange county, of a nuisance <lue to the discharge of sewage into
the Wawavanda creek at Warwick.
Sewkkaok and Sewage Disposal 511
Wauayanda creek rises in the soutliwerttern part of the town of Chester.
Orange county, and flows southwest through Warwick, cmptjnng about seven
miles below Warwick into the Pochuck er<H»k. The recent drought had so
decTeased the volume of water in the stream that very little flow was per-
ceptible and the sewage discharged into it remained there for periods of time.
Xumerous complaints were received by this Department of the insanitary con-
<!ition of the stream and the odors arising from it. On November I4th, Mr.
Fritz M. Amolt, inspecting engineer with this Department, visited Warwick
and examined the condition of the Wawayanda creek with respect to the
discharge of sewage into the stream.
At Warwick the Wawayanda is from a foot to several feet deep and about
thirty feet wide. In a distance of about a thousand feet, while flowing through
the center of the village, it receives hewage from about thirty pipes sewering
single houses or small groups of houses. These houses are located in the
business section and most thickly settled portion of the village and the sewers
serve several hundred people.
One of these sewers is a 12" pipe, laid in the bed of a small stream locally
known as Creamery brook. This discharges the creamery wastes from Mutu-
aFs creamery which is located several hundred yards back from the Wawa-
yanda into that creek. Sewers from private hons»es formerly tapped into this
pipe or discharged into Creamery brook, causing a serious nuisance alcmg this
brook. The local health board has ordered all persons discharging sewage
into the brook, or having connections with the 12" pipe, to remove these
connections, discontinue discharging sewage into the brook and build cess-
pools to receive all their sewage and lii]uid household wastes. Dr. J. S.
Cummins, former health officer of Warwick, stated that as far as he knew
the orders of the board of health had all been carried out. There is, how-
ever, evidence that sewage or wash water is still discharged into Creamery
brook.
There can be no doubt that the discharge of sewage into the Wawayanda
creek will create a serious nuisance in the future as it has in* the past, espe-
cially in the dry perio<l of the year. Unless steps are taken to prevent this
discharge of sewage the volume of sewage will doubtless increase and a seri-
ous nuisance will be present in the heart of the village, detrimental to the
public health and welfare of the residents of the village. The local l)oard
of health has the power under section 20 of the Consolidated Public Health
I^aws to cause the suppression and removal of all nuisances and conditions
detrimental to the life and health found to exist within the municipality.
Under this section the local board of health can prevent the discharge of
sewage into the stream when such discharge constitutes a nuisance.
Such a step, however, unless means were provided for the proper ilisposal
of the sewage would be disadvantageous and a serious handicap to the busi-
ness and welfare of the village, if not utterly impossible, to carry out with-
out serious inconvenience to the residents afl'ei'tpd. Many of the business
houses are located so as to fac<» on Main street, and the rear of these buildings
is on the edge «>f the creek, leaving no available space for the construction
of suitable cesspools.
The liest way to remedy the ])resent conditions is to install a comprehen-
sive system of sewerage and a suitable sewage dispimal plant. The insanitary
conditions existing in the village are a serious detriment to the health and
welfare of the village. Warwick has reachetl the stage where the ))opulation
is becoming congested and the older methods of dis])osal in cesspools and
the discharge of sewage into a stream, which is now unable to proi)erly take
care of the sewage, are no longer suitable and the installation of a compre-
hensive syst<'iil of sewerage and sewage disfK)sal has Inn'ome an urgent
necessity.
In conclusion, I beg to recommend that the Imard of health of the village
of Warwick be advised to take up witli the village authorities the matter
of the preparation i)f plans for a comprehensive system of sewerage and
sewage disposal for the entire village. These plans should be submitted to
this Department for consideration, and when approved a permit will be
issued allowing the discharge of the effluent into the Wawayanda creek.
512 State Department of IIealth
Arrangement can be made, in accordance with the Village Law relating to
sewers, whereby only such portions of the system as may seem desirable from
time to time need be constructed. In this way the initial cost is reduced
to a minimum, while assurance is had that all sewers that are constructed
will form a part of a general, comprehensive system of sewers for the entire
village.
Respectfully sitbmitted,
TirEODORK HORTOX,
Chief En^ncer
YONKERS
Albant, N. Y., November 16, 1910.
Eugene H. Porter, M.D., State Commissioner of Health, Albany^ N, T, ;
Dear Sir: — I beg to submit the following report on an examination of
plans for a sewage disposal plant on the property of Mr. M. Arndtstein on
Two Hundred and Forty-second street near Martha avenue, in the city of
Yonkers, and near the New York city line. These plans were submitted ou
Septemiber 28th by Dr. W. S. Coons, health officer of the city of Yonkers,
the plans having previously been filed with the city board of health. As
may be noted from the correspondence on file in this Department a complaint
was received on September 5th (the latter being dated August 2d) from
Mr. L. K. Peecock, secretary of the Woodlawn Heights Taxpayers' Associa-
tion, in which on behalf of the association he made complaint of an alleged
public nuisance due to the discharge of an overflow from a cesspool on the
property of Mr. Arndtstein into a stream which crosses Two Hundred ana
Forty-second street and the block between Two Hundred and Forty-second
and Two Hundred and Forty-first streets, and flows into the New York city
sewer at Two Hundred and Forty-first street.
On receipt of this complaint the attention of the health officer of Yonkers
was called to the complaint above referred to, and he was asked to investi-
gate the circumstances surrounding the complaint and to advise you as to the
facts in the case, and as to what action had been taken by the city board of
health to abate any nuisance found.
Health Officer Coons subsequently reported that Mr. Arndtstein had con-
structed several houses on McLean avenue and had also constructed a sewage
disposal plant on Two Hundred and Forty-second street, through which the
sewage from his houses was dieharged, and from which the overflow led to the
above described stream. Dr. Coons also stated that previous to the construc-
tion of the sewage disposal plant Mr. Arndstein had laid a sewer to serve his
houses which connected with the New York city sewer in Two Hundred and
Forty-first street, but that the public works department of the city of New York
had cut off this sewer connection without notice to the owner of the property
and in consequence the sewage had been discharged into vacant lots at the
corner of Martha avenue and Two Hundred and Forty -first street. Dr. Coons
stated that Mr. Arndtstein had partly cleaned up the vacant lots where
sewage was discharged while the sewage disposal plant was in course of con-
struction and had promised to fully abate the nuisance.
The attention of Dr. Coons was then called to the requirement of the Public
Health Law, which provides that no discharge of sewage effluent into streams
in this State may be caused except under permission ifrom this Department,
and his attention was called to the fact that the owner of the premises was
responsible for caring for sewage from the houses in a sanitary manner until
a public sewer was provided by the city of Yonkers, sewers in this section not
having as yet been constructed by the city of Yonkers.
On September 28th, Dr. Coons w^rote this Department stating that the con-
struction of the sewage disposal plant without the submission of plans to this
Department for approval and the issuance of a permit for the discharge from
the plant was entirely due to an oversight, and he sfubmitted for the approval
of tnis Department on behalf of Mr. Arndtstein plans for the sewage dis-
Sewerage and Sewage Disposal 513
posal plant which had been constructetl, said plans having been filed with the
inspector of plumbing and signed by the city engineer and the health oflScer
instead of being forwarded to this Department for approval.
In this connection. Dr. Coons stated that he had made arrangements for a
conference between Mr. Arndtstein, a committee from the McLean Heights
Taxpayers' Association and the Yonkers health department, and assured you
that the Yonkers department would promptly cause the abatement of any
insanitary conditions resulting from the operation of the disposal plant.
In order that the plans might be intelligently considered. Dr. Coons was
thereafter requested to have forwarded to this Department a report describing
tlie design of the plant, the proposed method of operation, the character and
relative flow of the stream into which the effluent is discharged, and the
number of persons served by the sewer discharging into the plant. On
November 4th, Mr. Charles M. Mapes, ('. E., who designed the plant for Mr. M.
Arndtstein, submitted to you a report describing the design and stating the
number of persons to be served by the plant.
The disposal plant as shown by the plans and described by Mr. Mapes con-
sist* of a septic tank 12' x 5', with a depth of liquid of 9' 6", having a
capacity of 4,275 gallons, a dosing chamber 4' x 19' with a depth of 2', and
a two-compartment cinder and gravel contact filter about 12' long, with a
total effective width of 11', a depth of 28" over all and a depth of 18" below
the distributing tile near the surface of the beds. The dosing tank is pro-
vided with two alternating siphons for discharging alternately on two filter
beds, and the filter beds are provided with two 3" Miller siphons, having a
draft of 13".
The report of Mr. Mapes states that the plant was designed for a daily flow
of 8,000 gallons, equivalent to sewage contribution from 100 people at eighty
gallons per person.
With respect to the adequacy and suitability of the plant, it appears that
whereas the settling tank is adequate to provide ample sedimentation for the
sewage contributed by 1(0 persons, the filter bed is entirely inadequate, since
the rate of operation would be alwut 2,000,000 gallons per acre per day, or
about six or eight times the rate at which a filter of this type should be
operated to produce the proper efliciency and to prevent a clogging of the
filter and the consequent interruption in a portion of the plant and the
setting up of a nuisance in the vicinity of the plant.
Furthermore, it does not appear that the efl'ective depth of the contact filter
below the distributing tile is to be used, since this depth is 18", while the
draft of the siphons discharging the effluent from the filter is but 13".
The filter as designed cannot be properly operated as a contact filter, since
the dose from the dosing chamber is three or four times the liquid capacity
of the filter, so that all but the very last dose from the dosing chamber will
pass directly through the contact filter without any period of contact or
•• resting full.*' Even if the dimensions of the dosing chamber were properly
designed with reference to the liquid capacity of the filter beds, the beds
could not readily be properly operated as contact filters, since the plans show
a regular siphon and not a timed siphon to discliargc effluent from the beds
with which latter type of siphon a proper cycle of operation of the bed might
l»e arranged which cannot be provided for by the plant as shown by the plans.
I beg to report, therefore, from a consideration of the plans and the con-
ditions under which the effluent is to be discharged, that it would not be
justiflable for you to grant a permit for the discharge of effluent from this
plant by reason of its inadequacy to care for the amount of sewage which it
is designed to treat and because of its faulty design.
I would, therefore, recommend that a copy of this report be sent to the
designing engineer and that the plans be returned to Dr. Coons, from whom
they were received.
With respect to any nuisance which may be caused by the discharge of
effluent from tbe plant as constructed into the stream near Two Hundred and
Forty-second street, it is obviously the duty of the board of health of the city
of Yonkers to abate any such nuisance, and I would recommend that the
health officer of Yonkers be informed that this Department cannot approve
17
514 State Department of Health
the plans as submitted, for the reasons heretofore stated and, therefore, can-
not issue a permit for the discharge of eiBueut from the plant, and that any
public nuisance which may be found to exist by reason of the operation of
the plant as constructed, should be abated by action of the city board of health.
Respectfully submitted,
THEODORE IIORTOX,
Chief Engineer
In accordance with the recommendations of this report, the plans were dis-
approved on November 17, 1910, and returned to the health officer of Yonkers.
A letter, inclosing a copy of this report, was also sent to the board of health
of the city advising them as to their duty in suppressing any insanitary con-
ditions or conditions of nuisances which might arise from the operation of
the plant.
YORKTOWN HEIGHTS
Albany, X. Y., October 28, 1910.
Eugene H. Port?:r, M.D., State Commissioner of Health, Albany, \. Y,:
Bear Sir: — I beg to submit the following report on an inspection made
October 17th by Mr. Fritz M. Arnolt, inspecting engineer with this Depart-
ment, of a sewage disposal plant constructed and maintained at Yorktown
Heights by Glennon & Co., contractors, in connection with their work on the
Cat^ill aqueduct construction.
This plant consists of an open settling tank and two sand filters. The
sewage from the labor camp above is discharged a few feet from the edge of
the settling tank and runs over the ground before entering the tank. This
tank, which is about 50 feet long and 35 feet wide, is exposed to sunlight,
wind and surface wash. At the time of tlie inspection the surface of the
liquid in the tank was covered with a light green scum, indicating the presence
of microscopic organisms due to surface wash. The beds, which are each about
40 feet long and 35 feet wide, were covered at the time of the inspection with
sewage. Some laborers from the camp stated that sewage was continually
present on the beds. A green scum was also present on the surface of this
sewage.
At the time of the inspection an offensive odor was given off" from this
plant, creating a positive nuisance in the surrounding neighborhood. While
the effluent from this plant appears clear, analyses submitted by Mr. Theodore
DeLong CofRn, sanitary engineer of the Department of Water Supply, Gas and
Electricity, showed that the effluent polluted the stream, a tributary to the
Croton supply, into which the effluent was discharged and that B. Coli were
present in one-tenth c.c. samples. Furthermore, no plans of this plant have
ever been submitted to this Department and no permit has ever been issued by
this Department allowing the discharge of the effluent from this plant into
the stream, wliich is a tributary to the Croton supply.
It is evident that as a modern disposal plant this plant can be considered
as little more than a makeshift, and is neither correctly designed nor properly
3)erated. Furthermore, it has been constructed in violation of the Public
ealth Law in so far as that the plans were not submitted and approved by
this Department before being constructed, and is a public nuisance.
I beg to recommend that a copy of this report be sent to the Department of
Water Supply, Gas and Electricity and that they be notified that this plant
constitutes a violation of rules 27 and 28 of the rules and regulations enacted
for the protection of the Croton water supply and be advised to take the neces-
sary steps to have the violation abated; also that a copy of this report be
sent to the board of water supply of New York city, advising them that this
plant has been constructed and is being maintained in violation of the Public
Health Law.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
Sewerage and Sewage -Disposal 515
In accordance with the recommendations of this report, letters, inclosing
copies of the report, were addressed to the proper New York city authorities.
On November 12, 1910, a letter was received from the board of w^ater supply
of New York city acknowledging the receipt of the report and stating that
the matter was being investigated by their sanitary experts and that on the
receipt of the reports of these experts the board would take the necessary
action.
In addition to the foregoing, correspondence was had with and advice given
in matters relating to sewage and sewage disposal at the following places:
Glen Cove.
Lancaster.
Newark (State Custodial Asvlum).
PROTECTION OF PUBLIC WATER SUPPLIES
[517]
GENERAL EXAMINATION OF PUBLIC WATER
SUPPLIES
The protection of public water supplies will probably always
head the list of important duties devolving upon the Sanitary
Engineering Division since a pure supply of water has always
been accepted among sanitarians as one of the greatest conservers
of public health. Indeed, the record of past epidemics of disease
traceable to infected water supplies has lost none of its force in
the present day in causing the public to realize that whatever
else is lacking in the way of municipal cleanliness, a clean and
unpolluted water supply should be procured and maintained at
almost any cost.
Unfortunately the lay mind docs not dwell as often or as con-
scientiously as it should upon these grave questions and for this
reason it becomes incumbent upon the State Department of
Health, in addition to the regular duties required of it under the
Public Health Law, to perform also a large amount of voluntary
work in this field. Considerable work has therefore been devoted
to examinations into, and reports upon, special features or
problems which have arisen in connection with water supplies not
protected by rules and regulations. These have usually been in
response to particular requests and in these cases field examina-
tions have usually been made and advice freely given.
Municipalities where examinations into special problems or
features have been asked for during 1010 and where advice has
been furnished, are as follows:
BLAUVELT (State Rifle Range)
On November 17. 1010, plans for a development of a reservoir site for a new
water supply for tie State Ritle Ranfre at Blauvelt were submitt{»d for ap-
proval hy the State Arcliitect. Those plans were approved on l)ecoml)er 1,
liilO, on condition that the privy referred to in the second report jriven below
be removed from the watershed of the proposed reservoir and its contents re-
moved in a sanitary manner.
A letter was also addre.-sed to the comniandinj? oflicer of the Division of
National Guards on December 1. 1910. inclosing a copy of the foUowin? report
dated November 30, 1910, callinjr his attention to the recommendations of
tlii« report in reference to the rigid patrol necessary to maintain tl e water-
.'*he<l in a sanitary c<mdition at all times so as to prevent any pollution of
the water supplv,
[519]
620 State Department of Health
Albant, N. Y., November 30, 1910.
Eugene H. Porter, M.I)., State Commissioner of Health, Albany, N, >'.:
Dear Sib: — I beg to submit tbe following report on an examination of
plans for a development of a reservoir site for a new water supply for the
State Rifle Range at Blauvelt submitted to this Department for approval by
the State Architect on November 17, 1910.
The records of the Department show that plans for sewerage, sewage dis-
posal and water supply were approved on July 13, 1910. As noted in my
report of July 12, 1910, on an examination of these plans, the State Architect
stated that the rifle range would have a maximum permanent population of
125 persons between May and November, with a maximum population of about
500 persons for one day at irregular intervals. It was also assumed by him
that a storage capacity of about 15,000 gallons would be ample and that the
then proposed water supply, which was to be derived from a driven well 125
feet deep, would l)e suflicient for the needs of the range, judging from the
yield of similar wells driven in the vicinity.
According to the report of the State Architect accompanying the plans for
a new sunnly recently submitted for approval, it appears that the driven well
yields only some 10 or 15 gallons per minute, which is inadequate to meet
the requirements of the rifle range.
The plans now before the Department and under consideration show that it
is proposed to develop an existing pond and tributary creek located near the
institution as a source of water supply and do not include details of the new
dam, spillway, intake, etc., inasmuch as these will be included in a separate
contract for erecting the pumphouse. water tower and pipe lines, ancf it is
presumed that additional plans will be presented for approval showing such
additional works. A portion of the existing pond is to be used as a reservoir,
the old earthen dam is to be removed and replaced by a concrete dam, the
undesirable swampy area east of the pond excluded from the reservoir by
banks or dikes formed from the earth excavation of the site and the swamp
drained by means of a 14" ca>tiron pipe carried through the reservoir to a
point below the concrete dam. The reservoir is to be about 150 feet long by
120 feet wide, and from 2 feet to 4 feet of soil containing large portions of
organic matter is to be removed from the bottom so as to obtain a depth of
water of not less than 5 feet or G feet, and at the same time remove objection-
able organic matter from the reservoir site. The sides of the reservoir are
to be protected by twelve inches of rip-rap. It is estimated that a storage
capacity of about S(JO,000 gallons will be obtained.
The creek tributary to the present pond is to he intercepted some GOO feet
above the reservoir and the water conveyed to the reservoir through an 8"
castiron pipe so that the water will not flow througli that part of the pond
which is not to be cleaned or included in the reservoir site.
Although the watershed of the creek tributary to the existing pond has an
area of only about 0,5 square miles, it has been found according to the report
of the State Architect, that by actual pumping done by the contractors on
the rifle range during tlie past summer, a minimum flow of about 50,000
gallons can be expected from this source. It is also stated that springs have
been found in the bottom of the pond and that the creek is undoubtedly spring
fed. It appears, therefore, that this new supply should be adequate as to
quantity to meet the re<juirements of the range on the assumptions used.
An inspection of the watershed of the creek was made on November 29,
1910. by Mr. A. O. True, assistant engineer of this Department. This in-
spection showed the watershed to be uninhabited, of approximately 0.5 of a
square mile in extent, and. with the exception of perhaps sixty acres of
cleared land in the vicinity of the pond, completely wooded.
Near the southern part of the waterslied are the remains of a ruined
dwelling. Twenty or thirty feet from and in the rear of this house is the
privy. This privy has no vault. It has been moved some little distance from
its former position and its contents are lying on the surface of the gnnnid.
which slopes to the stream about 150 feet away. Two other structuresi were
noted in this vicinity — a small electric j)unipl'ouse ami alwve it and distant
from it ^ome 800 feet, a small concrete reservoir. Tliese structures are pre-
Protection of Public Water Supplies 521
sumably part of some local water works deriving water from a spring or well
on this watershed. As to the source of this water, its use, and the effect,
if any, on the present or future supply of the watershed were not ascertained.
With these exceptions no other permanent strnctiires were found on the
watershed.
The northern end of the new reservoir has been excavated to a depth of
about four or five feet below the original ground surface to a hard bottom of
gravelly clay. * The southern end is being excavated and a large quantity of
clay, mud, roots and humus material has been taken out. The embankments
are being so built as to exclude the swamp water and the water from the
northwestern part of the watershed which will be presumably subject to con-
tamination from the buildings of the range.
In view of the careful provisions incorporated in these plans for the ex-
clusion of undesirable drainage and the removal of organic matters from the
reservoir, and further, in view of the good sanitary condition of the water-
shed with the exception of the one instance noted above, I recommend that
these plans be approved with the provision that the privy mentioned in this
report together with its contents or any other dangerous substances on the
premises be removed from the watershed or taken care of in a sanitary
manner, and that the ground be disinfected with lime or other suitable dis-
infectant.
Further, in view of the possibility of conditions endangering the sanitary
quality of this water arising from the intermittent and temporary occupancy
of the locality by numbers oif troops, visitors or the public, I recommend that
a copy of this report be transmitted to the proper military authorities, and
that they be urged to keep at all times a strict patrol of the watershed to
prevent any accidental, careless or willful contamination of the water supply.
Kf'spect fully submitted,
THEODORE IIORTOX,
Chief Enpinecr
COLD SPRING
Albany, N. Y., Jub/ 22, 1910.
Eugene IT. Porter, M.D., State Commissioner of Health, Albany, N, Y.:
Dear Sir; — I beg to make the following report in the matter of a com-
plaint of the board of water commissioners of the village of Cold Spring con-
cerning certain insanitary conditions alleged to exist on Foundry brook at
the reservoir of the Mt. Taurus Park Association, above the point from which
the public water supply of the village is taken.
The water supply of the village of Cold Spring is taken from the Foundry
brook about one and one-half miles above the village, at which point is
located the dam and distributing reservoir owned by the corporation. About
half a mile above this reservoir is a low masonry dam built in the summer
of 1909 by the Mt. Taurus Park Association and forming a shallow reservoir
about half a mile in length and averaging about 400 feet in width. About
one mile above this reservoir and on the mountains at an elevation of 640
feet above sea level are two storage reservoirs at the headwater of Foundry
brook.
The last named works and the water rights to the stream are controlled by
the West Point foundry, which was established in Cold Spring in 1817. There
exists an agreement between the village and the foundry whereby the former
is permitted to divert a certain amount of water for public uses for which
privilege a nominal rental is paid. With the exception of the storage reser-
voirs and the distributing reservoirs, none of the watershed above the cor-
poration dam is owned by the village or foundrj'.
On July 21, 1910, I caused an inspection of the stream to be made by one
of the assistant engineers of this Department. From this inspection it was
found that the reservoir, before mentioned, and owned by the Mt. Taurus
Park Association, was formed by the construction of a low masonry dam
522 State Department of Health
across the stream in a low, swampy area adjacent to the highway. Due to
the ab&<?nce of any conisitlerable natural banks to retain the back water from
the (lam, the area flooded is comparatively large and very shallow. In several
places the surface of the water is within a few inches of the grade of the
highway. The dam has a spillway, but the same cannot serve as a waste weir,
as the water flows over the sides of the reservoir through a stone wall a«<l
along the edge of the road at an elevation of 1.5 feet below the crest of the
spillway.
The surface of the reservoir was not stripped before filling and contains
swamp grass bushes and a few trees. The water around the edges of the
flooded area were, at the time of inspection, muddy, and the water filled witli
abundant growths of blue-green algae. At one point along the west side of the
reservoir, the shore was somewhat unsightly from the presence of rubbish and
tin cans. Above the reservoir the stream was clear, but below the dam it ap-
peared to have gained a considerable incicmcnt of color, presumably vegetable
stain.
I am of the opinion that this reservoir of the Mt. Taurus Park Association
in its present condition injures the quality of the water for the purposes of a
public water supply flowing to it from the storage reservoirs of the West
Point foundry. The condition, however, is a natural one and must be dis-
tinguished from the more common and dangerous case of the contamination
of a water supply by organic matter which results from man's economy. In
the present state of our knowledge of the eff'ect upon the human system of
drinking water containing the products of decaying vegetation, it cannot be
said that water standing in or flowing over an area such as is found in the
reservoirs in question has any deleterious efl*ect on the health of those drink-
ing the same, provided that no sewage or refuse from habitations is placed
therein. Tliat is, such a condition injures the aesthetic rather than the
sanitary quality of the water.
If this be the case, this matter is one for the local authorities to deal with,
and it is doubtful if any construction of the Public Health Law would bring
it within the province of the official Health Board. In this connection I beg
to refer to the following interpretation of sections 70, 71 and 73 of the Public
Health Law, rendered in an opinion of the Attorney-General :
" In my opinion the proper and only lawful construction which can be
placed on section *72 of the Public Health Law is that all damages and
injury to the owner of any property afl'ected by changes required to be
made to comply with the rules of the Department of Health must be
ascertained and paid prior to the taking possession of the property, and
is a prerequisite to the enforcement of said rules in all cases except such
as are a nuisance in and of themselves, in which cases the Department of
Health would have power and authority outside of sections 70, 71 and 72 *
to abate the same. Any other construction would to my mind render the
law unconstitutional. In brief, I am of the opinion that the State De-
partment of Health, ♦ ♦ * can make and promulgate rules regulating
and controlling the use of premises surrounding the sources in all re-
gards, and that a person violating any of these rules can be punished as
provided by the penalties, but before such punishment can be inflicted,
the corporation for whose benefit the rules are made and established must
pay or tender to the owner of the property afl'ected by the enforcement of
such rules an amount equal to all damages for making the changes
necessary."
Inasmuch as the water supply of Cold Spring is protected by rules and
regulations enacted by this Department, the above opinion would seem per-
tinent as distinguishing between a condition which on the one hand " in and
of itself " is a public nuisance and on the other hand a condition which might
be construed as a violation of the rules and regulations if the setting up of the
conditions complained of had been specifically prohibited by the rules, and
consequently subject to sections 70 and 71 of the Public Health Law, but re-
quiring compensation in the event of the removal of the reservoir. The object
♦Section 72 of old Public Health Law is ow «© ion 7.3 of the Consolidated Laws (tbo Public
Health Law).
of sucli rules is to protect the stream from coutaiuiuuiiou by tlie discharge
into it of sewage, refuse or any other contaminating substance which con-
stitutes an unreasonable use of the water. It becomes a question, then, as to
wliether the condition caused by the Mt. Taurus Park Association reservoir
could be considered a " reasonable use *' of the stream, and such a question
would have to be decided by the courts. In any event, the matter is one in
which any action taken would necessarily have to be taken by or under the
ruling of the local board of health and it is not evident that any action can
be taken by this Department, although the resulting conditions due to the
construction of the dam should be removed.
I would, therefore, recommend that a copy of this report be transmitted to
the board of water commissioners of Cold Spring and that they be advised to
take steps to either purchase or obtain partial control of the entire watershed
from which their supply is derived.
Very respectfully,
THEODORE JIORTON,
Chief Engineer
Albany, N. Y., July 27, 1910.
Mr. GouvERNEUR Kemble, Secretary, Board of Water Commissioners, Cold
Spring, A'. Y.;
Deab Sir: — I am inclosing herewith the report of the Chief Engineer on
an examination of certain insanitary conditions affecting the water supply of
Cold Spring.
As discussed in this report, it is my opinion that the water commissioners
must take action in this matter of controlling any conditions on the water-
shed which do not constitute nuisances in and of themselves.
The conditions which you called to my attention are not such as are covered
by the rules and regulations protecting the supply, and even if such conditions
were prohibited by the rules, in all probability the courts would determine
that compensation must be made to the owTiers of property for prohibiting
what appears to be a proper and reasonable use of the stream on ordinary
grounds.
Trusting that your board of water commissioners will at once proceed and
enter into some ajjreement with the owners of the property for the improve-
ment of the conditions now existing, I am,
Very respectfully,
EUGENE H. PORTER,
Covunisaioner of Health
CORNING
The conditions surrounding the ('orning water supply were further investi-
gated during the year by the Engineering Division.
This supply has been under investigation at intervals during the past few
years with the purpose of improving the condition or the quaEty of the
water. The supply is taken from a large circular well located in the valley
not far from the river on the outskirts and just below the city. Chemical
anal^'ses of the water taken at intervals during the past few years have
shown the water to be contaminated at times, while at others the water is
apparently free from this contamination.
Acting upon recommendations contained in a special report by Prof. Ogden,
Special Assistant Engineer, the city luis made certain improvements in the
hope of securing a water of better sanitary quality. Extended investigations,
however, seem to prove that notwithstanding the improvements made, the
water is still subject to intermittent contamination and in order to correct
this the city installed a hyp<»chlorite treating plant for disinfecting the supply.
On April 19, 1010, tlie Chief Engineer visited Corning and made a further
524- State Departmknt of Health
inspection of the condition of tlie wells, of the operation of the hypochlorite
plant and conferred with the city officials concerning the water supply situa-
tion as it then appeared, and making certain suggestions and recommendations
for either improving the supply or securing an independent new supply free
from any possibility of contamination.
The following statement of factrs anti of the recommendations made by the
Chief Engineer to the city officials during his visit and investigation of April
19 are taken from the memorandum of the Chief Engineer covering his in-
vestigation at that time:
The well is situated just below^ the city in alluvial deposit, and from the
topography I should judge is located almost directly in line with the general
underground flow of water beneath the city. There are two sewers, one within
500 feet of the well and one within 200 feet of the well. The character of the
soil was stated to b^ alluvial, containing sand, gravel and clay. It was stated
that the clay strata has been perforated in many places throughout the city
which would give a connection between any underground flow of polluted w^ater
above the clay strata and the deeper seated ground- water flow below the
strata, in fact, one would expect that pollution of this lower stratum would
take place continually and purification would be variable, the analyses ap-
parently supporting this view. As pointed out by the Engineer the position of
this w^ell is one which an expert sanitary engineer wonld not select for a pure
supply.
It was found that hypochlorite was not being added regularly as was
recommended and understood from the report of Prof. Ogden previously re-
ferred to. The inspection of the hypochlorite plant showed that it was not
suitable, for the following reasons:
1. On account of having no storage period following application of
chemicals, the water being driven directly to the mains.
2. There is no satisfactory opportunity to apply and mix the chemicals
in the well and no independent force main extends to the reservoir where
the chemicals might more appropriately be applied.
3. There is only one tank used as a mixing tank and a solution tank,
the chemicals being dumped into the solution tank and mixed by hand.
It is evident, therefore, that any precipitation of the chemicals during the
mixing would result in a more concentrated solution in the lower strata of
the tank and hence the application of the chemical to the tank would not be
uniform. That this might and does occur was evidenced from the fact that
frequent complaints had been made about the taste of chlorine in the water
by the residents in the city.
' During the conference of the Chief Engineer with the mayor, city attorney
and health officials the following views and recommendations were made:
1. The location of the w^ell is unfortunate and must be subject to inter-
mittent pollution.
2. The chemical analyses made during the past few years amply support
this view.
3. The conditions are most unfavorable for the moat efficacious appli-
cation of hypochlorite of lime and wtith the present installation a lack of
uniform application of this chemical must necessarily result.
4. That as previously pointed out by the Commissioner of Health, the
treatment of water by hypochlorite of lime can not, with our limited
knowledge and experience, be recommended as a permanent means of
purification and can only be recommended as a temporary or emergency
means.
5. That whereas chemical and bacteriological studies might be con-
tinued to further prove the extent of pollution, in my opinion there is
sufficient evidence to justify the securing of an expert sanitary engineer
to make a detailed investigation and report upon the present water
supply and means for improving it or oi securing a new one of un-
questioned purity.
G. That if such an investigation be authorized by the city the engineer
should study carefully not only the possibility of improving the present
Protection of Public Water Supplies 525
well supply, which appears to be futile at this time, or of cleaning the
same so as to make it safe, but should carefully investigate the develop-
ment of some new source of supply such as:
a A filtered supply from the Chemung river.
b A driven well supply taken at some suitable point above the city
in the Chemung valley or some nearby tributary.
c A gravity supply from some stream in the vicinity which is un-
polluted.
In pointing out the desirability of a thorough investigation of the water
supply situation by a recognized expert engineer I made it clear to the city
officials that the Commissioner would be pleased to review the report of such
an expert and give his opinions as to the findings and conclusions reached by
such engineer. I jwinted out that the situation was a difficult one in many
ways and cautioned them to secure the best advice possible. I explained at
the same time that neither the Public Health Law nor the appropriation fur-
nished the Department would authorize or warrant the Department in making
the detailed investigation necessary for advising the city in a matter of this
kind although the Department stood willing to give every assistance possible
within its resources.
DELHI
An inspection of the watershed from which the public water supply of the
village of Delhi is obtained waa made by a representative of the Engineering
Division on June 25, 1910, at the request of the water board preparatory to
the formulation, by this department, of rules and regulations for the pro-
tection of their water supply.
DOBBS FERRY
Albant, N. Y., November 30, 1010.
EroEXE H. PoRTEB, M.D., State Commissioner of Healthy Albany, N, Y,:
Deab Sib: — I beg to submit the following report of an investigation of a
complaint made by the Paton estate at Dobbs Ferry, Westchester county, N. Y.,
against the New York Juvenile Asylum, because of the alleged pollution of a
stream and springs said to Ih3 the source of public water supply, located on the
Paton estate.
Tlie Paton estate is located about one mile east of the villa^ of Dobbs
Ferry. The water supply in question consists of numerous springs for the
most part rising on the Paton estate and the stream fed by these springs
and whatever run-off reaches the stream from the watershed — some of the
latter lying outside the Paton estate. Below the springs is a small artificial
pond which has been u^ed, according to Mr. M. S. Paton, as a source of water
supply and ice supply by a considerable number of people. Below the Paton
estate pond is another small pond from which it is proposed to obtain a water
Mupply for Miss Master*8 school, the latter property adjoining the Paton
estate. This school has about 400 occupants.
Adjacent to the Paton estate on the «outh is the property of the Xew York
Juvenile A»ylum occupying the top of the hill. This institution is occupied
by some 500 boys. It comprises some twenty-eight buildings surrounded
by extensive grounds. To the east and directly adjacent to the Paton estate
there has been built a new road to the Juvenile Asylum over a right-of-way
on property belonging to F. Q. Brown. The ground over which part of this
road has been built is of the same general nature as the adjacent wet " spring
area " on the Paton estate, several springs discharging directly under the
road. The grade of the road at this point is some ten feet higher than the
ground surface on the Paton estate side.
In thi'^ road ha« been located the main sewer from the Juvenile Asylum.
The !M?wer is a 10" or 12" vitrified pipe and is said to have been laid about
526 State Department of Health
the year 1901 or 1902. This sewer has leaked in several places and the
fiewage escaping from it has contaminated the water flowing from the
springs under the road. One of these springs known as the Walgrove spring
No. 1, has been diverted from the stream by leading the water from it
through a castiron pipe to the nearest manhole on the sewer.
Analyses of the water from one of the drain pipes from the road have been
made, and it is claimed by Mr. Paton that the evidence shows not only contam-
ination of hi9 water supply from sewage but also a decided depreciation
in the quality of the water from the discharge from the storm water passing
through the culverts under the road, from the water of the catch basins along
the road and also from the drainage of the poultry yards near the head-
quarters of the stream.
Some 300 feet from the stream on higher ground are the stables and barn
belonging to the Paton estate. It is claimed by the superintendent of the
juvenile asylum that a certain amount of organic matter is washed from these
buildings into the stream, and that analyses show this to be one source of
pollution.
The matter of the Paton complaint has been investigated by the village
health officer, Dr. Joseph Ilasbroiick. In his report to the board of health of
the village of Dobbs Ferry, Dr. Hasbrouck recommended the laying of a cast-
iron pipe sewer from a point near the intersection of Walgrove avenue and
the road to the asylum to replace the present vitrified pipe sewer for a dis-
tance of some five or six hundred feet toward the asylum.
A hearing subsequent to on order of the village board of health requiring
the asylum to show cause why they should not cease to pollute the aforesaid
water supplj-, has been held by the village board of health. A hearing is now
being held in which the village board of health, the New York Juvenile
Asylum and Mr. C. M. Paton are represented by their respective counsel.
The' reply of the asylum ofl[icials to the order of the board of health is to
the effect that the leaks which were discovered by an inspection of the sewer
have been repaired. That the sewer was well built in accordance with general
practice and subject to the inspection of the board of health; that whatever
pollution reaches the stream from surface water above the Paton estate is
with the exception of that from the asylum poultry yard only that which is
incident to the lawful improvement of the property, and comes only in part
from the asylum property; that although they were willing to take all reason-
able steps for the prevention of unnecessary pollution from the asylum
f)roperty, they did not think that the stream in question would, because of its
ocation in a populated watershed, yield a potable water.
Accompanied by Dr. Hasbrouck, the village health officer, Mr. Morgan, the
superintendent of the asylum, and Mr. C. M. Pat<jn, Mr. A. O. True, Assist-
ant Engineer of this Department, made an inspection of the stream and the
part of the watershed under discussion. No samples of the water were taken
for water analysis. The recent records and reports pertaining to this mat-
ter were examined at the corporation room and Dr. Ilasbrouck and Mr. True
were interviewed by Mr. Robinson and Mr. Corcoran, engineers representing
the asylum.
At the time this inspection was made, the upper part of the channel of
the stream was dry, although one or two of the springs from the roadway
embankment were flowing. Although no visible evidences of pollution were
noted at this time, it is evident from the inspection that the stream receives
the natural run-off from the adjacent properties. Such part of this water
as comes from the populated and improved areas of the watershed is sub-
ject to surface contamination which may be objectionable even if not
dangerous. No leakage of pewage was apparent at the time of the inspection.
Regarding the powers of t:ie local boards of health and the State Depart-
ment of Health in the conservation of the purity of the waters of the state,
the Public Health Law prohibits the discharge of sewage into such waters
and provides for the protection of public water supplies and their water-
sheds by the enactment of rules and regulations by the Ck)mmission€r of
Health. It also provides for the abatement of conditions declared to be
public nuisances.
Protection of Public Water Supplies 527
If this supply can be defined as being a public water supply, the officer,
board or corporation having control of the same can require by application
to the State Commissioner of Health the enactment of rules and regulations
in accordance with section 70 of the (Consolidated) Public Health Law. Such
regulations when enacted fix the minimum distance at which buildings,
yards, etc., and all the waste substances resulting from man*s economy can
Le placed from the reservoirs and watercourses. The cost of any permanent
changes necessitated by the enforcement of such rules and regulations must
be borne by the corporation or board benefited thereby.
There remain the questions of the leakage of sewage and the discharge of
storm water into the water supply, and as to whether these actually con-
stitute a public nuisance. Under the Public Health Law these are questions
under the jurisdiction of the local board of health, and only in ease such
matters affecting the health of a considerable number of people would it be
the duty of the State Commissioner of Health to take action.
From the foregoing, I have come to the following conclusions:
1. That the stream and springs on the Paton estate above referred to do
not in my opinion and at the present time constitute a public water supply.
2. That ii at some subsequent time this water supply should be so de-
veloped or used as to be considered a public supply, the party or parties
controlling the same should apply to this department for tne enactment of
rules and regulations for the protection of the watershed.
3. That the alleged pollution of the water by sewage and storm water to
the extent of being or becoming a menace to health or an injury to property
are matters, the facts and circumstances of which can only be settled by
court procedure.
4. That if it is shown after careful investigation that discharges from the
present sewer and storm drains consrtitute a nuisance, it is the duty of the
local board of health to require the abatement of the same.
In conclusion I recommend that the local board of health be required to in-
vestigate this matter and to ascertain if there exist any local nuisances
and to cause the abatement of any such as are found to exist in accordance
with their powers under the Public Health Law.
Respectfully submitted,
THEODORE HORTOX,
Chief Engineer
In accordance with the abo\e recommendations a copy of this report was
Jent to local board of health on December 5, 1910, and they were asked to
make a thorough investigation and to report to this department as to what
action is taken in the matter.
LETCHWORTH VILLAGE
Plans for water supply, sewerage and sewage disposal for Letchworth vil-
lage were submitted for approval by the State Architect on July 22, 1910, and
were approved on July 26tn.
Reference is made to page 429 of this report for the report of the Chief
Engineer on an examination of these plans.
MONTICELLO
Advices were received of several cases of typhoid fever existing in Mon-
tieello during the summer, although they were believed by the local authori
ties to have been imported. Information was received, however, of the occur-
rence of pollution of Kiamie&ha Lake from which the vill^e water supply is
derived and the analyses made by the State Hygienic Laboratory showed
528
State Department of Health
considerable contamination of the water. A telegram was accordingly dent
to the local board of health on August 3, 1910, requesting them to publish
notices in the public press, issue hand bills and post placards advising
the consumers of the public water supply to boil all water before using until
further notice. A telegram was also sent to the president of the b^rd of
water commissioners, requesting that every rule and precaution be enforced
immediately to protect their water supply.
-The department was advised that immediate steps were taken upon the
receipt of these telegrams to prevent pollution of the lake by the removal
of pipes from cesspool drains and other sources of pollution and that daily in-
spections and patrol had been established.
NIAGARA FALLS
Albany, N. Y., June 10, 1910.
Eugene H. Porter, M.D., State Commissioner of Healthy Albany, y. T. ;
Dear Sir: — I beg to submit the following report of an investigation to de-
termine the source of the water supplies for the hotels, restaurants and ice
cream and soda water parlors at Niagara Falls, N. Y.
Tlie inspections were made by Mr. Fritz M. Arnolt, engineering inspector,
on June 7, 8 and 9, 1910. Thirty-six hotels, twenty-two restaurants and eight
soda water fountains and ice cream parlors were included in the investigation.
The results are tabulated below imder the respective heads of hotels, res-
taurants and soda water and ice cream parlors.
Only two of the latter are therein noted as served city water direct. The
other six used city water filtered by small pressure filters which gave a very
clear water, but of doubtful bacterial purity.
Tnvrstifjation of Wafer Supplies for Public Places
Hotels
1
Persons served 1
NAME OF PLACE
day in busy
Kind of water served
<
season
Capitol, hotel
50+
Ongiara.
Cataract House
1,000
200-300
Clifton, hotel
Well water and Ongiara. People will
drink from taps.
Columbia Hotel
200-300
City water. Goat Island spring water
becomes too roily.
Cosmopolitan Hotel
150
Goat Island spring water.
Echota, hotel
100+
Ongiara.
Edwards House
100-150
City water clarified by porcelain crock
filter. Occasionally Ongiara and
from Johnson's well.
Emoire Hotel
100+
City water clarified by patented Pas-
1
teur filter.
European Hotel
100+
Ongiara.
'FaMs Hotel and Rcht.i
400-500
City water.
Harvey House
50+
Ongiara.
Imperial Hotel
1
300-500
Spring water. (City water may be
served.)
International House
1,000
Condensed steam filtered, three char-
coal and sand.
Johnson's House
50 100
1 Johnson's well.
Protkction of Public Water Supplies
529
Investigation of Water Supplies for PuhJlc Places — (('out. )
Hotels
NAME OF PLACE
Persons served 1
day in busy
season
Kind of water served
Kaltenbach, hotel 100-200
Lehigh, hotel 50-100
Mayle Hotel , 50+
Nassau Hotel 50+
N. Y. Central Hotel 50+
New Walker House 50-100
Niagara Falls House 50-100
Oak European Hotel .... 200+
Pacific Hotel i 40 (No transients)
Pittsburgh Hotel I 100-200
Power City Hotel 100+
Prospect House 75
RApids House ' 150+
Raines Hotel and Res- 300-400
taurant. '
Richmond House 100+
Robinson's House ' 50-100
Temperance House 300+
Tower House 300-500
Union House 50
Vancouver Hotel 100+
Watflon House 100+
Wayne Hotel 50
Restaubants
Adams Restaurant 100-200
Allen Restaurant 300-400
Cascade Cafe 200-300
Cataract Restaurant .... 400-600
Chandler's Restaurant.. 400-500
Chicago Lunch 150
Coffey's Restaurant ' 1 ,000
European Restaurant — 200
Exchange ResUurant ... J 100-200
Hubbard's Restaurant. . . 400
King's Restaurant 200-300
Well on Jefferson St.
City water clarified by porcelain crock
filter of 2 gallons capacity.
Brewery well, artesian.
City water.
Well and Ongiara.
Ongiara (may serve city water on
calls).
Vartray Crystal water.
Goat Island spring water.
City water.
Well.
WeU.
City water clarified in porcelain crock
filters. Unfiltered city watei
served.
City water when clear. Otherwise
Goat Island spring water, Davis and
Ongiara waters.
City water. Use Ongiara when city
water becomes too roily.
Table Rock spring and Ongiara.
Johnson's well.
Artesian well.
City water clarified by small pressure
fQter.
Ongiara water.
Ongiara water.
Goat Island spring and bottled water
from Niagara Falls Ice and Water
Co.
Temperance House well.
Well on Jefferson St.
City water boiled.
Johnson's well on Prcspect St., and
from Davies' well, Canada.
City water, when clear. Otherwise
Johnson's well.
City water clarified by pressure filter.
City water clarified by pressure filters.
City water.
Johnson's well.
City water claiified by Clarine Tab-
lets and filtration through cotton.
City water clarified by pressure filter.
City water, when clear. Otherwise
water from well on Jefferson St.
5ao
State Department of Health
Investigation of Water Supplies for Public Places — (Cont.)
RESTAUBANra
name of place
Keelty's Restaurant
Maple Leaf Restaurant
Mitchell's Restaurant . . .
Neidhart Restaurant ....
New England Restaurant
Old Home Restaurant . . .
Park Restaurant
Russ's Restaurant
Wagner's
Whitwell (Board)
Women's Union
Sarkee Bros
Persons served 1
day in busy
season
20 regulars and
some transients.
200
200-300
300-400
400-500
30-50
20-40
20-30
100+
20
50-100
Kind of water served
City water.
City water (Claimed that filter was
being repaired by proprietor. Wait-
ress stated no filter was used).
Goat Island spring water.
Goat Island spring water. Also water
from well on Jefferson St.
City water. Use well on Jefferson St
when city water becomes too roily.
Well water.
City water.
WeU.
Well on Jefferson St.
City water boiled.
City water boiled and *'C Clarine."
Ice Cream Parlors
1,000-1,500
City water, unless it gets too roily.
Then use well water.
Six drug stores having Foda fountains were visited, and in each case it was
found that city water clarified by small pressure filters was used. These drug
stores were located on Falls street south of Second street.
No house-to-house investigation of the rooming and 'boarding places was
made. Since there are from 500 to 1,000 or more of these places, this was
impracticable in tlie time available. About a dozen people coming from such
places were interrogated and they stated that the water used was either from
Goat Island or the city water from the taps. It is the opinion of Dr. Jerauld,
health officer of Niagara Falls, that most of these places use city water from
the taps.
The small filters used in some of the hotels and restaurants and also in
the drug stores are of two general kinds, the porcelain erode filter and the
pressure filter. The former consists of two porcelain crocks, one setting on
top and fitted into the other. Tlie bottom of the upper one consists of a
porous plate through which the water trickles or filters into the lower crock
which is used a« a reta»iner or cooler.
The pressure filter consists of a cylinder of natural or artificial porous
stone having a hollow core. This is inclosed within an iron cylinder. The
water passes into the iron cylinder and filters through the porous cylinder
of stone into the hollow core. From here it is lead into a cooler.
Both of these filters give a remarkably clear effluent. The city water before
being filtered is very turbid, but in only a few cases was any turbidity no-
ticed after the water had been filtered by the above means.
The other general source of water supply is the spring on Goat Island.
This spring is located on the north bank of Goat Island, about 100 yards
east of the bridge connecting Goat Island with the mainland. The distance
from the spring to the west bank of the American channel at a point where
Protkction of Public Water Supplies 531
the river water is at about tlie same elevation as that of the spring is only
seventy feet. The spring is located in limestone which is greatly cracked
and fissured. In all probability the water in the spring is river water that
has entered by some fissure. This spring has never been known to run dry
in summer. This water is used by a great number of people and, considering
its geological features, its bacterial purity is questionable.
The bottled waters used are either distilled water, as the Ongiara, or waters
from well known springs in New York State and Canada. The wells used are
driven wells, ranging in depth from 50 to 150 feet.
In all cases city water is used to wash dishes, glasses and vegetables. In a
great many instances ice cut from the river is served in the water on the
tables. The larger hotels, liowever, use hygienic or distilled water ice.
In summary, ten hotels and twelve restaurants used city water, four of
which in each instance clarified this water by the use of pressure or stone
crock filters. Two restaurants and one hotel stated that they boiled the
city water before serving it.
All the soda water and ice cream parlors ufed city water, but six out of
the eight investigated had pressure filters.
Ten hotels, but no restaurants used bottled waters. Eleven hotels and six
restaurants used well or spring water other than the Goat Island spring
water. Four hotels and two re€?taurants need water from Goat Island. One
hotel used condensed steam filtered through charcoal and sand.
All of the hotels and restaurants using city water stated that tbey served
bottled waters at the periods the city water became roily. The lodging and
rooming houses used city water or water from Goat Island spring.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
Albany, N. Y., July 11, 1910.
Eugene H. Pokteb, M.D., State Commissioner of Healthy Alhani/, N. T. :
Deab Sib: — In connection with our recent investigation of the sources of
water furnished guests at hotels and restaurants at Niagara Falls, you
directed me to secure additional and definite information concerning the pres-
ent public water supply of this city, and especially as to the eff'ects and prog-
ress recently made by the city officials to secure a pure supply.
In accordance with your request, I beg to state that I detailed one of our
inspecting engineers, Mr. Fritz M. Arnolt, to visit Niagara Falls, to inspect
its present public supply and to confer with certain of the city officials to
secure the information above referred to. Tlie following is a statement of
faots so far as they could be learned from an inspection and through hearsay
from the city officials:
Niagara Falls is at present being supplied with water by two plants. One
is operated by the city and has an intake at the lower end of the hydraulic
canal. At present this water is not purified, but distributed in its raw
state. Mr. Bobbins, the city engineer, stated that a contract had been let
for the installation of a hypochloride plant to sterilize this water until a fil-
tered supply could be obtained. There had been some delay in getting this
under way, but he expected it to be in operation by the middle of August.
This plant, operated by the city, distributes 5,000,000 gallons per day.
The second plant is operated by the Western City Water Works Company,
Mr. James H. Macbeth, superintendent, and distributes from ten to eleven mil-
lion gallons of water per day. It has its intake near the upper end of the
power or hydraulic canal. About 4,000,000 gallons of water passes through
mechanical filters and is clarified to some extent. No coagulant is used.
The other 7,000,000 gallons are by-passed directly into the mains. The super-
532 State Department of Health
intendent stated that lie bad under consideration the installation of a liypo-
chloride plant to sterilize the wa;ter. lie staited that he was expecting an
engineer from Philadelphia any day to look over the situation and design a
suitable plant.
Tlie city of Niagara Falls has let a contract to the Norwood Engineering
Company for the construction of coa^Ia.ting basins and rapid filters to treat
16,000,000 gallons of water a day. Thi3 plant is to be located near the southern
city line on the Niagara river. The intake extends 2,000 feet into the Ameri-
can channel and is in 18 feet of wuter. The river at this point is about
6,000 feet wide. A proposition to extend the irutake to the Canadian side
was d<»feated last June. The city engineer stated that the present intake is
located at the place where the analyses made by the State Hygienic Labora-
tory showed th«5 purest water, in the American channel, was to bo found.
The two coagulating basins have a capacity of a million gallons each. Alumi-
num sulphate is to be used as a coagulant and this is to be followed by a
treatnient with hypochlorites. A sedimentation period of three hours is
provided for. The rapid filters are 16 in number, each having 360 square feet
and designed to treat 1,000,000 gallons each, or at a rate of 121,000,000 gallons
per acre per day. Estimating on the basis of payments about Va <*f the
plant is constructed. The contract calls for the completion of the plant by
August 1, 1910.
The general plans and specifications were drawni up by John W. Alvord and
Chas. B. Burdick, consulting engineers, of Chicago. The bid and detailed
plans submitted by the Norwood Engineering Company, of Florence, Muss.,
were accepted, and the contract awarded to them. I'heir guarantee states
that the water shall contain no undecomposed coagulant, shall be clear, bright
and practically free from color, odor, turbidity and suspended solids. The
filtered water shall contain less than 100 bacteria per c. c. and no B. Coli
communis. They are bonded for one year after the plant has been turned over
to the city in the sum of $50,000.
The city engineer, Mr. Bobbins, stated that it was unoflicially understood
that the city will supply water to the Western City Water Works Company
when the filters are in operation. As this would call for a draft of over
17,000.000 gallons per day the plantt would be slightly overtaxed at the outset,
as it is only designed for 16.000,000 gallons per day.
Respectfully yours,
THEODORE IIORTOX,
Chief Eninnrcr
On July 2, 1910, a telegram was sent to the health ofiicer at Niagara Falls,
directing him to notify the public of the polluted condition of the public
water supply, and on July 8th, he replied that every hotel keei>er, restaurant
and railroad in the city had been warned by the serving of personal notices
and the public had been warned through the press.
In addition, on July 30th and August Ist, copies of the following letter
were sent to the proprietors of hotels, restaurants and ice cream parlors in
Niagara Falls, as listed on pages 2, 3, 4 and 5 in the foregoing report of the
Chief Engineer to the Commissioner, dated June 10, 1910.
" I desire to call your attention to the polluted and unsafe condition
of the water supplies furnished by the city of Niagara Falls and by the
Wesftern City Water Works Company of Niagara Falls.
" You are doubtless aware of the fact that the water thus supplied is
not at the present time a proper and safe supply to furnish your guests,
but I wish to impress upon you and upon the proprietors of other hotels
and restaurants in your city the great need of providing a pure and satis-
factory water supply to guests until a pure public water supply is
available."
Very respectfully,
ErV,ENE II. rORTKR.
Commissioner of Ilrnlth
Protection of Public Water Supplies 533
OGDENSBURG
On February 16, 1910, Mr. Horton, Chief Engineer of the Department, vis-
ited Ogdensburg at the request of the water board and Mr. Lord, the superin-
tendent of the water works, for the purpose of being present at a meeting of the
taxpayers called to consider the question of securing a new water supply for
the citv.
During the afternoon, Mr. Horton, accompanied by Mr. Ix)rd and two of
the consulting engineers of the city, drove over the grounds, inspecting the pro-
posed locations of filters and stand pipe for the new supply, after which the
various questions concerning the recommendations of the consulting engineers
for filtration of the St. Lawrence river water wvre discusj.-ed with the water
board.
The meeting of the taxpayers in the evening, at which some 150 persons
were present, was addressed by Mr. Horton, and Mr. Hazen of the engineering
firm of Hazen and AATiipple, following which the question of securing a better
wuter supph' was discussed generally and fully. Although there has always
been a strong sentiment in favor of the filtration of the Oswegatchie river by
the taxpayers of the city, the expert opinions and advice seemed to prevail,
and it was evident that the majority of the taxpayers present at this meet-
ing were willing to accept the conclusions of the experts and were in favor of
a filtration of the St. Lawrence river.
SKANEATELES
Alhaxy, N. Y., Xorembcr 22, 1910.
Eugene H. Pokteb, M.D., Htate Commissioner of Health, Albany^ \. Y.:
Deab Sir: — I beg to make the following report of an investigation in the
iHiatter of certain public water supplies derived from wells along the Skane-
ateles lake outlet, otherwise known as Skaneateles creek.
There are some six villages (unincorporated) located along the outlet below
the village of Skaneateles. These are all in the town of Skaneateles in Onon-
daga, county, near the foot of Skaneateles lake, and about fifteen miles south-
west of the city of Syracuse. The present populaition of these villages aggre-
gates in the vicinity of 2,000 people. There is considerable industrial activity
along the outlet, chiefly in the manufacture of woolen cloth, wall paper,
wrapping paper and lumber.
The water supplies for these settlements are taken from many wells along
the outlet. The majority of these are dug wells though a few are driven.
These wells are privately owned and in nearly every case the water is raised
by a hand pump. They varj- in depth from 16 feet to 34 feet, as far as
could be learned. As evidence of the close relation between the water in the
outlet and the ground water level it is said that three-quarters of these wells
go dry when the water is shut off from the outlet. Most of them are only a
few feet from the outlet and apparently extend considerably below the sur-
face of the water in the outlet. Others are somewhat removed therefrom,
and in some cases probably wholly above the outlet water level. Were it
Hhown that there exists a close relation between the w^ater levels in the out-
let and those in the adjacent wells, and that more or less free interflowage
as distinguished from infiltration through soil was probable between the out-
let and the wells, it immediately becomes important to know if there is a
possibility of frequent pollution of the wells by the flow of water Iron tire
outlet through fissures in the shale and limestone underlying tiw
534 State Depaktmknt of Health
Tlie water from the outlet is receiving the unpurified sewage of two sew-
ers at Skaneateles in addition to a number of drains discharg-ing below the
lake. It is also receiving the effluent from the septic tank which treats the
sewage of the village of Skaneateles. From the carporation line of the vil-
lage of Skaneateles to the boundary between the towns of Skaneateles and
Elbridge the outlet receives the sewage and trades waste from the mills in
this region.
In discussing the question of the effluent discharged from the septic tank at
Skaneateles village it must be remembered that whereas the septic tank pro-
vides one of the best preliminary processes for "the purification of sewage,
when used alone its function is concerned chiefly with ithe prevefttiou of nui-
sances and it does not, nor is it designed to, eliminate fecal bacteria. When
properly operated it undoubtedly does remove a comparatively large percentage
of these bacteria.
On November 2, 1910, Mr. A. 0. True, assistant engineer of this Depart-
ment, visited the town of Skaneateles, and in company with Doctors Brown
and Giles made an inspecbion of some of the wells in this district.
Samples of water for sanitary analysis were collected from five wells lo-
cated in different parts of this district and from the outlet near the corpora-
tion line, and near the Skaneateles-Elbridge town line. The results of these
analyses, together with the results of the analyses of one well and one spring,
made in July, 1910, in parts per million, are given on inclosed table.
These results indicate that the wells tested were probably polluted by sur-
face water at the time the samples were collected. All the wells, with the
exception of that at the Hartlot Paper Mill, gave positive tests for the colon-
bacillus, and with two exceptions the bacterial counts were high. The wells
tested were located in comparatively widely separated points of the district
at various distances from the creek, and the repeated occurrence of the B. Coli
type of organism in samples so distributed and taken at two distinctly different
times, viz. July and November, 1910, would indicate a contamination of the
ground water of this region by surface water. The actual source or sources of
this contamination is not so clear, and its determination would require a more
extended study than has been given to this matter, or could be given by this
Department under the present limitation of its time and resources for such
work.
This is a region of shale and limestone, a geological structure which usually
admits of the passage of underground water, with little or no filtering action,
through fissures or even natural conduits in the rock.
The fact that the elevations of the water table at the wells is influenced by
and responds quickly to variations in the quantity and height of the water
in the ouitlet is not proof that there is a flow of water from the outlet to
the wells. It is true such a condition might occur during a dry period when
the draft upon any well had lowered the water table at that point below the
water level in the outlet. But there may be other means of contamination
operative which allows surface water or drainage to find ingress to and to
contaminate the ground water. Among several ways in which surface con-
tamination might reach the wells may be mentioned seepage of surface water
from the waitershed above through rifts in the underlying strata to the water
in the well, and the washing of contaminated surface material through the
loose open well covering. Most of these wells are not provided with water-
tight well curbs and some are shallow wells. In short there are in the ab-
sence of an extended invesitigation so many indeterminate factors which may
directly influence the quality of a well water supply that it is impossible to
trace with certainty the actual cause or causes involved.
From a consideration of the results of the several analyses of tl ese well
supplies, in the light of the geoh^y and hydrolo«ry of this region, I am of
the opinion that:
Puotp:<ti()X of PruLit' Wateu Supplies 535
1. The wells in this region are subject to contamination by surface waters.
2. That the results of the present investigation give no certain index to
the exact source or sources of this contamination, but that it may be due to
the seepage of surface waters through a fissured substratum above the wells
or from the creek below the wells, or from a local washing in of organic mat-
ter from the open coverings of the wells.
I, therefore, recommend that a further study of local conditions be made
by the owners of the water supplies with a view to determiniing the sources
of polhifcion. Further, in the event that it is shown to be impracticable to
remove the sources of j>ollution or otherwise remedy the danger therefrom,
these settlements be advised to develop new sources of supply.
Respectfully submitted,
THEODORE HORTOX,
Chief Engineer
In accordance with the recommendations of this report a copy of the report
was sent to local health officers on November 26, 1910, urging that the board
give the conclusions and recommendations contained therein immediate and
careful consideration.
WATERLOO
Subsequent to, and as, the result of the report of this Department trans-
mitted on November 11, 1909 (see Thirtieth Annual Report, Vol. II, p. 356),
on an investigation of the village water supply, the village board of health and
board of trustees met in joint session to consider the matter. Ihe report of
the special assistant engineer, who was present at this meeting, is as follows:
Ithaca, N. Y., January 14, 1910.
Mr. Theodobe Hobton, Chief Engineer, State Department of Health, Albany,
A. y.;
Deab Sib: — I have the honor to report that in accordance with your direc-
tions, I visited the village of Waterloo, Thursday, January 13th. and con-
ferred with the board of trustees and the board of health, in joint session, on
the subject of their water supply.
I found that your report had been already read aloud to both boards and
that they generally acquiesced in it, except for the minor grievances already
pointed out by the health officer.
Upon the invitation of the president of the village I took the chair and
expressed to the meeting, as well as I could, not only tlie desire of the De-
partment, but also their sense of responsibility, to have the present condition
of the quality of the water improved. 1 pointed out that when, as in this
case, tl^e water supply was in the hamis of a private ompany, no direct
move was possible by "which that company could be forced to modify or im-
prove existing conditions. I added that in some eases indirect methods might
be employed and cited, without names, in-tances where the agreements of tie
franchise by which the company guaranteed to furnish "wholesome and palat-
able water ** had been invoked to force the water company to m^ke im-
provements.
I suggested the possibility of a refusal to pay hydrant rentals if the other
terms of the franchise were not carried out.
It appeared that the president of the board of trustees had no definite
knowledge of the terms of the franchise, of its period, or of any of its par-
ticulars. After investigation it was found that the terms of the franchise
required the company to furnish " pure and wholesome water," and that the
536 State Department of Health
fraiiclus>e was limited for twenty years, being granted in 1885. It appeared,
therefore, that while evidence might be obtained by which to cancel the fran-
chise under which the company is now ojMjrating, such action would not be
necessarj' because of its lapse.
It would further appear that the water company is indifferent to the needs
of the community, being controlled by nonresidents, and that it is not likely
that they will be persiiade<l to take any desired action.
As a result of the discussion two committees were appointed, one of whom
is to confer with the president of the water company, in order to ascertain
what steps, if any, the waiter company will take, leading toward an improved
supply; tlie other committee was directed to examine into and report on the
terms of the franchise and the postiibility of inaugurating a movement for a
municipal water supply.
I inclose herewith the correspondence sent me in this matter.
Yours respectfully,
H. N. OGDEN,
Special Assistant Engineer
In addition to the foregoing, correspondence was had and advice was given
in matters rel-ating to the quality of the water supply at a large number of
municipalities in the State.
PREPARATION OF RULES FOR THE PROTECTION OF
PUBLIC WATER SUPPLIES
Perhaps the most important provision of the Public Health
Law relating to water supplies is the enactment by the State Com-
missioner of Health of rules and regulations for the protection
from contamination of public water supplies when application has
been duly made by the proper authorities having control of these
supplies, and during 1910 apiolications were received and rules
and regulations prepared for enactment in the cases of the follow-
ing municipalities :
Delhi Cortland Cooperstown
West Carthage Syracuse Suburban Haverstraw Water
Deansboro Water Co. Supply Co.
These applications were received in the latter part of the year,
and since it is necessary in each aase to carefully inspect the water-
sheds, and customarv to submit drafts of these rules for considera-
tion and comment of local authorities, these rules and regidations
were at the close of the year enacted only in the cases of the
Syracuse Suburban Water Co. and the Haverstraw Water Supply
Co., the remaining ones being at this time in the hands of the local
authorities for consideration.
Abstract of the Xew York State Public Health Law
providing for the protectiox from contamination of the
PUBLIC WATER SUPPLIES THROirOHOUT THE StATE. ChAPTER
45 OF THE Consolidated Laws (Public Health Law)
" § 70. Rules and reffidaiions of department, — The state de-
partment of health may make rules and regulations for the pro-
tection from contamination of any or all public supplies of potable
waters and their sources within the state. If any such rule or
regulation relates to a temporary source or act of contamination,
any person violating such rule or regulation shall be liable to
prosecution for misdemeanor for every such violation, and on con-
[537]
538 State Depabtment of Health
viction shall be punished by a fine not exceeding two hundred dol-
lars, or imprisonment not exceeding one year, or both. If any
such rule or regulation relates to a permanent source or act of
contamination, said department may impose penalties for the vio-
lation thereof or the noncompliance therewith, not exceeding two
hundred dollars for every such violation or noncompliance. Every
such rule or regulation shall be published at least once in each
week for six consecutive weeks, in at least one newspaper of the
county where the waters to which it relates are located. The
cost of such publication shall be paid by the corporation or
municipality benefited by the protection of the water supply, to
which the rule or regulation published relates. The affidavit of
the printer, publisher or proprietor of the newspaper in which
such rule or regulation is published may be filed, with the rule
or regulation published, in the county clerk's office of such county,
and such affidavit and rule and regulation shall be conclusive
evidence of such publication, and of all the facts therein stated
in all courts and places.
" § 71. Inspection of water supply, — The officer or board hav-
ing by law the management and control of the potable water
supply of any municipality, or the corporation furnishing such
supply, may make such inspection of the sources of such water
supply, as such officer, board or corporation deems it advisable,
and to ascertain whether the rules or regulations of the state
department are complied with, and shall make such regular or
special inspections as the state commissioner of health -may pre-
scribe. If any such inspection discloses a violation of any such
rule or regulation relating to a permanent source or act of con-
tamination, such officer, board or corporation shall cause a copy
of the rule or regulation violated to be served upon the person
violating the same, with a notice of such violation. If the per-
son served does not immediately comply with the rule or regula-
tion violated, such officer, board or corporation shall notify the
state department of the violation, which shall immediately ex-
amine into such violation ; and if such person is found by the
state department to have actually violated such rule or regulation,
the commissioner of health shall order the local board of health
of such municipality wherein the violation or the none mpliance
Rules foe Peotection of Public Water Supplies 639
occurs to convene and enforce obedience to such rule or regula-
tion. If the local board fails to enforce such order within ten
days after its receipt, the corporation furnishing such water sup-
ply, or the municipality deriving its water supply from the
waters to which such rule or regulation relates, or the state com-
missioner of health or the local board of health of the munici-
pality wherein the water supply protected by these rules is used,
or any person interested in the protection of the purity of the
water supply may maintain an action in a court of record, which
shall be tried in the county where the cause of action arose against
such person, for the recovery of the penalties incurred by such
violation, and for an injunction restraining him from the con-
tinued violation of such rule or regulation.
" § 73. Sewerage. — When the state department of health shall
for the protection of a water supply from contamination, make
orders or regulations the execution of which will require or make
necessary the construction and maintenance of any system of
sewerage, or a change thereof, in or for any village or hamlet,
whether incorporated or unincorporated, or the execution of which
will require the providing of some public means of removal or
purification of sewage, the municipality or corporation owning
the water works benefited thereby shall, at its own expense, con-
struct and maintain such system of sewerage, or change thereof,
and provide and maintain such means of removal and purification
of sewage and such works or means of sewage disposal as shall
be approved by the State Department of Health. When the execu-
tion of any such regulations of the state department of he alth will
occasion or require the removal of any building or buildings, the
municipality or corporation owning the water works benefited
thereby shall, at its own expense, remove such buildings and pay
to the owner thereof all damages occasioned by such removal.
When the execution of any such regulation will injuriously affect
any property the municipality or corporation owning the water
works l)enefited thereby shall make just and adequate compensa-
tion for the property so taken or injured. Until such construction
or change of such system or systems of sewerage, and the provid-
ing of such means of removal or purification of sewage, and such
work or means of sewage disposal and the removal of any build-
542 State Department of Health
these rules is intended to mean and refer to the impounding and distribut-
ing reservoirs at Stony Point, and to any additional reservoirs which may
be constructed on Cedar Pond brook or any of its tributaries. The term
" watercourse," wherever used in these rules, is intended to mean and in-
clude every spring, pond (other than the artificial reservoirs and filter
basins), stream, ditch, gutter, or other channel or permeable pipe or con-
duit of every kind, the waters of which wlien running, whether continuously
or occasionally, eventually flow or may flow, into the water supply of the
said Haverstraw Water Supply Company.
Wlierever a linear distance of a structure or object from a reservoir or
from a watercourse is mentioned in these rules it is intended to mean the
shortest horizontal distance from the nearest point of the structure or object
to the high-water m«,rk of a reservoir, or to the edge, margin or precipitous
bank forming the ordinary high-water bank of such watercourse.
Privies Adjacent to any Reservoir or Watercourse
1. No privy, privy vault, pit, cesspool or any other receptacle of any kind
used for either the temporary storage or the permanent deposit of human
excreta shall be constructed, placed, maintained or allowed to remain with
its nearest point within fifty (50) feet of any reservoir or watercourse of
the water supply of the Haverstraw Water Supply Company.
2. No privy, privy vault, pit, cesspool or any other receptacle used for
the permanent deposit of human excreta shall be constructed, located, placed,
maintained or allowed to remain with its nearest point within one hundred
and fifty (150) feet of any reservoir or watercourse of the water supply
of the Haverstraw Water Supply Company.
3. Every privy, privy vault, pit. cesspool or other receptacle or place
used for the temporary storage of human excreta which is constructed* lo-
cated, maintained or allowed to remain within the limiting distance pre-
scribed and stated by rule (2) from which privy, or other receptacle the
excreta are not at once removed automatically by means of suitable water-
tight pipes or conduits to some proper place of ultimate disposal, as here-
inafter provided, shall be arranged in such manner that all such excreta
shall be received temporarily in suitable vessels or receptacles which shall
at all times be maintained in an absolutely water-tight condition and which
will permit of convenient removal to some place of ultimate disposal as
hereinafter set forth.
4. The excreta collected in the aforesaid temporary receptacles permitted
under rule (3) shall be removed and the receptacles thoroughly cleaned and
deodorized as often as may be found necessary to maintain the priv>' in
proper sanitary condition and to effectually prevent any overflow upon the
soil or upon the foundations or floor of the privy. In effecting this removal
the utmost care shall be exercised that none of the contents be allowed to
escape while being transferred from the privy to the place of disposal here-
inafter specified, and that the contents, while being transferred from the
privy to the place of disposal, sliall be thoroughly covered and that the
least possible annoyance and inconvenience be caused to occupants of the
premises and the adjacent premises.
5. Unless otherwise specially ordered or permitted by the State Depart-
ment of Health the excreta collected in the aforesaid temporary receptacles
permitted under rule (3) shall, when removed, be disposed of by burying in
trenches, or by thoroughly digging it into the soil in such place and manner
as to effectually prevent them being washed over the surface of the ground
by rain or melting snow, and at distances not less than three hundred (300)
feet, horizontal measurement, from the high-water mark of any reservoir,
or not less than two hundred (200) feet from the edge, margin, or precipi-
tous bank of any watercourse of said water supply.
6. Whenever it shall be found that owing to the character of the soil or
of the surface of the ground, or owing to the height of flow or of subsoil
or surface water, or other, special local conditions, the excremental matter
from any privy or aforesaid receptacle, or from any trench or place of dis-
RuLKs FOE Protection of Public Water Supplies 543
po^al, or the garbage or wastes from any dump, may, in the opinion of the
State Commissioner of Health be washed over the surface or through the
soil in an imperfectly purified condition into any reservoir or watercourse,
then the said privy or receptacle for excreta or the said trench or place of
disposal or the said garbage or waste dump, shall, after due notice to the
owner thereof, be removed to such greater distance or to such place as shall
be considered safe and proper by the State Commissioner of Health.
Sewage, House Slops, Sink W<iste, etc.
7. Xo house slops, bath water, sewage or excremental matter from any
water-closet, privy, or cesspool shall be thrown, placed, led, conducted, dis-
charged or allowed to escape or flow from any pipe, drain or ditch either
directly or indirectly into any reservoir or watercourse of the water supply
of the Haverstraw Water Supply Company, nor shall any such matters be
thrown, placed, led, discharged or allowed to escape or flow onto the surface
of the ground or into the ground below the surface within three hundred
(300) feet of any such reservoir or watercourse.
8. No garbage, putrescible matter, kitchen or sink waste, refuse or waste
water from any creamery, cheese factory, laundry, nor water in which
milk cans, utensils, clothing, bedding, carpets or harnesses have been washed
or rinsed, nor any polluted water or liquid of any kind shall be thrown or
discharged directly or indirectly into any reservoir or watercourse of the
water supply of the Haverstraw Water Supply Company; nor shall any such
liquid or solid refuse or waste be thrown, discharged or allowed to escape
or remain upon the surface of the ground or to percolate into or through
the ground below the surface in any manner whereby the same may flow
into any reservoir or watercourse of the water supply of the Haverstraw
Water Supply Company, within one hundred (100) feet of any such reservoir
or within seventy-five (75) feet of any such watercourse.
9. No clothing, bedding, carpets, harness, vehicle, receptacles, utensils, nor
anything that pollutes water, shall be washed, rinsed, or placed in any reser-
voir or watercourse of the water supply of the Haverstraw Water Supply
Company.
Bathing, Animals, Manure, Compost, Etc,
10. No person shall be allowed to bathe in any reservoir or watercourse of
the water supply of the Haverstraw Water Supply Company, nor shall any
animals or pH>ultry be allowed to stand, wallow, wade or swim in said res-
ervoir or watercourse, nor be washed therein.
11. No stable for cattle or horses, barnyard, hog yard, pig pen, poultry
house or yard, hitching place or standing place for horses or other animals,
manure pile or compost heap, shall be constructed, placed, maintained or
allowed to remain with its nearest point less than, one hundred and fifty
(150) feet from any reservoir, or fifty (50) feet from any watercourse of
the water supply of the Haverstraw Water Supply Company; and none of
the above-named objects or sources of pollution shall be so constructed,
placed, maintained or allowed to remain where or in such manner that the
drainage, leachings, or washin^rs from the same may enter any such reser-
voir or watercourse without first having passed over or through such an
extent of soil as to have been properly purified, and in no case shall it be
deemed that proper purification has been secured unless the above drain-
ing*, leachings or washings shall have percolated over or through the soil
in a scattered, dissipated form, and not concentrated in perceptible lines of
drainage, for the distance of not less than one hundred and fifty (150) feet
before entering any such reservoir, nor less than fifty (50) feet before enter-
ing any such watercourse.
12. No human excrement or compost containing human excrement shall
be thrown, placed, or allowed to escape into any reservoir or watercourse,
nor to be placed, piled or spread upon the ground, or dug or buried in the
poil, within a distance of three hundred (310) feet from any reservoir, or
two hundred (200) feet from any watercourse of the water supply of the
544 State Department of Health
Haverstraw Water Supply Company; and no manure or compost of any kind
shall be placed, piled, or spread upon the ground within one hundred and
fifty (150) feet of any such reservoir, or fifty (oOl) feet of any such water-
course.
13. No decayed or fermented fruit or vegetables, cider mill waste, roots,
grain or other vegetable refuse of any kind shall be thrown, placed, dis-
charged or allowed to escape or pass into any reservoir or watercourse, nor
shall they be thrown, placed, piled, maintained or allowed to remain in such
places that the drainage, teachings or washings therefrom may flow by open,
blind or covered drains or channels of any kind into any reservoir or water-
course of the water supply of the Haverstraw Water Supply Ck>mpany, with-
out first having passed over or through such an extent of soil as to have
been properly purified, and in no case shall it be deemed that sufficient puri-
fication has been secured unless the above-mentioned drainage, leachings or
washings shall have percolated over or tlirough the soil in a scattered, dis-
sipated form, and not concentrated in perceptible lines of drainage, for a
distance of not less than one hundred (100) feet before entering any such
reservoir or fifty (50) feet before entering any such watercourse.
Dead Animals, Offal, Manufacturing W<i9te, Etc,
14. No dead animal, bird, fish, or any part thereof, nor any offal or waste
matter of any kind, shall be thrown, placed, discharged or allowed to escape
or to pass into any reservoir, or watercourse of the water supply of the
Haverstraw Water Supply Company ; nor shall any such material or refuse
be so located, placed, maintained or allowed to remain that the drainage,
leachings, or washings therefrom may reach any such reservoir or water-
course without having first percolated over or through the soil in a scat-
tered dissipated form, and not concentrated in perceptible lines of drainage,
for a distance of not less than one hundred and fifty (150) feet before enter-
ing any such repervoir, or one hundred (100) feet before entering any such
watercourse.
Fishing, Boating and Ice Cutting
15. No fish shall be taken from anv reservoir or watercourse, nor shall
any person fish in any reservoir or watercourse or through the ice upon the
same, nor trespass upon the waters of any reservoir or watercourse or the
ice thereon, nor maintain or use any boat or boats thereon except the officials
or duly authoriacd employees of the Haverstraw Water Supply Company
in the exercise of their duties in the management and operation of the res-
ervoirs; nor shall any person or persons cut or remove any ice from any of
the reservoirs which form or are tributary to the sources of the public
water supply furnished by the Haverstraw Water Supply Company.
Inspection
16. The Haverstraw Water Supply Company, through its superintendent
or other duly authorized official, shall maintain systematic and thorough
inspection of the reservoirs and streams and of the entire drainage area
tributary thereto, for the purpose of determining whether the above rules
are being complied with. At least two such inspections shall be made each
year and such others as may be directed by the State Commissioner of
Health, or as may be deemed necessary by the Haverstraw Water Supply
Company to insure the maintenance of the watershed in a safe, sanitary
condition. A full and detailed report of each such inspection, including a
statement of each violation or noncompliance with the rules, shall be sub-
mitted in writing to the State Commissioner of Health within ten days after
the completion of such inspection.
Penalty
17. In accordance with section 70 of chapter 45 of the Consolidated Laws
(Public Health Law) the penalty for each and every violation of, or non-
Rules foe Pkotection of Public Water Supplies 545
compliance with, any of these rules and regulations which relate to a per*
^L manent source or act of contamination, is hereby fixed at one hundred ($100)
d t dollars.
rii' The foregoing rules aud regulations for the protection from contamination
of the public water supply of the Haverstraw Water Supply Company of
rwt Uaveratraw, Rockland county, N. Y., were duly made, ordained and estab-
liahed on the 14th day of July, 1910, pursuant to chapter 45 of the Consoli-
dated Laws (Public Health Law) of the State of New York.
EUGENE H. PORTER, M.D.,
State Commissioner of Health
AiaANY, N. Y.
ThcBe rules and regulations to be operative and valid must first be pub-
liHhed at least once each week for six consecutive weeks in at least one
newspaper in Rockland county, and at least one newspaper in Orange county,
and the affidavit of the printer, publisher or proprietor of each newspaper
in each county in which such publication is made, that the publication was
BO made, together with a copy of the rules and regulations, must be filed
with the county clerk of that county.
The cost of each such publication, affidavit and filing must be paid by the
Haverstraw Water Supply Company.
SYRACUSE SUBURBAN WATER COMPANY
Rules and regulations for the protection from contamination
of the public water supply furnished by the Syracuse Surburban
Water Company from Otisoo Lake in Onondaga county.
Genebal Regulations
The rules and regulations hereinafter given, duly made and enacted in
accordance with sections 70, 71 and 73 of chapter 45 of the Consolidated
Laws (the Public Health Law), as heretofore set forth, shall apply to the
entire drainage area of Otisco lake which forms the source of the water sup-
ply developed, furnished and controlled by the Syracuse Suburban Water
Company, of Syracuse. N. Y.
The term ** kike " wherever used in these rules is intended to mean Otisco
lake. The term " watercourse " wherever used in these rules is intended to
mean and include every spring, pond, lake (other than Otisco lake), stream,
ditch^ gutter, or other channel or permeable pipe or conduit of every kind,
the waterB of which when running, whether continuously or occasionally,
eventually flow, or may flow, inito Otisco lake.
Wherever a linear distance of a structure or object from the lake or a
watercourse is mentioned in these rulet it is intended to mean the shortest
horizontal distance from the nearest point of the structure or object to the
high-water mark of the lake, or to the edge, margin or precipitous bank
forming the ordinary normal high-water mark of such watercourses. High-
water mark of the lake shall be construed as a flow line, established and laid
down upon a map by the Syracuse Suburban Water Company, filed in the
Onondaga county clerk's oflice to which reference is hereby made for a more
particular description, said flow line being at an elevation of 789.6.
Rules and Regulations
Privies Adjacent to any Reservoirs or Watercourses
1. No pri>% privy vault, pit, cesspool or any other receptacle of any kind
or place useS for either the temporary storage or the permanent deposit of
human excreta shall be constructed, placed, maintained, or allowed to remain
18
54G State Department of Health
on the banks or shores of the lake below the flow line as established and as
referred to nhove.
2. No privy, privy vault, pit, cesspool or other receptacle of any kind or
place for the permanent deposit of hiunan excreta shall be constructed, placed,
maintained or allowed to remain at a less distance than 100 feet from the
flow line of the lake as established and referred to above, or from any water-
course leading into the lake.
3. Every priw, privy vault, pit, cesspool or other receptacle of any kind
or place used for the temporary storage of human excretf. which is con-
structed, placed, maintained or allowed to remain within the said distance
of ICO feet from which privy or other receptacle the excreta are not at once
removed automatically through suitable water-tight pipes or conduit« to
some proper place of ultimate disposal as hereinafter provided, shall be
arranged in such manner that all such excreta shall be received temporarily
in suitable movable receptacles which shall at all times be maintained in an
absolutely watertight condition and which will permit of convenient removal
to some suitable place of ultimate disposal as hereinafter set forth.
4. The excreta collected in the aforesaid permissible temporary receptacles
shall be removed and the receptacles thoroughly cleansed and deodorized as
often as may be found necessary to maintain the privy in a proper sanitary
condition and to eflfectually prevent any overflow upon the soil or upon the
foundations or floors of the privy. In effecting this removal the utmost
care shall be exercised that none of the contents be allowed to escape in
being transferred from the privy to the place of disposal hereinafter specified
and that the contents, while being transferred from the privy to the place
of disposal, shall be thoroughly covered and that the least possible annoyance
and inconvenience be caused to the occupants of the premises and of adjacent
premises.
5. Unless otherwise specifically ordered or permitted in writing by the
State Commissioner of Health the excreta collected in the aforesaid recep-
tacles shall, when removed, be disposed of by burying in trenches or by thor-
oughly digging into the soil in such place and manner as to effectually pre-
vent them being washed over the surface of the ground by rain or melting
snow, and at distances from the lake or from any watercourses of not less
than 200 feet.
6. Whenever it shall be found that, owing to the character of the soil
or of the surface of the ground, or owing to the height or flow of subsoil or
surface water, or owing to other special local conditions, the excremental
matter from any privy or aforesaid receptacle, or from any trench or place
of disposal may, in the opinion of the State Commissioner of Health, be
washed over the surface or through the soil in an imperfectly purified con-
dition into the lake or any watercourse, then the said privy or receptacle
for excreta or the said trench or place of disposal shall, after due notice
to the owner thereof, be removed to such greater distance or to such place
as shall be considered safe and proper by the State Commissioner of Health.
Sewage, House Slops, Sink Waste, Etc.
7. Xo house slops, bath water, sewage or excremental matter from any
water-closet, privy or cesspool, shall be thrown, placed, led, conducted, or
discharged or allowed to escape or flow from any pipe, drain or diteh, into
the lake or into any watercourse, nor shall any such matter be thrown,
placed, led, conducted or discharged or allowed to escape or flow onto the
surface of the ground or into the ground below the surface within a distance
from the flow line of tlie lake as referred to above, or from any watercourse,
of 150 feet.
8. No garbage, putrescible matter, kitchen or sink waste, refuse or waste
water from any creamery, cheese factory, laundrj% nor water in which milk
cans, utensils, clothes, bedding, carpets or harnesses have been washed or
riuFed, nor any polluted water or liquid of any kind, shall be thrown or
dischar^ direitly or indirectly into the lake or any watercourse; nor shall
any such matter be thrown, discharged, or allowed to escape or remain upon
the surface of the ground or to percolate on to or through the ground below
1
Ullks for Protection of Public Water Supplies 547
the surface in any manner whereby the same may flow into the lake or
into any watercourse at any distance from the flow lino of the lake as re-
ferred to above, or any watercourse less than fifty feet.
9. No clothing, bedding, carpets, harness, vehicle, receptacle, utensil, nor
anything that in any way or to any degree pollutes the water shall be washed,
rinsed or placed in the lake or in any watercourse.
Bathing, AnimaU, Manure, Compost, Etc,
10. No person shall be allowed to bathe, swim, wade or stand in the waters
of Otisco lake or any of its tributaries within a distance of two (2) miles of
the intake of the Syracuse Suburban Water Company; nor shall any cattle,
poultry, swine or any other animals be allowed to stand, wade, swim or be
washed in the waters of Otisco lake or any of its tributaries within a distance
of two (2) miles of the intake of the Syracuse Suburban Water Company.
11. No stable for cattle or horses, barnyard, hogpen, poultry-house or yard,
hitching post or standing place for horses or other animals, manure pile nor
compost heap shall be constructed, placed, maintained or allowed to remain
within a distance of twenty-five feet from the flow line of the lake or any
water course as referred to above or from any water course leading into the
same. And none of the above named objects or sources of pollution shall be
constructed, placed or maintained or allowed to remain where, or in such
manner that the drainage, leachings or washings therefrom may enter the
lake or any water course without having first been passed over or through
such an extent of soil as to have been properly purified, and in no case shall
it be deemed that proper purification has been secured unless the above drain-
age, leachings or washings shall have percolated over or through the soil in
a scattered, dissipated form, and not concentrated in perceptible lines of
drainage, for a distance of not less than twenty-five feet.
12. No human excreta or compost containing the same shall be thrown,
placed or discharged, or allowed to escape or to pass into the lake or any
water course, nor to be placed, piled or spread upon the ground, or buried, or
dug into the soil, below the flow line of the lake or the imme<]iate bank of
any water course leading into the same. No manure or compost of any kind
shall be thrown, placed, discharged or allowed to escape or to pass into the
lake or any water course, nor to be placed, piled or spread upon the ground,
or buried, or dug into the soil, within a distance of 200 feet.
13. No decayed or fermented fruit or vegetables, cider mill waste, roots,
grain «r other vegetable refuse of any kind shall be thrown, placed, dis-
charged, or allowed to escape or to pass into the lake or any water course,
nor shall be thrown, placed, maintained or allowed to remain in such places
that the drainage, leachings or washings therefrom may flow into the lake or
any water course, nor may any such material or the drainage, leachings, or
washings thereof percolate through the ground to the lake or any water
course, without first having passed over or through such an extent of soil as
to have become properly purified, and in no case shall it be deemed that suffi-
cient purification nas been secured unless the above mentioned drainage,
leachings. or washings shall have percolated over or through the soil in a
scattered, dissipated form, and not concentrated in perceptible lines of drain-
age, for distances of at least twenty-five feet.
Dead Animah, Offal, Manufacturing Waste, Etc.
14. No dead bird, animal, fish, nor any part thereof, nor any ofl'al nor
I'efuse from any slaughter-house, nor any decomposed or putrescible refuse or
Waste matter of any kind shall be thrown, placed, discharged or allowed to
Mcape or to pass into the lake or any water course, nor shall any such
material or refuse be so placed, maintained or allowed to remain that the
<lrainage, leachings or washings therefrom may reach the lake or any water
course without having first percolated over or through the soil in a scattered,
dissipated form, and not concentrated in perceptible lines of drainage, for the
distance of twenty-five feet.
548 State Departmekt of Health
Refuse From Boats
15. No excreta, garbage, slops nor any decomposed or purtrescible matter of
any kind shall be thrown, discharged or allowed to escape or to pass into the
lake or any water course from any steamer, barge, launch, sailboat or rowboat.
Steamers, barges and other boats having watercloset or toilet accommodation
shall be provided with removable, water-tight receptacles, which shall l)e
regularly emptied, cleaned and deodorized at least once each day, under the
same restrictions as those which are imposed by rules 4, 6, 6.
Inspcciions
16. The Syracuse Suburban Water Company shall maintain systematic and
thorough inspections of the lake, boats used on or navigating the same, the
lake shores and the entire drainage area of the lake, for the purpose of de-
termining whether the above-mentioned rules are complied with. At least
two sueli inspections shall be made each year, and such others as may be
directed by the State Commissioner of Health, or as may be deemed necessary
by tlie Syracuse Suburban Water Company to insure the maintenance of the
watershed in a safe, sanitary condition, and a full and detailed report of each
such inspection, including a statement of each violation or noncompliance with
the rules, shall be submitted in writing to the State Commissioner of ilealth,
within ten days after the completion of such inspection.
Penalty
17. In accordance with section 70 of chapter 45 of the Consolidated Laws
(the Public Health Law), the penalty for each and every violation of, or non-
compliance with, any of the above rules and regulations which relate to a
permanent source or act of contamination is hereby fixed at one hundred
dollars ($100).
The foregoing rules and regulations for the protection from contamination
of the water supply furnished by the Syracuse Suburban Water Company were
duly made, ordained and established on the 14th day of January, 1910, pur-
suant to chapter 45 of the Consolidated Laws (the Public Health Law) of
the State of New York.
EUGENE H. PORTER,
l^fatc Commissioner of Health
Albany, N. Y.
Those rules and regulations, to be operative and valid, must first be pub-
lished at least once each week for six consecutive weeks in at least one news-
paper in Onondaga county and in at least one newspaper in Cortland county,
and the affidavit of the printer, publisher or proprietor of each newspaper in
each county in which such publication -was made, that the publication was so
made, together with a copy of the rules and regulations, must be filed with the
county clerk of that county.
The cost of each publication, affidavit and filing must be paid by the
Syracuse Suburban Water Company.
INSPECTION OF VIOLATIONS OF RULES FOR THE
PROTECTION OF PUBLIC WATER SUPPLIES
During the past year inspections were made by the Department
of violations of rules for the protection of public water supplies of
Auburn, Kingston, Mt. Vernon, New Rochelle, New York City,
Saugerties, Utica and Yonkers.
In some cases a number of inspections were made, a great many
violations were examined into by the Engineering Division and
the necessary orders issued to the local boards of health. In the
case of Auburn 5 inspections were made, 133 violations were
examined into and reported upon and 10 orders were issued to the
proper local boards of health. In connection with the Kingston
water supply 2 inspections were made, 60 violations examined
into and 2 orders were issued. In the case of New York City IG
inspections were made, 89 violations examined into and 56 orders
were issued. In the case of the Yonkers water supply 91 casrs
of violations were examined into and reported uj)on.
During the year orders were issued to three railroad companies
requiring the closing of toilets on trains while passing over water-
sheds protected by rules and regulations. On June 30, 1910, an
order was issued to the Lehigh Valley Eailroad Company to lock
toilets on trains while passing over the watershed of Owasco lake
from which the Auburn water supply is derived. The order
covered a distance of ten miles reaching from one mile south of
Cascade to two miles north of Wyckhoff. On November 11, 1910,
at the suggestion of Mr. Edward Hatch, Jr., orders were issued to
the New York Central and Hudson River Railroad Company
and to the New York, New Haven and Hartford Railroad Com-
pany requiring the closing of toilets on trains while passing over
the watershed of the Croton river from which the New York
City water supply is derived. On the former road, four sections
aggregating 67 miles in length were affected and on the latter
road a section fifteen miles in length was covered by the order.
[M9]
INVESTIGATION OF SANITARY CONDITIONS ON
WATERSHEDS PROTECTED BY RULES
Atk»utiou was called iu my last rei>ort to the lack of clear under-
standing on the part of many water boards and companies as to the
methods of procedure to follow in removing violations under these
rules and regulations, and to the responsibility both legally and
financially in causing these rules to be rigidly complied with. It
was also pointed out that, owing to these responsibilities and es-
pecially the burden of expense entailed by the enforcement of
rules, there appeared to be some hesitation on the part of many
municipalities and water companies in enforcing the rules and
regulations, and, further, a reluctance on the part of many mu-
nicipalities where their supplies were not protected by rules but
the sanitary quality of which was unquestionably subject to sus-
picion to apply for enactment of these rules.
Realizing this hesitancy on the part of local authorities to mqet
their full responsibility in this matter, and with a purpose of
counteracting to some degree at least this undesirable, and at
times dangerous, consequence, a special investigation was made of
the watersheds of a considerable number of public supplies which
were protected by rules and regulations. These inspections proved
clearly that the fears entertained regarding the enforcement of
rules and regulations were in a measure well founded; for in a
number of cases violations were found to exist on the watershed
and in a few cases the conditions revealed a shocking disregard of
the moral and legal responsibility which undoubtedly rests upon
water boards and water companies.
The municipalities, the watersheds of which were inspected dur-
ing this investigation, are as follows :
Avon and Genesoo Cold Spring Dolgeville
Canastota Corinth Elmira (Stiite
Chester Comwall-on-Hudson Reformatory)
Cobleskill Coxsackie Elmira
[660]
Investigation of Saxitauy Conditions on Watersheds 551
Fredonia
Newburgh
Rome
I lion
Norwich
Sherburne
Little Falls
Nyack
Tarry town
Livonia
Oneonta
Troy
Meohanicville
Ossining
West Point
Monticello
Penn Yan
VValtcn
Middletown
Pleasantville
Waverly
Middleville
Port Jervis
Following these inspections communications were addressed to
the different water commissioners and water companies detailing
the violations disclosed by the special investigations. At the close
of the year arrangements were being made with those municipali-
ties which had not reported the removal of the violations to follow
out the provisions of the Public Health Law which provides for
the enforcement of this law.
It is not to be inferred that any considerable number of water
boards and companies are delinquent in maintaining a proper sani-
tary patrol over the watersheds of their supplies. On the contrary,
the water supplies of this State which are protected by rules are
mostly very carefully and conscientiously patrolled and the boards
and companies are very prompt in reporting any violations of
these rules and regulations to the State Department of Health, as
required of them l)y law. These cases are always promptly in-
spected for verification following which the customarj* notices ar^
issued and actiim bv the State or local authorities in accordance
with the procedure required by these rules is taken.
SPECIAL INVESTIGATIONS OF PUBLIC WATER
SUPPLIES
By far the larger proportion of public water supplies iu tlie
State are not protected by rules and regulations enacted by the
State Department of Health. Many of these are, however, very
efficiently patrolled, but at the same time it has been found that a
considerable number of them receive practically no regular or
even occasional inspection for the purpose of ascertaining and
removing sources of pollution.
There may be a number of reasons to account for the relatively
few public water supplies in the State that are protected by water
rules and undoubtedly the question of expense of abatement is,
as pointed out above, a very important, if not the principal one.
At any rate it has been found that the number of such supplies
improperly patrolled is a serious question, one which might well
deserve the consideration of some change in the laws relating to
the control of waters of the State used for water supply. In order,
however, that the dangerous conditions which do exist in connec-
tion with many of them may 'be brought more forcibly to the at'
tention of the local authorities responsible, as well as to the peo-
ple themselves, the special investigation of these unprotected sup-
plies, begun in 1908 and extended during 1909, was continued
during the present year.
It is noteworthy to find that many more applications were made
by municipalities in the State for these examinations and reports
during 1910 than in either of the two preceding years, which can
only be accounted for by a mare general knowledge throughout
the State of the activities and successful results accomplished by
the Department through these investigations in improving the
condition of many supplies not protected by rules. A list of the
municipalities where such investigations were made during 1910,
and where reports setting forth the findings and recommendations
were duly transmitted to the local authorities, is as follows:
[552]
Special Investigations of Public Wateb Supplies 553
East Worcester Lyons Rouses Point
Fonda N'orth Tarrytowii Seneca Falls
Glens Falls Oxford Sonyea
Kingston Round Lake Whitehall
These rejxjrts are herewith presented.
EAST WORCESTER
On July 4, 1910, a letter was received from Dr. D. H. Davis, health officer,
stating tliat the water from the public water supply was subject to disagree-
able taates and odors, and requesting ilmt one of the engineers from this
Department be sent to look into the matter. This investigation was made on
August 18, 1910, and the report thereon was aa follows:
Albany, N. Y., September 23, 1910.
Eugene H. Porter, M.D., State Commissioner of Health, Albany, N, Y.:
Dear Sir: — I beg to submit the following report of an investigation, made
in accordance with your directions and in compUunce with the request of D.
H. Davis, M.D., health officer of East Worcester, of the sanitary condition
of the watershed supplying the water used by the village of Ea«t Worcester.
The water woikH are owned by the Ea^t Worcester Water Company. Mr.
J. Terpen ing. of JefTerson, N. Y.. is president, and Mr. A. H-allenbeck, of
East Worcester. i« secretary. The water works were designed and conetructed
by Mr. E. W. Moxley about the year 1898. Since then very little alterations
or additions have been made. The water works consist essentially of an
intake, a strainer, about 3 miles of mains ranging from 8" to 4^ atnd 80 serv-
ice taps. The water is supplied by gravity at a pressure from 90 to 100
pounds. The population of East Worcester is about 000 and about 55 per
cent, of these are served by the water company. The daily draft is from
160,000 to 200,000 galk>ns, but about 75 ner cent, of this is used by the Dela-
ware and Hudson railroad to feed the boilers of their locomotives.
The results of the analysis of a sample of water collected on July 22d, dur-
ing the course of the routine work of the State Hygienic Laboratory, are shown
on table following page 589. The chemical anal}'»i8 showed the water to be
rich in nitrogenous organic matter.
A request was made by the local authorities for a field investigation, and on
August IHth >Ir. Fritz M. Arnolt, inspecting engineer with this division, ac-
companied by D. H. Davis, M.D., health officer of Blast Worcester, and A. Hal-
lenbeck, secretary of the water company, on part of the investigation, and
by Mr. .1. Terpening, president of the company, on the entire investigation,
examined the watershed and reported on the conditions existing there.
The water supply tor East Worcester is derived from Bear Swamp brook.
It has a catchment area above the intake of 9.65 square miles. This is located
north of the vill-age and consists primarily of pasture land, cultivated land
and s%ranips with small areas of woodland. The main branch of the Bear
Swamp brook rise* in tlie Dailey l^ar swamp which is located about 4^^
miles in a t-traitrht line, north of East Worcester. This swamp contains
about 85 acres, (i5 of which are no^v covered with water, and the rest is a
cranberry muisli. Within a few feet of the upper end of this swamp is the
divide between the Susquehanna and Schoharie watersheds. An earthen dam
has l)een constructed by the Great Bear Light and Power Company to im-
pound the water in this swamp, forming a shallow storage reservoir of 65
acres in area and from 6 to 10 feet deep. In dry season this is drawn upon
to augment the flow of Bear Swamp brook upon which the Electric Light Com-
pany depends primarily for its power. This pond ie studded with stumps,
t*^ii State Dei'aetmext of Health
moat of which Are black nMi. It has large growths of alga« and pond weeds
besides the 18 acres of Cranberry marsh mentioned. Tins w«ter was highly
colored and had a distinctly oily or fishy taste.
Coming from this pond the water flows through rich posture land for about
two miles until it empties into Ferris pond. Cows pasturing on this Und had
free aecew* to tlie brook. On the day of the inspection altout fifty were seen
in this section between Ferris pond ajid tlie Dai ley l^ar Swamp pond. A
privy belonging to Charles Rury of Gotlucville is locate<l on a watoroouisc
leading to the brook. This is on top of a steep hank, forming one shore of
the brook and is open at tlie buck. Although, at the time of the inspection,
no water was in this course, it was stated by the electrician of the Great
Bear Light and Power Company and by Mr. Terpening that this brook gen-
erally had considerable water and only ran dry in extendetl periods of drought
such' as the present oite. Any rain wouM wash fecal mivtter into this course
whence it would find its way <lirectly into Bear Swamp brook, a tpiarter of a
mile below.
Ferris pond is a shallow povid about a quarter of a mile long an<I 200 feet
wide. It has a rather soft bottom and contains <*onsiderable growths of
algae and pond weed. On the west side is pasture land, and on the east side
wood lan<I. Cattle have free access to this pond, and five cows were counted
standing in the pond. For two miles below Ferris pond the stream flows south-
ward and at no place receives any noticeable human pollution. But during
modt of this stretch it is exposed to pollution from pasture landn and receive*
the wash from the road running along side of it. Aliout one-half a mile above
the intake it is joined by the east branch of the Bear Swamp brook.
The east branch rises about 2^ miles above the intake in the Kitton Bear
swamp. A dam has been thrown up at the mouth of this swamp by the Elec-
tric Lighting Ooonpany, inundating about 42 acres of land. This pond is
from 4 to 12 feet deep. It contains a great number of atumps and Urge
algae and pond weed growths. The water coming from this pond flows souths
ward and slightly to the west until it joins the main branch of Bear Swamp
brook about half a mile above the intake. Several small ponds have been
formed in the east branch for power purposes. Most of these are not need
for power at present, the mills formerly on these ponds being closed up or
torn downi. One of these ponds is used as a swimming pook This branch
receives surface wash from the adjacent pasture lands and cattle have free
access to it. The Dailey Bear Swamp pond, tlie Kitton Swamp pond. Ferris
pond, ami the rights to the stream are controlled by the (Jreat Bear Light and
Power ( onipauy of Kiist Worcester. The Eiist Worcester U'ater Com|>any has
the privilege of taking whait water it needs from the ntreani.
The intake is located about half a mile above the center of the village. It
consists of a covered stone drain leading water from the creek into a side
channel and an auxiliary opening or pipe leading into the side channel to
provide a larger flow, if necessary. The covered drain is aliout 10"xlO" and
made of flat stones, not cemented. It leads diagonally across the bed of tljc
stream and is covered with a few inches of very coarse gravel or broken rock.
The water enters through the cracks and openings on top and is led into the
side channel. The auxiliary' channel consists of an opening about the same
size as the other, leading from the brook directly into the side channel. Ihis
supplies the major quantity of water entering this channel. About 50 feet
from the intake is a so-called filter which is really nothing more than a crude
strainer. It consists of a gravel bed from 12" to 15" thick, 25 feet long and
about 10 feet wide. This is located in the side channel. The water flows over
it. Some of the water percolates through the gravel which is from ^" to 1"
in diameter and is led by 6 lines of open-jointed tile pipes into a collectiug
box. This box is about 4^ feet by 6 feet and contains 3 feet of water. A
6" main leads from this box. The end of the main is covered with a copper
mesh of about W size. The main is laid underneath the water in the side
channel, through the storage pond below, through a valve house and into the
village. Tlie greater quantity of water passes over the strainer and into the
small atorage pond below.
Special Investigatiois's of Public Wateb Supplies 555
The valve house is so arranged that when the supply is greater than the
demand the \vater rises through an open valve into the well at the valve house
and flows into the storage pond. If for any reason sufficient water could not
be obtained from tlie intake above a second valve could be opened allowing
water fr<»m this pond to enter the main. The president of the water company
stated that this was, however, never resorted to as sufficient water could
always l)e obtained from above.
A few hundred yards below the valve house a spring supply is led into the
main. This supply comes from three covered springs on the hillside. It is
led into a manhole or concrete well and from there into the main* The springs
were below ground and covered and could not be located by inspection of the
surface, but at the time of the investigation a stream of wat^ only as big
as one's small finger was flowing into the well, and this supply is practically
a negligible factor.
In nummary the following points may be emphasized:
1. The ponds and streams from which the supply is drawn are controlled
by the Great Bear Light and Power Comi>any and not by the water
company.
2. The ponds at the same source contain a great amount of dead wood,
algae^ pond weed growths and miscroscopic life, and are in the main
responsible for the tastes and odors in the water.
4. One privy, that belonging to Charles Rury at Gothicville, is so located
on a tributary of the stream as to constitute a serious menace.
5. The purification apparatus is extremely crude and the efficiency must
be very slight.
G. Only about 25 per cent, of the present supply is used by the village
and the remaimier by the Delaware & Hudson Company.
The village of East Worcester is confronted with a problem in water supply
which is beginning to assume serious aspects for many of our small towns.
The ponds or impounded sw>amps at the upper end of the catchment area are
entirely detrimental to the water supply for drinking purposes but are essen-
tial to the storage of water for power necessarj' to drive the plant of the
(Jreat Bear IJglit and Power Company, which has the premier rights. The
stream receives pollution from the a/ljoining farms during its entire course,
and this polhition it would be impracticable to prevent, llie microscopic
orflanisma present in the water to which the odors and tastes are due can
only be removed by thorough filtration and aeration. The question of two
supnlies, one for the village and one for the Delaware & Hudson Company, is
one of ecomMuy.
In conclusiun I would, therefore, say that the present supply from an
esthetic standpoint, owing to extensive swamps and the deterioration of the
supply due .to the organic matter from these sources, is unfit for use, and
owing to the polhition upon the v^-atershed as shown by the inspection ami
confirmed by the laboratory analyses, unsafe to use generally witliout purifi-
cation, ami 1 would, therefore, recommend that the East Worcester Water
Company be advised:
1. That measures shouM be taken at once to remove from its present
location and rophiced in such position and under such management as will
prevent any contamination from this source.
2. That a more complete inspection be made of the watershed to de-
termine all sources of pollution or ccm-taniination and tliat measures be
taken to prevent any possibility of their entering the water supply.
3. 'Iliat if any difficulties are encountered in removing this pollution
that they apply to the State Department of Health for the enactment of
rules and regulations for the protection of the watershed which will afford
by means of condcmiration or purchase means and procedure by which any
violations of such rules can l)e abated.
4. That steps be taken to improve the esthetic quality of the waters
by drainage of swamps and removal of organic matters from reservoirs,
or by corrective measures such as sand filtration and aeration.
556 State Depaetment of Health
I would furtlicr recommenil that a copy of this report be transmitted to
the local board of health aiid that they be adviged to take the matter up Avrth
the water (K)mpaiiy with a view of having the improvements carrietl out a?*
alK)ve siipjge»t«*<i.
Resi)ect fully submitted,
THEODORE HOHTON,
Chief Engineer
FONDA
Albany, X. Y., December 6, 1910.
EuGE>'E H. Porter, M.D., SUtte Commissioner of Health, Albany, X, Y.:
Dear Sir: — I beg to make the following report of en invesfeigation in the
matter of the public water supply of the village of Fonda.
Fonda is an incorporated village in Montgomery courety, located on the left
bank of the Mohawk river, forty-four miles west of the city of Albany. The
population of the village is estimated at 1.200.
The public water supply is obtained partly from springs and partly from a
stream known as Briggs Run. One group of these springs is located one and
one-half miles west of the village, the water issuing from the foot of a knoll
composed of sand, locally known as the *' Sand Flats." The water from these
springs is collected by channels inrto an adjacent reservoir called the loift'er
reservoir, or Kei-crvoir No. 1. Water from the second group of springs and
from the stream called Briggs R^in is collected into the upper reservoir, or
Keservoir No. 2, located on the stream four and one-half miles west of the
village. Approximately half of the supply comes from these springs and one-
half from the creek, the lower reservoir being in the na/ture of a reserve and
emergency supply, and is ordinarily shut off from the syKtem.
From the upper reservoir at en elevation of approxima/tely 530 feet above
sea level, water Hows by gravity through a castiron pipe to a point near the
lower reservoir, where it passes through pressure-reducing valves and joins
the outlet pipe from the lower reservoir. This pipe delivers water directly to
the distributing s\T5tem in the village. Stop valves are so arranged on the
pipe lines from each reservoir that the lower reservoir can be used in case
of emergency and at certain times to allow of the cleaning of the upper
reservoir. The elevation of the lower reservoir is approximately 400 feet
above sea level and about H 0 feet above the ground at the railroad station in
the village.
Tlie lower reservoir is about 150 feet long and averages about 50 feet in
width. The average depth is estimated at 6 feet. The upper reservoir is about
;joO feet long and averages .a^)Out 75 feet in width. Its average depth is 7 feet.
The watershed of Briggs Run above the upper reservoir is approxim&tely
two square miles in area. The stream ri^s about a mile and one-half west
of the upper reservoir, in which distance it flows through a deep, rocky valley,
a considerable portion of which is forested.
Waiter is delivered to the village distributing system at a pressure of about
85 lbs. per scjuare inch. There are about six miles of castiron water mains
in the village, ranging from 4" to 6" in diameter. The number of service
taps is about 270. one of tliese being metered. Practically all of the 1.200
iiiiiabitants (»f tlie village are connected with the public water supply. No
figures wore cMroctly available as to thi» water conaumption of the village.
'ilie water works are owned by the village, and are under the direction of the
village lK>ar<l of trustees, constituting the lx)ard of water comnii.ssionersu Mr.
lulgar Leonhardt is president of the board, and the suj>erintendent of water
works is Mr. V. B. Clute.
An inspection of the water works of Fonda wsus made on December 1, 1910,
by Mr. A. O. True, a.ssistant engineer of this Dc|>artment. Tlie a^tistant
engineer was accompanied by Mr. C. B. Clute, superintendent of waiter works.
Both reservoirs were inspected, the springs supplying these, the intake from
Special Investioattoxs of Public Water Supplies 557
the creek at the upper reservoir, and the headwaters of the creek whrrc it is
ciaiiTie<l the greater part of the pollution of the creek supply takes place.
Although, ill general, good sandtary conditions were found at the n^Hcrvoi^8
ami in the vicinity of the springs and on the greater part of the watci>lMHl
of thp btrctuu al)ov<* the intake, several sources of pollution were found »i
the headwaters of the stream. At this point are several dwellings, a small
cheese factory, barns and animal enclosures in proximity to the stream. Con-
Miderable contamination of the atr€«im mvuit naturally result from thcMi
structures, the drainage from wluch is directly tributary to the strciim. The
cheese factory, which is not operating at this season, maintains a whey tub
on the edge of the stream, part of the contents of wliich because of inadequate
capacity or carelesgness is spilled over into the stream. Adjacent to the factory
aiid directly over the stream is a urinal, said to be in frequent use during
those months the factory is open.
Below the factory are fields and pasitures bordering the stream; and there is
always tlie opportunity for contamination from the drainage from the manure
used as fertilizer, and the cattle which have access to the stream.
Jn the table following page 589 are given the results of a uumber of chem-
ical and bacteriological analyses* of samples of water collected by the local
health oflioer from various parts of the water works during the present year.
These results indicate a hard water, which is normal for this locality where
the underlying rock is of shale, schist and limestr>ne. Tlie organic content of
all the samples was very moderate in amount. With one exception all samples
showed a high bacterial content and B. Coli was generally present, and in two
samples was isolated in as small quantities as 1 c.c. of the water.
The persistent presence of comparatively large numbers of the B. Coli type
of organism in a water supply usually indicates contamination of the water
from organic matter of animal origin. The colon bacillus is frequently found
in small numbers in normal or unpolluted waters, and even when found in
quantity, its sanitary significance is not always clear. Its presence in large
numbers is suspicious of sewage pollution, though a sanitary survey may show
that it ds due to other sources which while being objectionable are less danger-
ous than house sewage. It is very important, then, in interpreting such
analyses to take cognizance of all the factors bearing on the chemical and
physical quality of the water, as shown by analysis, and the effect which the
surroundings of the stream would be expected to have on these qualities.
The samples of this water supply analyzed this year show comparatively
smaH amounts of organic matter, which is consistent with what would be
expected from a sparcely settled watershed. The number of bacteria was high,
and probably due to the contamination of the water by organic matter from
the various sources discussed above. tSuch results could be caused by barn-
>*ard or house drainage or surface wash having become contivminatctl by the
contents of privies k>cated too near the stream.
The large quantity of the colon bacillus type of organLsnis indicated by the
analyhes* are evidence of pollution from animal sources. Tliey are not incon-
si«tent with conditions as found to exist on the upper watershed where barn-
yard drainage, whey and the pollution incident to the wallowing of cattle in
the stream reach the water supply.
Summarizing from the results of the analyses made by the State laboratory
and the inspection made by this division, I beg to submit the following con-
el usions:
1. Tliat the public water supply of the village of Fonda, while normally,
with the exception of its hardness, is of good quality, is subject to a con-
siderable amount of pollution from animal sources.
2. That although much of this pollution appears to be from sources other
than tliose afSfKriatcd with the sewage and other wastes of human origin,
nevertlM'less the opportunity and danger of such pollution exists at the dwel-
lings and other buildings in the upper part of the watershed.
3. That the correction of the dangerous conditions noted could probably be
undertaken without great expense by the village.
Finally. I recommend that should the board of water commissioners ex-
perience any difficulty in abating insanitary conditions or otherwise fintl it
^58 State Department of Health
impracticable to protect their watershed, they shouW consider the <|iu*stioii of
application to this Department for the enactment of rules and rei^ulationn in
accordance with the provisions of seKions 70 and 71 of tlie Public IlcaUli Law.
Kespectfully submitted,
THKODORE llORTUX,
Chitf Eitijinrvr
GLENS FALLS
At the reque^«t of the board of water cominrissioners of the city, under date
of March 'i^ttt, a special investigation of the public water supply was made
and the following report thereon transmitted to the local board of health and
boanl of water commissioners.
Albany, X. Y., May 2:>, IJUO.
EuQKN'E H. POBTER, M.D., HiiUc Commissiwttr of Health, Albany, S. Y.:
Dkar Sir: — I beg to submit the foll'O^ving reiwrt of an investigation in
the matter of the public water supply of the city of (flei» Falls.
Glens Falls is a citv in Warren countv. located on the left bank of the
Hudson river, sixty miles north of Albany; is on the Glens Falls branch of
the Delaware & Hudson railroad, and part of the town is on the divide between
the watersheds of the Huds<m river and Lake Cham<plain. T"he population of
the city, according to the recent census, is coneervatively placed at 18,000
people.
The water supply is obtained from catchment areas on Luzerne mountain,
situated about six miles northwest of the city. The water collected from
these areas is impounded in storage reservoirs which are supplied by mountain
streams, numerous springs and the natural runoff from rainfall aiwi snow.
From the intakes situated on the streams and below the reservoirs the water
is led by gravity to a junction point from whence it flows, also by gravity in
two mains to the citv. The works are owned br the citv ami are under the
direction of a board of water commissioners, Mr. S. D. Kendrick (by virtue
of his office as mayor), president. Mr. Howard M. West is superintendent of
water works.
The colk*cting area is divided naturally into three main watersheds, the
two most northerly of which are tributary to Halfway creek, finding their
outlets in Lake ( ham plain awl the St. I^awrence: and the third is tributary
to the Hu(Is<m river at a point a few miles almve Glens Falls. The main
streams run in a general southeaisterlv direction. Their courses are rockv and
Hteep, and they exhibit all the cluira*-teri»ties of a typical mount^iin brook.
The greater part of the collecting area lies in the township of (^ueensbury.
but a small part lies partly in the townships of C.'aklwell and Luzenie. Thew
collei*ting areas are, for the most p«rt. upland and w<»oded. Many of the
slopes are precipitous, and only aboiit 20 ])er cent, of the area is Use<l for
[Agricultural purposes. The soil, even on the higher and steeper parts of the
mountain, appears to Ik? rich and of fair depth, yet in the lower parts towanl
Mie plain it becomes sandy 'in character and exhibits a coinsiderable quantity
)f loose stones.
The first water works were buiU in 1872 and consisted of a small reservoir
\nd intake formed by a dam built across the junction of two streams. This is
cnown as the Wilkie intake, and the area flooded is about 9/10 of an acre.
Mws supplied the needs of the village for a few years, the water being de-
livered to the city by gravity through a 12-inch cement-lined pipe.
In 1875 a new intake and masonry intake basin was built on a watershed to
the south of the Wilkie works. This intake, known as the Keenan. was con-
nected by a 24-inch castiron pipe with the original sj'stem at a |>oint now
called the " upper junction."
In 1878 a storage reservoir was built on the Wilkie watershed and near the
lieadwaters of one branch of the stream some two miles above the intake.
Specul Txvestioations of Public Water Supplies 7)7>0
This reservoir, known as tlie Wilkie storage reservoir, has an area of about
eighteen acres, a capacity of 55,000,000 gallons and an average depth of ten
feet.
In 1892 the Kennan storage reservoir was constructed by damming and
flooding al>out sixtv acres near the headwaters of the stream. This has a
capacity estimated' from 200,000,000 to 225,000,000 gallons. Its average
depth is uliout twelve feet.
Tn 100.1 tlic city sought an additional Rupply and built the Butler intake on
a Ktreani from Butler pond. This is a small basin of masonry about 0.16 of
an acre in urea. The Butler artorage reservoir was constructed in 1909 by Mr.
M. M. We^t. It is located several hundrcMl feet above the Butler in^ke and
wuH fornie<l by building an earthen dam with concrete corewall some sixty feet
high. Near the center of the dam is a concrete spillway about twenty fe€»t
whle and adjoining a concrete valve chamber. Water can be drawn at four
different levels, and discharges into the stream under the dam. This reservoir
has a naftural contour, but was stripped and cleaned before filling. The
capacity is 130,000,000 gallons, area of water surface approximately fourteen
acres and the depth averages about thirty-three feet.
The pipes from all three in-takes are converged and connected at the upper
junction. From the upper junction a 12" cement-lined main and a 20" caat-
iron m>ain run to the ** lower junction," From this point 16" and 12" cast-
iron pipes deliver the water to the city distributing system at two points.
The distributing system comprises about thirty-five miles of mains from
4" to 10" in diam«iter. The average pressure is about eighty-five pounds per
square inch. Tlie s^'stem is a gravity one throughout and only in case of
emergency would temporary pumping be resorted to.
(ileus Falls has a population according to the recent census of about 18,000,
of which more than 90 per cent, are connected with the public water supply.
There are 3..300 service taps, but nine of which are metered. Tlie average
daily consumption is about 1,700,000 gallons, of which approximately 70 per
cen^ represeikts domestic use, 25 per cent, commercial use and 5 per cent,
public use.
An inspection of the Glens Falls watershed was made on May 13 and 14,
1910, by Mr. A. O. True, assistant engineer of this Department. The total
population on the watershed is only twelve persons, occupying four farm-
houses. With the possible exception of the two cases noted below, no nuisances
or insanitary conditions which could be considered dangerous to health were
found :
William Stewart farm on Butler watershed maintains waterinor trough
in brook in winter for cattle, said to have caused accumulation of manure.
Cattle belone^ing to Andrew Stewart and William Stewart are pastured
along the brook in which they are free to walk and drink.
Sampler of the water for sanitary analysis were collected at the three in-
takes and at a tap in tlife city, and sent to the State Hygienic Laboratory.
I lie results of this analysis in parts per million are given in the table fol-
k>wing page 58J».
Thougli the results of the bacteriological analysis of the sample from the
Wilkie iiftake nhow a total bacterial content, according to standard methods
of 170 per c. c. they are consistent with what would be expected in a water
of this iyyp. Positive results for B. coli were obtained in two out of three of
the 10 c. c. samples, and negative results in all of the 1 c. c. and 1/10 c. c.
samples. Tliese results are consistent with the conditions found in the sani-
tary inspeotion of the watershed. The occurrence of occasional positive re-
STiHs for B. coH iir large samples of water from a watershed known to be in
good sanitary condition cannot be taken as evideiice of the unsatisfactory sani-
tary quality of the supply.
ITie chemical analyses of samples from the Keenan intake are characteristic
of a normal surface water of this locality. The bacterial content is not
abnormal and the absence of positive tests for B. coli is consistent with con-
ditions existing on the watershed.
The chemical analyses of the samples collected from the Butler intake show
a greater organic content than the other sources. Tbis is indicated in the
560 State Departmext of Health
higher color, albuminoid ammonia and oxygen consumed. The bacteriological
results, however, are satisfactory, and an inspection of these analyses to-
gether with a knowledge of physical conditions on the watershed indicate that
the water from the Butler reservoir is of good sanitary quality. The high
organic content is undoubtedly due to the coloring extracted from natural
organic substances on the watershed, and is not, at least to any appreciable
extent, traceable to pollution from dwellings.
The analysis of the sample from the disfiibuting system is, in view of the
condition revealed by the sanitary inspection, satisfactory, and consistent with
opinion that the city is at the present time and from the present works being
supplied with a water of good sanitary quality.
In ctHiclusion, I beg to recommend that the board of water commissioners
make regular sanitary inspection of the total watershed and that they re-
quire that that part of the brook running through pasture land be kept free
of accumulations of manure.
While there appears to be no direct source of pollution from any of the
houses on the waJtershed. it is well to remember that there are two houses
which might, from their pusitionw and proximity to the brook, become sources
of pollution in the event of considerable surface wash. Tlie apparent policy
of the water commissioner in acquiring by purchase those places which might
become sources of pollution is commendable, and in aoitordance with the
practice of town authorities desiring to positively eliminate such conditions.
Should, however, the board of water commissioners experience any difficulty
in abating insanitary conditions or otherwise find it impracticable to thus
protect their watershed, they should consider the question of application to
this Department for the enactment of rules and regulations in accordance with
the pro\ision8 of seotions 70 and 71 of the Public Health Law.
Respectfully submitted,
THEODORE HORTOK,
Chief Engineer
KINGSTON
AiJiAXY, X. Y.. July 20, 1910.
Eugene H. Porter, M.D., State Commissioner of Healthy Albany y N. Y.:
Dear Sir: — In accordance with your direction I beg to submit the follow-
ing report of an investigation of the public water supply of the city of
Kingston.
This investigation was made at the request of the l>oard of water commis-
sioners of the city of Kingston and was conducted by C. F. Breitzkc, absistant
engineer. Tlie inspection of the w^atershed required two days. April 15 and
April 20, 1910. On the fonner date our engineer was accompanied by President
Wm, R. Harrison and Messrs. Block, Johnsoai and Wood of the board of
water commissioners. Dr. L. K. Stelle, city health oflicer. and Mr. .lohn H.
Harrison, superintendent of water works; on the latter date l)y Ma\x>r Roscoe
Irvin, Dr. Stelle and Superintendent Harrison. On April 20 representative
samples of the water also were taken and sent to the Sta»te Hygienic I>iil>ora-
tory for chemical and bacteriological analysis. Tlie report on the findings of
the investigation and the discussion of the analysis is presented herewith.
The city of Kingston is located in the eastern part of Ulster county on the
west side of the Hudson river, fifty-four miles south of Albany, ami is situated
between Esopus creek, fomli^lg its northwestern lx)undary, and Rondout creek,
bounding it on the southeast. It is a station on the West Shore railroad and
is the eastern terminal of the Wallkill Valley railroad and of the UUter &
Delaware railroad.
Kingston has a population of about 27,000, of whom about 90 per cent, ob-
tain their water suppiv directly from the public water works. The water is
obtained from Sawkill creek in the Catskill mountains and after passing
Special Intestigattons of Public Watek Supplies 561
through mechanical filters is furiitshed to the conaiiniers by the city. Rules
an<l regulations for the protection of this supply were enacted by this De-
partment May 22, 1901.
The original water works were installed in 1883 by the Kingston Water
Contpany. On March 1, 1896, they were taken over by the city, and sub-
sequently have been enlarged until they now consi&t of four impounding and
storage reservoirs on Sawkill creek and its tributaries, designated as Reser-
voirs Nos. 1, 2, 3, or Cooper lake, and 4, respectively, having a combined ca-
pacity of 367,000,000 gallons; of a small diverting dam on Mink Hollow creek,
diverting water from that stream through a 12-inch, main 1.06 miles long
into C<JOper lake; of a filter house equipped with twelve Xew York Continental
Jewell mechanical horizontal pressure filters having a capacity of 6,000,000
gallons per twenty-four hours; and of 67.15 miles of mains, ranging from
4-inch to 20-inch in diameter, of which 16.95 miles are outside of the city,
and consist of 6.87 miles of 18-inch main from Reservoir No. 1, serving as
a low service system supplying that portion of the city below Ilasbrouck and
Delaware avenues, Broadway and Stuyvesant street, and West Pierpont street
and Monirepose avenue, and of 9.02 miles of 20-inch main from Reservoir
No. 2, serving as a high service system supplying all of the city above the
three points just referred to. The two lines of mains can be connected at
any one of four places, viz.: (1) just below Reservoir No. 1; (2) at a point
on the north bank of Esopus creek, 2V{j miles from Kingston; (3) at a point
on the south bank of Esopus creek just opposite (2) ; and (4) at the corner
of Albany and Manor avenues within the city limits, making it possible for
the city to obtain its supply from the high or the low service reservoirs, or
from cither of them for the whole or a part of the city.
There are about 4,725 service taps, of which about 100 are metered. The
average daily consumption is about 6,000,000 gallons, of which about 3.800,000
are used for domestic consumption; 200,000 gallons by commercial users, and
about 2,000,000 gallons for public purposes. The water is furnished by
gravit)'. In the lower portion of the city the pressure is from 80 to 130 pounds
per square inch; in the upper portion from 55 to 105 pounds per square inch.
Reservoir No. 1 is located on the main stream of Sawkill creek, and is
part of the original water works, being built in 1883. It has a masonry dam
backed by an earth embankment. The intake is a rectangular rubble masonry
well, located at the toe of the dam, and having three inl€rt;8 five feet and
fifteen feet from the srurface and at the bottom, respectively. The spillway is
at an elevation of 351 feet above sea level. The reservoir is uncovered, has an
area of nineteen acres and a capacity of 05,000,000 gallons. It has a maximum
depth of twenty-five feet and an average depth of about eleven feet.
Reservxjir No. 2 is locatetl on the main stream 2Vi» niiU^ al>ove Reservoir
"So. 1. It was constructed in 1897 and put into service in the spring of 1898.
It has an ashlar masonry dam backed by an earth embankment. The intake
fhanil)er is ln;ilt into the upstream face of the dam and has inlets 3, 1:{ and 2*{
feet from the surface, respectively. The elevation of the sjjillway is 451 fe<»t
above tidewater. The reservoir is uncovered, has an area of thii-teen acres,
and a capacity of 45,000,000 gallons. The maximiun depth of the water is
twent>-bix feet and the average depth is about eleven feet.
Reservoir No. 3, known ajs Cooper lake, is located about sixteen miles north-
west of Kingston, near the head of Lake brook, a small stream tributary to
the Sawkill at Shady. It was first used as a source of water supply in the
year 1893, when on account of the inadequate storase capacity of the im-
pounding reservoir (Reservoir No. 1) the water company was forced to obtain
water from this lake by purchase and made a contract <*overing similar pur-
cbai^es for a period of seven years. After the water works were taken over
by the city in 189(i, the water commissioners purcha.«ed the property rights of
the o^nlers of land adjoining the lake and procecnled to build a new dam five
feet higher than the old one, increasing the area of the lake's surface from
C5 to 80 acrea, and its storage capacity from 50,000,000 to 200,000.000 gallons.
The <lam is about 100 feet long and 20 feet high. It is constructed of earth
with a masonry core wall and has a concrete spillway about 35 feet long and
impounding about 15 feet of water. The gatehouse is a circular well and
5Q2 State Department of Health
tower built in the toe of tlie dam. It Iiajj intakes 6 and 11 feet, respectively,
below the flow line, and when needed water is passed through a 20-inch oirtlet
pipe and discharged into Lake brook, whence it follows the natural channel of
that stream to the SawkiU. The elevation of the lake is about 1.100 feet
above tidewater. Its average depth is al)out seven feet.
In 1900, on account of the great drought prevailing at that time, an
auxiliary supply was obtained from Mink llollow creek by laying a 12-inch
pipe 1,0*6 miles' long from Cooper lake to a small intake well and diverting
dam on Mink Hollow creek at a point opposite the district school at Lake
hill. This supply, however, is used only in time of drought to supplement the
water stored in Cooper lake.
Reservoir No. 4 was constructed in 1909 west of Reservoir No. 1, on a num-
ber of small streams tributarA- to the Sawkill on land the location of which
is such that in time of freshet the system will be protected from muddy water.
This is done by discontinuing the use of water from Reservoir No. 1 and
No. 2, which are located on the main stream, which is very roily after a
storm, and by usijig clear water from the new reservoir. The area of this
reservoir is 19.5 acres, and it has a capacity of 57,000,000 gallons. The
elevation of the flow line is about 380 feet above tidewater. The maximum
depth is 24.4 feet and the average depth about ten feet.
The filter plant is located a few hundred yards below Reservoir No. 1. The
building is a two story structure 73 feet, 6 inches by 62 feet, 7 inches, con-
struoted of blue ^tone ashlar work with a concrete floor. The lower part of
the building is occupied by twelve horizontal pressure filters, manufactured by
the New York Continental Jewell Filtration Company, and guaranteed col-
lectively to deliver 8,000,000 gallons of water daily. Both of the mains re-
ferred to above pass through the filter house and connections are so arranged
that all or a portion of the filters can be supplied from them. Usually, eight
of the filters are connected with the higher pressure and the other filters
supply the lower part of the city. On each main is a large Venturi meter,
which meters by means of clockwork register at intervals of ten minutes the
quantity of filtered w-ater which passes down to the city. On the upper floor
of the filter house are ninety-six valves, by means of which all operations of
the filters are controlled.
The filters are 8 feet in diameter and 20 feet long. The shells are made of
tank steel 9/16ths of an inch in thickness with sheet steel heads ll/l&ths of
an inch thick, and are capable of withstanding an internal pressure of 200
pounds to the square inch. The filter units are arranged in two rows, six on
a side, with the ends about ten feet apart. The water mains from the reser-
voirs pass through the space between the two rows quite close to the ceiling.
These 8-inch pipes convey the water to the top of each filter, whence the
water pushes through spreader troughs along the sides onto a perforated %-inch
steel plate and thence onto the filtering surface. Tlie filtering material con-
sists of 0Y2 ft'et of selected silica sand sliipped from Bayonne, N. J., and over-
lying 10 to 11 inches of selected Cape May, N. J., gravel. Beneath the gravel
at the bottom of each tank and imbedded in a bed of concrete are 102 cones or
strainer tubes al>out }V2 inches in diameter filled with pea-sized gravel and
each connccte<l with %-inoh brass pipe connecting directly with the piping
system, discharging through an 8-inch pipe into the mains leading to the city.
The coagulant is applied by shunting a slow current of raw water through
coagulant drums. Tliere are four of these, two for each row of filters, and
arranged in series. These drums are of the usual New York filter construction,
and are castiron cylinders with bolted tops having a 6-inch hole closed by a
cover clamped in place. Tliey are 3 feet high and 2 feet in diameter. The
flow of shunted raw water is regulated by valves on inlet and outlet pipes
opened a few turns. There are no graduations and no device to give a clue
as to the rate the coagulant is applied beyond noting the length of time it
takes to use up a charge. The coagulant used is crystallized alum ief[f^ size
obtained from the Pennsylvania Salt Manufacturing Company of Philadelphia
Ten pounds are used per charge, and it is estimated by the superintendent ol
water works that 1/10 to 1/8 grain per gallon are used.
The filters are washed by reversing the flow from the bottom. The inlet
Special Tnvertioatioxs of Public Water Supplies 563
valvt* and two of the three effluent valves are closed. A valve conneoting with
a waMo water pipe is opened and filtered water is forced backward through
the effluent pipe up through a section of the strainers and on through the
gravel and sand and out through the waate water pipe. In this manner each
8^'tion iH waj^hed and after the three sections are washed, all three effluent
valves are ojiened and the entire tank is washed. This is continued until the
waste water is clear. The w^ashing of a filter usually takes ten minutes.
Fnd^r nrdiimry conditions each filter is cleaned once a day, but when heavy .
rains h;ivc inireased the turbidity of the water, the filters are washed two or
three timeK a day. Tlie dilliculties due to turbid water, however, have been
largely ovi^rcome by the construction of Reservoir No. 4, described above, the
completion of which has made it possible to use a practically clear water in
times of freshet.
Sawkill creek is tributary to Esopus creek at a point about three miles
north of Kingston. It has its beginuing as an outlet of Echo lake, located in
the Catsskill mountains in a valley between the Overlook and Indian Hea<l
mountains, at an elevation of al>out 3,000 feet above sea level. The watershed
of the irtream is about thirty-three square miles in area. It diains the
southern slope of the C'atskill mountains and is adjacent to the upper part of
the Scloharie drainage area on the north, to that of the Plattekill on the
eaut, and to that of the Esopus creek on the west and south. Beginning with
Echo lake the main stream flows in a southwesterly direction for about five
miles to JSl.ady, thence in a southerly direction for two miles to Bearsville,
thence four miles in an easterly direction through Woodstock to Reservoir
Xo. 2, about two miles east of that village, and thence in a southeasterly
direction to Reservoir Xo. 1, and to Esopus creek.
The chief tributaries of Sawkill creek are as follows: Above Shady, a
number of streams enter it, draining the southern slopes of Indian Head
mountain and Twin mountain. At Shady a stream enters from the northeast
draining tl e njilhern slopes of the mountains extending from Shady to Meads.
Ju«t Ik'Iow Shady a stream known as Lake brook and flowing from Cooper
lake enters it from the northwest. The next large tributary drains an area
west and northwest of Bearsville and enters just below that village. South of
Woodstock two streams draining the southern slopes of the mountains extend-
ing from Shady to Meads and which unite at Woodstock, enter. About a
fourth of a mile further east a large stream draining the western half of the
southern slope of the mountains extending from Meads to Overlook mountain
discharges into it. Below Reservoir X"o. 2 another large stream draining the
eastern haJf of the southern slope of tli© mountains just referred to enters it
from the north. About the last large tributary enters Sawkill creek about a
half mile above Reservoir Xo. 1 and drains a settled area of about 3.5 square
miles lying ea>it of Tontah mountain and Glenford and north of West Hurley.
The northern half of the watershed of the stream is characterized by steep
and rocky slopes, covered for the most part by a second growth of timber.
In the southern half the slopes are not as steep and have been stripped of
practically all of their forest and are used for agricultural purposes. The
underlying rock is shale and so far as could be learned the watershed is free
from limestone. The average declivity of the watershed is high, causing a very
rapid drainage of the surface and of the ground. The stream is subject to
spring floods of great magnitude. The average rainfall in the mountainous
portion i^ the watershed is about 50 inches. A rainfall record has been kept
by the Kingston Water Works oflicials at Reservoir Xo. 1 and shows an
annual rainfall of 43 inches to 61 inches. Evidence available tends to show a
rapid downp<Kir of a large proportion of the total rainfall in sudden show-
er i». a c<n)dition unfavorable to soaking into the ground, but causing a rapid
runi>lT. 1 he watershed belongs to the class styled " flashy,'* the streame ris-
ing quickly during heavy rains and discharging their flood waters very rapidly
after the storms nave passed.
'(be Mink Hollow stream watershed above the diverting dam is about eight
square miles in area, and for the most part its slopes are steep and wooded.
The main stream has its source at Mink Hollow between Plateau mountain
and Sugar I-oaf mountain, and flows in a southerly direction in a very nar-
564- State Depaktment of Health
row valtey into Beaver kill. From its source to the diverting dam is a dis-
tance of about four miles. About a mile above the intake a largo stream
draining the southern slopes of Sugar Jjoaf mountain and the »outbern slope
of Twin mountain enters. The character and topography of the watershed
are similar to the north part of Sawkill wa^tershed.
The details of the inspei'tiou of the Sawkill creek watershed arc given in
Appendix I and II:* Appendix I being a report of violations of the rules and
regulations enacted for the protwtion of this supply, made in accordance with
the provisions of section 71 of chapter 45 of the Consolidated Laws (Public
Health Law) and for which orders were accordingly issued to the local boards
of health; and Appendix II being an additional list of violations and dan-
gerous sources of contamination discovered at the time of the inspeotion, but
in the cases of which the procedure prescribed by section 71 Kad not been
followed.
Owing to the size of the watershed and to the roughness and steepness of
its slopes, making the work of the inspection slow and difficult, it was im-
]K>s8ible for our engineer to make a complete inspection of the watersheds In
the two days at his disposal, lu^wever, he covered the more thickly settled
portions of the watershed, particularly at Cooper lake. Shady, Bearsville,
Byrdecliffe, Woodstock, and in the vicinity of Reservations Nos. 1 and 4. Dur-
ing this inspection some sixty places were noted from which it was possible
that contamination of the water supply might take place at time of heavy
rainfall, some of which, as will be seen from Appendix I and II were a seri-
ous menace to the purity of the supply. In a large number of cases privies
without vaults were situated close t<i the streams. Serious conditions were
found to exist particularly at Woodstock where houses close together extended
along the edge of a branch of the Sawkill for nearly a mile. At Byrdecliffe
four cesspools, receiving the sewage from nearly 100 people, are located on a
steep and springy side hill. One of these visited was located directly in the
path of a stream and an overflow equivalent in volume to the discharge of a
6" pipe was coming from it. The other cesspools were reported to be in a
similar condition. At one place just north of Woodstock and close to a
81 ream a case of typhoid fever existed.
The resident population on the watershed is about 1,300 or about 40 per
square mile. Most of it is concentrated on the southern half, giving a ratio
of 75 to 80 per square mile. The region is a beautiful one and is fast becom-
ing popular as a summer icsort, thus introducing an additional menace to
the purity of tl:e supply. The construction of the large storage reservoir of
the New York city water su}>ply at West TTurley. Brown's Station and Shokan
has necessitated a change in the location of the Ulster and Delaware railroad
and the new route will ])a8S through Wo<Kistock and Bearsville. A new State
road is. also to jnu-s througli these places, thus making them more accessible
to t-ouri»ts and sumraor boarders.
Time did not permit the inspection of the watershed of the Mink Hollow
stream. From tl»c Tinted States topographical map for this region, however,
it ai)pears that there are f^omc tifteen houses abi>ve the supplementary intake
of the Kingston water work.s, and all of them are in a steep narrxnv valley
ilobc to the streani. If the conditions on the Sawkill creek watershed hold
goo<l here there are evidently a number of privies without vaults close to the
stream.
The results in parts per million of a series of analyses of samples of water
cxdleoted during 1900 from various points of the distributing system, together
with the analyses of the sojmi^les co]k>cted by our engineer at the time of the
inspection are given in the table following page 58JK The amount of nitrog-
enous organic matter was rather high in the majority of the samples, and
fecal bacteria were found present in quantities of water as small as one-t»iih
of a cubic centimeter in the sample of the filter effluent collected on April 20,
1010. The analyses of samples of raw water taken near the spillway of Res-
ervoir No. 4 and from Sawkill creek gave a high bacterial count, and confirm
the results of the inspection of the watershed in thajt they indicate that
• The appendices arc omitted from this report
Special Investigations of Plblic Watee Supplies 565
contaminoiion of the water supply is taking place. The low bacterial couut
in the water applied to the filxers shows the efficiency of Reservoir No. 4 as
a settling basin. The analyses of the effluent of the filters show a variable
and low efficiency, and at the time of the inspection the efficiency of the plamt
was practically nil. At that time the effluent wa>t f(»und to contain li, voli
in two out of three of the onc-'tenth of a cubic centimeter samples.
It is evident, therefore, that immediate steps should be taken to remove
not only aa far as possible all sources of contamination, but steps should
also be taken to operate the filter plant more efficiently. The first can be
brought about by a strict enforcement of the rules and regulations eniacted
by the Department for the protection of this supply; the latter by applying
the coagulant scientifically.
The efficiency of a mechanical filter dei)ends upon the proper use of a coag-
ulant. The coagulant generally used is alum or sulphate of aluminum. When
this is introduced into the water chemical action takes place, the natural
carbonates and bicarbonates of the water acting on the alum, decomposing it
and forming aluminxun hydrate, a gelatinous mass which entangles bacteria
and other suspended matter in the applied water and forms floes which are
removed by the sand laj^er. In the ease of very soft waters soda ash is
added to prevent the filtered water from becoming acid.
Th« present method for applying the ahun is to place an indefinite bulk
of alum in receivers through which a small current of water is shunted
and which again enters the applied water before reaching the filter. It
requires but little reflection to satisfy oneself that the water thus passing
about the large bulk of alum soon after the charge is first placed in the
receivers must necessarily be a saturated solution and may be applying more
grains per gallon of \i'ater than is necessary to produce the precipitation of
the organic matter and thus allow alum to remain in the filtered water and
pass into the mains. In a like manner when the alum in the receivers has
been reduced to a minimum from its constant contact with the shunted cur-
rent of water, the remaining amount of alum can not give up the necessary
amount of grains per gallon to efficiently i)urify the water. The present
method of applying the alum to the water is therefore unreliable.
The method of applying alum which in practice has given best results is one
in which a solution of standard strength of alum is mixed, the standard de-
pending upon the amount of organic matter present. This solution is ejected
into the applied water in quantity proportional to the amount of water pass-
ing through the mains.
The latter application is brought about by different devices by different com-
panies. An example of this method can be found at Hornell, N. Y., where
mechanical pressure filters have been installed under conditions similar to
those at Kingston. A description of the method is given on page 3.52 of vol-
ume II of the Twenty-ninth Annual Report of this Department for 1908.
" The coagulant is dissolved in a c>"prcs3 tank four by six feet at
the rear of the filter liouse; from, the dissolving tank the solution is
turned into a mixing tank of the Fame size, where it is diluted to the
strength required!. From the mixing tank the coagulant solution flows
through a lead pipe to a pit at the front end of the filter house to a small
1%" Gould pump operated by the raw water pressure. The pump forces
the coagulant into the raw water line. The coagulation takes place in
the raw main and in the filter tanks, the penod of detention being not
over thirty minutes. The rate of application is gau^red by the speed of
the pump, the amount to be added being determined by the inspection
of water taken from the effluent line."
The scientific application of coagulant should be carried on under the »uper-
viaion of a sanitary chemist who is competent to make analyses of the water
from time to time to determine the amount of coagulant to be applied, whether
soda aiih is required, and the quality of the effluent. This may be done
under the direction of a consulting chemist and bacteriologist as at Norwich
and Oneonta, both of which places are considerably, smaller than Kingston,
or by regularly employing a sanitary chemist as at Elmira, a city only
•lightly larger* than Kingston. At Norwich (population, 7,000) a small
6^(> State Depabtment of Health:
laboratory is maintained where teats for the removal of color, turbidity,
bacteria and B, coli, and for the reduction in alkalinity can be determined
by the operator every day working under the instructions of a consulting
chemist and bacteriologist. At Oneonta (population, 10,000) a labora»toTy
was installed on the operating floor so that the operators can make the
necessary tests to see that the fiVteis arc working properly. In this way
the plant is always under control. At Elraira (population, 40,000) an e-\-
tensive laboratory is maintained. Prior to May, 1U05, tests were made al»out
five times a year. Coinnient'ing with that date daily chemical and baotcrio-
logical determinations have been made which have made it possible to keep
the plant under control at all times, and the results obtained &how better
efficiency and more uniform results.
In view of the foregoing, therefore, I recommend that a copy of this report
be sent to the board of water connnissioners of the city of Kingston, and
that they be advised that:
1. A thorough inspection should be made of the entire watershed of Saw-
kill creek and also ol Mink Hollow brook, provided it is intended to continue
to use that stream as a source of supplementary supply, and steps taken to
enforce the rules, and regulations enacted by this Department for the pro-
tection of their water supply, to remove as far as possible all existing vio-
lations of these rules and sources of contamination of their supply and to
guard against their recurrence in the future.
2. The watershed of Sawkill creek is becoming increasingly popular aa a
eummer resort, and an increasingly serious element of danger lies in the
pollution from the large number of tourists and sinnmer boivrders living in
isolated houses and camps. The only effective protection of the water sup-
ply that can be secured against such pollution is the efficient filtration of the
water before it supplies the city.
3. Inmnediate steps should, therefore, be taken to increase the efficiency of
the filter plant bj' scientifically applying the coagulant to the raw water
and by placing the operation of the plant under the supervisicm of some
sanitary expert.
Very respectfully,
THEODOHK IIORTOX,
Chief Engineer
LYONS
At the request of Mrs. E. M. Finigan, secretary and superintendent of the
Lyons Water Works Company, made on May 28, 1010, an examination of
the public water suj>ply was m-ade and reported upon as follows:
Albany, X. Y., June 21, 1010.
EuoENE H. PoBTER, M.l)., State Commissioner of Health, Albany , N. Y,:
Dkar Sir: — I beg to submit the following report on an investigation of
the water supply of the village of Lyons, Wayne county. Tlie investigation
was requested by local authorities, and on June 16 and 17, 1010, Mr. F. M.
Arnolt, inspecting engineer, visited Lyons and made the investigation.
Lyons is an incorporated village in Wayne count), lui'tited on (ranargua or
>iud cheek, a tributary to the Clyde river, on the New V»>rk Central and
Hudson River and West Shore railroads.
The village has a population of about 5,000, of whicli somewhat over half
are connected with the public water works. The wnter is furnishe^l by the
Lyons Water Works Company, of which Mr. C. J. Ryan, Jr., is president,
and Mrs. E. M. Finigan is secretary and superintendent. No sewer system
is installed in the village.
The water works consists of two intake tremdies filled with gravt^l, lead-
ing from Mud creek to an open impounding and sedimentation reservoir, a
small charcoal filter, a clear water well, 10 driven wells, pump station, stand-
pipe and distributing system. There are 10 miles of 10" to 4" cast-iron pipe,
578 service taps, of which only 380 are in use, and of which 9 are metered.
Special Investigations of Public Watek Supplies 567
The pressure on the mains varies from 73 to 80 pounds. The average con-
sumption i« about 300,000 gallons per day in summer and about 200,000 gal-
lons per day in winter. Ihe original water works were put into service ii;
1887.
'Ihe water supply is a mixed supph' taken from Ganargua creek and a
series of driven wells, llie geological formation at Lyons is such as to
make ver^' dilflcult the problem of obtaining a salisfaotory supply. In this
region are found the Niagara and corniferous limestones and the Salina
!«liates. At no place in the neighborhood can welis be driven to yield any
considerable supply without striking water that is almost brackish. Many
trial wells have l>een sunk by the Lyons Water Company to obtain a suffi-
cient and satisfactory supply of ground water, but they have all failed.
'I hey have, therefore, drawn on Ganargua or Mud creek, and at present over
half of the Lyons supply is taken from this source.
The two intake trenches are 0 feet wide and 11 feet deep and are filled
with gravel of '/^" to 2" size. Cinders have been dumped over the intake end,
forming a layer 0 feet deep. Ihe water from Mud creek flows through the
trenchet* and enters the sedimentation reserv<iir which is from 39 to 44 feet
wide and from 70 to 75 feet long. Three 12" wells, 40 feet deep, are sunk in
the bottcMii of the reservoir.
Tlie reservoir was in a very unclean condition, being overgrown with algae
and pond weeds. Tlie attendant in charge stated that this growth was so
abundant that the reservoir had to be cleaned out at least once a week. The
cleaning was done by cutting the weeds with a chain and then scooping out
the floating masses with a shallow net. It was stated that no a'ttempt had
ever been made to remove the growths in the reservoir by the use of copper
sulphate or by the u»^e of any other chemical. Xo cognizance of the fact
seemed to Have been taken that the reservoir was an open one, containing a
mixture of ground and surface water and, therefore, would invariably cause
ti-oublo by growths of algae, pond weeds and microscopical organisms.
The reservoir leads into a rectangular brick well. This is 5 x 12 x 17 feet
and covered with plank. It contains 120 bushels of charcoal extending part
way into the reservoir. Just beyond this charcoal filter lies a circular clear
water well which contains the intake to the pumps. Four lO-inch welU on
the north side and three 10-inch wells on the south side of the reservoir lead
into the clear water well.
The pumphouse is a brick structure 34 x 28 feet, containing two Davidson
So, 12 l,0(»0,0(M)-gallon compound steam pumps, two Davidf^on No. 2 air
pump}< and one small Davids^on Xo. 3 l)oiler-feed pump. Tlie adjoining
iMiiler wing houses two 125 II. 1*. lioilers.
The water is pumped to a standpipe located about half a mile east of the
pumpbouse on a hill. It is a steel cylindrical structure 50 feet high, 20 feet
m diameter, open at the top and is elevated 20O feet.
Cranargua or Mud creek is a slow flowing, highly turbid, yellow colored
Htream rifling in Ontario and Monroe counties. It has a catchment area of
299^2 square miles and discharges into the Clyde river at a rate of 1,900 cubic
feet per second. It passes through and receives the pollution of a large
number of villages. Swamps extend from a few hundred feet to over a mile
on each side of the stream for over ten miles above the Lyons intake. Be-
tween Lyons and Newark, Ganargua creek itself receives very little pollution.
1 he farm hou«es are located away from the stream on flat ground and the
danger of pollution from their privies, cesspools or other sources reaching
the creek is very slight.
The main pollution of the Lyons supply is cai-.sed by the discharge, into
Military Run, a feeder to Ganargua creek, of i?ewage contributed by at least
3,000 people at ihe village of Xewark.
Military Run is a small stream running through the center of Xewark and
<li«charging iirto Ganargua creek about eight miles above the Lyons intake.
In the upf»er reaches of the brook, open and tile drains collect the sewage
from about 100 people on West Maple avenue, Ma<lison i^treet and adjacent
property and diselvarge it into Military brook at the rear of Jackson and
Perkins's nurseries. The owners of the property through which the original
open drains ran, objected to the odor arising from them and advised the vil-
568 State Bepa&tmekt ok Health
lagc authorities of Newark that they would permit the drains to run across
the property only on the condition that they were suitably covered. The
village of ?}<'wark then constructed the tile drains.
The mofit siTious pollution occurn at the we»t end of the Bartlo lumber
yards on \V<'.st Union street. Here a State drain discharges the sewage of
about 2.500 people into Military Run. This drain was constructed by the
State for the purpose of draining the cellars below the canal level. It runs
from East avenue westward on East and West Union street and discharges at
the point mentioned. Sewer connections have been made in recent years by
all the business houses on Kant and West Union streets. Laterals have been
constructed, one man connecting with the pipe of his neighbor until now half
of the village of Newark is connected with this drain.
Ju]$?t beyond the outlet of the State drain, Military Kun crosses under the
Erie canal and at the north side of the canal is a pool of septic sewage
15' X 30' and from 4' to 0' doe^p, which is constantly bubbling up and giving
off foul gases.
Just below the point where Military Run cro8.ees under the canal there is
a waste weir on the north bank of the canal. When the .traffic is light and
the locks below are not used the water in the canal rises and flows over the
weir, to some extent flushing and diluting Military Run. The weir gates are
raised for a short period at night to flush Military Run.
For a half a mile below this point the stream receives a large amount of
poUiitioii. Privies and drains from factories, hotels and houses discharge
directly into the stream. At East Sherman street the Reed Manufacturing
('onij)any discharges its sewage. In tliis short .stretch below the outlet of
the State drain the sewage of at leaHt 300 people is discharged into Militftry
Run.
At the time of the inspection the stream was discolored with sewage,
although not as strong as ordinarily, since waste from the canal wad diluting
it approximately four-fold. This happens only at very irregular intervals.
Fecal matter, paiper and garbage were seen in large quantities floating down-
Ktream.
The people of Lyons state that for the greater part of the year the water
tastes so fishy that it is unfit for use. This is probably due to the immense
numbers of microscopical organisms present in the reservoir and in Ganargua
creek. Temporary relief could prolmbly be obtained by thoroughly cleaning
the reservoir and treating it with copper sulphate. This, however, must only
be ap])lied under the direction of an expert in such matters. Covering the
reser\'oir would afl'ord little relief, for while it would tend to check the heavy
growth in the reservoir itself it would have no influence on the large munbers
of microscopic organisms coming in with the water from Ganargua creek, as
this water does not remain in the reservoir more than a few hours.
The health officer. Dr. M. A. Vee<ler, stated that no epidemics of typhoid
have occurred in tlie villagt». but that it has had about twenty oases of
typhoid fever a year, lie attributes most of these to imported cases.
Samples of water were taken at the time of the investigation and at ])re-
vioua perio<l«5, the results of their analyses being given in the table following
page 589. Theise results show that the water from Ganargua creek contains a
large amount of putrefactive organic matter. The B, coli type is found
regularly in 1 c.c. samples and the total bacterial count is very high. The
results of the analyses confirm the evidence as to the pollution of the supply
deduced from tlie sanitary survey and show that Ganar^a. creek is a very
liiglily polluted and dangerous sitpply. It has a very large drainage area
and flo^s through a great number of villages and towns, receiving more or
lor^s jK)llution from e.ich of them. It would l)e difficult to clean up the water-
shed so a-s to make tliis a safe su])ply and it would also be inexpedient and
exi)e!isivc at present, for aside from the contaminated condition of the water
due to sewage pollution, the stream is unfit for use without proper treat-
ment, on account of the presence of the large numbers of microscopical
organi.»-nis imparting to it a very disagreeable fishy taste and odor. The water
supolie*! to the village is a mixture of water from Ganargua creek and from
wells, in proportion of aliout 1.1. The analyses of this water show^ it to be
Special Investigations of Public Water Supplies 5G0
iitile, if any, better than the Ganargua creek supply and that it is wholly
unfit for use and dangerous to the life and health of the community.
I should, therefore, recommend,
1. That since the sanitary survey has shown that Ganargua creek re-
ceives extensive sewage pollution and since the various analyses of the
Lyons water supply, made by the State Hygienic Laboratory have always
shown the water to be dangerously polluted, the Lyons Water Company
be notified that their supply is unfit and unsafe for use.
2. That as a temporary safeguard imtil a better supply can be obtained,
the Lyons Water Company be advised to continue notifying their cus-
tomers to boil the water before using.
3. That since the field investigation has shown that the watershed of
the Lyons supply is in an insanitary condition and that the water is
dangerously polluted that the Lyons Water Company be advised to im-
prove their supply or obtain a new and pure supply.
The problem before the Lyons Water Company is a serious one and needs
much study. They should secure expert advice as to the advisability of secur-
ing a new and wholesome supply or as to the best means of making tlic
present supply a safe and wholesome water.
Respectfully submitted,
THEODORE HORTOX,
Chief EiKjinccr
NORTH TARRYTdWN
A special investigation of the water supply and tlie filtration plant was
made at the request of the health officer of tlie village of Hastings-on-Hudson,
made to thi« Department under date of March 16, 1910. The report on
this inve5>tigati(m follows.
Aluaxy, X. v., October 3, 1910.
Er«E.NE li. PoHTEB, M.D., State Commissioner of Health, Albany^ N. Y.:
Deab Sib: — I beg to submit the following report of an investigation in
the matter of the public water supply of the villages of Xorth Tarrv-lown,
Hastings-on-Hudson, Dobbs Ferry and Ardsley. and the town of Scarsdalo.
These places are all located in Westchester county, 15 to 25 miles north of
Xew York city, and with the exception of the town of Scarsdale, are on the
Hudson river, and the main line of the X^ew York Central and Hudson River
railroad. Scarsdale is four miles eaet of Hastings and on the Harlem
division of the New York Central and Hudson River railroad.
The aggregate population of these communities which are served from one
source of water supply is roughly about 10,0<;0.
The water supply is obtained from the water.shod of the Pocantico river
at Pocantic(> lake, located in X'orth Tarrytown. three miles northwest of the
village of Tarrytown. The waterworks are owned and operat<'d by the Con-
solidated Water Company of Suburban X>w York. This is a purfare supply,
Pocantico lake being an impounding reservoir and formed by holding back
the Pocantico river by means of an earthen dam. From an intake shaft
located near this dam the water flows by gi^vity to a coagulating basin in
the form of a steel standpipe located below the dam. The suction lines of the
pumps are hnl from this standpipe. On these suction lines are located the
mechanical filters of the ** pressure " type used in filtering the supply. The
filters, steam pumps, boilers and lal)oratory are housed in a substantial stone
building situated just below the dam. The filtered water is pumped to several
reservoirs and standpipes by means of two steam pumps of tlie reci])ro-
cating type. One of these pumps is a Dean compound tandem, duplex,
10"x30"x 18''xl2'', of 2,000,000 gallons per day capacity. The other a
Worthington triple expansion, tandem steam punip, 12"xl9"x30"xl4Vy'x24'',
570 State Department of Heai^th
of 3,000,000 gallons per day capacity. Steam for the pumps is generated in
three boilers, two rated at 75 H. P. each, and the third at 125 H. P.
The filters are of the mechanical, pressure tj"pe. There are four iwits, each
consisting of a cylindrical steel tank 25 feet long by 8 feet in diameter. Tlie
filters are arranged in two batteries of two units each lying with their long
dimensionfi horizontal. Each tank has an 8" inlet and an 8" outlet, and is
provided with a manhole. There are no distributing pipes or troughs. Each
tank has a strainer system consisting of transverse manifolds and 2^*^
galvanized pipe lateral* tapped for %" brass strainers. Over each strainer
system is placed 6" of gravel and above the gravel 3 feet of filter sand. New
strainers and new filtering material were placed in the filters on June 25,
1910.
To within a recent date sulphate of alumina as a coagulant has been the
only chemical used in operating. During the inartallation of a new strainer
system and new filtering material on June 25, 1910. hypochlorites were used
while the filters were by-passed. During a visit to the plant by an engineer
of this Department on August 2, 1910, hypochlorites were being applied to-
gether with alumina to the influent of the filters.
In the normal operation of the plant the course of the water is as follows:
After leaving the intake shaft the water flows by gravity to a coagulating
tank 20 feet in diameter and 30 feet high, containing baffles. Before entering
this tank the water receives the coa^lant solution, prepared in a small build-
ing situated nearby and above the hydraulic grade line of the plant. From
the coagulating tank the water passes to the suction lines of the pumps.
Between the coagulating tank and the pumps are the filter tanks, constituting
part of the suction lines of the pumps. After passing through the filters the
water is pumped to the various reservoirs and standpipes supplying the
several villages. In washing the filters the inlet valve is closed, the over-
flow valve is opened ; and the outlet valve being closed, water under pressure
is allowed to flow through the filtering material in the reverse direction.
Xo agitation is used other than that resulting from the reverse flow of
water. The total filtering area is approximately 500 square feet. At the
average consumption per day of 1.700,000 gallons this would mean an average
rate of filtration of about 148,000,000 gallons per acre per day. This is a
high rate even for a rapid or mechanical filter.
In the pumproom there is a small laboratory used by the engineer in charge
of the pumps to make a few chemical tests of the raw and filtered water.
These toits. ho\vev(M', are made under the surveillance of a firm of expert
chemists, by whom more complete chemical and bacteriological analyses of
the water are made from time to time.
The average daily consumption of water from these works is said to be
1.7C0..000 gallons per day. Most of the supply is metered. There are 65 miles
of main.s from 4 inches to 16 inches in diameter. There are 1,800 servici^
taps, which would indicate upwards of 10,000 consumers. Roughly, the
average pressure in the mains is 100 pounds per square inch.
On June 2r>, 1910, an inspection of the filter plant and part of the water-
shed of the Pocantico river was made by Mr. A. O. True, assistant engineer
of this Department. Samjples of the raw and filtered water were taken oh
August 2, 1910. and analyzed at the State Hytrienic Laboratorv. The results
of these analyses together with other results of the analysis of the Pocantico
river are given in parts per million in the table following page 589.
The results indicate considerable pollution of the Pocantico river above the
reservoir. The raw water at the intake well was of better quality than in the
river or its tributaries, indicating the removal of organic matter and bacteria
effected by the reservoir. However, the bacterial count of 2,300 was not low
for an impounded surface water. The stream coming: from St. Joseph's college
is undoubtedlv polluted, as is evidenced by the high bacterial count and tlic
presence of B. coli in all dilutions. The analyses of the filtered water in-
dicate that the filters were giving rather poor results. They were efficient in
removing organic matter but were inefilcient in the removal of bacteria. The
filtered water showed no B. coli even in as l-arge quantitdes as 10 cc, and
the filters were removing a considerable amount of color and turbidity.
Special Txvestkjatioxs of Public Water Supplies 571
All iii«pectiou of poHions of the watershed showed that there were build-
ings near the tributaries from which sewage or other contaminating material
could readily reach the streams. Except at St. Joseph's college no specific
instances were noted in which there was a pollution of the streams at the
time of inspection. However, circumstances indicate considerable pollution
on the various streams though time would not permit of an inspection of the
whole watershed. At St, Joseph's Normal College there is a pond fed by
springs from which a small brook flows to the Pocantico river above the
reservoir. The outlet of this pond has been dammed up and it is used for
bathing by the students of the college. About 200 feet from the pond on a
gentle slope, covering an area 4-70 feet by 135 feet, is an irrigation area for
the disposal of the sewage of the college. After passing through a settling
tank and a dosing tank the sewage is discharged by means of a siphon into
a system of w^ooden troughs laid on the surface of the irrigation area. Here
it finds outlet through holes in the troughs over the whole area. The sewage
after passing down through the soil is collected in a system of open tile under-
drains and the effluent led to a nearby branch of the brook. The sludge from
the settling tank is blown off at iirtervals into a sludge pit, allowed to drain
and finally mixed wMtli earth and disposed of on the land.
Complaints having been recently made that this disposal plant was not
operating efliciently, and that sewage was entering the brook and finally
being carried into the Pcw^antieo reservoir, a careful inspection of the plant
was made by this Department on September 28, 1910. This inspection was
made by Mr. C. A. HolmquivSt, assistant engineer of this Department, and
Mr. Karquhur, of the firm of Waring, Chapman & Farquhar, the designers of
the plant. As the result of this inspection it was found that sewage was
reaching the stream without proper purification. This was apparently due
not to any defect in the design of the plant but to the existence of a crack or
opening in the clayey soil of the irrigation area, whereby the sewage dis-
charged upon it reached the underdrains immediately. This was shown from
the fact that sewage appeared in the outlet of the underdrains directly after
it was discharged over the surface of the irrigation area.
I have arrived at the following conclusions:
1. That the filter plant, as shown by analyses made at various times
by the State Hygienic Laboratory, is not giving good results and that
its efficiency is low.
2. That this low efficiency is undoul>tedly due in part to the high rate
of filtration which at times is probably double the normal rate for a
mechanical filter.
3. That owing to the goinewhat uncertain performance of mechanical
filters due to the inherent defects in their construction and operation it
is important to remove the several sources of pollution now existing on
the watershed of the reservoir.
In view of thene conclusions I would recommend that the water company
be urged to consider the feasibility of increasing the filtering area with a
view to lowering the rates of filtration and thus improving the efficiency of
the filters. That they take steps to prevent the pollution of the streams
entering the Pocantico reservoir. That the trustees of the Christian Brothers
Normal School at Pocantico Hills be notified to take immediate steps to cor-
rect the defect in the sewage disposal plant and prevent any unpurified sewage
reaching the nearby brook. Finally, that if the water company si" uld ex-
perience any difficulty in abating the insanitary conditions affec ing the
water supply, and further, in view of the uncertain elements attending the
operation of presirure filters, they should apply to this Department for the
enactment of rules and regulations for the protection of the watershed.
Respectfully submitted,
THEODORE HORTOX,
Chief Engineer
Copies of ithis report were transmitted to the following parties: Conaoli-
datecf Water Company, of Suburban New York ; Christian Brothers Normal
572 State Department of Health
College, Pocantioo Hills, N. Y.; Joseph Hasbrouck, M.D., health officer, Dobbs
Ferry, N. Y. ; Ralph R. Ryan, M.D., health officer, town of Scarsdale, N. Y. ;
Francis R. Lyman, M.D.. health officer, Hastings-onhHudson, N. Y.; G. Q.
Johnson, M.IX, health officer, Ardsley, N. Y.; John W. Small, M.D., health
officer, North Tarrytowii, N. Y.; Mr. John J. Sinnott, president board of
health, town of Mount Pleasant, N. Y. ; The T^derle Laboratories, 39 W. 38th
street, NeAv York citv.
OXFORD (Woman's Relief Corps Home)
Albany, N. Y., February 10, 1910.
Eugene H. roRTER, M.D., State Commissioner of Health, Albany, N, 7,:
Dear Sib: — I beg to submit the "following report on an investigation of
the proposed additional water supply of the Wom^an's Relief Corps Home,
Oxford, X. Y.
On December 14, 1909, samples of a proposed additional supply were re-
ceived by the State Hygienic Laboratory. These samples were analyzed, but
owing to the fact that they were not received in a satisfactory condition and
tbe information accompanying them not being clear, you directed the Engi-
neering Division to make an investigation of this supply. I accordingly de-
tailed Mr. C. F. Breitzke, assistant engineer, to visit Oxford for this pur-
jiose on January 0, 1910.
The Woman's Relief Corps Home is located on a hill along the east bank
of tl:e Chemiiigo river, just beyond the eastern boundary oi the village of
Oxford, about a mile northeast of the center of that village and about six
miles southeast of Norwich. The main buildings are located on a wide berme
near the foot of a high hili and sloping somewhat abruptly toward the
t'lienango river, at the edge of which there is a strip of flat, low land about
2ro feet wide. The tracks of the Delaware, Lackawanna and Western railroad
]»a8s directly at the foot of this slope. A pumping station, including a heat-
ing plant and laundry, arc located aUo at the foot of the slope jusrt east of
the railroad. The institution has a sewerage system, the outfall sewer pass-
ing about 3.>0 feet north of the pumping station and discharging into the
Chenango river.
The regular water supply of the institution is derived from springs located
on the side of the hill 2,5*00 feet to 3,000 feet east of the institution, where
tlere are some twenty springs just north of the tracks of the New York,
Ontario and Western railroad piped into the upper reservoir, at an elevation of
about 300 feet above main building and thence directly to the buildings
through a 2lv,-ineh pipe. This is supplemented by pumping water into a
second and lower reservoir ordinarily from a tank belonging to the Delaware,
J>ackawanna and Western railroad, fed by a spring located about 1,000 feet
southeast of the institution buildings. The lower reservoir is located on the
sidehill at an elevation of about 100 feet above main building and about
1,700 feet east of it. This reservoir was installed in 1902 for fire protection
and is connected by a C-inch pipe with a hydrant system on the institution
grounds. The pumps are coujiected with the same system. Cross connections
have been made between this and the regular system both at the lower reser-
voir and on the institution grounds. In addition to this the system has a
3-inch )»ii>e. through which water can be pumped from the Chenango river
at a point about 800 feet northwest of the pumping station.
The upper reservoir is 50 feet long, 20 feet wide and 10 feet deep. It has
concrete sides and bottom and is covered over with a wooden roof. The
lower reservoir is 40 feet long, 30 feet wide and 10 feet deep and is similar to
the upper reservoir in construction. Its storage capacity is about 85.000
gallons. The Delaware, Lackawanna & Western railroad tank is 16 feet in
diameter and 15 feet deep. The institution intake pipe enters it 6 feet aibove
the bottom.
There are two Snow duplex pumps at the pumping station: one 7x4^5x8
Special Investigations of Public Watee Supplies 573
lueheSy a feed pump, pumping water from the river to three 100 horse-power
boilers of the heating plant ; the other, 10 x 6 x 10 inches, used for water
supply.
'Ine daily consumption of the institution is estimated to be from 17,000 to
25,000 gallons per day, of which about 6,500 gallons is supplied by gravity
from the springs and the remainder pumped from the Delaware, Lackawanna
and Western railroad tank. During the past summer the daily yield of the
springe has been only about 4,000 gallons. Owing to the heavy draft by
the Delaware, Lackawanna and Western railroad engines only 1,000 gallons
per day additional supply could be obtained from the tank above referred to.
Consequently, water was pumped from the Chenango river and the two sys-
tems separated, the kitchen and administration building being supplied from
the gravity spring water supply system and the other buildings with river
water, the inmates having been warned not to drink it and special tanks with
drinking water were provided.
The prevailing drought led ^. P. J. O'Connor, superintendent of the
Woman's Relief Corps Home, to request the State Ai'chitect to prepare plans
for a new intake from the Chenango river to provide a more abimdant supply.
Plans were accordingly prepared in September, 1909, which provided for a
bulkhead intake works on the Chenango river, a pump well about seventy-five
feet west of the pumping station, and a ten-inch vitrified pipe line leading from
the intake works to the pump well.
Samples of water were taken at the time of inspection and were sent to the
State Hygienic Laboratory for analysis. The results of this analysis are given
in the table following page 589.
The samples taken from the upper reservoir indicate a pure and wholesome
supply. On the other hand, those obtained from the Chenango river show the
prei*ence of a considerable amount of nitrogeneous organic matter, chlorine and
large numbers of bacteria of which the B. coli type were found present in
minute quantities of water as small as one-tenth of a cubic centimeter, facts
which are consistent with the discharge into that river of sewage from some
5,000 people at Norwich at a point less than six miles above the proposed
intake works. The sample taken from the Delaware, Lackawanna and Western
railroad tank shows some contamination which may be explained by the fact
that the spring supplying it is located in a field used for agricultural purposes.
The anaJyses of the samples taken from the proposed pump well showed the
presence of a comparatively large amoimt of organic matter and an excessive
number of bacteria. While this may be due in part to the difficulty in obtain-
ing a representative sample and also to the fact that the well has been re-
cently excavated and built, the chlorine content of the water is largely the
same as that of the Chcjiango river, about 200 feet distant.
It is evident that the Chenango rivor is polluted and therefore should not
lie used as a source of water supply, even if separated from the regular spring
supply for where a dual supply has been installed there is always danger of
the polluted one being used for potable purposes. Furthermore, the fact that
the pipe line from the intake works to the pump well is to be made of vitrified
tile and must cross the line of the institution outlet sewer, there would always
be danger not only from a break in the sewer line at the point of crossing
but also from the leakage from the sewer which is bound to occur when the
ground water level is lowered in dry weather.
The securing of an additional supply from the pump well supplied through
collecting drains in the river bottom lands west of the Delaware, Lackawanna
and Western railroad tracks is as proposed also improper from a sanitary
Rtai»dpoint. The Chenango river must at times of high water flood the low
land along its banks. The soil consists of a thin layer of alluvial soil under-
lain largely by coarse gravel. From the analyses referred to above it appears
that there is infiltration from the river below the point of discharge of the
institution sewer. Furthermore, the danger of leakage and infiltration of
•ewage from this seWer would be great. The proposed pump well is now
only 200 feet from the sewers and, if a system of collecting drains is installed,
this distance of the sewer would be reduced considerably and there would
be danger of infiltration into the system of sewage imperfectly purified in
its pasMge through the soil
57 J: State Department of Health
In conclusion, therefore, I recommend ilmt a copy of this report be sent
to Mr. P. J. O'Connor, superintendent. Woman's Relief Corps Home, and
that he be advised that this Department can not give approval to the two
proposed means for obtaining an additional supply either by taking unpuri-
fled water from the Chenango river directly or by collecting water by drains
in the low lands between the river and the railrcmd embankment.
It is evident, however, that an additional supply is needed by the insti-
tution. It is possible this may be secured either by developing additional
springs, by driving wells east of the Delaware, Lackawanna and Western
railroad at a place where they will not be endangered by leakage from the
institution sewer or by infiltration from the Chenango river, or possibly by
driving them in the level ground east of the institution buildings at the' foot
of the steep slope leading to the reservoirs. I'nquestionably, a safe and
wholesome additional supply can also be obtained by installing a filtration
plant to purify Chemung river water.
As to which of these or other mean3 of securing an additional pure supply
would be better and more economical to develop can not be determined with-
out malcing a more detailed investigation of the problem. Under the cir-
cumstances, I would suggest that the institution authorities have such a
furtlier and careful study made of the problem in order that they may obtain
definite advice as to the best means of providing an additional safe and whole-
some supply of water.
Respectfully submitted,
THEODORE TIORTOX,
Chief Engineer
ROUND LAKE
Albany, X. Y., June 22, 1910.
EtTGENE H. Porter, M.D., State Commissioner of Health, Albany, N. Y,:
Dear Sir: — I beg to submit the following report of an investigation in
the matter of the water supply of the Association of Round Lake.
Round Lake is an incorporated association in the town of Malta, Saratoga
counity, about twelve miles south of Saratoga S])ring8. It is on the main
line of the Delaware and Hudson railroad. During the summer season the
population of Round Lake is about 1,500, but the remainder of the year it is
only about 500.
Ihe water supply is obtained from a stream whose several tributaries
derive their flow principally from springs. The watershed of this stream
is located about 1^ miles southwest of the village. Here has been con-
structed on the main stream a small intake reservoir with an earthen dam.
The intake is some 12 feet from the shore of the reservoir on the down
stream side, and consists of an upturned elbow having a perforated plate.
The water is conducted by gravity to the village through a 6" cast-iron
pipe, the flow varying with the draft in the distributing system. The surplus
water flows over a circular wasite weir, passes through a 12" pipe under
the dam, the stream therefrom finally discharging into Round Lake. Tlie
works are owned by the Round Lake Association and are under the direction
of a water supply conmiittee, of which Mr. Milliard Rogers is chairman.
Mr. John D. Rogers is superintendent.
The collecting area is approximately three-fourths of a square mile. Tlie
upper end of this area is bounded by high banks of sand with precipitous
slopes. From these the water issues in springs. The area is wooded except
where a considerable part of the wood has been cut in the upper portions.
At the reservoir there is some accumulation of organic matter around the
swampy edges at the inlet due to decaying vegetation. A deposit of clean
sand washed down from the headwaters of the stream is gradually encroach-
ing on the inlet end of the reservoir. There are no dwellings upon or adjacent
to the watershed.
The water works were built in 1887. The water collected from the stream
Special Investigations of Public Water Supplies 575
described above being discharged by gravity into tv^o small reservoirs situ-
ated about % mile southwest of the village. Here is located a piunping sta-
tion equipped with a &mall direct acting steam pump and a boiler. Nearby
and on a small hill arc two elevated wooden tanks with a combined capacity
of 70,000 gallons. They are at aibout 90 feet higher elevation than the
pump. These tanks are kept full, but ordinarily are not used except in
case of fire when they are connected with the distributing sj'stem by opening
the gate on the line to the town. In the sunmier season the fires are banked
in the pumping station and the machinery kept ready for emergency use.
1 he normal pressure in the system at the town is about 15 pounds per square
inch : with the elevated tanks, however, this can be increased to about 45
pounds per square inch. The uee of the two small reservoirs has been dis-
continued, the supply now going directly into the distributing system.
The distributing system comprises al)out 5 miles of mains from 2" to 6"
in diameter.
The average population the year round is roughly about 850. Practically
all the inhabitants are supplied from the public water supply. There are
300 houses in the community and about 280 service taps, none of which are
metered. No figures are available for the daily consumption of water.
An inspection of the Round Lake Association water supply was made on
.Tune 16, 1910, by Mr. A. 0. True, assistant engineer of this Department. No
miisances or insanitary conditions were found to exist on the watershed.
Samples of the water for sanitary analysis were collected at the reservoir
and from the distributing system and sent to the State Hygienic Laboratory.
TIms re»ulta of this analysis in parts per million are given in the table fol-
lowing page 589.
The analysis of the sample taken at the outlet of the reservoir indicates
the presence of considerable ground water flowing off in the stream. This
is shown by the comparatively large percentage of mineral residue and high
degree of hardness. Tliis is due, apparentlv, to the large percentage of
water from the numerous springs. The analysis also indicates a consider-
able amount of organic content which evidently reaches the water in the
reservoir and in the marshy land in the lower part of the stream. However,
the chemical analysis interpreted in the light of a knowledge of the physical
features of the collecting area indicates a normal water from surface and
underground sources.
The bacteriological analysis shows a high bacterial count for a surface
supply, but this is very probably due to the presence of harmless water forms
which find a natural habitat in certain ground waters. Xo bacteria of the
B, coli type indicating fecal pollution were present in the 10 c. c and 1/10 c. c.
samples.' though one of the three 1 c. c. samples indicated this type of organ-
ism. In view, however, of the absence of any permanent sources of pollution
on the watershed the results of this one analysis should not be considered as
suspicious of intestinal pollution. Xo /?. coli was found in the sample taken
from the tap in the village, and the total bacterial content of this sample
was low.
The sanitary inspection of the watershed would indicate that Hound Lake
^as an adequate supply of water of good sanitary quality. There are no
habitations on the watershed and no fixed sources of pollution. It should be
borne in mind, however, that accidental pollution of the water due to
carelessness may occur through those entering upon or working on the water-
shed unless careful sanitary inspection is frequently made.
I. therefore, recommend that the water committee make such regular sani-
tary inspections of the watershed to prevent any occasional pollution which
Alight occur.
Respectfully submitted,
THEODORE HORTOX,
Chief Engineer
578 State Department of Health
is its own sewage. Combined sewers were installed at Konses Point in 1905
subs'tantially in accordance with plans approved by this Department in 1891
except that no public sewers have been built north of Pratt street, nor inter-
cepting sewers along the water front. Sewage outlets are at the foot of
State, Chapman, Liberty, Academy, Pine, and Champlain streets, the last
and most distant of which is only three-fifths of a mile from the intake, and
the first three of which are within 1,200 feet of it. In addition to these
sewers all houses along the lake front have sewer drains discharging into
the lake.
At times of heavy rainfall the volume of storm water discharged with the
sewage must necessarily be of sufficient volume to produce currents flowing
out into the lake, particularly the three sewers referred to above, which are
only 1,200 feet from the intake. The heavy winds from the south referred
to above, which raise the waters at the upper end of the lake often to the
depth of two feet, induce surface current in the direction of the wind and
under currents in a reverse direction, which not only stir up the waters of
the lake, but probably also carry sewage which has accumulated near the
shores out toward the intake. Direct evidence that such is the case is found
in the fact that after such a storm from the south the water from the taps
in the village is roily. The danger of sewage contamination at such times
is further increased, owing to the fact that severe wind storms from the
south will change very commonly to the west and lower the water at Houses
Point a foot. This condition sometimes lasts for several days, and dur-
ing these times the sewage is also carried from the shore out toward the
intake.
Samples of the water were collected at the time of the inspection from the
outlet of Lake Champlain near the intake and in the channel and from a tap
in the village, and were sent to tlie State Hj-gienic Laboratory for chemical
and bacteriological analyses. Tlie results of the analyses of these samples,
together with those of samples collected by the health officer and the super-
intendent of water works, on January 11, 21 and 26, 1910, and on February
24, 1910, from taps in the village, from the outlet of Lake Champlain, both
near the intake and from the channel opposite the pumping station, and
from the lake two miles above the village, three-fourths of a mile from shore
south of the end of the breakwater, as well as of a sample collected by a
representative of the laboratory on March 29, 1909, are given in the table
following page 5S9.
Tliese results show that all samples of water taken from taps in the village
\A'erc grossly contaminated, bacteria of the B. coli type having been found in all
the samples taken, and in the majority of cases even in amounts as small
as .1 c. c. No recent chemical analyses have been made of samples taken from
the village taps, but if bacteriological analyses can be used as a basis of com-
parison it appears that the water from the taps contained much more con-
tamination than samples taken from the lake at the point of intake, suggest-
ing the presence of some contaminating influence such as currents of sewage
passing the point of intake, or perhaps the inflow of sewage laden water
through a possible break in the intake pipe. Tliis source of contamination
is one of great danger and is one which should be investigated and remedied
without delay.
The sample taken on March 29, 1909, confirms the results of recent an-
alyses and shows that the water has been badly polluted for a considerable
period in the past. The samples taken from the outlet of the lake, both at the
point of intake and the channel, show that the water is subject to contami-
nation at the point of intake and at times in the channel, which is evidently
subject to a variable amount of pollution dependent upon atmospheric or
meteorological conditions. The sample taken south of the head of the break-
water also showed some contamination.
That infection as well as contamination of the water supply of Rouses
Point has been taking place is further evidenced by the recent epidemic of
typhoid fever in that village where some 35 to 40 cases have occurred since
the first of last November, and 19 of which occurred during the month of
February. The accompanying table gives information concerning 25 of these
cases for which report cards have been filed with the Department.
Special I^VESTIGATIo^"s of Public Water Supplies 579
Table Showing Occurrence of Typhoid Fever Vases in Village
of Rouses Point, with Accompanying Information from
available Records from November 3, 1909, to February 27,
1910
Case
Age
Occupation
Date of
onset
Water
supply
1
Milk
supply
Shell-
fish
Remarks
1
41
Wife of draw
. 11/ 3/09
Lake Cham-
Farmer at None
Water supply taken
bridge tend-
1 plain and
Windmill
from channel in
er.
I village
' supply.
Point, Vt.
Ijake Champlain.
•
Also had been in
.
village daily. Case
(
fatal. Stools and
urine disinfected
1
1 and thrown into
1
1
channel of lake.
2
14
Daughter ol
f, 11/19/09
Lake Cham-
Farmer at None
Went to school in
draw-bridge
1
plain and
Windmill
village.
tender.
village
supply.
Point. Vt.
3
9
School girl... .
12/16/09
Village
Whitman... None
Died of pulmonary
supply.
phthisis as result of
typhoid.
Half-brother of (3).
4
28
Laborer
1 1/11/10
Village
Whitman. . .
None
supply.
Premises not in
sanitary condition.
Typhoid led to de-
velopment of tuber-
cular meningitis re-
sulting in death.
5
40
Express agent.
1/ 5/10
Village
Neighbor. . .
None
supply.
6
02 Housekeeper. ,
1/15/10
\ illage
supply.
Neighbor. . .
None
7
8 School boy . . .
1/31/10
1
Village
supply.
T^ware
None
8
41 1 Dentist
1 2/ 1/10
Village
Whitman.. .
None
1
1
supply.
9
34
Dressmaker. . .
1 2/ 3/10
1
Village
supply.
Weed
None
10
19
Housekeeper. .
, 2/ 5/10
Village
supply.
Gibault .... 1 None
1
11
13
School girl . . . .
1 2/ 5/10
1
Village
supply.
Laware None
12
16
School girl
, 2/ 5/10
t
Village
supply.
Own cow . . . ' None
1
13
11
School girl... .
; 2/ 6/10
V illage
l>aware. None
Cases (13) and (14)
supply.
Whitman.
are sisters.
14
8
School girl . . . .
2/ 8/10
Village
Laware,
None
i
supply.
Whitman.
15
12
School boy. . . .
1 2/ 9/10
Village
supply.
Laware None
16
28
Housekeeper. .
1 2/12/10 '
i
Village
supply.
Gibault. . . . None
Sanitary condition of
house not good.
17
22
Laborer
2/12/10
1
V illage
supply.
Whitman. . .
None
18
28
Housekeeper. .
• 2/12/10
1
Village
supply.
Own cow . . . None
1
10
8
School boy . . .
2/14/10
Village
.supply.
Laware and None
neighbor's.
20
7
School girl. . . .
' 2/14/10
Village
supply.
Couture. . . .
None
21
15
School girl.. . .
2/17/10
Village
supply.
Whitman. .
None
22
7 1
School boy
1 2/18/10
I 1
Village 1
supply. ;
Laware
None
Brother to case (7).
23
20
Laborer
1 2/21 10 ,
Village
supply.
Own cow. . .
None
24
10
School girl ....
1 2/25/10 1
1 1
Village
supply.
Laware
None
25
0
School boy
2/27/10 ,
Village
Laware and None
1 '
i 1
supply. 1
Whitman.
580 State Department of Health
In addition to securing the information presented in the above table a
careful inquiry was made as to all i>os8ibIe sources of infection, such as water
bupply, milk supply, sliell-fish, unctjoked vegetables and other factors that
might have a bearing upon the caubC of the epidemic. From the informatioa
thus secured it appears the cases of t3*phoid fever are distributed through-
out the village, irrespective of class and age. All the cases used the public
water su])ply. Ihe milk supply came from a variety of sources. So far
as could be learned none of the cases had eaten shell-iish during the twenty
days immediately preceding the onset of illness and only a few had eateu
uncooked vegetables during the incubation period. Precautions have been
taken to prevent a further spread of the disease and transmission by second-
ary infection does not seem to have been a factor in the epidemic.
The milk suj)ply of the village is obtained in part from two dealers, Whit-
man Bros., having a farm two miles from the village on the road to Cham-
plain, and Joseph La ware, one and a-half miles from the village on Chapman
btreet, and in part from twenty live to thirty smaller sources. The milk
distributed by the two dealers is distributed in bottles. The dairies have
been inspected by the health oflieer who found tliat they were not properly
cared for, but that no sickness existed at either plaee.
In view of the lack of association of any particular dairj', with the epi-
demic and the elimination of other factors, there appears to be no doubt that
the gros>ly contaminated and infected condition of the public water supply
is re&punsible for the outbreak of typhoid fever. The fact that this epidemic
has nr^t assumed larger proportions has doubtless been due to the warning
issued by the local lx>ard of health on receipt of the results of analyses from
the State Hygienic Laboratory and through the distribution of printed no-
tices calling the attention of the people of Houses Point to the existence
of typhoid fever in the village, the marked pollution of the water, and urged
them to boil their water until further notice.
It is evident, therefore, that steps sliould be taken without delay by the
village authorities along two lines; first, as to the prevention of the further
spread of tyj)]ioid fever: second, the improvement of the water supply.
As to tlie first, the boiling of the water should be continued until a purer
and safer water siipi)ly is obtained. The dairies from which the milk supply
is obtained should immediately be put into a sanitary condition and every
precaution should be observed to prevent a spread of the disease through
this medium by a mo'*t careful supervision and management of the dairies,
especially as to sterilization of the bottles, prohibitions against the carry-
ing of milk bottles into houses where typhoid cases exist, and the guarding
against, or quarantining, or removal of any persons or employees alx)ut the
dairies who may have contracted typhoid fever. It is also important to see
that all prerautions are taken in the care of patients suffering with the dis-
ease with respect to isolation, disinfection of urine, stools, bedding, dishes,
etc., and such other measures as will prevent a spread of the disease from
these foci of infeetion.
As to measures which should be taken looking toward the improvement of
the supply the data on hand is not sulbcient to warrant making any recom-
mendations other than that a further study of the problem be made. The
analyses of samples taken from the channel of the outlet of Lake Champlain
show' that this is undoubtedly subject to pollution and that it would be unsafe
to extend the intake and take water from the lake at any point opposite the
village. It is possible that the intake may be extended to a point above the
I)reakwater, but even at this point the water has been showTi to be polluted,
although better than the present supply in quality. It is evident, therefore,
that either filtration of the lake water should be adopted or that Lake Cham-
plain should \ye abandoned as a source of water supply and a neAv supply ob-
tained elsewhere.
It is only after a careful study of local conditions that a proper and
economical solution of the problem can be arrived at. The Department has
not facilities or funds to make such a study, and owing to the many factors
associated with the improvement of the water supply of Rouses Point it
would be the part of wisdom and economy for the village authorities to
Special Investigations of Pubjjc Water Supplies oSl
employ an expert sanitary engineer to make a study of the problem along the
lines suggested in this report, and advise them more fully and in more detail
as to the best and most economical means for carrying out improvements to
their supply.
This may take some little time and, owing to danger involved in the use
of an infected water supply, some temporary but effective method of treat-
ment of the entire supply ought to be made to render it safe until such time
as the arrangements for its permanent improvement are completed.
It is possible to temporarily sterilize a supply by the cautious application
of hypochlorite of lime in such small amounts as will kill disease germs and
not affect to any appreciable degree the chemical quality or wLoletomeness
of the supply. This method of sterilization has been recently successfully
practiced by Jersey City, Albany, Poughkeepsic and other places, and while
as at this time, I do not wish to place myself in a position of recommending
this method as other than a temporary' or supplementary one, I believe it is
worth careful consideration and immediate investigation by some competent
expert in water purification in the present instance. In any event it should
not be undertaken by any one excei)t a competent expert after a careful in-
vestig:ation of local conditions and requirements.
I believe that, if these suggested measures are carried out by the village
authorities and the people, a speedy termination of the typhoid fever epidemic
will result and that a recurrence of it prevented in the future. I should,
therefore, recommend that a copy of this report be transmitted to the local
board of health and to the board of water commirtsioners, and that they be
urged to give this report careful consideration and to take immediate action
in carrying out the recommendations contained herein.
Respectfully submitted,
THEODORE HORTOX,
Chief Engineer
SENECA FALLS
At the request of the village board of health, made through the health
officer, on September 18, 1010, an investigation of the conditions surrounding
the public water supply was made, the report upon which is as follows:
Albany, X. Y., yovcmher 5, 1010.
EuGEXE n. Porter, M.D., State Commissioner of Health, Albany, y. Y.:
Deiar Sir: — I beg to submit the following report of an investigation in the
matter of the public water supply of the village of Seneca Falls:
Seneca Falls is a village in Sone<'a county, located on the vSeneca river,
between I^akes Seneca and Cayuga. It is on that branch of the New York
Central and Hudson River railroad known as the Auburn road, 15 miles west
of the citv of Auburn and 61 miles southeast of the citv of Rochester. The
present population is estimated at al)ont 7,000. In 1005 the population was
6,733.
The water supply for the village is taken from Cayuga lake, at a point
near the middle of the northern end of the* lake, opposite the village of Cayuga.
The pumping station is located on the western shore of the lake and about
2% miles east of the village of Seneca Falls. The intake extends about half
a mile from shore to a crib on the bottom of the lake. The intake pipe is
of cast iron, 16" in diameter, and laid with universal joints. The pumping
machinery consists of two steam reciprocating pumps manufactured by A. E.
Russell, of Newburyport. Mass., each with a rated capacity of 1,500.000 gallons
a day. One of these pumps is driven by a crof^s- compound engine and the
other by a double-steeple compound engine. The suction lift of the pumps
varies from 5 to 7 feet. The boiler equipment consists of two boilers each
of ao horsepower.
582 State Department of Health
There is a 14" force main from the pumping station to the distributing
system and connecting with a standpipe located in the northwestern part oi
the village. Thig force main is about 2Vi miles in length. The net lift ia
about 197 feet, which together with the friction head causes a pressure at the
delivery of the pumps at times of ordinary operation of 98 pounds per square
inch.
The distributing reservoir is a steel standpipe 30 feet in diameter and 100
feet high, holding 502,000 gallons. It is located on high ground in the north-
western part of the village, and when full its water surface is about 125 feet
higher than the average elevation of tlue streets at the center of the village.
The distributing system comprises about 15 miles of castiron mains from
4" to 14" in diameter. Ihe average pressure is approximately 50 pounds per
square inch.
Ihe water works were built in 1886 by the Water Works Company of
Seneca Falls. The original distributing system was built of cement-lined
pipe with a comparatively thin outside slicU, presumably of wrought iron.
This has been replaced since 1909 by a system of castiron pipes. Ihe water
works are owned by the Water Works Company of Seneca Falls. Herbert
Paj-son of Portland, Maine, is president of this company, and S. W. Pratt of
Seneca Falls, superintendent of the company.
Of the estimated 7,000 population of the village, about 6,000 are served
from the public water supply. There are about 1,400 active service taps, of
which 30 are metered. Tne average daily consumption of water is about
1.000»000 gallons.
An inspection of the Seneca Falls water works and a small portion of the
watershed of Cayuga lake was made on November 1, 1910, by Mr. A. 0.
True, assistant engineer of this Department, accompanied by William M.
Follett, M.D., health officer of the village of Seneca Falls. No samples of
the water supply for analysis were taken at the time.
Cavuga lake, from which the water supply of the village of Seneca Falls
is taicen, is in the southwestern part of the Oswego watershed and occupies
a central position among the so-called Finger lakes. Cayuga lake has an
area of about 67 square miles and its watershed has an area of about 800
square miles.
The principal centers of population on the watershed of the lake are, not
including those along the Seneca river, the city of Ithaca, with a population
of 14,600, and the following villages: Aurora, Cayuga, Dryden, Freeville,
Newfield, Trumansburg and Union Springs, with an aggregate population of
about 4,700. Of these, Ithaca, Aurora, Cayuga and Union Springs are located
on the border of Cayuga lake, and the village of Trumansburg is situated on
Trumansburg creek at a point a little more than two miles southwest of the
lake and the mouth of the creek. The city of Ithaca has a system of sewerage.
The seAvage after passing through a septic tank is discharged into the Cayuga
inlet. Most of the other villages have some sewers and cesspools discharging
more or less directly into Cayuga lake. The village of Cayuga, which is
directly opposite the Seneca Falls water supply intake, is partially sewered,
the sewage being discharged without treatment into the lake.
Other sources of pollution exist along the western shore of the lake among
the summer residences situated closely together and extending for a distance
of about two miles above the water works pumping station. These houses
for the most part occupy a narro>v strip of level ground between the steep
embankment of the road and the waiter's edge. They are supplied with village
water and most of them have water-closets. The latter are discharged to-
gether with other household wastes into soil pipes leading into the lake. In
this region and about one and one-half miles abnove the water works pumping
station there is an amusement park operated in the summer season by the
electric railway company. Drains from urinals and other fixtures in the
pavilions of this park discharge into the lake.
Although complaint has been made by the village officials that the embank-
ment which has been built by the New York Central railroad across the
northern end of the lake has injured the quality of the water and obstructed
the natural flow of the lake so as to increase the amount of pollution reach-
Speciai. Investigations of Public Water Supplies 583
ing the intake, it was not practicable to investigate these claims in order to
be able to say as to just what effect this structure has had on the strictly
sanitary quality of the water. However, this embankment has obstructed the
natural circulation of the water and no doubt injured its esthetic qualities.
In view of the conditiojis and circumstances obtaining on the Cayuga lake
watershed, and more particularly on that part of the lake which furnisl ed
the more immediate supply for the village, as outlined above; and also in
view of the further evidence of frequent pollution shown by the series of
chemical and bacteriological analyses of the public water supply, the results
of which are shown in tlie table folowing page 589, I am of the opinion that
the public water supply of the village of Seneca Falls pumped from Cayuga
lake, i» subject to frequent and dangerous pollution, and may become a menace
to the health of its citizens.
A complete consideration of the problem of providing a safe and adequate
supply of water for the village entails a study of local conditions and questions
of sanitary engineering outside the resources and duties of this Department.
However, it is possible to restrict by lawful regulations the uses to which the
wator of Cayuga lake is at present put with a view to preventing pollution of
the water supply, though such a step would probably be expensive, as it
would affect tne interests of a great number of people.
The Public Health Law provides for the protection of public water supplies
through the enactment by the Commissioner of Health of rules and regula-
tions, but it also provides that the municipality or corporation owning the
water works benefited shall bear the expense of the construction of or the
changes in sewer systems or purification works necessitated in executing any
of such rules and regulations. It also provides for just and adequate pay-
ment by the corporation benefited for all injuries to property caused in the
enforcement of these rules and regulations.
Prom a chemical and physical standpoint, Cayuga lake water is of ex-
cellent quality, though somewhat hard, and if its sanitary quality be im-
proved by purification, it should yield a water supply satisfactory from every
standpoint. It would seem that one of the approved processes of filtration
together with a possible relocation of the intake would safeguard this supply
from the danger of water-carried diseases.
Summarizing from the foregoing consideration, I have come to the follow-
ing conclusions:
1. That the water reaching the intake of the public water supply is at
present subject to frequent and dangerous pollution from sewage now being
emptied into the lake.
2. That through the enforcement of rules and regulations enacted by the
Commissioner of Health, in accordance with the provisions of the Public
Health Law, for the protection of the public water supply of Seneca Falls,
the pollution now existing at the lake would be eliminated. The enforcement,
however, of such regulations would probably be expensive, and it is question-
able if anything less than a complete control of Cayuga lake watershed would
be effective in completely removing all pollution. Also that it would not teem
practicable to remove by enforcement of rules, only that portion of the pollu-
tion existing at the northern end of the lake, because of the possibility of
pollution from other parts of the lake being carried by means of currents to
the water works intake.
3. That, owing to the pollution of the lake water and the difficulty of pre-
venting the same from reaching the water works intake, the water supply of
Seneca Falls should be subjected to some approved process of purification,
notwithstanding any protection afforded by rules and regulations applying to
the watershed of the lake either as a whole or in part.
I recommend that copies of this report be transmitted to the Water Works
Company and the trustees of the village of Seneca Falls, and that they be
advised to engage the services of an expert sanitary engineer, to investigate
ami report a» to the best and most economical means for carrying on the
above recommendations. Further. I recommend that the attention of the
board of health of the town of Seneca Falls be called to the existence of
private sewers discharging into the lake from the summer cottages on the
580 State Department of Health
3. That the use of a dual distributing system, one supplying water
for drinking and culinary purposes, and the second for all other purposcR,
is to be deprecated on the ground that obviously the latter, or lesR pure
water, would be frequently used for drinking because of carelessness^, in-
advertence, or failure to distinguish betw^een the two supplies.
I recommend that the board of trustees be advised to discontinue the use
of unpurified water from Keshequa creek as a household water supply for
the Craig Colony. That they be advised to defer the development of the
spring water supply until they have ascertained conclusively that no per-
manent source of pollution exists, and that any opportunity for intermittent
pollution has been corrected. That they engage an engineer to investigate
thoroughly and report upon the most economical means of providing the col-
ony with an adequate and safe water supply. Such an investigation should
include a careful consideration of the following: The improvement of the
present supplies by the enactment of rules and regulations by the Commis-
sioner of Health for the protection of the watershed, the application of «ome
approved process of water purification or the development of some new soifrce
which will yield an adequate and safe supply of water for present and future
needs.
I do not think it would be advisable before careful investigation to develop
the present works with a view to taking the whole supply from the present
spring for two reasons: First, there is no assurance that the present spring
would yield an adequate quantity for the needs of the colony; second, in
view of the evidence that the spring is at present possibly receiving polluted
water, the opportunity for further pollution would be enhanced should the
ground water be lowered at that point by an increased draft upon it.
Very respectfully,
THEODORE HORTOX,
Chief Engineer
WHITEHALL
On May 20, 1910, President Aubrey E. Meyer and Health Officer J. S.
Guinan, M.D., of the village, were in conference with the Chief Engineer of
this Department relative to the desire of the trustees of the village to secure
a better water supply. Their request that an engineer from this Department
be sent to Whitehall to look into the situation, with reference to the public
water supply, was complied with, and the results of this investigation are
given in the following report:
Albany, X. Y., July 1, 1910.
Eugene H. Pobter, M.D., State Commissioner of Health, Albany, N, Y. :
Df.ab Sir: — I beg to submit the following report of an investigation in
the matter of the public water supply of the village of Whitehall.
WTiitehall is a village in Washington county, located on both banks of
the Mettawee river, at its confluence with Lake Champlain. It is on the
main line of the Delaware and Hudson railroad, and part of the northern
boundarv of the town is coincident with the Xew York-Vermont interstate
boundary. Tlie present population is estimated at 6,000, which indicates a
substantial increase since 1905, at which time the census showed a population
of 4,148. The industries of the village comprise the following establisnments:
Champlain Silk Mills, employing 350 hands.
Delaware and Hudson Company shops, employing 100 hands.
D. F. Keenon Stone Crushing Plant, employing 50 hands.
Whitehall Shirt Factory, employing 50 hands. .
Whitehall Lumber Company, employing 35 hands.
Champlain Tfansportation Company, employing 25 hands,
StaFO Paint Company, employing. .' 15 hands.
Whitehall Motor Boat Company, employing 10 hands.
Special Investigations of Public Watek Supplies 587
The water supply for the village is obtained from the Mettawee river,
otherwise kjiown as East creek, at a point one-quarter of a mile above its
confluence with Wood creek, and about one and one-half miles south of the
village. Here is situated a pumping station in the low land on the right
bank of the river and some 100 feet from the water. The intake extends
12 feet into the river to an intake crib on the bottom. Between the river
and the pumping station there is a circular brick suction well 50 feet in
diameter, to which the water flows by gravity from the intake crib through
a 12" pipe. The pumping set consists of a Triplex Dean pump, of rated
capacity of 1,500,000 gallons per day, belted to a Corliss engine. This ma-
chmery was installed in 1905. Previous to this the pumping was performed
by a Davison single direct acting steam pump which waB installed in 1884
at the time of the building of the water works system. This latter pump is
now used only in case of emergency. The suction lift of the pumps is
about 13 feet. The boiler equipment consists of two boilers of 75-horsepower,
and one of 1 •25.horsepower.
There is a 10" force main from the pumping station to the distributing
reservoir on West Mountain about one mile west of the village. The nel
lift is about 260 feet which, together with the friction heads, causes a pressure
at the delivery of the pumps at times of ordinary operation of 125 pounds
per square inch.
The distributing reservoir is an uncovered basin with earth embankments.
It has an area of approximately 1.25 acres, a capacity of 5,000,000 gallons,
and an average depth of 12 feet. In addition there is an impounding reser-
voir, located near the distributing reservoir at a little higher elevation. This
reservoir receives its supply from a small stream having a watershed of
about 0.2 of a square mile. It has an area of about 3 acres, a capacity of
7.000,000 gallons, and an average depth of 7 feet. Water is drawn from
this reservoir as often as it becomes filled and it affords valuable storage
when the pumping station is shut down for repair or cleaning.
The distributing system comprises about 8^ miles of castiron mains from
4" to 12" in diameter. The average pressure is approximately 100 pounds
per square in'^h.
The water works were built in 1884, though a report was made upon the
problem of a public water supply some ten years before. At that date much
consideration was given to the practicability and economy of securing a
complete gravity supply from a watershed comprising a system of ponds and
streams on the mountain 3^ miles southwest of the village. ,
The water works are owned by the village and are under the direction of
the board of water commissioners, Mr. S. W. Perry, president; Mr. Fred S.
Cowan, superintendent.
Whitehall has an estimated population of 6,000, of which about two-thirds
are connected with the public water supply. There are 607 service taps, of
which 204 are metered. The average daily consumption of water is about
750,000 gallons, of which approximately 70 per cent, represents domestic
use; 25 per cent., commercial use, and 5 per cent., public use.
An inspection of the Whitehall water works and the watersheds of sev-
eral proposed new supplies for the village was made on June 14 and 15,
1910, by Mr. A. O. True, Assistant Engineer of this Department.
Samples of water for sanitary analysis were collected from Long Pond
and from the present system and sent to the State Hygienic Laboratory. TTie
results of this analysis in parts per million are given in the table following
page 589. Xo chemical analysis was made of the present water supply at
thfs time.
The sample taken at the tap in the Hall house shows a bacterial content
in that point of the distributing system at that time of 450 per c. c. This is
a high bacterial count for a surface water supply and is prooably due to the
presence of organic matter from animal sources. WTiile some ground waters
may contain at times great numbers of harmless bacteria, which find sus-
tenance on the mineral contents of the water, surface supplies showing more
than 300 bacteria per c. c. are looked upon with suspicion. It is also seen
that one-third of the 10 c. c. samples show the presence of B. coli or bac-
teria of that type. While the occasional occurrence of this type of intestinal
588 State Depaetment of Health
bacteria in large samples would not necessarily indicate gross pollution, never-
theless, its appearance would be suspicious and, in this case, in conjunction
with the knowledge that sewage is lining dist-harged into the river above th?
water works, would be indicative of an uns-afe water.
The chemical and bacteriological analvsis of the sample taken from Ijong
Pond is consistent with what would l>e expected from an unpolluted s*urfai'e
supply. B. coli type of organisms are absent and the total contents of bac-
teria is but 00 per c. c. The color is somewhat higher than is usually found
in a river or stream receiving no swamp water. This is probably due to tie
collection of leaves and other dead organic growths at or near the «»utlet of
the pond. The other figures for the mineral and organic contents are nor-
mal for an unpolluted surface supply in this locality, with the possible ex-
ception of tlie chlorine which seems somewhat high. In the light of the
physical characteristics of the watershed this water appears to l)e an excel-
lent source of supply from a sanitary standpoint.
The high bacterial count and pre>ence of H. coli type of organisms in tbe
>ample taken from the school well would indicate considerable contamination
from organic matter reaching this water.
In di-^cussing the question of the public water supply of the village of
Whitehall, 1 shall confine myself largely to the condition of the present
supply from a sanitary standixjint. It is not the purpose of this report
to inquire into, or make recommendations upon, the engineering problems
which must be carefully considered in improving the water supply of the
village. While it is the intention and duty of this Department to render
such advice and assistance, as it is possible to do within the limitations of
the resources allotted to such purposes, in procuring a safe and adequate
supply of water for the community', it is not within its province to under-
take any extended btudy of IoquI conditions with a view to making final
rcTommendations, or drawing conclusions as to the best course for the author-
ities to pursue.
Tlie Mettawee river, from which the water supply of the village of Wliite-
hall is pumped, ri^^es in the mountains of Dorset, Vermont, al>out 27 miles
southeast of Whitehall. According to the United States (Geological Survey
topographic maps the watershed of this streiim above Middle Granville is
]61.i5 square miles, and between that point and the confluence of the Metta-
wee and Wood creek 46.1 stpiare miles, making a total watershed above the
present pumping station of al^out 207 s<piare miles. According to the report
of the State Kngineer for 15K)4 the discharge of the Mettawee river, at the
first bridge above the junction with Wood creek was, on September 17, 1903,
57.8 cubic feet per second, or the equivalent of 0.217 cubic feet per second
per scjuare mile of trilmtary watershed. This is in all probability nearly a
minimum flow for a stream of this character.
The principal centers of population on the watershed are Dorset. Vt. ;
Pawlet, Vt.; Wells, Vt. ; Granville. N. Y.; ^liddle Granville. N. Y.; lYuth-
ville. X. Y. ; and North Granville. X. Y. The population of these communi-
ties along the river probably nggregntes about 12,000. The largest of these
is the village of Granville, X. Y., having, in IDOo, about 3.000 people.
This village is partiaUy sewered, the sewers having been built for the
mo^t part by private parties, and subsequently were taken over by the cor-
poration. The scwiige from these sewers i.s disposed of by discliarging Into
the Mettawee river below the Granville water works intake.
At Granville, and aNo at Middle Granville, there are numerous privies near
or directly over the stream.
In the winter and spring of the years 1904-1 OO.^-IOOG and 1007 there were
outbreaks of typhoid fever at Whitehall, which were investigated by this
Department. After a careful study of the conditions at Whitehall and on
the watershed above the village water works this Department reported that
the prevalence of typhoid fever was undoubtedly due to the pollution of
its water supply by the village of Granville and other places on the water-
shed. These dangerous conditions were brought to the attention of the
l)oard of health of the town of Granville, and orders were issued to abate
the nuisances and dis<iontinue the discharge of sewage in violation of section
7fi of tlie Public Health Law.
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Special Investigations of Public Water Supplies 589
In so doing lliis Department did all within its power to correct the pre-
vailing conditions and safeguard the water supply of the village of White-
Ha.ll. There is no provision in the Public Health Law for enforcing the dis-
continuance of the discharge of sewage from sewers constructed prior to
1O03. Hence, the recommendation of this Department, in 1907, to safeguard
tlie water supply of Whitehall by some approved process of purification.
i From the results of the several investigations made by the chemists and
engineers of this Department. I am of the opinion that the present water
supply of the village of Whitehall is dangerously polluted by communities
lip stream, and is not a safe supply in the absence of any process of
purification.
fXhe alternative to the purification of the present supply is the development
of a new supply. It was with a view to a further consideration of new
e»ources of supply by the village that one of the assistant engineers of this
Department accompanied some of the officials of the village on an inspec-
tion of two watersheds on the mountain but a few miles distant. The indi-
cations are that these supplies are of excellent quality and, with ordinary pre-
cautions, free from any pollution. The quantity of water which these sup-
plies can be expected to furnish, and the amount of storage which it would be
necessary to provide in order to insure a constant reserve in the future, are
questions of great importance, and involve engineering problems which re-
quire investigation by a professional engineer.
1 am of the opinion that the present water supply of the village of White-
hall is at times seriously polluted by sewage and. therefore, may become the
source of disease to the village. Such insanitary conditions as have been
shown to exist upon the watershed of the present supply cannot probably be
wholly eliminated. The village should, therefore, have recourse either to' the
development of a new source of supply or the purification of the present
supply. Such a procedure involves questions of sanitary engineering which
require careful inquiry and study.
In conclusion, I recommend that the corporation of the village of W^hitehall
take steps to improve their water supply and retain an engineer to fully in-
vestigate local conditions, and report on the best solution of the problem
on the basis of health and economy.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer..
K
"V
INVESTIGATION OF OUTBREAKS OF
TYPHOID FEVER
[591]
INVESTIGATION OF OUTBREAKS OF
TYPHOID FEVER
Although typhoid fever through the State during 1910 was on
the average less prevalent than for the past decade or semi-decade,
it appears that the number of outbreaks or cases of undue preva-
lence of this disease in cities and villages were nevertheless more
numerous. In most, but not all, of these cases the Department
was appealed to for aid in searching out the sources of infection
and in giving recommendations for remedial measures.
Since the sources of infection responsible for such outbreaks
are in general most frequently found in conditions associated
with infected water supplies, infected foods and insanitary con-
ditions of living or premises, and involve frequently many ques-
tions of a strictly engineering nature associated with water sup-
plies and sewage disposal, this epidemiological work devolved
largely upon the Sanitary Engineering Division. In every in-
stance a careful study was made of the infected territory and a
searching investigation made to determine the source of infection.
This investigation work was not always simple but was neverthe-
less ultimately successful, for the sources of infection were dis-
covered and measures promptly recommended to Esuppress them.
The places, where the prevalence or epidemics of typhoid fever
were thus investigated and reported upon by the Engineering
Division during 1910, are given below, and in all cases, copies of
the following reports setting forth the results of these investiga-
tions were sent to the proper local authorities.
HOBART
This Department being notified early in February, 1910, of the occurrence in
this viUage of some twelve cases of typhoid fever, within the short period of
three weeks, an investigation was ordered, and its findings are presented in
the foUowini? report:
Ai.BA>'Y. N. Y., February 23, 1910.
ElDGVlQc H. PoBSBt, M.D., Sterte Oomwisaioner of Healthy Albamy, N. T.:
Deab Sib: — In accordance with your directions to investigate tbe causes
of a recent otrtbreak of typhoid fever in the village of Hobart, referred to you
by Dr. O. L. Hubbell, health oflScer of the village, and to make such recom-
[593]
594 State Department of Health
mendations in the premises as the facts in the case would seem to warrant, I
bee to submit the following:
Hobart is a village having a population of about 600, and is situated in the
town of Stamford, Delaware county, at the junction of Town brook and the
Delaware river. It. is provided with a public water supply furnished by a
w^ater company, of which Mr. Jaeob Lawrence is president, and Mr. A. J.
Lawrence is superintendent. The village is not provided with a public system
of sewers, but there are a number of private drains which discharge into
Delaware river and Town brook. The topography of this section of the State
is rather precipitous, and much of the soil fs of a sandy nature. The land
in this vicinity has been largely denuded of forests, which has a tendency to
increase the flood flow of the streams.
The water supply furnished by the Hobart Water Company is derived
from two sources, namely, an old source from two small impounding reservoirs
on the Grant stream, about one-half mile east of the village, and a new sup-
ply from Town brook, at a point about three miles east of the village. The
average daily consumption varies from about 150,000 gallons in winter to
about 350,000 gallons in summer, of which about 60,000 to 100,000 gallons
are used for domestic consumption, 50,000 to 100,000 gallons by the Slaiison
& Decker Creamery and 50,000 to 150,000 gallons by the Ulster and Delaware
Railroad Company.
The old supply derived from Grant stream has a watershed of about two
square miles, upon which are located some five houses, three of which are
used as summer boarding houses, having a population of from 90 to 100 per-
sons, or approximately 40 to 50 per square mile. One of these places has a
privy without a vault, on the slope of a drainage channel, within 100 feet
of the main stream. Another place, where about 100 boarders are accommo-
dated during the season, has a cesspool in gravel within about 75 feet of
and slightly above the stream. At other places stables are located near the
stream and manure from the farms in this district is spread upon the fields,
and at the time of our inspection one of these fields at the edge of the stream
WHS so spread with manure.
The reservoirs on this stream are shallow, open impounding reservoirs,
having masonry covers, and the earthern dams forming them were in a
dilapidated condition. The upper reservoir has a storage capacity of about
one-half million gallons and the lower reservoir about 300,000 gallons. The
lower reservoir has a masonry well, 3x4 feet and a depth of 7^ feet, partially
filled with charcoal, and from the bottom of which an 8-inch main leads to
the village. Both reservoirs are badly silted and are in a dirty condition.
In fact, the entire works of this old supply are in bad repair and unsatis-
factory condition.
Tlie new supply on Town brook comes from a watershed having an area of
about eight square miles and a population of about 125 persons upon it, which
is equivalent to sixteen persons per square mile. There are some thirty or
more houses on the drainage area, of ivhich about eighteen have stables and
privies in dangerous proximity to the streams. Owing to the severe snow-
storm and the difliculty of making an inspection at this time of the year, a
complete inspection of the watershed of Town brook was not attempted.
Judging from the portion of the watershed covered by this inspection, it will
be safe to assume that many of the privies on this watershed are probably
constructed without vaults and are a serious menace to the purity of the
supply.
The intake of the Town brook supply comprises a small intake well and
dam with a strainer of gravel and sand. The intake well is located at the
edge of the stream, and its construction forms a part of the dam projecting
across the stream at this point. The dam is four feet high, three feet of
which is below the bed of the stream. The strainer system is located just in
front of the intake well, the soil being excavated and .the place filled in with
one and one-half feet of coarse gravel above which is a layer of two and
one-half feet of sand and gravel.
A 6-inch pipe connects the intake well with a covered, concrete storage
reservoir about 250 feet distant, the reservoir being 24 feet long, 5% feet wide
Investigation ov Outbreaks of Typhoid Fever 595
and 6 feet deep, from the bottom of which a 6-inch gravity supply main leads
to the village. The above descriptions of these two supplies are given some-
what in detail in order thait a clearer understanding may be had of the
relation of these supplies to the outbreak of typhoid fever in the village,
which will now be considered more in detail.
It appears that some twelve cases of typhoid fever have occurred in the
village between January 25th and February 17th, the time when our engineer
visited Hobart to make his investigation. The occurrence of these cases of
typhoid fever, together with certain important information concerning them,
are shown in a table which accompanies this report. In addition to securing
the information so presented, a careful inquirv was made as to all possible
sources of infection, such as water supply, milk supply, uncooked vegetables
and other factors that might have a bearing upon the cause of the epidemic.
By reference to the table, it will be seen that all of the cases used the public
water supply, and that eight out of the twelve used the milk supplied by one
of the milk dealers in the village, Mr. Justin Decker, who supplies some
thirty families, the rest of the people in the village using milk supplied from
their own cowa or their neighbors who own them.
Since eight of the twelve cases used the milk from the Decker farm a care-
ful inspection was made of this dairy. There are some twelve cows kept on
this dairy, and the condition of the stable was found to be fair. The milk-
house was separate from the stable, and all the washing and bottling is done
in the milkhouse. The bottles are washed by hand with a brush and washing
powder, and hot water obtained from the Slauson & Decker creamery was
used to waah the bottles. The water otherwise used was piped from springs
on an unoccupied hillside.
It was found that no hands upon the farm had been afl9icted in any way
with typhoid fever or any ailment resembling it. In fact, there was nothing
connected with the operation and management of this farm which would
indicate that the milk supplied from it was in any way responsible for the
outbreak of typhoid fever in the village.
So far as can be learned, only one of the cases had eaten shellfish during
the preceding twenty days or within the incubation period prior to the out-
break of the epidemic. Furthermore, this case ate oysters six days before
the onset of his illness, which is too early an incubation period to indicate
that these oysters were the source of the illness.
Transmission by flies or transmission by secondary infection did not seem
to be a factor in the present epidemic, as can be readily gathered from the
sequence of the cases and the fact that at this season flies are not prevalent.
It now remains to consider the question of the water supply, and the facts
associated with the epidemic. These facts and the condition of the water
supply seem to furnish evidence that this supply was repponsible for this
outbreak of typhoid fever. A sample for chemical analysis was secured from
the new supply, and samples for bacteriological analysis were collected from
both the old and the new supply by Assistant Engineer C. F. Breitzke during
the investigation. These were forwarded to the Hygienic Laboratory for
analysis, and the results thereof, together with the results oi analyses of
samples collected under the direction of the health officer three days before
our engineer collected samples, accompany this report.
These analyses indicate that the old supply was very seriously contaminate<i,
fecal pollution being found in the smallest quantities teatedi and they oor-
robate very clearly the evidence of pollution which was found from our in*
apection of the watershed. The analyses of the new supply, while showing
somewhat less contamination, indicate, however, that tnis supply also re-
ceives contamination as might be expected from the conditions found to exist
upon the Town brook watershed. The most noteworthy and coincident fact
associated with the present epidemic is that the old Grant stream supply is
not used regularly to supply the village, but that on January lOth and again
on January 23 and 24, 1910, this supply was drawn from, owing to the
diffienltiefl encountered at the Town brook intake works, and that at this time
a flood condition occurred upon these streams.
In other words, during this period of heav^ rainfall and high flows a
water was temporarily supplied the village which drained an area more or
596 State Depabtment of Health
less groasly polluted with human pollution, and infection derived from this
source was quickly transmitted to the people of the village on these dates.
The dates on which this water supply was used would bring the eases within
the incubation period of the disease, and when we consider the amount and
probable intensity of this infection and the absence of other causes as outlined
above, there is the strongest presumptive evidence that the water supplied
from this watershed on these dates was responsible for the outbreak of this
epidemic.
If any further evidence is needed in this respect, it can be no better shown
than by the unusual facts presented by a closer study of the occurrence of the
disease during the epidemic. Ihus we have some nine of these cases occurring
between the dates of January 25th and January 28th, which eorreapoiKls to
the infection received the first time the water from Grant stream was turned
into the mains on January 10th, the time subsequent to January 10th until
the outbreak of these cases being approximately the accepted incubation
period of about two weeks for typhoid fever. Again, we have some three
other cases falling between the dates of February 9th and February i2th,
which corresponds to the infection received on January 23d and 24th, the
time subsequent to January 23d and 24th until the outbreak of these oases
being approximately the accepted incubation period of about two weeks for
typhoid fever.
It should not be lost sight of, however, that the supply of water drawn
from Town brook is also polluted and that, although a small portion, if any.
of this supply, was delivered to the people at the time of the excessive flood
conditions on the watershed, there is a strong possibility, if not a likelihood,
that this supply may have also been partially responsible for the infection
which caused this epidemic. The analyses indicate very clearly that the new
supply is contaminated, although it must be admitted that the danger from
the new supply is considerably less than that from the old supply.
In view, therefore, of the facts and conditions briefly outlined in the fore-
going, it is my opinion —
1. That the occurrence of some twelve cases of typhoid fever in the
village of Hobart within the short period of three weeks is sufficient to
cx)nstitute an epidemic of this disense.
2. That the cause of this epidemic was an infected condition of the
public water supply.
3. That in all probability the infected condition of the old supply from
Grant stream was the more important cause of this outbreak.
4. That the new water supply from Town brook is subject to con-
siderable contamination of a dangerous nature, and that this source may
have also been partially responsible for the recent outbreak of the disease.
5. That whereas some eight out of twelve cases of the disease took
milk from tlie Decker dairy farm, an inspection of the condition of this
farm indicates that the condition of management and methods of
handling milk make it improbable that ihis supply had any responsibility
in this epidemic.
6. That other sources of infection frequently associated with causes of
epidemics such as secondary infection, fly transmission, use of uncooked
foods, etc., were not found to be factors in either the cause or spread of
til is epidemic.
In view of the foregoing conclubious. I would submit the following recom-
mendations:
1. That the old supply of water taken from Grant stream be entirely
abandoned as a permanent or temjwrary source of suj^ly.
2. That immediate steps be taken to improve tlw new supply from
Town brook by removing all direct pollution upon the watershed liad
possibly .supplementing these precautions by more effective meaas «f
purification than that secured by the present system of strainer*.
3. That if any difilculties are experienced by the water oompany in
securing a removal of pollution upon the watco'fihed of the Town teook
supply, the water company apply to you for the enactment of rules and
regulations for the further protection of this supply.
_J
INVESTIGATION OF OUTBEEAKS OF TyPHOID FeVER 597
4. That until a safer and purer water supply is furnished by the water
company or the village, the people continue to boil the present supply.
5. That in regard to the milk supply every precaution be observed to
prevent a spread of the disease through this medium by a most careful
super¥ision and management of the dairies, especially as to sterilization of
the bottles, prohibitions against the carrying of milk bottles into houses
where typhoid cases exist, and the guarding against, or quarantining, or
removal of any persons or employees about the dairies who may liave
contracted typhoid fever.
6. That all precautions be taken in the care of patients suffering with
the disease with respect to isolation, disinfection, etc., as will prevent a
spread of the disease from these foci of infection.
I believe that, if these recommendations are carried out faithfully by the
village authorities and the water company and the people, a speedy 'termina-
tion of the outbreak of typhoid will result, and that a recurrence of it may
be prevented in the future. I should, therefore, further recommend that a
copy of this report be transmitted to the local board of health and the water
company, and that they be urged to give this report careful consideration and
that they be urged to take immediate action in carrying out the recom-
mendations and conclusions contained therein.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
State Department of Health
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Investigation of Outbreaks of Typhoid Fever 599
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600 State Department of Health
TOWNS OF LONG LAKE AND WEBB
The prevalence of typhoid fever in the summer resorts located in these
towns was brought to the attention of this Department by the health officer
of the town of Long Lake and by individuals who were visitors there during
the summer. These places were visited by one of the inspecting engineers,
and reported upon as follows.
Albany, N. Y., October 14, 1010.
Mr. Theodore Hortox, Chief Enqincer, State Department of Health, Albany,
N, v.:
Dear Sir: — I beg to submit the following summary on an inves^tigation
made October Hl.^th, of the prevalence of typhoid fever at Raquctte Lake,
IvOiig Lake, Kag^e Bay and Eagle Lake.
Hannette Lake
At least four en fees occurred at Raquette Lake this summer.
1. Threc-vcar <dd son of Mrs. L. Blanchard wixh taken down with tvphoid
about the 10th of August. Home located about a mile from station. Played
in shallow water of lake. Cause not known. Fed on evaporated milk.
2. Five-year old son of Mrs. F. D. Carlin was taken down about first week
in August. Lives about 300 feet from station. Played a good deal in lake,
and origin of fever attributed to polluted lake water.
3. Butler at Mrs. R. Beagulin's camp. Came down with typhoid about first
week in August. 8ent out to Utica immediately. No information as to
probable cause.
4. Winchester McDowell, photographer, camping at a small island about 500
feet from station, contracted typhoid about first week in September. Drank
lake water, as there was no other water on the island.
Three cases at this end of the lake occurred last year among natives. No
information of any other cases among campers could be obtained, as they had
all left the camp.
Most of the cases have occurred at the upper end of the lake. This receives
considerable sewage from the R^iquette Lake Hotel, two cottages, the store,
and from the railroad station. There are ten closets at the hotel, one of
which has five seats. In summer the hotel accommodates about forty people
a day and has a large bar trade.
A restaurant is connected with the railroad station, and in the summer
season a large number of people pass through the station every day.
The sew^age is discharged directly into the lake, and at the time of the
inspection fecal matter and paper was seen floating on the water or sus-
pended in it.
Eagle Bay — Fourth Lake
One case originating at Fagle Bay was reported from Rome. N. Y. This
was that of Miss Linda RalTauf, who was staying at the Eagle Bay Hotel.
She had been at the hotel five weeks before being taken down. The sanitary
conditions at the hotel are good and no evidenoes of insanitary conditions
afl"ecting the drinking water could be obtained.
Miss Cecil Jones of Forest port contracted typhoid fever while at Eagle Bay.
Information that two other cases at the foot of the lake had occurred this
siunmer were obtained, but these people had moved and no reliable facts
could be obtained.
Long Lake
Six cases of typhoid fever this summer were reported by the health officer.
The first case, J. Dwyer, occurred about the middle of July. J. Dwyer came
from Mineville, Essex county, about the first week in July and stopped at a
boarding-house in Long Ijake. Mineville had a small epidemic of typhoid at
this time. Alx>ut three weeks after J. DwAcr came down with typhoid, two
I^VK8TIGATIO^ OF Ol TBUEAKS OF TyPIIUID FeVKB 001
other ca868 at the same board iiig-houFc developed, and sliortly afterward three
more ca**e8. All the^e either boarded at this house or were employed there,
and the last five eases came from direct contact with the first.
Eagle Neat Country Club — Eagle Lake
Eighteen ca^es of typhoid originated at the Eagle Nest Country Club this
summer. 'J he first case was a caddy boy employed by the club, who was taken
down about the first week in August. He was sick about eight days before It
was diagnosed as typhoid fever, lie was removed to Now York city. About
a week later auother caddy boy was taken down, and then one after another,
nine more caddy boys. Ihese eleven caddy boys were all sleeping in the same
room in intimate relationship with one another. They all came from the
Brace Farm School, Valhalla, N. Y. They arrived at Eagle Nest July Ist,
and the first hoy taken down had been there five weeks.
Mrs. E. Stack, a laundry girl, boarding at this hous-e, was taken down with
typhoid fever about the 15th of August. Walter Ilockschild, the son of a
club member, who often played with the caddy boys, was also taken down with
typhoid about this time. The caretaker stated that five other persons, some
of whom were guests at the place or their maids were taken down shortly
after they had left the club.
The house in which most of these cases prevailed was used to board the
help. Until this year typhoid did not appear at any other house on the place.
The first case at this house was in IflOU, when Miss Kitty Roas, the sister of
the proprietor's wife, was taken sick with typhoid. In' 1907 a young man
boarding at this house contracted typhoid. In 1908 a chore man boarding at
this house contracted typhoid. In 1009, five cases were present. A laundry
woman, Mrs. Tibido; a carpenter, Richard Lewis: a general helper, Henry
John.«-on, and two carpenters, Paul Kruger and Paul Christianson, all board-
ing at this place, were taken down with typhoid fever.
The sanitary arrangements at the house were good. Flush closets, running
water with enameled washbowls and bathtubs drain into a oessiK>ol. The
drinking water comes from a spring half a mile up on a hill. No houses are
anywhere above it or on its catchment. It is piped to the place. The milk
is obtained on the place.
Mrs. Waddell, who has been cook at this boarding-house for the past five
years, has had typhoid fever many years ago. Circumstantial evidence seems
to point to her as a carrier of typhoid bacilli and giving origin to the first
case. The others were contracted by direct contact.
Respectfully submitted,
ERITZ M. ARXOT/l\
Inspecting Engineer
Albany, N. Y., October 20, 1010.
Mr. F. H. Pl.VTT, Xo. 2 Reetor fitreet, Neir York City:
D£AR SiB: — With reference to the alleged prevalence of ty]>hoid fever in
the vicinity of Raquette Lake which you took up with me recently, I U'g to
say that I have had one of our inspecting engineers visit Raquette Lake and
other lakes in the vicinity of this one to inquire into the question of the
occurrence of typhoid fever during the past summer, and I inclo>e herewith his
report as to what he found in tliis action.
You will note from the report that with the exception of one local epidemic
that occurred at the Eagle Nest Country Club on Eagle hike, which is still
under investigation as to the probable cause, the number of cases found were
Komewhat scattered and their origin, owing to the general transiency of resi-
dents, somewhat obscure. Notwithstanding this obscurity, however, tliere
appears to be suflicient grounds to believe that some of the.-e cases may have
been contracted as the result of insanitary conditions and practices at the
camps and hotels in this section.
This qnefttion of the sanitary condition of summer resorts is one that has
been under special investigation by the Department for the past three years
002 State Department of IIealtu
and the Department has spent considerable time and has used what powers it
possesses under the Public Health Law in trying to improve the conditions of
many of thes-e resorts. Practically all of the hotels and resorts having a
capacity larger than twenty-live persons have been visited by inspectors of the
Engineering Division during the past three summers and notices have been
sent to all proprietors where insanitary conditions were found to exist notify-
ing them of the violations of the Public Health Law aud seeking their co-
operation in trying to remove these conditions. As a result of reinspections
it has l>een found that many of these places have corrected the insanitary
conditions and at the same time it was found that in some cases thev have not
been corrected, and tlie.'-e later will be made the subject of further action by
the Department before th.e opening of the next summer season.
As you know, the l*ublic Health I^aw does not give the State Commissioner
of Health peremptory power to remove pollution from the waters of the
State except in certain restricted cas-es, and as the law now stands the local
board of health is the only body tliat can proceed directly against any viola-
tion that is discovered within its jurisdiction. During the past two winters
1 have stiongly favored, and bills have been presented to the Legislature which
would confer upon the State Commissioner of Health the necessary authority
and power to compel the removal of pollution in cases where it was found
necessary. Ihese bills, as you may remember, were defeated at both gessiona
of the Legislature, and until such legislation is passed, my powers are limHed
largely to those of recommendation.
I wish to assure you of my deep interest in this matter and in the present
case I am writing to the local health board in this section pointing out such
insanitary conditions as are found to still exist at Raquette Lake and in this
vicinity and pointing out to them their duty in enforcing such powers as are
vested in them in the removal of any pollution that now exists.
I trust that this action will result in an improvement of the insanitary con-
ditions in this district and that if the matter of further legislation is brought
up during the coming session of the Legislature, that I will be more successful
in securing the increased powers necessary to more effectively removing pollu-
tion and of otherwise improving the sanitary conditions of our summer re-
sorts in this State.
Yours respectfully,
p:rGENE n. porter,
Commissioner
Albany, X. Y., December 14, 1910.
Mr. J. W. Ei3ER, Superintendent, A'. Y. C. d II. R. R., Utiea, iY. Y.:
Dear Sir: — In further reference to my communication of December 5,
1910, relative to the construction of a sedimentation basin to treat sewage
from the Raquette Lake House at Raquette Lake, N. Y., I beg to state that
following an investigation of the prevalence during the past summer and fall
of typhoid fever at Raquette Lake and vicinity, I am taking up with the
several property owners at Raquette Lake tlie question of eliminating by
direct disclmrge of sewage into the lake, and for this reason I am writing to
suggest that in the plans for treatment of sewage fiT>m the Raquette Lake
House, which. Mr. Patrick Moynehan of Raquette Lake informs me, you are
to have piepared, you provide for the treatment of sewage from the railroad
station of tie New York Central and Hudson River railroad as well as from
any other properties owned by the railroad company at Raquette Lake.
'Jrusting that you will give this matter early consideration and that pro-
vision will have been made for partial treatment of all sewage for the dis-
charge of which into the lake the railroad company is responsible before an
inspection of conditions at Raquette Lake is again made by an inspector from
this Department, I am,
Yery respectfully.
EUGENE H. PORTER,
Commissioner
IxVESTRiATrON OF OUTBREAKS OF TyPIIOID FeVER GOS
MORAVIA
On March 18, 1910. it was reported to this Department that several cases
of typhoid fever liad developed in this village and Dr. H. II. Crura, medical
expert for this Department, was at once sent to Moravia to investigate. The
findings of the medical expert indicating the probability of the public water
supply being the source and medium of infection, the investigation was car-
ried further with the co-operation of the Engineering Division, the report
thereon being as follows.
ALBA?iY, N. Y.. April 8, 1910.
Eit;KN'E H. Porter, M.D., State Commissioner of Healthy Albany, N, Y,:
Dear Sir: — In accordance with your direction, I beg to submit the follow-
in«< report of an investigation of the public water supply of the village of
Moravia with special reference to a recent outbreak of typhoid fever which
has occurred in that village.
Although the primary object of this investigation was in connection with
the water supply, considerable attention was given also to the question of the
extent and cause of the recent outbreak of typhoid fever in the village, and
for the purpose of securing the necessary information concerning these two
matters, Mr. C. F. Breitzke, assistant engineer, was detailed to visit Moravia
on March 28th. The information and data secured by him and by Dr. H. H.
Crum, medical expert, and Dr. H. E. Anthony, local health officer, who had
previously submitted reports to you concerning the recent outbreak of typhoid
fever, and the results of the laboratory analyses of samples taken from various
sources comprising the water supply of the village, will be presented and
discus.<»ed as follows:
Moravia is an incorporated village in the southern part of Cayuga county.
It is located on tlie east side of Owasco inlet, about four miles south of
Owasco lake, and is a station on the Lehigh Valley, eighteen miles south of
Auburn.
The village has a population of 1,500, about 80 per cent, of whom obtain
their water supply from the public water works. The water is obtained from
springs and at present is furnished to the consumers by the Moravia Water
Company, of which Mr. W. E. Greenfield is secretary and general manager.
The village, however, at a recent election voted to take over the works on
May 1, 1910.
The water works were installed in 1885 and consist of a number of springs
j>iped to an equalizing and distributing reservoir, and about seven miles of
mains ranging from IV^" to 10" in diameter. This supply is supplemented at
times by pumping from a driven well. There are about 2.30 service taps, none
of which are metered. The average daily consumption is estimated at 125,C00
gallons, and is furnislied under an average pressure of 80 to 90 pounds per
hquare inch.
The water supply is taken from five springs, three of which are being used
at the present time. Four of these springs are located in the town of Summer
Hill and one in the town of Moravia, four miles southwest and one mile east
of the village, respectively.
The first spring, known as the Sears spring, is situated on the Dwight
Harris place in the town of Summer Hill, about 500 feet east of the highway
forming the boundary between that town and the town of Ix>cke. The spring
ha.s been inclosed by rubble masonry well -curbing 314 feet in diameter and
a lout 3 feet deep, projecting a few inches above the surface of the ground and
covered over with a flat wooden roof. It is located in a slate formation
covered by a thin surface layer of loam and hardpan. in a small valley, at the
edge of a small brook, on the opposite side of which and between it and the
hiphway are a hoiise, barn, large hennery, hog-pen, and privy on ground
sloping toward it. While under ordinary conditions this stream would inter-
604 State Department of Health
cept surface drainage from these buildings, the spring is so situated that in
time of flood, surface water can easily enter it. The henhouse and privy are
about 100 feet and 225 feet from the spring, respectively. The privy is with-
out a vault and until recently the feces of a family of six have been de-
posited directly on the surface of the ground. This condition existed at the
time of the heavy thaw and flood on February 27 and 28, 1910. Just prior to
the inspection on March 28, 1910, however, the accumulation of feces had
been removed and our engineer was informed during his visit that steps were
being taken to provide the privy with a watertight removable box. Two
years ago there was a case of " grippe " in the above house.
The second large spring making up the main source of the Moravia water
supply is located in a gully about 400 feet south of the one just described and
is known as the Ingalls spring. This has been excavated down to rock and
has been inclosed in a concrete vault 7x9 feet in plan and about 3 feet deep.
The walls rise about 2 feet above the bed of the stream and the spring has
been covered over with a wooden house. The stream which flowed in the
gulley has been diverted by the spring-house through a drain. The inspection
showed, however, that at times of high water the stream floods the gully and
can flood the spring. About a mile east of the spring on the west side of the
highway leading from Lickville to North Summer liill, there is a privy with-
out a vault at the Lovelace place on the line of drainage of this stream.
In the open field a few hundred feet east and southeast of the Sear's spring,
there are two others of similar construction. These springs have been piped
to the Ingalls spring, but for some time have not been used. The southeast
spring is almost east of the Ingalls spring and is not far from the stream
flowing by it. The appearance of the field showed that this stream had
recently flooded considerable area, and doubtless the spring al-so.
The above springs and the streams reported flowing near them form the
headwaters of Dry brook, which flows through the lower end of the village of
Moravia. It has a rather steep bed and its drainage area has been stripped
of its forest and during the h])ring thaws it is subject to floods. During the
last week in February, the nui-ofl* of this stream was so great as to inundate
a large portion of the village of Moravia on February 27 and 28, 1910, and
to create considerable damage.
The water from tlie Sears and Ingalls springs flows through a pipe varying
from 3" to 4" in diameter, following the court^e of Dry brook for about two
miles, and thence northwest to the reservoir. At a point about a mile from
the reservoir it receives a 2" pipe from the Harris spring.
The Harris spring is located near the Skinner Hill road about one and one-
half miles east of tlie village. It is located on the side of a bill in a slate
formation underlying a thin soil layer. Its construction is ^similar to that
of the Sears spring described above. The privy of the Ferro family is about
250 feet east of the spring on higher ground but with surface sloping to one
side of tlie spring. The stable is about 200 feet from the spring on higher
ground sloping toward it. Al>out 500 feet from the spring on higher ground
is the privy of the Spafford family. The thin surface layer of soil imder the
privy hem been removed and slate rock forms the bottom of the vault. There
are ^ve members in this family, all of whom have had " grippe " during the
past winter.
The distributing reservoir is located on top of a hill at the eastern edge of
the village. It has perpendicular masonry walls and is uncovered. It is
113x73x12 feet, and is estimated to liavc a storage capacity of 700,000
gallons, or about a week's supply. From the reservoir the water is brought
through a 10" main in Church street to the center of the village and thence
is distributed through smaller mains over the larger part of the village.
At times the yield of the springs is insufficient to supply the needs of the
village, and at tliese times the supply is supplemented by pumping water into
the mains from a driven well in the northwest part of the village, located
about 75 feet south from Cayuga street and al)out 150 feet west of the rail-
road tracks.
Investigation of Outbreaks of Typhoid Fever 60*5
Two 4" wells have been driven, one to a depth of 42 feet, the other to a
depth of 150 feet. The water in each of them rises to within 2 feet of the
surface and it has been found necessary to use only one of them (i. e., the
one 42 feet deep). The water is pumped directly into the mains by a
6" X 5" X 9" Buffalo duplex steam pump having a suction lift of 4 feet arid
pumping against a pr^essure of 90 pounds per square inch.
These wells are located in the flat valley of Qwasco inlet, which is subject
to more or less flooding. There are a number of houses in the vicinity of the
piunping station, the nearest privy being 150 feet distant. The geological
formation is chiefly gravel, slate and limestone. The water is very hard and
for this reason the above well supply is to be abandoned when the village of
Moravia takes over the water works and will be replaced by a new supply
from additional springs on which the village authorities have obtained an
option.
Samples of water from the various springs and from taps in the village
were collected on March 19, 1910, for chemical and bacteriological analyses
by the State Hygienic Laboratory. The results of tlieae analyses, together
with those of other samples analyzed by the Department during the past two
years are given in the accompanying table.
These results show that bacteria of the B. Coli type have at times appeared
in samples from both spring and well supplies even in quantities as small as
0.1 c.c. That contamination has been taking place is further substantiated
by the chemical analyses, which show the presence of nitrites, high chlorine,
and rather high albuminoid ammonia. It is also interesting to note that
until the recent set of samples taken on March 19, 1909. B. coli were found
present only in the summer and fall months, indicating that direct pollution
takes place with a lowering of the ground water level. The analyses of recent
samples indicate that surface wash has occurred.
This contamination of the water supply of Moravia it will be shown is a
vci-y significant and important factor in connection with the recent epidemic
of typhoid fever which occurred in the village where since March 6, 1910,
some twenty-seven or more cases have developed. The essential facts concern-
ing these cases are given in the accompanying table:
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IXVKSTIGATION OF OUTBREAKS OF TyPHOID FeVEB 607
In addition to securing the information presented in the above table, a
careful inquiry was made as to possible sources of infection such as water
supply, milk supply, shell fish, uncooked vegetables, and other factors that
might have a bearing upon the cau«;e of the epidemic.
From the data thus collected and also presented in the above table, it ap-
pears that the cases are distributed more or less uniformly throughout the
village irrespective of class and age. Beginning with March 6, 1910, the
date of onset, the cases have occurred almost daily. All but four of the
cases have been directly furnished with the village water. Three of these
four cases, however, are members of the same household, two being taken
ill almost a week after the first case and may have been infected by this
case. Of the oases listed twenty-one obtained their milk supply from three
dealers, the number of cases being distributed among these dealers in almost
direct proportion to the extent of their respective routes.
An inspection of the various dairies was made by our engineer, but nothing
was revealed which pointed toward tlieir being a source of typhoid fever,
which fact appears to be borne out by the uniform distribution of cases
among the dealers and in the village. So far as could be learned, none of
the cases had ea^en shellfish during the twenty days immediately pre-
ceding the onset of illness and only a few had eaten uncooked vegetables
during the incubation period. Precautions have been taken to prevent a
further spread of the disease and transmission by secondary infection does
not seem to have been a factor in the epidemic.
One-half mile north of the Sears spring there are now two cases of typhoid
fever in one family (listed in the table as Xos. 1 & 6). The first was taken
ill on February 13, 1910. Before this he had been ailing for some time, but
had been in the habit of going to the village and elsewhere. The other (case
No. 6) was taken ill on March 11, 1910. It is not probable that the drainage
from this place could infect the village water supply, and the family does
not know w:here it contracted the disease. These cases are interesting to
note, however, since they show that typhoid fever exists on or near the
Moravia watershed and it is not improbable that some of the cases referred to
as "grippe** on pp. (3) and (5), of this report may have been typhoid fever.
In view of the lack of association of any particular dairy with the epidemic,
the insanitary conditions found existing near two of the springs, the presence
at times of B. coli in very small quantities of water, the existence of typhoid
fever on or near the watershed, the heavy rain and thaw in the last week of
February which undoubtedly flooded the springs, and the elimination of other
factors there appears to be no doubt that the public water supply has become
infected and is responsible for the outbreak of typhoid fever.
It is evident, 'therefore, that steps should be taken without delay by the
village authorities along two lines; first as to the prevention of the further
spread of typhoid fever; second, the improvement of the water supply.
As to the firsrt, the boiling of the water should be continued until all sources
of pollution have been removed from the watershed and analyses show the
water to again be pure and wholesome. A careful supervision and manage-
ment should be maintained over the dairies from wliich the villa*;e milk
and cream supply is obtained, especially as to the sterilization of the bottles,
prohibitions against the carrying of milk bottles into houses where typhoid
cases exist, and the guarding against, or quarantining, or removal of any
persons or employes about the dairies who may have contracted typhoid
ifever.
It is further important to see that all precautions are taken in the care
of patients suflTering with the disease with respect to isolation, disinfection
of urine, stools, bedding, dishes, etc., and such other measures as will prevent
a spread of the disease from these foci of infection. Not only are these pre-
cautions necessary to protect the health of the people of* the village of
Moravia but also to prevent infection of Owasca T>ake which is being used
by the city of Auburn as a source of water supply.
As to measures which should be taken looking toward the improvement
of the water supnly, it appears that the supply from Sears and Ingalls springs
can be made safe by protecting these springs from surface wash by properly
608 State Dkpartment of Health
enclosing them in man-holes with heavy iron covers on locks, the tops of
which fehall extend well above high water mark. It is important, moreover,
that sources of pollution near tliem shall be removed as far as poissible,
particularly the privy near the Sears spring, which should be provided with
a water-tight removable box. which should be cleaned regularly. A eesepool
located down stream from the spring should also be provided to care for the
liquid wastes from this place. Owing to the fact, however, that the springs
are located in a slate formation, this cesspool should be water tight. It would
alno be wise to observe similar precautions at the I»vclace place.
In rejxard to the spring locntcd on the Skinner Hill road, a further study
should be made of its sanitarv condition. While the data at luind is not
s«urticirnt to detinitely draw conclusions as to its sanitary quality, it iiever-
thelesis opens it to suspicion. The analysis shows the presence of B. Coli
at the pro.-ont time, 'i he spring is located in a slate rock formation and
2r>() feet and .100 feet, respectively, distant from two privies, the latter of
which has a vault extending down into tlie rock and which during the past
winter has received the excrement of a family, five of whom have been ill
with '* grippe " during the past winter. Furthermore, analyses of samples of
the village water taken in tlie summer and in the fall of the year show the
presence of H. C<di in 1 c. c. samples, and from the conditions ol>serve<l on
the waterslied it would appear that contamination might have come from
this spring.
In connection with the improvement of these springs attention should be
called to the proposed plan of developing an additional supply by securing
other i-prings as referred to alK>ve. Ihe investigation did not extend to the
proposed additional source of supply since the quality of the present supply
and its relation to the outbreak of typhoid fever was the only matter under
consideration and the Department h«s not facilities nor funds to make such a
study. The village should, therefore, retain the services of an expert sanitary
engineer or water analyst to lulvise them as to. the sanitary quality of the
water from the springs under consideration before taking steps to connect
them with the water works.
In view of the foregoing. I, therefore, beg to recommend that a copy of this
report be transmitted to the local board of health and the board of trustees
and tiiat thev he advised that:
1. l*recautionary measures should he taken by them with reference to
the outbreak of typlund fever, such as a careful supervision of the
• milk supply as is outlined in the foregoing report, the proper care and
isolation of patients, the disinfection of urine, stools, bedding, dishes,
etc., and such otlier measures as will prevent a further spread of tlie dis-
ea.se and the pollution of the streams and water supply of the city of
Auburn.
2. Until the present water supply is made safe, or a new supply devel-
oped, the boiling of the water should be continued.
3. They should proceed at once to thoroughly protect the Sears and
Ingalls springs from surface pollution, and to remove all sources of con-
tamination of the watershed.
4; Owing to local conditions surrounding the spring near Skinner Mill
road, this spring should be abandoned imless further study by an expert
shows that it can be protected from pollution.
5. In the selection of an additional supply a careful study should be
made to insure that such supply from springs or other sources is free
from contamination.
It is my opinion, that if steps are taken by the village authorities, in ac-
cordance with the recommendations contained in the above report, that the
cause for the recent outbreak of typhoid fever will be removed and a purer
supply of water will be secured, which will prevent a further outbreak from
the water supply.
Respectfully submitted,
THKODORE HORTON,
Chief Engineer
J
lNVESTIOAl*I0Jr OJ- OUTBKEAKS OB" TyPHOID FeVER G09
QUARRYVILLE (Town of Saugertics)
Albany, N. Y., November 1, 1910.
£UGENE H. PoBTEB, M.D., State Commissioner of Health, Albany, N. Y.:
DcAB SiB: — I beg to submit the following report on an investigation made
at Quarryville, Ulster county, of an outbreak of typhoid fever wnicli occurred
there this summer. On October 20th^ Mr. Fritz M. Arnolt, Inspecting lijigineer
with this Department, accompanied by J. A. DeWitt, M.D., heaHL otticer of the
town of Saugerties, visited V^uarryville and made an investigation there with
r^^d to the probable origin and the means hj which the fever was spread.
Quarryville is a small hamlet in the town of Saugerties, having a popula-
tion of about 200. Aa its name indicates, its principal industry is its quar-
ries from which bhie stone, curbing and flagging are taken. During the past
summer, beginning with th« first week in uuly and extending until the last
week in September, at least ten cases of typhoid fever occurred. These cases
appeared gradually one after another in aiUerent parts of the hamlet in
about the following order, the approximate dates of onset being given first:
July 7th. Mrs, James Schoonmaker. Water was taken from a well
opposite. Ibis well was, and is, used by several other families. Milk
supply from Wells farm.
July I3th, Mr, James Schoonmaker, husband of above person.
July ISth, Iwo years and eight months old child of Mrs. Charles Mc-
Laugiilin. Water oDtamed from laylor's well, next door. Ihis well is
used by several other families. Milk supply from Well s farm.
July 27th. Mrs. Fitzpatrick. Recovered from typhoid fever, but died
subsequently from operation for removal of abdominal tumor. Mo data.
July 2dth. T, R, Rooney, Keeps saloon with brother. Saloon is op-
posite Charles McLaughlins place. Water obtained from well on prop-
erty. Milk supply from Well's farm and Monroe's.
August 6th. J. R. Rooney, brother of T. R. Rooney. Keeps saloon
with him.
August 5th. Michael Orouke. Teamster working in quarry. Water
supply obtained from well on property. Milk from Monroe's and Well's.
August l(yth, Mrs. Valkenberg. Water supply obtained from well on
premises. Mo milk used until she was taken sick.
September Qth. Isabella Ribsamen. Ten years old. Had been in poor
health all summer. Water supply obtained from well next door. Milk
supply also from neighbor next door.
September 25th. Mrs, James Cook. Water obtained from same well
used by Schoonmaker. Milk obtained from Well's farm. This place is
adjacent to J. Schoonmaker's.
No positive information as to the origin of the outbreak could be obtained.
In regard to the general conditions which exist in the village it may be said,
in the first place, that no very extensive quarrying is carried on at present,
and that very little real intercourse with the outlying towns is held. Again,
it may be said that no summer people or outside residents were in the habit
of visiting the place. Ihe conclusion can only be reached, therefore, that
the first case was brought in by a transient, or that some local person had
so light an attack that it was not recognized.
In so small a community the spreading of the outbreak by contact is a
very general agent. There can be no doubt that Mr. Schoonmaker contracted
the fever by direct contact infection. Although seven days elapsed between
the onset of Mr. T. R. Rooney and Mr. J. R. Rooney it is not probable that
20
610 State Department of Health
J. R. Eooney contracted the fever from his brother, but more likely that both
of them became infected at the same time and from the same sources. Al-
though Mr. J. R. Rooney did not take to his bed until seven days later than
his brother he was sick several days before taking to his bed. In several
other instances circumstances point to conta<*t infection, although the per-
sons who contracted the fever do not appear willing to admit such. It is
very probable, however, that contact infection played its proportionate share
in spreading the fever.
A glance at the articles of food common to all cases immediately brin^
out that, with two exceptions only, milk obtained from Well's farm was com-
mon to the persons who had contracted the fever; but the outbreak was not
characteristic of a milk outbreak which, as a rule, is of a sudden and violent
nature. Uhis outbreak was gradual and extended over a period of almost
three months. Milk through the means of contact infection may have played
its part.
Tlie water supply immediately arouses suspicion. This supply is obtained
from wells. Some of these are driven wells, but all are comparatively shal-
low. The cases of fever mentioned are located in different parts of the town
and in the ten ca^es reported at least six different wells contributed to the
water supply. Ihe persons who contracted the fever all stated that they
had obtained no water from any other well except the one that they regu-
larly use. These wells, however, are located in a rock country. They prob-
ably all have underground connections with each other and with the quarry
pits by means of cracks, faults and crevices. The well used by the Schoon-
makers and several other persons in the vicinity is about 150 feet from an
abandoned quarry pit which is filled with water. This is about at the same
elevation as the well. A few feet from the water's edge is a privy in back
of a house tenanted by Mr. Hallenbeck. Ihis privy is full and the contents
are washed into the quarry pit. lliis case points out the dangers in using
such a well in a region like Quarryville, as water passing through rock mate-
rial receives practically no filtration and purification.
Most of the villagers have their own truck gardens supplying their vegetables.
They do not use shellfish to any extent, as these are difficult to obtain and
expensive. They do not ordinarily use ice but cool their milk and other
articles of food by suspending them in the wells.
A very probable cause in spreading the infection is through the agency
of files. The fly is a common carrier of infection when infected material is
accessible, and is consequently an important agent in the spreading of sum-
mer and autumnal typhoid. It is common knowledge at Quarryville that
physicians* orders, in regard to the proper disposal of fecal discharges, were
not rigidly carried out, and that some of the fecal discharges were carelessly
thrown in shallow pits, covered loosely with boards and more or leas acces-
sible to flies, or not covered at all. It is very probable that flies may have
played a very important part in the spreading of this outbreak.
Ihe suspicion that the water in the quarry pits was responsible for the
outbreak of typhoid has no very definite foundation. The water in itself
unless infected cannot spread the fever. The water filling these pits comes
from springs. The quarries that are being worked are pumped out regu-
larly. The others, however, are filled with stagnant water whose surface
is filfed with a heavy matting of algae growth. ITie rock in this region con-
tains faults, cracks and crevices, and there are probably connections through
these between the different quarry pits and even between the wells ond pit».
Privies are located close to these quarries and some of them are in an ex-
tremely insanitary condition, the contents finding their way into the water
and polluting it. No evidence could be obtained that the water in the quar-
ries was ever used for drinking purposes; but the probability that some of
these pits have connections by means of cracks and faults with some of the
wells leads to serious thought of danger of infecting the wells.
Investigation of Outbreaks of Typhoid Fever Oil
It must appear that the outbreak is one in which no conclusive evidence
as to one specific cause could be determined; but, on the contrary, that there
are several factors, as pointed out before, which contributed to the spread of
the outbreak. Ihese should receive attention at once and measures taken to
remedy them. For instance, care should be exercised to see that all cans or
receptacles into which milk is placed and kept should he thoroughly cleaned
and sterilized by scalding with boiling water or steam. Such receptacles
when in use should always be kept covered to prevent the access of flies.
Again, many of the privies are in a very insanitary condition, with the
contents overflowing or leaching out. This constitutes a serioua public nui-
sance, for the privies may at any time become a source of infection in pollut-
ing well water, or through the agency of flies transmitting infectious material
to food. They should be thoroughly cleaned out and the vaults made tight
to prevent the contents from leaching out and also to prevent the access of
flies. All windows should be screened to keep out flies.
Finally, the water supply must be viewed with considerable apprehension
us to its purity. This matter is rather a serious one from a practical stand-
point, considering that the residents now rely upon a series of individual
wells for their supply. AJthough the more shallow wells might be abandoned
and only the deeper driven wells used, it is very probable that on account of
the widely scattered nature of the pollution and to the particular geological
formation found in this section, none of the present wells can be considered
permanently safe not without the danger of at some time becoming infected,
it would be much safer to abandon all of them, if possible, and secure some
other public supply of unquestioned purity.
As a result of this investigation, and in view of the facts and information
presented above, I am of the opinion that the cause of this epidemic cannot
be traced definitely to any one particular source, but is the result of a num-
ber of conditions and factors which have worked cumulatively to account for
the spread of the disease from the first one or two cases which occurred.
These conditions or factors relate more especially to the milk and water sup-
ply and agencies of secondary infection, including dissemination through
the medium of flies, and in order that these factors or influences may be
suppressed and a further prevalence of the disease checked, I beg to
recommend:
1. That every precaution be taken in the care of patients and in the
disinfection of excreta, and so prevent the spread of infection through this
channel.
2. That a careful guard or siipervision be kept of the source of milk
supply and its distribution, especially its distribution to families where
typhoid fever cases exist, to prevent an infection of the supply and a
spread of the disease through this channel of infection. Particular atten-
tion should be given to the sterilization of all cans and bottles in the
distribution of milk.
3. That all insanitary privies be cleaned and that they be protected,
so far as possible, against flies by screening.
4. That screening of doors and windows of all houses be encouraged
M> far ns possible.
5. That all shallow open wells be abandoned in favor of deeper drilled
wells and, if possible, all wells be abandoned in favor of a public sup-
ply secured from some unquestionably pure source.
In conclusion, I should beg to recommend that a copy of this report be sent
to the health officer of the town of Saugerties, and that he be advised to rec-
ommend such action by his board as will result in carrying out the recom-
mendations given above, as far as it is possible.
Respectfully submitted,
THEODORE HORTOX,
Chief Engineer
612 State Department op Health
ROUSES POINT
jSee Special Inveetigation of Public Water Supplies, page 376.
SYRACUSE
See Inv^BSbigations Ordered by the Governor, page 662.
SYRACUSE STATE INSTITUTION FOR FEEBLE-
MINDED CHILDREN
Albany, N. Y., September 16, 1910.
Eugene H. Pobteb, M.D., State Commissioner of Health, Albany, N, T,:
Dear Sib: — I beg to report that, in accordance with your direction, I vis-
ited on September Idth the Syracuse State Institution for Feeble-Minded
Children, and by appointment conferred with Dr. J. C. Carson, superintend-
ent, and hie assistant medical officer, concerning the prevalence of typhoid
fever at the institution and the sanitary conditions thereof.
I found that between August 12 and September 12, 1910, there occurred 8
or 9 cases of typhoid fever, but that at the time of my visit there was no
indication that the prevalence of this disease was on the increase. This ty-
phoid rate for one month, witli the population of 650 in the institution
(including the farm containing 40 hands), corresponds to a yearly mortality
of about 150 per hundred thousand. In other words, taking this maximum
month, it would appear that typhoid fever is some three or four tim^s the
normal, although it is no greater than what the cities of Chicago, Pittsburg
and Philadelphia put up with uncomplainingly for years. It beinff above the
normal, however, it is a matter of concern, and one which should be thor-
oughly looked after and eradicated. It should not be lost sight of, however,
that these 8 cases represented the only cases of the year, and that the yearly
mortality on this basis would be little, if any, above the ordinary mortality
of the StAte.
In order to find out the cause for this prevalence of the fever I inquired
carefully into the sanitary conditions of the institution, and found that the
water supply of the main institution is from the Syracuse public supply and,
although there is considerable typhoid fever in the city, according to the
statement of Doctor Totman, whom I telephoned, it would hardly seem that
this prevalence could be attributed to the water supply.
I found that the sewerage conditions were unsatisfactory since the sewage
was discharged into a small stream, which flows only 500 feet from the main
buildings and where I found the sewer outfalls insanitary, there being fecal
and sewage matters spread around the vicinity of the few outlets of this creek.
I found that the milk supply was secured from the farm, situated some few
miles distant, and I drove with Doctor Carson and inspected the conditions
of the farm and found a driven well supply which, so far as the natural
quality was concerned, should be comparatively pure, it being a driven well
sunk some 125 feet into the soil. One or two old wells were found on the
place, but it was declared that these were not used for drinking purposes at
any time or for other purposes than washing carriages.
I found that the milk supply was handled according to modem methods,
the cans all being thoroughly washed and sterilized in a steam sterilizer, the
water cooled by an ice cooler and properly stored in a refrigerator.
I found that the cattle were all carefully washed and wiped off carefully
Investioation of 0utbb£AK8 of Typhoid Feveb 613
before milking, and it was claimed that the milk man's hands were washed
before milking. The 8tiU>le had a concrete floor and eTerything appeared
sanitary. Screens were freely used, although I found a number of flies in
the stable and in the milk room.
At the main well, which is pumped by a wind mill, I found that the ten-
ants were in the habit of drawing water for drinking purposes from this
well by hand, and that they stood on a platform which was loose plank, and
it was evident that there was an opportunity for contamination from the
feet to pass directly down into the well and around the nipe, and possibly
get down into the water. The soil was partially gravel and it was very pos-
sible that a small channel might be formed along the pipe which would permit
the polluted water to sink down and be pumped out again.
A very important observation was the fact that the pail system of removal
of excreta was in use, and this privy was within 150 feet of the milk barn
and receiving room, although this privy was in a sanitary condition for a
farm privy and under the circumstances of this method of disposal of the
excreta and, although disinfectants were used, it was evident from my inspec-
tion that the method was insanitary and there was ample opportimity for flies
to carry excretal matter from this privy across to the milking operations.
When it is considered that the typhoid fever is not epidemic, but is merely
unduly prevalent for this season of the year, and when we consider that the
cause for it must not be a prominent one, it is my opinion that three factors
are mainly responsible for the disease, namely, the insanitary sewerage con-
ditions at the institution, the pail system of removal of excreta, with its
accompaniment of fly transmission and possible infection of the well water
due to surface pollution from persons who draw drinking water from the
well. These factors might be emphasized when we consider that the insti-
tution is one for feeble-minded, and that the personal habits of the inmates
could hardly be expected to be equal to those of perfectly sane people.
In view of the foregoing it would seem that efforts should be made at once:
First, to secure a satisfactory method of collection and disposal of sewage of
the main institution in the city, and this I understand is in prospect, through
the extension of the Syracuse system of sewers to intercept the institution
sewage; second, to abolish the can system of collection of excreta and sub-
stitute for it a proper system of sewage collection and disposal for the entire
farm buildings; third, a prohibition against the drawing of water by hand
at the main well, thus removing the surface pollution from such operations.
Until these three possible sources of infection are removed, I do not see
that there can be any hope to entirely eradicate the disease of typhoid fever
from the institution, and I would recommend that a copy of this report be
sent to the proper authorities for suitable action.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
WILLARD STATE HOSPITAL
Albany, X. Y., Septemher 30, 1910.
Eugene H. Pobteb, M.D., State Commissioner of Health, Albany, V, T.:
Deab Sib: — I have the honor to report that in accordance with your direc-
tions I visited the State Hospital for the Insane, at Willard, and made an
inquiry into the recent outbreak of typhoid fever at this institution, and an
investigation of the sanitary* conditions of the institution in connection
therewith.
The Willard State Hospital is situated on the east shore of Seneca lake,
about midway of its length, and some 15 miles south of the outlet and of
the city of Geneva. The lands comprise some 1.2(M) to l.oOO acres used for
614 State Department of Health
institution building and for farming purposes. The census at the time of
my visit showed 1,165 male and 1,224 female inmates, which, with some 500
attendants, makes a total of approximately 3,000 persons.
It was learned that although epidemics of diphtheria of more or less mag-
nitude have occurred during past years, the institution has, up to the present
year, been comparatively free from prevalence of typhoid fever. During this
year, however, beginning with about August 1st and continuing for six or
seven weeks, there have occurred some 25 cases of typhoid fever, practically
all verified by Widal tests. This outbreak followed a normal course, reaching
a maximum, diminishing, and at the time of my visit had practically disap-
peared. The cases were apparently not confined to any specific building nor
class of inmates or attendants, and the outbreak was apparently not explo-
sive but slow and progressive. These 25 cases occurring in some two months*
time, a>t this season, correspond, with proper allowanoe for seasonal distri-
bution, approximately to a mortality rate of about 300 per 100,000, or some
ten times a reasonable normal.
To inquire into the probable source of this infection I conferred with the
superintendent. Doctor Elliott, and his assistant physician, and made a care-
ful inspection of the grounds, water supply, sewerage, and milk and food
supplies, in company with the steward and the chief engineer of the institution.
The institution is provided with a water supply taken from the lake through
an intake pipe, extending some 1.3C0 feet northwest from shore opposite north-
erly end of the grounds, the intake being approximately 1,000 feet from shore.
The water is pumped at pumping station, situated close to shore, to a masonry
reservoir holding some 3,000,000 gallons, situated at an elevation of some
160 feet above lake near the middle of the institution grounds. This reser-
voir supplies low service system, a high service system being maintained
by direct pumping at station near reservoir, for buildings at higher elevation
than reservoir. An elevated tank to connect with this high service is in
process of construction at Grand View, the highest summit on the institution
grounds.
The institution is provided with a sewerage system, constructed many years
ago and, so far as could be learned from plans and inquiries, is largely
on the " separate " plan, though rain water from roofs and other areas enter
the system. The outfall of the main system of sewers discharges into the
lake in front of the institution, some 200 feet from shore and in shallow
water. In addition to this main outfall sewer, serving most of the buildings,
there are some four or five other sewers serving individual buildings, which
discharge into the lake near the shore line at various points along the water
front, one or two being not far distant from water intake line.
Although a careful inspection of the unusual, if not startling conditions
which were found to exist in connection with the method of disposing of sew-
age into the lake almost directly opposite the front of intake and source of
the institution water supply, would incline one not to seek further for a pos-
sible or probable source of typhoid fever infection in the recent outbreak, or
the occurrence of the disease a(t other times, I made a careful inspection of
the source of milk supply and method of handling it. since this factor is
always an important one, not only in connection with a specific outbreak
of this disease and other diseases, but as a general safeguard against infec-
tion, even when other important matters such as water supply and sewage
disposal are satisfactorily attended to.
The milk supply is secured from a herd of Holstein cows owned by the
institution and kept and milked in two barns at the easterly portion of the
institution grounds. Some 1,500 quarts of milk are consumed daily, milked
by a force of 15 milkmen, practically all of whom are inmates selected from
among the more intelligent class, and who, it is claimed, are required to
wash their hands before milking. The milk is not cooled but is shipped at
once to the different buildings in cans holding about 40 gallons, each build-
ing having and caring for its own cans. The cans, after using, are at once
cleaned at the building, set in the open, and later collected and returned to
milk house, a building used for washing pails, receiving and sending out
milk cans, and provided with a hot water heater. Xo sterilizing of cans is
Investigation of Outbreaks of Typhoid Fever 615
fracticed, though it is claimed that they are all rinsed with hot water,
he milk house is provided with screens, but notwithstanding this flies were
in abundance in the milk house, as were they also in the stable and receiving
room at the bam.
The stables, where the cows are fed and milked, are of modern construc-
tion, provided with masonry floors and cleaning and flushing devices. They
were generally clean but open to objection of considerable manure spattering
on the walls, and due, in my opinion, partly to defective construction of
gutters. The manure is stored in the yard and carted away at intervals of
ten days to two weeks and used as fertilizer.
Two privies are maintained in connection with the two barns which are
insanitary as to construction, protection and disposal of excreta, which is
thrown in with manure, exposed to flies and used for fertilizing fields. These
open privies should be abandoned and new ones of proper construction pro-
vided, properly screened, and the contents of them disposed of by burial in
trenches. It would be much better, if practicable, to provide a washrooln
and inside closets and connect them with sewerage system.
In reaching a conclusion as to the cause of the recent outbreak and of
prior oocurreitces of typhoid fever and probably of other epidemioe which
the institution has suffered from one does not have to consider, except very
generally any other factors than those presented by the condition of the
water supply and sewage disposal of the institution. These so overshadow
any others having a bearing on the question that one may temporarily ignore
them.
A waiter intake situated in such close proximity to a series of sewer outlets
a0 that existing at Willard, where opportunity is given for a free and easy
conveyance of sewage matters from these sewer outlets to the water intake,
under transporting power of surface currents and waves, induced by wind
action, creates a picture so clear and so emphatic in its meaning and im-
portance as to leave no room for argument or for doubt aa to its great
danger, nor for any delay in taking measures to correct them. The most
surprising fact is that a greater prevalence or more outbreaks of typhoid
and other diseases have not occurred at the institution, and, in my opinion,
this can only be accounted for by the great dilution that takes place, and
the good fortune of not having disease germs present in great numbers during
the times when sewage has been carried by waves and surface currents from
the sewer outlets to the water intake. It would certainly be a dangerous
precedent now. in the face of these facts, to rely on such chance influences
as a source of immunity from typhoid fever and other infectious diseases.
In view of the facts set forth above it is my opinion that, whereas there
are certain factors outside of the questions of water supply and sewage die-
posal which on general grounds should receive the attention of the institu-
tion authorities, and to which allusion will be later made, the principal
source of infection which has occurred during the recent outbreak of typhoid
fever, and which may have been an important feature in the outbreaks of
other diseases which have occurred at the institution during the past years,
has been a contamination of the water supply by the sewage of the institu-
tion discharged in relatively close proximity to the intake; and I beg, there-
fore, to recommend the following modiflcaitions and extensions be made in
the water and sewerage systems and methods of sewage disposal:
1. That a new water supply intake be constructed with location some
half mile or more south of the institution, extending sufficiently out into
the lake to insure a depth below the line of wave action and superficial
lake currents.
2. That a water purification plant be installed to properly filter the
water supply secured as above.
3. That all of the sewers leading from the institution buildings be
intercepted by an intercepting sewer and carried to a suitable point of
sewage disposal on the lake front at the northerly end of the institutipn
grounds.
4. That all surface or storm water be diverted from all sewers carrying
domestic sewage, and be led in other conduits independently to the lake
or the nearest streams tributary thereto.
616 Static Dspa&tmxnt of Health
5. That a sewaipe disposal plant be installed to partially or completely
purify (or disinfect) the sanitary sewage before it is discharged into the
lake.
The question of exact location of water intake, location of sand filters,
route for an intercepting sewer and exact location and type of sewa?e dis-
posal plant and outfall cannot be determined without a more careful study of
local conditions and topography. That the changes and arransrements abore
referred to can be readily determined from an engineering 8tandTX>int, I have
little doiibt, and the general project above outlined should be referred to the
State Architect or some consulting engineer employed by the institution
authorities for solution of details and preparaition of plans which, in accord-
ance with the statutes covering these matters, should be referred to and
approved by this Department before construction is begun.
While the above important matters should not be overshadowed by refer-
ence to other important, though less essential changes, which should be car-
ried out in order to place the condition and management of the institution on
a more thorough sanitary basis, I wish to make the following recommenda-
tions with reference to improving the conditions surroundinsr the source and
handling of the milk supply, believing that they are essential to the further
protection of the health of the institution and that they can be carried out
with comparatively little expense:
1. That a steam sterilizer be installed for a thorough sterilisation of
all milk cans and utensils used in the collection and shipping of milk to
the various institution buildings.
2. That cooling apparatus be installed for purpose of cooling milk
as soon as it is drawn.
3. That more thorough screening of windows, doors and other open-
ings be provided at the bams and milk house.
4. That the open and otherwise insanitary privies at the barn be abol-
ished and that suitable closets and lavatories, connected with the sewer
system, be installed at the barns for the enforced use of milkmen and
stablemen and for providing enforced washing of hands preliminary to
milking operations.
I am of the opinion that unless the improvements and changes as above
recommended are carried out there will continue to exist sources of danger
or menace to the health of inmates and attendants at the institution: and
I would suggest that a copy of this report be transmitted to the State Board
of Lunacy and the superintendent of the institution for their consideration
and suitable action, to the end that the above recommendations may be ear*
ried into effect with as little delay as possible.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
YONKERS
ALBAirr, N. Y., October 17, 1910.
EuoRNE H. Poster, MJ)., State Commissioner of Health, Albany, N, Y.:
Deab Sib: — In accordance with your request I beg to submit the follow-
ing report of an investigation of the sanitary condition of the public water
supply of the city of Yonkers. This investigation and report was called for
with special reference to any relation which might exist between the condition
of the supply and the continued presence or prevalence of typhoid fever in the
city.
For the purpose of this investigation Yonkers was visited and inspections
were made by the writer, as Chief Engineer, and Mr. Holmquist, Assigtant En-
gineer, of the sauitary condition of the watersheds of the two main sources
of supply, the quality and condition of the water in the storage reservoirs of
Investigation of Outbeeaks of Typhoid Fevee 617
the Grassy Sprain supply, and the condition and efficiency of the slow sand
filters used in connection with the Saw Mill or Nenperhan riyer supply. To
supplement the findings of these inspections chemical analyses have fa«en made
by the Laboratory division.
The report of Mr. Holmquist of the results of his inspections of the water-
sheds of the Saw Mill river and of the Sprain and Urassy Sprain rivers,
accompanies and forms a part of this report. The results of a laboratory
analysis of river water and filter effluents is also appended herewith, while
the results of the inspections of the writer will be referred to in the body
of the report.
Without giving a detailed description of the water supply system of the
city of Yonkers it may be said in general that the supply is taken from two
main sources; one from the Saw Mill river and the other from the combined
catchment areas of the Sprain and Grassy Sprain rivers which flow into the
Grassy Sprain reservoir. The Sprain and the Grassy Sprain supplies which
are impounded in their reservoir, holding some eight or nine hundred million
gallons, is distributed to the city through low and high surface pressure systems
without filtration. The Saw Mill river supply, however, is filtered at a fil-
tration plant located just north of the city where are located two old and two
new slow gravity sand filters, the water after filtration being pumped directly
into the mains and to a distributing reservoir.
Since the waters in both of these main sources of supply are surface sup
plies, and since one of them is filtered, and the other is not, the question of the
sanitary condition upon these catchment areas is a very important matter and
it was for this reason that a careful survey was made by our Assistant Engi-
neer to determine what pollution, if any, entered the watercourses of these
two main sources of supply. The report of Mr. Holmquist shows very clearly
and with marked contrast the sanitary conditions on these two watersheds.
It will be seen from the accompanying report that there was found to be
little, if any, appreciable pollution upon the watershed and around the reser-
voirs of the Sprain and Grassy Sprain supply. In other words, the sanitary
patrol of this watershed was found to be good, and aside from its limited
quantity no special criticism can be made of it at the present time.
With reference to the Saw Mill river, however, I find a marked contrast
as to the conditions upon the watershed. This river drains a territory, a
large part of which is without the jurisdiction of the city of Yonkers and
veiT little of which is controlled either by purchase or easements by the city
of Yonkers. This watershed, as well as that of the Grassy and Grassy Sprain
supplies is protected by rules and rcgiilations enacted by this Department, but
notwithstanding these rules, which would enable the city of Yonkers to pre-
vent and remove any pollution that may exist upon the watershed, there were
found some ninety violations.
Attention should be called at this time to the significance of these rules
and regulations and of the failure of the city of Yonkers to correct any vio-
lations, as well as to the repeated efforts made by this DeparUnent to induce
the city officials to have these violations removed in accordance with the
procedure laid down in the Public Health Law.
In 1908 this Department called for a special inspection and report from
the Yonkers water board as to the condition upon the watershed and as to
the existence of any violations of the water rules protecting the supply. This
inspeetion resulted in the discovery of some sixty or more violations of the
water rules and, after they were duly reported to the Department, orders
were issued by the State Commissioner of Health upon the local boards of
health for the abatement of these violations. At this time the water board
was thoroughly advised as to the procedure under the rules and reffulations
which should be followed in the abatement of these violations and it was
particularly pointed out to them that the final action and responsibility in
the abatement of these violations rested with the water board which, under
seetion 72 of the Public Health Law, requires that adequate compensation
must be made by the city in cases of all permanent changei or damages occa-
sioned by the enforcement of the rules.
The matter of violations was again taken up with the city in June, 1909,
when the commissioner of public works was again advised that further action
618 State Department of Health
in the abatement of these violations devolved upon the board of public worlu,
again pointing out the procedure for the board to take in the cases which up
to that time had not been removed and advising him that the board of water
commissioners had a right to maintain action against all violations cited in
the orders sent to the local boards of health, copies of which had been pre-
viously sent to the water board.
It appears then from the accompanying report of Mr. Holmquist, and not-
withstanding the previous advices to the water board, that of the 81 cases of
violations verified by the Department inspection in January, 1909, 52 of these
case« still remain uncorrected and 29 have been only partially abated; and
that, whereas, 6 cases have been entirely abated, 10 new cases of violations
were diacovered, making a total of 91 violations still existing on the Saw
Mill river watershed, an increase rather than decrease in the number of vio-
lations of the water rules.
In view of this existing pollution upon the Saw Mill river watershed and
of the failure of the city to cope with it, notwithstanding rules and regula-
tions which give it ample power and authority to remove any violations,
the question of efficiency of the filter beds is a very important matter, and a
very careful inspection was made of these filters by the Chief Engineer dur-
ing his inspection on October 3, 1910. These filters are four in number, two
old ones constructed some ten years ago, and two new onea constructed some
year or more ago and put in operation last January or February.
The older filters are apparently substantially constructed and, though not
of the most modern, are still of good design and, if properly maintained and
operated, should give a satisfactory efficiency in the removal of bacteria. The
new filters are of more modern and improved design and should give even a
higher degree of efficiency than the older ones. As a matter of fact, however,
neither of these filters give a high or a satisfactory efficiency of bacterial
removal and, what would appear to be an inconsistency, the new filters show
a less efficiency than the old ones. These general facts were learned not only
from the records of Doctor Harne, the resident chemist, but were proven more
clearly by the recent laboratory analyses made by the Laboratory division
of this Department. The results are appended herewith and show that the
efficiency of both such filters to be not only very low, but that the effluent from
each at the time of the collection of the last samples was unsatisfactory and
unsafe.
The reason for the unsatisfactory operation of these filters was readily
accounted for from investigation of the method of operation of these filters.
In the first place the equipment of the new filters was not all in operation;
that is, the rate measuring and loss-of-head gauges, which are necessary to
determine the rate of filtration and the loss of head of the water passing
through the filters, were not in use, and the apparatus had evidently been
abandoned. The filters were not being operated uniformly and at certain
times of the day were not being operated at all, the result of which was to
cause a nonuniform rate of filtration which is not conducive to good efficiency
of these filters. Still further, it was found that in order to correct the ap-
parent low efficiency of these filters, especially the new ones, " hypochlorite "
treatment was being practiced, and this was bedng done in a very crude and
inefficient and fundamentally wrong manner. That is, it was found that the
hypochlorite was being added to the water before filtration, which would tend
to destroy the biological action of this filter by killing the " sclunutzdecke "
or biological surface film upon which depends the bacterial efficiency of slow
sand filters of this type. It was also found -that the hypochlorite was being
mixed in ordinary barrels and applied through ordinary spigots for measur-
ing, a very crude and inefficient* if not precarious, manner of applying a
solution of this kind for the purpose intended. If hypochlorite is to be used
as a disinfecting agent it should be applied to the effluent from the filters
and not to the water before passing through the filters, and it should be ap-
plied with a definite strength at a iiniform rate proportional to the amount
of water and in such manner as to be thoroughly mixed with the water.
It could hardly be expected, from the method of operation as above de-
scribed, that the new filters should show any high degree of purification and,
considering the high pollution of the raw water, it is evident that these filters
Investigation of Octbrkaks of Typhoid Fever 619
are giving very little protection to the citizens of Yonkers against the dan-
gers of this pollution. The fact that hypochlorite was not being added to
the raw water which ia applied to the old filters probably accounts for the
general higher efficiency of these old filters, and were it not for the cleaning
and removal of sand which had taken place just prior to the collection of the
last samples from these filters it is. probable that the results would have
shown a higher absolute and a much higher relative efficiency than the new
filters.
After reviewing carefully the conditions which have been found to exist
upon the watershed of the Saw Mill river, and of the inefficient method and
results of operating the filters, I am of the opinion that the portion of the
water supply of the city of Yonkers that is now taken and treated from the
Saw Mill river is unsafe. It is true that the water supplied from this river
furnishes at the present time only two or three of the eight or nine million
gallons daily water consumption of the city, and it is probably due to the
relatively small proportion of this inadequately purified water consumed by
the citizens that accounts for the relative absence or infrequency of any seri-
ous prevalence or epidemic of communicable diseases.
In connection with the conditions which exist upon the Saw Mill river
watershed reference should be made to the sewage disposal plant of the West-
chester Almshouse, at East View, which appeared to be the only sewage dis-
posal plant or means of sewage disposal on the watershed not operating satis-
factorily, from which sewage pollution was being discharged directly into
the river. This plant, as pointed out at length in the accompanying report
of Mr. Holmquist, waa found to be neither constructed in strict accordance
with the plans approved by this Department, nor operated in accordance with
the conditions of the permit issued at the time of the approval of the plans;
and as a result the effluent from the plant did not show a high or a proper
degree of purification. It ii^ true that this plant is located some ten miles
above the intake of the Yonkers water supply, but notwithstanding this the
purity of the effluent was insufficient to be discharged into a stream of such
small volume when used as a source of water supply, and notwithstanding
the fact that this water is filtered, for as pointed out above, the efficiency
of this filtration is inadequate at the present time.
It should be pointed out also, in connection with this plant, that under the
Public Health Law and in accordance with the rules and regulations for the
protection of this supply it was primarily the duty of the water board and
the local board of health to ascertain the compliance of the construction and
operation of this plant, with the permit issued to the authorities of the
county almshouse, in order that action might be taken by this Department
to demand a proper operation of this plant in accordance with the conditions
of the permits issued, or to revoke the permit. In view of the present failure
of the county almshouse authorities to operate this plant in a satisfactory
manner, I beg to recommend that the matter be taken up with them and that
they be required to make such improvements in the construction and opera-
tion of this plant as will produce a satisfactory effluent, or if they fail to do
this that the permit be revoked.
That action should be taken at once by the water company looking, not
only to the removal of the large number of violations of water rules cited in
the accompanying report of Mr. Holmquist, but to making such changes and
improvements in operation of the filter beds, there can be no question. I,
therefore, recommend that copies of these reports be transmitted to the water
board and that they be again urged to take action without delay in removing
the violations upon the watersheds of their supply, and to make the neces-
sary improvements and changes in the management and operation of their
filters as will result in a higher degree of efficiency.
It is my opinion that unless these measures are carried out the citizens of
Yonkers will continue to be subject to an undue prevalence of typhoid fever,
and possibly of recurrent epidemics such as appeared to be started, but for-
tunately were checked, during the early part of the present year.
Respectfully yours,
THEODORE HORTON,
Chief Engineer
G20
State Depaktmknt of Health
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Investigation of Outbreaks of Typhoid Feveb 621
Albany, N. Y., October II, 1910.
The(»x>BE Hobton, Chief Engineer, State Department of Health, Albany, N. T, :
Deab Sib: — I beg to report that in accordance with your instructions I
made an inspection to determine the violations of rules for the protection
from contamination of the public water supply of the city of Yonkers on
October 7 and 8, 1910. The entire waterslied of the Nepperhan river was cov-
ered in the inspection. While it was impossible for me to cover in detail
the watersheds of the Grassy Sprain and the Sprain brooks in an inspection
of this kind, these watersheds were generally inspected but no violations were
found on these streams, and it was stated by the officials of the water bureau
that no violations exist on thege two watersheds.
The impoimding reservoir on the Grassy Sprain has a capacity of 900,000,000
gallons. At the time of the inspection the water in this reservoir was very
low, there having been practically no rainfall for a period of forty-nine days,
and it was estimated by the superintendent of the water bureau that about
200,000,000 gallons were available, equivalent to about thirty days* supply.
The records of the Department show that on December 8, 1908, some eighty
cases of violations were reported to this Department by the commissioner of
public works of Yonkers in accordance with section 71 of the Public Health
Law. These violations were examined into by the Department on January
4-6, 1909, inclusive, and of the number reported, 81 were verified, 4 had been
abated and in 2 cases no violations existed. On January 23, 1909, orders
were sent to the local boards of health having jurisdiction, directing them to
take definite aotion in the matter of abating the eighty-one cases of violation
examined into and verified by this Department, and copies of these orders
were also sent to the commissioner of public works.
Under date of May 28. 1909, a report was received by the Department from
the commissioner of public works of Yonkers which showed that 69 violations
had not been abated up to that time and that 6 additional cases had been
found, making a total of 75 cases of violations existing at that time.
These six new violations were examined into by this Department on June 7,
1909. One of these cases had been verified on the previous inspection made on
January 4-6. 1908, inclusive, and order issued on January 23, 1909; the other
five cases were verified and orders issued to the local boards of health having
jurisdiction directinir them to take immediate action in the matter of abating
the conditions set forth in the orders.
The commissioner of public works of the city of Yonkers was notified on
June 1, 1909, that in regard to the old violations, this Department had taken
all the action required of it under the provisions of sections 71 and 73 of
the Consolidated Laws (the Public Health Law), and that further action in
abating these violations devolved upon the board of public works. The
proper methods of procedure for the board to take in the matter of abating
the violations was clearly pointed out to the commissioner of public works in
a letter from this Department dated February 23, 1909, in which a portion of
section 71 of the Public Health Law was quoted stating also that the board
of water commissioners had a right to maintain action atcainst all the vio-
lations cited in the orders sent to the local boards of health, copies of which
orders had previously been sent to the commissioner of public works.
Tlie insnection made on October 7 and 8, 1910. showed that out of the 81
cases verified by the Department in January, 1909, and the 6 addHional cases
of violations reported by the commissioner of public works, 52 violations re-
mained the same as on the previous inspection, 29 have been either partially
abated or become more serious, 6 cases have been entirely abated, and 10 new
cases of violations were foimd, making a total of 91 violations existing upon
the Nepperhan watershed at present.*
• Space not taken here for the ennmeratioo of these violatloni.
622 State Department op Health
In connection with the inspection of the violations cited above, an in-
spection was also made of the sewage disposal plants for the Westchester
county almshouse at East View and the Children's Aid Society at Chappaqua.
Plans for the disposal plant for the almshouse at East View were ap-
proved by the Department on June 20, 1906, and a permit issued to the board
of supervisors of Westchester county on June 27, 1900. Amended plans were
approved on February 28. 1907.
The plans approved provided for a settling tank, pump well, four coarse-
grain filter beds and subsurface irrigation. It appears that the sewage dis-
posal plant has been constructed in general accordance with the plans, except
that the filter beds are somewhat smaller than those provided for by the
plans and a cesspool has been substituted for the subsurface irrigation system
to receive the effluent from the filters.
The sanitary sewage of the institution flows by gravity to a settling tank
and thence to a pump well, both of which are located near the main buildings.
From the pump well the settled sewage is pumped about once a day through
a C" force main to the filter beds located about one-quarter of a mile from
the settling tank.
The filter beds are between four and five feet deep and are filled with
coarse gravel and a mixture of fine gravel and sand, the coarser material
being at the bottom. It appears that the top- layer consists of the " run " of
the gravel pit except that the largest material have been removed.
Two of the four filters are used alternately, while the other two beds are
resting empty. The valves of the underdrains which lead to a central man-
hole are kept partially closed so as to control the flow of the effluent and to
keep a portion of the sewage in contact with the lower layer of filtering
material for some time. It appears, therefore, that the filter beds under the
present method of operation act as intermittent filters and contact beds.
The effluent from the filters is discharged into a large, shallow cesspool,
located near the highwater mark of the Nepperhan river and from whicn it
finds its way into the stream in a partially purified state, as the turbid gray
color and disagreeable odors of the effluent would indicate.
It appears that, while the plant as constructed is being carefully operated,
it is not adequate to properly care for the sew^age contributed by the present
population of some 380 |)cr3ons, and does not produce a satisfactory effluent
to be discharged into so small a stream as the Nepperhan river, from which
a portion of the water supply for the city of Yonkers is taken. The settling
tank has sufficient capacity to give the proper time of detention of sewage on
the usual assumption as to water consumption. The supplementary treat-
ment works, however, do not produce a satisfactory effluent and have not been
constructed in complete conformity with the plans as approved.
The filter beds as pointed out above are smaller than those shown by the
plane and tho ©ubsurface irrigafjon system if constructed has been superseded
by a cesspool. It was also learned from the man temporarily in charge of the
institution that the filter beds, which were not operating properly when he
came to take up his duties at the almshouse, were reconstructed at the time
of the construction of the cesspool and new filtering material added. The
sewage disposal plant as designed did not provide for a direct discharge of
sewage into the stream, as the nearest point of the subsurface irrigation
system was about twenty-five feet from the edge of river, and it was the pur-
pose of the design that the effluent should reach the stream only after having
filtered through a considerable area of the subsoil.
The sewage from the disposal plant as constructed and operated at present
leaches through the cesspool near the edge of the river or overflows into the
stream in a partially purified condition. That the degree of purification
effected is low is shown by the discoloration of the stream near the cesspool
and by the disagreeable odors of the effluent.
Although this plant is situated a considerable distance, some ten miles
above the Yonkers wat*»r supply intake, it appears that, owing to the small
volume of this stream and the consequent low dilution of any pollution enter-
ing it, the efticiency of purification of this plant is insufficient and should be
increased. At the time of the inspection the plant was neither constructed
nor operated in accordHjice with the approved plans ns noted above und it
Investigation of Outbreaks of Typhoid Fever 623
wae further the duty, first of the water bureau in accordance with the rules
and regulations, to ascertain and remove this violation of direct discharge
from the plant, and secondly, the duty of the local board of health under
section 84 of the Public Health Law to ascertain the violations of section 76
of the Public Health Law.
In connection with the inepection of the watersheds of the Yonkers public
water supply the sewage disposal plant of the Children's Aid Society of
New York was also inspected on October 8, 1910. Plans for this sewage dis-
posal plant were approved by this Department on April 20, 1910.
This plant consists of a settling tank, sludge bed, contact beds, sand filters
and final absorption trenches in which a portion of the purified effluent is
absorbed before reaching a small stream which is one of the tributaries of
the Nepperhan river near its source.
It appeared from the inspection that the plant has been constructed in
complete conformity with the plans and that it was receiving proner atten-
tion. Although no chemical or biological analyses were made of the effluent
it was both colorless and odorless at the time of the insnection. which wmild
indicate that the plant was producing a satisfactory effluent for a disposal
plant of this type.
The plant will not be taxed to its full capacity until next year, when the
new main building now under construction will be completed and occupied.
With proper attention and operation, however, the plant should continue to
give a satisfactory effluent for a considerable period in the future, providing
that the plant be not overtaxed or required to operate at a rate higher than
that for which it was desicmed.
The labor camp of Rheinhardt &> Comnanv, maintained in connection with
the Catskill aqueduct construction, and located on the west side of the Saw
Mill river, about one mile north of Pleasantville, was not inspected by me
during mv inspection of the Raw Mill river watershed, but was subsequently
covered bv Mr. F. M. Arnolt, inspecting engineer of this Department, on
October 15, 1910.
This camp consists of twelve buildings, which are used for dormitories,
kitchens, bath-houses, stable, etc. The average population of the camp is
seventy-five persons.
It appears that no sewage, wastes or other refuse matter reaches the stream
from this camp, since the solids consisting of fecal matter, garbage and refuse
is burned in a small ineineratinsr plant, which is operated continually, and
since the liquid wastes from the bathe, washtubs and kitchen sinks are dis-
charflred into a tight concrete settling tank provided with an overflow pipe
which leads to a larsre open-iointed cesspool constructed in sandy soil and
located about 150 feet from the river.
Respectfully submitted,
C. A. HOLMQUIST,
Assistant Engineer
Albany, N". Y., October 22, 1910.
Board of Water Commissioners, Yonkers, N. Y.:
Dbab Sib : — I am transmitting herewith copies of reports of our en«nneer-
ing division in a matter which should be not onlv of interest, but of vital
importance to the reBidents of your citv. and especiallv to rour board which
is the bodv having official charge and management of the water supply system
of vour city.
These reports pointt out a f»eries of conditon-s existing in connection with
the water supplv of vowt city which, in my opinion, are of a serious
nsitupe. and call for prompt and effeotave action by your board. These
conditions, with reference to the watershed of the Saw Mill river, as vou will
remember, were bmno-ht to vour attention two years as'o in connection with
an order Issued by this Department, calling for an inspection by your officials
of th« lAoltAiy Qonditioni upon thU wat^ribed. At tbii tima you woro Ad'
624 Stats Dspabtment of Health
Tised at t« the pfocedure tlMtt should be taken by jour board to remove the
violations that were found from this inspection, and it was pointed out to
you at the same time the necessity for immediate action in regard to those
violations, and of the responsibility of your board in the matter.
In the face of these advices and warnings I regret to find, from investiga-
tion, that not only do a large majority of the violations which existed two
years ago still ronain uncorrected, but that others have been found, with a
net result that at the present time there are more violations upon the water-
shed than existed some two years ago. With equal regret I find, as pointed
out in the accompanying reports, that the municipal filters are not being
operated or managed properly, which results in a low efficiency and delivery
to the citizens of Yonkers of a water which can not be considered other than
unsafe.
The combination of these two unsatisfactory conditions, in connection with
your supply, is a matter which, in my opinion, can not be overlooked by your
board, and in transmitting the accompanying reports to you I beg to ask
that your board give the recommendations and conclusions prompt considera-
tion, and that you take the necessary action to remove without delay all
violations of the water rules now in force for the protection of your supply,
and to cause such changes in operation and management of your filter plant
as will result in such increased efiSciency as to produce a safe and satisfactory
effluent, and one which will protect the oitizens of Yonkers against the dan-
gers which now exist.
Owing to the importance of this matter I beg to ask that you advise me
as to the action taken by your board in this matter.
Very respectfully,
EUGENE H. PORTER,
Commisaioner
INVESTIGATION OF COMPLAINTS RELATING TO
STREAM POLLUTION
[625]
INVESTIGATION OF COMPLAINTS RELATING
TO STREAM POLLUTION
If there is any one subject or topic, excepting perhaps that of
tuberculosis, over which the people of this State have become
thoroughly aroused during the past few years, it is the pollution
and defilement of our streams. It is a subject which cannot be
discussed too frequently, nor can its importance he too often
impressed. Much has been done within recent years, it is true,
not only in curtailing but actually eliminating some of the wan-
ton defilement which has up to this time been permitted with
many of the streams of our State. A vast amount of work still
remains to be done, however, before these streams have been re-
claimed to a degree of cleanliness which public decency demand?*.
It is indeed fortunate that the people of this State have through
the educational campaign which has been waged during the past
five years, been awakened to a sense of appreciation on the one
hand of the healthfulness and comforts derived from preserving
our streams in a state of natural purity, and on the other hand
of the dangers and annoyance in allowing them to become defiled
with sewage pollution.
Difficult as a crusade must be against these practices of sewage
pollution, and made more difficult by the lack of adequate laws to
enforce its removal, it must "be continued energetically until these
streams, once pure, have been reclaimed to a reasonable d^^ee of
purity. The work of the Department in this field devolves neces-
sarily upon this Division, which is called upon almost daily to in-
vestigate and report upon complaints of nuisances arising from
stream pollution in different sections of the State.
These nuisances are usually of a public nature, frequently far-
reaching in their effect and not infrequently require considerable
time to thoroughly investigate and report.
The municipalities where the more important of these nui-
sances have arisen and rocoived the attention ^f the Department
are the following:
628 State Department of Health
ALLEGHENY RIVER
ALBAmr, N. Y., June 21, 1910.
Memorandum Re Inspection of Wood Alcohol Plant, at Red Bouse Cattaraugus
County, with Reference to Pollution of AUegheny Riier
At a conference heH on January 17, 1910, at the residence of Commissioner
lorter in New lork city, between Commissioner Porter and Chief Riffineer
Horton of the New York State Department of Health, and Chief ^Sineer
bnow of the Pennsylvania SUte Department of Health, it was agr^that
a representative from the New York State Department would be detailed to
Pa., since it had been found that creosote and acid tastes and odors in the
Allegheny river were not eliminated by the water filtration plant recently
constructed at Warren.
On May 17, 1910, Mr. Cleveland visited Red House and obtained the fol-
lowing data, with reference to the plant:
Location.— Town of Red House, Cattaraugus county, % mile south of
Pennsylvania railroad on northeast bank of Red House creek, 100 rods from
creek and 1 mile above Allegheny river.
Name of firm. — A. B. Smith Chemdcal Company; president, W. W. Smith,
921 White Building, Buffalo, N. Y.; secretary, E. S. Newhall, 921 White
Building, Buffalo, N. Y.; superintendent, W. W. Anderson, Red House.
Plant constructed and put in operation in 190O.
Number of employees. — Twenty-three.
Product manufactured. — Wood alcohol, 400 gallons daily; acetate of lime,
8,000 pounds daily; charcoal, 1,800 bushels daily.
Character and amount of wastes. — Drainage refuse from lime tanks, con-
taining, as estimated by superinitendent, from 2 per cent, to 2^ per cent, of
acetate of lime, together with washings from other tanks, vats and stills
cleaned out at irregular intervals. No chemicals, except lime used in process.
All work done by baking and distillation. From final process, that of col-
lecting acetate of lime after treatment of " liquid smoke " and distillation
of wood alcohol, has been carried on as described later, the residue, consist-
ing of small amounts of insoluble lime, tar and creosote, and about 2 to 2^ per
cent, of acetate of lime as noted above, and amounting to 18 or 20 50-gallon
barrels, is discharged about once in three weeks onto low ground on the
south side of the plant, through which passes a small stream formed by the
discharge of condensed water, and this drainage flows 300 feet into Red House
creek. There is no domestic sewage discharged with wastes.
Brief description of process. — There are 6 retorts or oTens for baking the
wood, 400 tons of soft coal per month being burned under the oven; each
oven is 5% feet wide. 7 feet deep and 32 feet long. Six cords of wood, con-
sisting principally of beech and birch, with about ^ maple, are pla^ in
each oven and baked for 24 hours. With 26 working days in a month this
amounts to 936 cords of wood consumed per month. Two years ago plant
wias increased 50 per cent, in capaciity. The charge is baked dry, with no
steam or chemicals added until charcoal is formed, and the distillation of
the wood is complete. Smoke from retorts goes from retort or oven into
condensers with water jackets; from condensers resulting liquid is pumped
into a series of tanks and some tar settles out and is drawn off; from the
tanks the liquid is led into three copper stills and heated by steam ooils;
from copper stills a portion of the liquid treated is passed into agitator
tubs: from the copper stills also tar is drawn off and, with the tar pre-
viously collected, is burned under the boiler in power house. The agitator
tubs have inside winsrs or paddles; no heat is applied to them, but common,
unslaked lime (45,000 to 48,000 pounds per month) is added until liquid turns
from green to cherry red in color; from agitators liquid goes to two stills, heated
by steam coils, and alcohol ii driven off, acetate of lime being left in the
Complaints Relating to Stream Pollution 629
siilh; this is forced out into a settling or lime tank where the insoluble
lime settles out and the acetate is drawn off into pans and boiled down to
82^ B. It is from this lime or settling tank that the final wastes are dis-
charged as described above.
Means for properly disposing of wastes, — The matter of improvements in
the operating arrangements at the plant whereby the wastes might properly
be disposed of and the pollution of Red Houyse creek and the Allegheny river,
by wastes from the plant thereby prevented, was taken up with the superin-
tendent of the plant, and later with the secretary of the company, at Buffalo.
Considering the relatively small volume of the residue or wastes from the
lime or settling tanks, and of the occasional washings from other tanks and
vats, it appeared that ample opportunity existed for the disposal of these
wastes on low sandy ground south of the plant, and well removed from the
stream, and that such a method would prove feasible and efficient, provided
the wastes from the settling tanks and the washings from tanks and vats
were kept separate from the condenser wa4;er.
This separation of clear condenser water from the wastes may be accom-
plished in two ways:
1. By conveying the condenser water in a separate outlet drain to the
creek or neaily to the creek. ,
2. By conveying the wastes and vat washings from the various pro-
cesses in a separate conduit to sludge beds or cesspools located at points
well away from the stream formed by the condenser water, and from Red
House creek.
It was thought by Secretary Newhall that the latter method would be the
most effective, as well as the most economical, and he agreed on behalf of
the company to proceed at once to effect such disposition of the wastes from
the plant.
It was stated that during the spring floods the low areas south of the plant
were washed over and the accumulated wastes would thereby be carried into
the stream, but at such times the great dilution occurring would minimize
the effect of the pollution in the waters of the Allegheny river.
Albany, N. Y., June 21, 1910.
Memorandum Re Inspection of Wood Alcohol Plant, at Vandalia, Town of
Carrollton, Cattarauffus County, with Reference to Pollution of Allegheny
River,
At the time of the inspection of the wood alcohol plant, at Red House, by
Mr. Cleveland (see separa/te memorandum) it was learned that a similar plant
had recently been constructed at Vandalia, and accordingly this plant was
visited for the purpose of determining the extent of pollution of the Alle-
gheny river by wastes from the plant, and of taking up with the proprietors
the matter of preventing any pollution of the river that might be found to
occur.
The t-lant is located in the town of Carrollton, one-half mile south of the
Allegheny riwr, and about ten miles above Salamanca.
The plant is operated by the Vandalia Chemical Company, of which Mr. M.
F. Quinn, of Glean, is president, and Mr. J. W. Collins is secretary. Mr. Col-
lins is aJso superintendent. Operations were commenced at this plant in
January, 1908.
The number of employees is 22.
Tb« daily output of the plant is 375 to 400 gallons of wood alcohol, 6,000
pounds to 7,000 pounds of acetate of lime, and 1,500 bushels of charcoal.
The processes employed are practically the same throughout as at the
Red House plant (see separate memorandum), except that the tar from the
settling tanks next in series after the condensers is distilled after being mixed
with &e lime the same as the smoke liquid, and except that the settlings
630 State Department of Health
in the final settling or lime tank, which received the liquid after the wood
alcohol has been driven off and from which tank the acetate of lime is drawn
off to be evaporated down to greater strength, are thoroughly drained and
the drainings utilized in the process.
This draining is accomplished by discharging onto a slat and burlap
strainer the residue in the lime tank. This tank is 4 feet wide, 3 feet deep
and 12 feet long and fills up once in two or three weeks so that it must be
emptied. The drippings from the burlap strainer fall on an inclined floor
and are caught in a trough and relumed to the stock vats. After a week
or so the trough is removed and the sludge or settlings are drawn into a bin
and from the bin are carried to a large cesspool excavated in the sandy soil
south of the plant, into which washings from vats and stills are also discharged;,
and frcHu which it does not appear that any drainage passes into the ditch
leading to the river. Some small amount of drainage from the sludge bin,
as described above, drains into a stream formed by the condenser water and
flows through a ditch to the Allegheny river, 'ihis is believed to be the
only point in the process from which wastes are discharged that reach the
river, and Superintendent Collins assured Mr. Cleveland that he would make
arrangements to collect all drainage from this bin and convey it by piping
to the cesspool or sludge bed so that pollution of the river would be entirely
eliminated.
Albany, N. Y., June 27, 1910.
Samuel G. Dicksox, M.D., State Commissioner of Health, Ilarrishurg, Pa.:
Deab Sir: — With reference to the pollution of the Allegheny river by the
Wood Alcohol Plant, at Red House, in the State of New York, a matter which
was taken up by your Chief Engineer, Mr. F. Herbert Snow, with me, and
our Chief Engineer, Mr. Horton, in New York, on January 17, 1910, I beg
to say that I have had one of our engineers visit this plant, and one not far
distant from it on the Allegheny river, at Vandalia, in the town of Carroll-
ton, Cattaraugus county, and I beg to inclose herewith memoranda concern-
ing his investigation of these plants.
These memoranda of our engineers show that a considerable pollution of
the river takes place from the discharge of wastes from them into the Alle-
gheny river, and you will note also the matter of removing or correcting
this pollution was taken up with the managers of these plants. In both
instances the question of possible means of an improvement were discussed,
and our engineer has pointed out certain ways whereby the correction or, at
least, improvement of the present unsatisfactory method of disposal might be
accomplished.
Although I have not the authority to compel the removal of the pollution
of these waters by these alcohol plants, you will note from the accompanying
memoranda that our engineer urged and recommended that necessary im-
provements be carried out without delay. In his efforts toward this end he
received considerable encouragement from the officials of these two plants,
and was practically assured by them that they would proceed at once to
effect such disposition of the wastes from their plants as would eliminate or
reduce the pollution which has up to this time existed.
Assuring you of my interest in this matter, and trusting that my efforts
to induce these companies to bring about an improvement of the present
method of disposal of their wastes will be successful. I 1)eg to remain,
Respectfully,
EUGENE H. PORTER,
Commissioner
Complaints Relating to Stream Pollution 631
AUGUR LAKE (Town of Chesterfield)
Albany, N. Y., September 9, 1 9 10.
£UGENE H. PoBTER, M.D., State CammisaUmer of Health, Albany, N. Y.:
Deab Sib: — I beg to submit the following report on an inspection of the
alleged insanitary conditions of Angur lake, in the town of Chesterfield, Essex
county, ae affecting the health of the gueBts of The Interla'ken Hotel.
A complaint of the " bad condition of the water in the lake " was made to
Governor Hughes by C. B. White, proprietor of Tlie Interla'ken, on Augur
lake, Keeseville, N. Y., on August 10, 1910. This complaint was referred to
you for invesrtigation by Col. GkKjrge Curtis Treadwell, Secretary to the Gov-
ernor, and at the direction of the Governor.
The inspection of Augur lake was ma'de by Mr. C. A. Holmquist, Assistant
Engineer of this Department, accompanied by Mr. C. B. White, his boatman,
and one of the guests at the hotel, on August 23, 1910.
This lake is located about 2^ miles southwest of Keeseville, at an eleva-
tion of 549 feet above sea level, and has a total drainage area at the outlet of
about 13 square miles. The area of the water surface of the lake itself is
.56 square miles, and that of Butternut pond, the principal tributary to this
lake, and located about 1^ miles to the south, is .22 square miles. Except
for Butternut pond the lake seems to be fed largely by small mountain streams,
some of which have their sourer in swampy districts.
The banks of the lake are for the most part steep and rocky, except near
the southern and western inlets where there are swampy and marshy areas
of considerable extent. It appears also that nearly one-half of the lake has
a muddy bottom and is less than five feet deep.
The water in the portions of the lake near the inlets is very shallow,
and large areas are covered with water lilies. A niunber of varieties of other
vegetable growths also flourished in the shallow portions of the lake, and in
some places were so thickly matted that it was difiicuH to row through
them. On the surface of the water among these growths was a green and
gray scum which was said to cover a considerable area at certain periods
of the summer.
The water, especially near the vegetable growths, had a slight fishy and
vegetable odor. Mr. White stated that these odors became very offensive
at times, and that his guests feared an epidemic of some kind. The odors
were apparently due to the growing vegetation or decaying vegetable matter
and not to sewage pollution, inasmuch as this district is very sparsely popu-
lated, and the two houses near the lake, one of which is The Interla'ken,
are provided wiith cesspools.
The water in the lake was of a pea green color which was undoubtedly due
to vegetation in the lake. The water, however, is not used for domestic
purposes, except for washing, bathing, and laundry purposes. The water used
tor drinking and cooking is derived from a well located near the hotel.
The proprietor of the hotel 8ta;ted that the green color of the lake and the
peculiar odors of the water prevails for about two months during the summer
and was more intense during sunmiers of low rainfalls. Mr. White was of
the opinion that inasmuch as the lake is the property of the State steps
should be taken by the State to remedy the conditions by dredging the lake,
constructing a dam so as to raise the waiter level some five or six feet, by
applying proper amounts of copperas, or by a combination of these methods.
The proprietor of the hotel has constructed a crude dam and flume to
furnish power for a water wheel which operates two pumps for the purpose
of forcing water from the lake to the storage tank in the attic of the hotel.
This dam raises the water level of the lake from one to two and one-half feet,
depending upon the season of the year and the amount of precipitation on
the watershed. It was impossible to determine what effect this dam has on
the condition of the water in the lake, inasmuch as none of the persons in-
632 State Depaetment of EEealtu
ter viewed seemed to have noticed any difference between the color and odor
of the water before and after the construction of the dam at the outlet.
According to Mr. White, however, it appears that there was, a number of
years ago, a mill and dam on the outlet some distance below the present dam
which raised the waAer several feet higher than the present level of the lake,
and that before this dam was removed the water was perfectly clear and
odorless at all times during the year.
It would appear, therefore, that the condition of the water in the lake would
be improved by constructing a dam so as to raise the level of the water in
the lake a few feet, but this would involve numerous other complications,
among the more important of which are the damage to riparian owners
caused by flooding comparatively large areas of pasture or farm lands on
the lake, the deleterious effect and possible pollution that would probably
result from flooding additional areas that are now thickly covered with
vegetation, and the possible damage to owners below the lake by restraining
the natural flow of water, to say nothing of the expense of constructing an
adequate dam.
The construction of a dam would also involve an extensive study and
require a survey which this Department has neither the facilities nor the
funds to undertake.
Dredging the lake, and thus excavating the mud and destroying the yege-
tation, is impracticable and prohibitive on account of the enormous cost of
such an undertaking.
The third possible aJtern^jtive suggested for improving the esthetic oondh>
tions of Augur lake, by applying copperas in proper proportions, is the most
practicable as well as the least costly of the methods suggested, and has
been used with success in connection with impounding and distributing reser-
voirs for public water supplies in different sections of the country where
vegetable growths in shallow portions of reservoirs have created disoolora*
tion or disagreeable taste or odors of the wa/ter. The problem^ however,
would require some study and possibly some experimental work, in order to
determine the proper amoimts of chemicals to use so as to effectually destroy
the vegetable growths in the water, and at the same time not injure the fish
in the lake. In connection with a scientific application of chemicals in the
spring and early summer large quantities of these vegetable growths which
tend to discolor the water and produce disagreeable odors could be destroyed
mechanically by dragging the shallow portions of the lake near the inlets.
In conclusion, I would say that although the water had a decided green
color and a fishy or vegetable odor at the time of the inspection, the condi-
tions were not such as to constitute a nuisance, and inasmuch «s the water
in the lake is not used for drinking or cooking, but simply for washing, bath-
ing and laundry purposes, and is not polluted by sewage, the condUion of
the lake, while not pleasant to the sight and smell, can not be said to be
detrimental to health.
The question, therefore, does not properly come under the jurisdiction of
this Department. It may, however, be possible for Mr. White to solicit the
interests of riparian owners and to co-operate with them or to appfy to
some other Department for assistance in improving the conditions of Augur
lake.
I would, therefore, recommend that a copy of this report be sent to Mr. C.
B. White, proprietor of The Interla'ken, Keeseville, N. Y., and that he be
advised to act in accordance with the suggestions embodied in this report.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
On September 24, 1910, a letter, inclosing a copy of this report, was ad-
dressed to Mr. C. B. White, informing him that, owing to the nature of the
problem, it is impossible for this Department to offer him any further assist'
ance beyond the suggestions embodied in this report.
CoHPuuNTs Relating to Stbeam Pollution 633
BRANT LAKE (Town of Horicon)
Albany, N. Y., September 15, 1910.
Eugene H. Pobteb, M.D., State Commissioner of Health, Albany, N, Y. :
Deab Sib: — I beg to submit the following report on the inspection of the
sanitary conditions surrounding Bran.t lake, in Warren county, made by this
Department on August 24. 1910.
A complaint of the insanitary conditions caused by the overflow and the
discharge of cesspools in connection with residences iuto Brant lake was made
to this Department by the Brant Lake Association on July 26, 1910. The
complaint further stated that " During the past year there has been at least
one death caused by typhoid fever at the lake and there have been similar
occurrences in previous years, and while we (Brant Lake Association) may
not be able to trace it directly to improper drainage, we wish to avoid every-
thing that may tend to a repetition of such occurrences."
The inspection of Brant lake with reference to the discharge of sewage and
sewage effluent into the lake was made by Mr. C. A. Holmquist, assistant
engineer of this Department, accompanied by Mr. Abel Crook and Daniel B.
Freedman, president and vice-president, respectively, of the Brant Lake
Association.
Brant lake is located in the town of Horicon, in the Adirondacks, at an
elevation of 801 feet above sea level and has a total drainage area at the
outlet of about forty square miles. The area covered by the lake itself is
2.2 square miles. The lake is fed by numerous mountain ponds and streams,
most of which have their source in swampy districts.
The banks of the lake are for the most part fairly steep, except near the
outlet and principal inlets, where there are large, swampy and marshy areas.
The soil is composed almost entirely of sand and gravel, affording excep-
tional facilities for disposing of sewage by means of cesspools or subsurface
irrigation.
The Brant lake watershed is very sparsely populated. Along the shore of
the lake are some twenty-five houses, mostly occupied by summer visitors.
There are also three summer hotels on the lake, one on the eastern shore and
the other two on the western shore.
All of the houses, including the hotels, except one cottage, are provided with
outside privies or cesspools. This cottage is the property of G. W. Van
Sl^ke of Albany, and is located on a small island about three-quarters of a
mile from the dam at the outlet. The complainants stated that Van Slyke's
cottage discharged sewage directly into the lake.
All of the cesspools except those connected with the hotels seemed to be
adequate to properly care for the sewage discharged into them.
The cesspool m connection with Armagh Lodge, owned by E. 11. McAuliffe
and run by £. O. Kelso, is located about fifty feet from the lake, and was
overflowing into the lake at the time of the inspection. The odors near the
cesspool were disagreeable and the conditions insanitary and would tend to
create a nuisance under certain atmospheric conditions. This hotel can ac-
commodate about thirty-five guests.
The Pebloe hotel which has been open to the public for five years is pro-
vided with two cesspools. One of these cesspools is used for laundry wastes
and is located back of the hotel and some 150 feet from the lake. While it
showed evidence of having overflowed, the wastes would^ probably not reach
the lake under ordinary conditions.
The other cesspool is located in the road in front of hotel property and
about twenty-five feet from the lake. This cesspool is provided with a 2-inch
overflow pipe which extends some thirty feet into the lake. It was learned
from the proprietor of the hotel that during one of the heavy rains this
summer the cesspool broke through the ground and its contents flowed into
the lake. This hotel has a maximum capacity suflicient to accommodate
634 State Depabtment of Health
eighty guests, and is owned by P. Smith of Horicon and (grated by H. W.
Stewart of New York city.
The Palisades hotel is located about midway up the lake on the western
shore. The present building has been located on the present site for about
three years and is owned and run by Margaret and William Owen. This
hotel has a maximum capacity for accommodating ninety -two guests and has
an average of seventy-five guests during the summer.
There are three large cesspools in connection with the Palisades. These
cesspools are all connected but are not provided with overflow pipes.
The first cesspool is located about 50 feet from the lake and is 14' x 13' x T
deep. The second is about 25 feet from the lake and is 7' deep and has au
area of 282 square' feet. The third cesspool is located about 15 feet from the
lake, is 5' deep and is 25 feet long by 8 feet wide.
These cesspools are inadequate as to capacity to care for the sewage as
shown by the fact that the last cesspool had overflown into the lake a short
time before the time of the inspection and several loads of sand and gravel
had been deposited near the break in order to cover up the filth caused by the
discharge.
While all the hotels and cottages cut their ice supply from the lake the
water of the lake is not used for domestic purposes as far as could be ascer-
tained, except for washing, bathing and laundry purposes. The water used
for drinking and cooking is supplied from individual springs and weHs.
In conclusion, I would say that while the amount of sewage that reaches
the lake from cesspools along its shores is comparatively small and would
probably not endanger the health of the people living along the lake, at all
times, contamination and pollution of the lake nevertheless exists inasmuch
as sewage or cesspool effluent reaches the lake at least occasionally from one
hotel and one summer house and continually from two of the hotels during
the greater part of the summer.
It appears, therefore, that danger of contamination is always present and
inasmuch as no permits have been issued by this Department to the owners
of these places allowing the discharge of sewage or sewage effluent into this
lake, any such discharge into the lake is in direct violation of section 76 of
the Public Health Law.
I, therefore, recommend that letters be addressed to the proprietors of the
hotels and to G. W. Van Slyke informing them of their violation of the
Public Health Law insofar as they are discharging or allowing the discharge
of sewage or sewage effluent into Brant lake without permits from this De-
partment and advising them to either enlarge their present means of sewage
disposal or if conditions permit to provide for supplementary treatment of
sewage, such as subsurface irrigation or sand filtration, and further that if
the conditions complained of are not remedied the complainants be advised to
bring the matter to the attention of the local board of health, which has full
power and authority under the Public Health Law to compel an abatement of
the insanitary conditions now existing.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
On September 30, 1910, letters, inclosing copies of this report, were ad-
dressed to Mr. G. W. Van Slyke and to the hotel proprietors, calling their at-
tention to their violation of the Public Health Law by the discharge of sewage
from their premises into Brant lake and urging them to provide for adequate
means for sewage disposal so as to improve the sanitary conditions by pre-
venting the discharge of sewage into the lake. The proper method of caring
for the sewage from their properties was outlined in a general way and they
were advised to secure the services of a competent engineer to work out the
details of the design of any system adopted.
CoMPUONTs Relating to Stbeam Pollution 635
BRONX RIVER
Albany, N. Y., December 8, 1910.
Mr. Theod6B£ Horton, Chief Engineer, State Department of Health, Albaiiyy
N, T. :
Deab Sib : — I beg to report on an inspection of the pollution of the Bronx
river, made at your direction on November 30, 1910. This inspection was
made in response to a request contained in a resolution passed by a joint
meeting of the town boards of health of the towns of Scarsdale and Green-
buigh, Westchester county, on November 22, 1910.
The communication from the secretary of the board of health of the town
of Grecnburgh in which the request for the inspection was made, also stated
that it was the desire of the boards of health of the towns of Scarsdale and
Greenburgh tbait following the inspection of the pollution of the Bronx river
from White Plains to the Yonkers city line, a joint meeting be called by the
State Commissioner of Health of the boards of health of the towns of Scarsdale
and Greenburgh and of the village of White Plains for the purpose of taking
up the question of the abatement of the nuisance caused by the pollution of
the Bronx river.
In connection with the investigation, a visit was made to the White Plains
sewage disposal plant, the operation and the inadequacy of which have been
previously described in your reports of inspection of the pollution of the
Bronx river dated October 24, 1906, and October 28, 1907, in a similar report
by the writer dated October 7, 1907, and in a report by Mr. E. T. King,
formerlv inspecting engineer with this Department, dated March 12, 1906.
In all the above reports, which are reproduced in the 28th annual report of
this Department, the grossly polluted condition of the Bronx river due to the
discharge of insufficiently treated sewage from the White Plains sewage dis-
posal plant is described.
In reference to the present operation of this sewage disposal plant it may
be said, from an inspection of the stream at the point of discharge of effluent
from the plant and from data obtained and observations made at the plant,
that although a decided improvement in the operation of the plant has been
made within the past two years, following, as far as such improvements
have been made, the suggestions contained in your report dated October 24,
1906, the effect of the discharge of effluent from the plant in polluting the
Bronx river is as great or greater than at the time of the former inspec-
tions. Since the plant was inspected by this division in 1906 the population
of White Plains has increased from 12,000 or 13,000 to 17,500, resulting in
an increase in the overtaxing of the plant which was occurring even at that
time, and which was then estimated to amount to at least a doubling of the
permissible rate of operation of a sewage treatment plant of this type.
Respecting the alternative means for improving conditions in the stream
by the adoption of suggested improvements in the operation of the plant con-
tained in your report of October 24, 1906, which were:
1. A changing over from the " fill and draw '* method of operating the
tank to the "continuous flow" method.
2. An increase in the efl^ective depth of the flow through the tanks.
3. An increase in the capacity of the tanks by means of a rearrange-
ment of the partitions.
4. An increase in the amount of lime used to precipitate the sewage.
5. Better arrangements for proper mixing of the applied solutions and
a greater uniformity in applying the milk of lime solution to the sew-
age at the entrance to the tank; it appears from the recent inspection
of the plant that several of these suggested improvements have been
brought about, as follows:
•1. The siphons which caused the intermittent discharge of the con-
tents of the tanks have been removed and overflow weirs have been placed
at the outlet of the tanks, thus changing the manner of operating the
tanks to the *' continuous flow " method.
636 State Depabtment of Health
2. Whereas the siphons originally in place allowed the tank to fill
to a depth of only 3 feet before discharge, the overflow weirs are now
placed so as to give a depth of flow- in the tanks of 5 feet, thua inereaa-
ing the capacity of the tanks by nearly 70 per cent.
3. No change has been made in the partitions of the tanks so thai the
sewage flows through the three channels in the tank, as formerly, before
its discharge.
4. Whereas, in 1906 and 1907, the amount of lime used daily was
stated to be 6 or 8 barrels, together with one carboy of perchloride, It is
evident from the statements made by Superintendent of the plant, Mr.
A. O. Comstock, and by Mr. Alonzo Boese, inspector for the board of
health for the town of Scarsdale, who visits the plani regularly, that
10 barrels of lime are now used daily, amounting to 14 grains per gal-
lon of sewage, together with 240 pounds of perchloride of iron daily,
amounting to 1% grains per gallon of sewage. In addition, 45 to 50
pounds of chloride of lime are placed in a manhole outside of the plant
over the main sewer.
5. The mixing trough, which was formerly under the floor of the plant,
has been raised above the floor; the lime is placed in this mixing trough
through the middle of the day at the rate of one and one-half barrels per
hour, two troughs being used, so that the lime is slaking in one trough,
while the solution is flowing to the sewage from the other.
Notwithstanding the improvements made in the operating arrangements of
the plant the increased amount of lime used and the increased care evi-
denced in the maintenance of the plant, the plant is very badly over-
taxed, the lack of increase in efficiency being due no doubt to the increased
amount of sewage which must be treated. The river is, therefore, still badly
polluted by the effluent from the plant and it is evident that a connection
from the White Plains sewer system should be made to the Bronx Valley
trunk sewer as soon as such sewer is completed and ready for use, in order
to remove the present pollution from the stream.
Respecting tne Bronx Valley trunk sewer, it was learned from a confer-
ence held at White Plains with Mr. George R. Byrne, chief engineer of the
Bronx Valley Sewer Commission, that this sewer was about 95 per cent, com-
pleted on December Ist, and was progressing at the rate of about 3 per cent,
of the total construction per month, the iinfinished portions being about 500
feet of the sewer in Tuckahoe, 500 feet in South Bronzville, and sections
aggregating about 2,200 feet from South Bronxville to the portal of the tun-
nel which extends from Wakefield to the Hudson river. It is expected that
the work of constructing the trunk sewer which was started in March, 1908,
and consists of the construction of 15 miles of trunk sewer, 3 miles of which
were in tunnel, will be completed by January 15th, and that the sewer will
then be ready for use as an outlet for sewage from the towns and villages
through which it passes. The chief engineer stated that there would be no
legal difficulties to prevent the use of the sewer on its completion, that no
permanent injunctions had been obtained against the work, and that no fur-
ther action or applications by village authorities were necessary in order
that sewage from such villages might be discharged into the completed
sewer, such use of the sewer depending simply upon the annoimcement by
the Bronx Valley Sewer Commission, that the sewer was completed and ready
for use.
In company with Mr. Alonzo Boese, inspector for the board of health of
the town of Scarsdale, an inspection was made of two sewers within the lim-
its of the village of White Plains, one discharging into a cesspool on the
east bank of the Bronx river, in the village of White Plains, a short distance
above the White Plains sewage disposal plant, the overflow from the cesspool
flowing directly into the river at the foot of Golden avenue; the other
sewer, which was formerly a blind drain, being laid through Stephens aTe*
nue and discharging at the southerly line of W^ite Plains village, at Farley
road, into a ditch which discharges into a small stream, this stream discharg-
ing into Bronx river about a half mile below the Hart«dale station.
Each of these sewers iieceives sewage from about thirty houses in the vil-
lage of White Plains. The first one (the one in Golden avenue) was cvi-
Complaints Relating to Steeam Pollution G37
(kiLtly constructed by the village authorities about five years ago. The second
one described has evidently existed as a ground water or storm drain before
connections for the discharge of hoitse sewage into this drain were made
by private owners.
An incompleted sewer has also been constructed in Farley road by the
Scarsdale estates, but no houses have been built as yet in the development
of the Scarsdale e9tates in this section, and the sewer at present has no house
oonneotioM and no outlet.
The discharge from these two sewers adds to the pollution of the river
and steps should be taken by the vilWe authorities to deliver the sewage
collected by these sewers to the Bronx Valley trunk sewer on its completion.
An inspection of the Bronx river was made at various points from White
Plains to Bronxville, with special reference to the effect on the river of the
discharge of effluent from the Whiite Plains sewage disposal plant, from the
two sewers described above, from the outlet of the septic tank of the Caro-
line Rest Maternity Hospital, at Hartsdale, and from the sewage disposal
plants at the villages of Tuckahoe and Bronxville.
At the bridge on Railroad avenue, in the village of White Plains, the
Bronx river showed no considerable visible evidences of pollution, although
garbage and rubbish have been thrown into the stream. The stream was
fairly clear and gave off no odors from this point nearly to the White Plains
sewage disposal plant.
As stated above, sewage from about thirty houses is discharged into a small
cesspool at a point a short distance above the sewage disposal plant, and
the overflow from the cesspool discharges into the stream and produces a
marked pollution of the stream.
The eflluent from the White Plains sewage disposal plant was of a reddish
brown color as it left the plant, and when it reached the stream through the
outlet sewer at a point about 2,000 feet below the plant, was of a light slate
brown color. The stream was badly polluted by the effluent from this plant,
as far as the Scarsdale station, a distance of some three miles, and sewage
growths covered the bed of the entire stream for the greater portion of this
distance.
•
The effect of the stream of the discharge of effluent from the Tuckahoe
and Bronxville sewage disposal plants, as well as from the septic tank at
the Caroline Rest Maternity Hospital, at Hartsdale, while adding consider-
ably to the pollution of the stream, in no way compares in intensity to the
pollution due to the dipcharge of effluent from the White Plains sewage dis-
posal plant. The plans for the septic tank to treat sewage from the Caro-
line Rest Hospital, at Hartsdale, approved by this Department on October
revocable on completion of the Bronx Valley trunk sewer.
During the inspection a conversation was had by telephone with Mr. Charles
D. Millard, president of the board of health of the town of Greenburgh, and
he stated that he was pleased that the matter had been taken up by the De-
partment, and also stated that the board of heaHh of the town of Greenburgh,
while realizing that with the early completion of the Bronx Valley trunk
sewer and the connecting of tlie White Plains sewer sj-stem with the trunk
Jitter, the pollution of the river now caused by the discharge of effluent
from the White Plains sewage disposal plant would be prevented, it was
the desire of the board, al^o, that pollution now added to the river from
other sewers not connected with the Wliite Plains sewage disposal plant be
removed from the river.
In conclusion it may be stated:
1. That, notwithstanding the improvements in the operation of the
White Plains sewage disposal plant made during the past two or three
years, the pollution of the Bronx river by the discharge of effluent from
the plant, owin|r to the increased amount of sewage to be treated has
not been diminished. '
2. That considerable sewage pollution is added to the river by the
two gewers, in the village of White Plains, described above, one dig-
638 State Dbpaktment of Health
charging at the foot of Golden avenue, and one into a stream which
reaches the river one-half mile below the Harisdale station.
3. That additional pollution is added to the river by the discharge
of partially treated sewage from the sewage disposal plants at the Caro-
line Rest Maternity Hospital, at Hartsdale, and at the villages of Tuck-
ahoe and Bronxville.
4. That the effect of the discharge of sewage and sewage effluent
at these principal points of pollution is to set up a condition in the
Bronx river which constitutes a public nuisance along the stream ad-
joining the towns of Scarsdale and Greenburgh, and along the major
portion of its flow adjoining the city of Yonkers and the town of
Eastchesrter.
5. That this condition of nuisance in the stream will be almost wholly,
if not entirely, eliminated by the discharge of sewage from the various
sewer systems and sewage disposal plants into the Bronx Valley trunk
sewer upon its completion, rather than into the Bronx river, as at present,
I would, therefore, recommend that the attention of the various municipal
authorities and of the authorities at the Caroline Rest Hospital be called to
the necessity and desirability of making early and definite arrangements for
the elimination of all sewage discharge into the Bronx river by the conveyance
of all sewage to the Bronx Valley trunk sewer upon its completion, if such
provision has not already been made.
Respectfully submitted,
IT. B. CLEVELAND,
Principal Assistant Engineer
This matter was taken up with the municipalities along the stream to deter-
mine what arrangements had been made to connect sewer systems with the
Bronx Valley sewer when completed.
CORTLAND
Albany, N. Y., February 11, 1910.
To the Mayor and Common Council, Cortland, N, Y.;
Gentlemen: — I beg to submit for your careful consideration the matter
of pollution of Tioughnioga river by the sewage of the city of Cortland, and
to urge that some action oe taken to relieve the insanitary conditions of the
stream resulting from this pollution by the construction of appropriate and
adequate means of sewage purification.'
This question is one which, as you know, has been under consideration
and investigation by this Department for a number of years, especially with
respect to the industrial wastes from the Wickwire Brothers* plant, and as
a result of these activities and the action of the Wickwire brothers a prac-
tical elimination of the pollution of this stream from this source has now
been accomplished. The insanitary conditions in and along this stream, re-
sulting from sewage discharged from the city of Cortland, still exist, and it
is to the elimination of this sewage that I now have particular reference.
Renewed complaints signed by many residents and property-owners along
the Tioughnioga river have only recently been received by me, and a careful
inspection of the conditions along the river has again been made by one
of the engineers of this Department. From his report of his inspection it
appears that the following conditions were found to exist:
The sewage of the city of Cortland is discharged without treatment into
the Tioughnioga river, about a mile below the city, and there can be no
question but that the effect of this discharge is plainly visible in the waters
of the river. The immediate effect of this discharge is a dirty white stratum
or current which clings to the west shore for a mile or more, its color
distinguishing it from the other parts of the stream. Two miles below the
outfall the velocity of the stream is decreased by the dam at Blodgett's Mills,
and from there on the water has a reddish brown or rusty color, due to par-
ticles of iron oxide, apparently, which in places seem to float in the water.
Complaints Relating to Stream Pollution 639
It was commonly believed that this iron rust came from the wastes of
the Wickwire Brothers' Ware Cloth Mills, and chiefly from the vats of dilute
acid which are used to clean the wire, and which are said to be emptied into
the sewers whenever the acid becomes too dilute to do its work. The Wick-
wire Brothers' plant was examined with reference to the vats above referred
to and to the method of disposal of their contents. It was found that, in
deference to the suggestions of the State Department of Health made to the
mayor of Cortland, and to Messrs. Wickwire, referred to on page 324, vol-
ume il, of the Twenty-eighth Annual Report, plans had been made and a
process inaugurated for treating this acid waste, and while it had taken a
long while to get the plant working properly, while machinery had been in-
stalled only to prove useless and to be thrown away, and while the treatment
of these wastes bad involved some extensive changes in the arrangement of
the vats themselves and in the drainage of the whole plant, success has
finally been achieved, so that all the vat liquor is now converted into sul-
phate of iron or copperas, with no wastes left to discharge into the stream.
Judging from the large quantity of sewage discharged by the city of Cort-
land and the small flow of the stream, especially during the season of low
flow, it is evident that the effect of the city sewage on the river can not
but be objectionable in the way of a nuisance. No gaugings of the Tiough-
ntoga river are available by which to determine the minimum flow of the
stream. Gaugings of the Chenango river (drainage area of 1,530 square
miles) show an ordinary minimum flow of about 0.2 cubic feet per second
per square mile. (U. S. G. S. Reports, No. 109, p. 37.) And on account
of the large watershed this i» undoubtedly higher. In fact, in other streams
of tnis part of the State, the writer has h^ instances, on small sheds of
flows as low as 0.05 cubic feet per second. It is reasonable to aasume that
in the case of Tioughnioga river above Cortland, the area of which is about
260 square miles, that the minimum fk)w may, in the summer, be as low as
0.1 cubic feet per second per square mile, or 26 cubic feet per second. If
the ratio of flow to persons contributing sewage to the streams be taken at
5 to avoid a nuisance the river will care for the sewage without nuisance
of only 5,200 persons. The present population of Cortland is estimated at
about 13,000, the 1905 census reporting 11.272. Even if all the city is not
entirely sewered it is evident that the amount of domestic sewage discharged
into the river at one point is more tb'an the oxygen in the river water can
aasimilate, and the production of a nuisance is assured. The fact that from
the wire mills, the milk station and other factories, organic matter is dis-
charged, tends to decrea«e the ability of the river to take eare of the wastes
from residences, and increase the nuisance in the river. It is also worth
noting that while the effects of the iron wastes are particularly noticeable
two miles or so below the mouth of the sewer the odors have not yet be-
come offensive, and it was not until below Blodgett's Mills that the de-
composition of the organic matter had proceeded so far as to be offensive,
indicating that the organic matter of the sewage wa» responsible for a part
of the nuisance, and that the iron wastes did not cause all the trouble.
It is clear, therefore, from the recent examination of the condition of
this river below Cortland, that this nuisance is due chiefly, if not entirely,
to the sewage of the city of Cortland, and that, while in the past, the acid
iron wastes from the Wickwire Brothers' Wire Works contributed to the
nuisance, since September this has no longer been an important factor. It
is further clear that the only effective means by which this nuisance can be
remedied or abated is by a proper and adequate treatment of the sewage
of the city before its discharge into the Tioughnioga river.
I would, therefore, urge upon you the importance of giving inunediate
consideration to this important matter, and of taking the necessary action
to provide plans and undertake the construction of such sewage treatment
works as will eliminate the existing pollution of these waters and remove
the nuisance and danger to health of the riparian owners and communities
along the river below the city.
Very respectfully,
EUGENE H. PORTER,
Commi$$ioner of Health
640 State DEPARTArKXT op Health
ESPERANCE
Albany, N. Y., October 21, 1910.
Eugene H. Pobteb, M.D., State Cotnmisaioner of Health, Albany, N. Y,:
Deab Sib: — I beg to submit the following report on an inyestigation juat
made, of an alleged nuisance with reference to the closing of a drain and the
consequent flooding of cellar and property of Mr. John Wright, located at
Esperance, Schoharie county.
Mr. Wright called at this Department recently and complained of the oon-
ditionfi near his home, stating that the board of health of Esperance desired
that an investigation be made by this Department and that recommendfttiona
be made to the village authorities to improve the conditions. On October 22d,
Mr. Fritz M. Amolt, inspecting engineer with this Department, visited Esper-
ance and investigated the alleged insanitary conditions.
Mr. John Wright's home is situated near a natural watercourse draining a
considerable area of land to the south and west of his house. To improve the
drainage in the vicinity of his house, Mr. Wright had constructed a ditch
years ago just west of his property which led the drainage through a culvert
under the Charleston road and then by means of drain, ditch and natural
watercourse into the Schoharie creek. The village authorities have con-
structed a tile drain on Charleston road and have closed up the culvert men-
tioned, forming, with the road, a dam, holding the surface waah south of
Charleston road. A considerable area of land we^ of Mr. Wright's home
becomes flooded in the time of heavy spring rains and the water remains near
his house for long periods of time and seeps into his cellar. The village
authorities in closing the culvert have interfered with the natural drainage
and have made no provisions to prevent the flooding of the property adjacent
to Mr. Wright's. This gives rise to a condition which is insanitary and
detrimental to the health and welfare of the residents of this section of the
village and especially of the occupants of Mr. Wright's hou#u».
I would, therefore, recommend that the board of health of the village of
Esperance be advised to take up with the trustees the m«a.tter of providing a
proper outlet for the natural drainage so as to remedy the insanitary con-
ditions caused by blocking the culvert above mentioned and the flooding of
the area near Mr. John Wright's house.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
On November 1, 1910, a letter, inclosing a copy of this report was addressed
to the local board of health, requesting that the matter be taken up with the
board of trustees and steps be taken to remedy the insanitary conditions com-
plained of to this Department.
HARRIMAN
AiBANY, N. Y., October 18, 1910.
Eugene H. Pobteb, M.D., State Commissioner of Health, Albany, N, Y.:
Deab Sib: — I beg to submit the following report on an investigation re-
cently made of an alleged nuisance at Harriman, N. Y., attributed to the dis-
charge of sewage into the Ramapo river and its supposed retention in a small
pond at Harriman.
Complaint has been received by this Department that the odors arising
from the pond were very offensive. On September 27th Mr. Fritz M. Arnold
inspecting engineer with this division, visited Turners (now called Harriman)
Complaints Relating to Stream Pollution 641
and inudt! an investigation with regard to the odors arising from this pond and
their cause.
Xho pond a;t Uarriman is formed by damming the Ramapo river. The
Ramapo river ri^es in Round Fake, which is located in the town of Monroe,
Orange county, N. Y. It flows northeast for about 1% miles to the village of
Monroe. Here it flows through a pond which is locally known as Knight's
mill pond. This pond receives from the west side the sewage from about nine
houses, from the cast side the sewage from iten single houses, and also on
this side from a private sewer serving nine oflice buildings in the village of
Monroe. This sewer has been constructed and has been in operation for about
twenty years. Three creameries, together handling about 100 cans of muk
a day, discharge their washwater into the pond. Most of the sewer drains are
not led beneath the surface of the water but discharge on the ground some
feet back from the shore. This gives rise to local nuisances.
Knight's mill pond is from 200 to 300 feet wide, about 2,200 feet long and
does not average more than a couple of feet in depth. The water is clear and
except in the immediate vicinity of the sewer outlets, shows no discoloration
from the sewage. I]i the dry season, only a small amount of water flows over
the dam. After leaving this pond the Ramapo flows southeast for about 2%
miles, through Turners, now called Harriman, continuing in this direction
about a mile beyond Harriman, and then flowing southward and emptying
into the Pompton river in New Jersey.
About a quarter of a mile below Knight's mill pond the Ramapo river re-
ceives a small tribuitary from the north, lliis tributary receives the sewage
of about eight houses in Monroe. A mile below Monroe is a small mill pond
about SCO feet by 500 feet. This water is clear and shows no evidences of
sewage pollution. A considerable growth of duck-weed or Lemna, however,
covered the surface of the upper half of the pond. About a mile and a half
further down is the storage pond at Harriman. Between Monroe and Harri-
man the Ramapo flows through uninhabited meadow land and receives prac-
tically no pollution.
The pond at Harriman is about 300 feet long and about 150 feet wide. The
area west of the Erie railroad track which is the upper end of the pond is
comparatively shallow. At the time of the inspection the pond was almost
empty and the larger portion of the bed was exposed. The bed was covered
with a thick m-at of algae growths. This was decaying in the sun and gave
otf an offensive odor. The exposed mud flats at the upper end of the pond
also gave off an offensive odor. Garbage is thrown on the west bank of the
pond on the Harriman-Monroe highway.
The dam at this pond, which is now owned by Mrs. £. H. Harriman, has
been poorly constructed and leaks considerably. Due to the extreme drought
of the past weeks there was very little flow in the Ramapo river. The Erie
Railroad Company also pumps considerable water from this pK)nd to supply
its engines, ihese three factors, leakage, drought and draft by the Eric,
have kept the water level in the pond very low and a large area of pond
bottom with its mud flats and algae growths have been exposed, giving rise to
offensive odors due principally to decaying microscopic life.
The quantity of sewage discharged into tlie Ramapo above Harriman is not
large and the dilution even in periods of low water is amply sufficient to
rentier the sewage non-putrescible before it reaches Harriman. It receives
considerable storage in the two mill ponds and is probably thoroughly oxi-
dized and purified by the time any of it reaches Harriman. No nuisance at
Harriman can, therefore, be attributed to the discharge of sewage into the
Ramapo at Monroe.
Ihe principal nuisance at Harriman is due to the odors from the decaying
microscopic fife lying exposed on the bed of the pond and also to the cndora
from the mud flats themselves. T)ie throwing of garbage on the bank of the
pond 18 also an insanitary feature.
I should recommend that the board of health of the town of Monroe be
advised to tnke such steps as may be necessary to keep the bed of the lake
covered. Seeing that the leaks in the dam are repaired would be a step
21
642 State Department of Health
toward this end. Also tliat they proliiblt the dumping of garbage on the
shores of this pond.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
On November 2, 1910, a letter enclosing a copy of this report was addressed
to the board of health of the tow^n of Monroe, urging them to take suitable
action to remedy the insanitary conditions existing at Hdrriman and calling
their attention to the provisions of section 76 of the Public Health Law, which
prohibits the discharge of sewage created since 1903 except under express per-
mission from this Department and to the duty of the local boards of health
to enforce this and subsequent section«( of the Public Health J^aw.
ONEONTA
Albany, N. Y., August 17, 1910.
Eugene H. Porteb, M.D., Ktate Commissioner of Healthy Albany, A". Y.:
Dear Sir: — I beg to submit the following report of an investiga/tion made
at your direction and in compliance with the request of the common council of
the city of Oneonta, Otsego county, of an alleged nuisance caused by the
discltarge of waste from the gas plant of the Oneonta Light and Power Com-
pany into the Susquehanna river.
On August ftth Mr.. Fritz M. Arnolt, inspecting engineer of this Department,
visited Oneonta and made an investigation of the conditions there. He was
accompanied on his first inspection, of the river and the gas plant by Dr. George
W. Augustin, health officer of Oueonta.
The gas plant of the Oueonta Light and Power company is located on the
south bank of the Oneonta Milling Company's power canal, about a hundred
yards southeast of the Delaware and Hudson railroad station. Mr. Edward
B. Arnold is president and Mr. John K. Glading is eecretary and treasurer
of the company, having an office at 55 Canal street, Providence, R. I. Mr.
C. A. Lane is superintendent at Oneonta. The plant consists of two sets of
gas making apparatus, to be used alternately with one set of scrubbers and
condensing apparatus. The capacity of the plant is about 60,000 cubic feet
of gaa p<*r day of twenty-four hours. At present the plant is in operation only
ten hours a day, manufacturing from 35,000 to 36,000 cubic feet of gas.
A set of gas making apparatus consists of a generator, a carburetter and a
superheater. The carburetter in this system is placed on top of the generator
and both inclosed in one steel cylinder. Tlie superheater, scrubber and con-
denser are all inclosed in steel cylinders. These cylinders are about 4% feet
in diameter and twelve feet high. Anthracite coal is placed in the generator
and live steam is passed through the heated coal, the run of steam lasting
Heven minutes and the blast live minaites. The gas formed during the run,
consisting of a mixture of HCO, COa and N, is passed upward at a high
temperature through the carburetter. During its passage through the car-
buretter, it is sprayed with gas oil to give it illuminating properties. The
use of crude oil in small plants has not proved sufficient. From the car-
buretter the gn« ]>a'9seft downwards imto the superheater, which is a 84;eel
cylinder of the same size as the generator lined with fire brick with about 50%
voids. Here a temperature of al)out 1,600 degrees Fahrenheit is reached and
the gas is made stable.
From the superheater the gas passes through a water valve to a scrubber.
The water valve has a steel shell two feet in diameter and two feet deep.
From the water valve the gas rises upwards through a scrubber, which
consists of a steel cylindrical shell four feet in diameter and twelve feet high,
containing perforated wooden trays through which water trickles downward.
The cooling in this wet scrubber produces condensation and considerable
Complaints Relating to Stream Pollution 643
precipitation of tar and ligliter hydrocarbons. These pass off with the waste
water into a settling basin which will be described later. From the scrubber
tlie gas passes downward through a tubular condenser which is inclosed in a
steel cylinder. 'Ihe gas passes through the tubes and water is caused to
circulate on the outside of the tubes. From the condenser the gas is passed
through the purifiers which consist of two castiron boxes S*xl<y\o'. A sheet of
burlap is placed in the bottom of the boxes. On top of this is spread a layer
of sawdust or planing shavings alwut six inches thick to absorb tar and other
hydrocarbons. ihe lest of the box is filled with Conley iron sponge. From
the purifiers the gas is passed into two storage tanks, one having a capacity
of 16,000 cubic feet and the other 10,000 cubic feet. A new storage tank having
a capacity of 100,OOD cubic feet is being constructed.
'J lie waste water from the water valve and from the scrubber flows into a
settling tank devised by the United Gas Improvement Company of Philadelphia
and known as a separator. This consists of a tank 4' x 5' x 9' with four baffle
walls. The waste water enters from a small box having a perforated end
and located at one end at the upper part of the tank. The eifluent leaves
by means of a 3" pipe located at the top of the other end. Here it passes
into a city sewer and is eventually discharged into the Susquehanna river.
About 3.550 cubic feet of water were used per day in the operation of the
plant. When this reaches the settling tank it is very rich in tar and lighter
hydro carbons. As the tank has a capacity of 1,350 gallons, a detention period
of about nine hours could be obtained. But this is considerably lessened by
the fact that a comparatively large amount of water leaks through the bank
of the power canal and fiows into the separator. The surface of the water
in the canal at the time of the inspection was 2V4 feet above the outlet of the
beparaior. Ihe water has either found its way through the bank alongside of
some root or through a boring made by water rats. Ihe amount of water was
measured, by means of a small triangular weir and was found to be about
4,800 gallons per day, reducing the detention period in the separator from
nine hours to about four hours. At the time of the inspection the effluent
from this tank contained very little oil and tarry matter. Two compartments,
formed by the baffles at the lower end of the tank, were, however, completely
filled with a thick unctuous tarry mass. A pipe extending to the bottom of
the tank is located at the lower end by means of which the tarry deposit
could be drawn off with a pump. No pump, however, was connected with this
pipe, the tank being cleaned monthly by means of buckets. The material
removed was buried ; no attempt being made to burn it in the plant, due to
great amount of smoke it would cause.
The effluent from the tank is discharged into the city sewer, flowing about
3,000 feet before being discharged into the Susquehanna river, just above
the mouth of the Milling Company's canal. An inspection of the river at this
point was made (m three successive daj-s, August sixth, seventh and eighth
and a walk along the bank four miles down tlie river on one side and then
back on the other, showed no evidence of any serious pollution due to gas
wastes. A few patches of oil were discovered but these could be traced as
coming from the bewer outlet furthest down the river serving the shop section
of Oneonta. In small sheltered coves just below the sewer from which the
gas wafttcH were discharged small patches of oil were visible. At no time,
however, was oil visible on the river at any extent that would cause a nuisance.
During the three days on the river no odor due to wastes from the gas
plant could be detecte<l. Interviews were held with a niunber of citizens
living or working in the vicinity of the sewer outlet through which the gas
wastes were discharged. Their opinions in regard to odors were very diversi-
fied, Mr. W. H. Johnson, who owns the house and property at 15 Main street,
about 000 feet from the outlet in question, and resides there during the sunvmer
months, stated that he first noticed the odor in May and had since noticed
it two or three times at intervals of al)out a month. He stated that it
smelled exactly like illuminating gas and that the odor was so intense and
disagreeable that he was forced to close his windows. Tlie odors he stated
always appeared between four and nine P. M. and at times when the atmos-
phere was very close and muggy. Mr. A. A. Frasier, living at 34 Main street,
644 State Department of Health
about 1,000 feet from the outlet in question, stated that he had noticed a very
Htrong disagreeable odor every three or four days. It was very apparent on
close and muggy nights and he stated that the direction of the wind did not
seem to have any influence. He wa^i positive that the odor resembled that of
illuminating ga^s. Dr. George V. Augustin, health officer, stated that he waa
continually receiving complaints from people living near the river and that
most of tiiete stated that the odor did not exactly resemble that obtained
when one opened the gas c<x'k in a house but had a tarry odor. Mr. U. M.
(loldsmith, superintendent of the Oneonta Milling Company's plant, situated
about 600 feet from the outlet in question, stated that he never had detected
any odor from the sewer outlet that wus so disagreeable as to constitute a
nuisance, nor had any of his men ever complained of any disagreeable odors
or mentioned it to him. Ihey would na>turally mention it he said, if wich
odors occur, as he was with hia men a good part of the time. Other citizens,
with whom interviews were held, either did not smell anything or stated
that they had occasionally noticed disagreeable odors but had attributed
them to smoke and gases from the railroad engines.
Several visits to the outlet in question failed to reveal any evidence of gaa
wastes in the sewage emerging from the sewer, either by the appearance of oils
or by any odor suggestive of gas wastes. There must, however, have been some
cause for complaint and an etl'ort was made to determine the origin of any
disagreeable odors. Although discounting largely for the fact that it takes a
trained observer to clearly dilTcrentiate odors, it seems probable that occasion-
ally an odor due to gas waste could be noticed. This could be brought about
when for some reason or other a large amount of tar and other hydro-carbona
were flushed out of the separator. Ihe condition of the separator showed this
to be possible. Jt is very probable that the gas from the engines on the Dela-
ware and Hudson Railroad would at times constitute a nuisance. This waa
noticed by the inspecting engineer while walking on Main street near Mr.
Johnson's home. Several of the citizens interviewed stated that they had
noticed a disagreeable odor occasionally and believed it to be caused by the
engines on the Delaware and Hudson Railroad.
No one seemed willing to attribute the odors to the discharge of sewage
into the Susquehanna river. At present, however, this constitutes a real
nuisance. The city of Oneonta is almost completely sewered. It had four
sewer outlets discharging into the Susquehanna river. The upper outlet,
located about half a mile above Main street, discharges approximately 100,000
gallons of sewage per day based on the tributary population. The outlet does
not run directly into the river but flows about 150 feet through an open ditch
and discharges into an open natural basin, formed on the shore of the river
by sand bars. This basin is about 100 yards long and from 20 to 40 feet
wide. It is filled with sewage which is retrained here for days and allowed
to undergo putrefaction, giving rise to intensely disagreeable odors. The
second and largest outlet is just above the mouth of the Oneonta Milling
Company's canal. It is this sewer which receives the wastes from the Oneonta
Light and Power Company's gas plant. This discharges about 400,000 gallons
of sewage per day. Ihe outlet at the present low condition of the river waa
above water. The river at this point was highly discolored with sewage.
Fish stirred up bottom deposits/ and large masses were frequently seen arising
to the surface accompanied by enormous bubbles of gas. This pool was
constantly gi\Ting ofl" bu])bles, showing a septic condition, and the odor could
without doubt be characterized as a serious nuisance.
Just below this under the Main street bridge over the Susquehanna is a
third outlet. The sewage bubbles through a pile of rocks above water and
flows into the stream. About 110,000 gallons of sewage per day comes from
this outlet, forming just below it another pool of sewage about 20 feet wide
and 150 to 200 feot long, which is also in a septic condition and gives off a
disagreeable odor. The fourth outlet is about a mile below this and discbarges
about 100,000 gallons per day. This sewage does not appear as strong aa
that coming from the other outlets. It is discharged into rapidly flowing
water and is quickly taken away. The outlet is far below the village and no
ieriouB nuisance due to odors can at present come from this outlet. The other
Complaints Relating to Stream Pollution 645
three outlets, however, give rise to a very disagreeable odor and it is very
probable that the nuisance referred to in the complaints is in a larpe measure
due to the discharge of sewage into the river, particularly at the periods when
the river is at its low stasre. In this connection it should be stated that -in
the permit issued by this Denartment on September 22, 1909, allowinsr the dis-
charge of sewage into the Susquehanna river from the sewer extensions in
Fonda avenue. Chestnut street and Gilbert street in the city of Oneonta, the
condition was imposed that plans for sewage disposal must be submitted on
or before April 1, 1911.
In conclusion, I beg to point out the following conclusions resulting from
th« investigation, that:
1. No evidence that the effluent from the separator at the gas plant
created a nuisance could be obtained at the time of the inspection.
2. However the efficiency of the separator was very low and it is very
probable that occasionally this effluent would create a nuisance.
I would recommend that the city authorities be advised to require the
Oneonta Light and Power Company to close the leak in the bank of the canal
and prevent any water from the canal entering the separator.
Also that they require the Oneonta Light and Power Company to provide
some satisfactory means of cleaning the separator efficiently and frequently
so as to prevent the po*isible occasional flush ini? out of the tar deposits. A
suitable pump with flexible suction arms would give the desired result.
Respectfully submitted,
THEODORE HORTTON.
Chief Engineer
On August 18. 1910. letters, enclosinsr copies of this report, were addressed,
to the local Board of Health and to the superintendent of the Ononta Light
and Power Company, urenntr that steps be taken to obviate the possibilitv of
anv discharc^e of aras wastes into the Susouehanna river and thereby prevent
the occasional nuisances due to odors from the gas wastes.
PIERMONT
Albany, N. Y.. Fiepiember 14, 1910.
Theodore Horton. Chief Enf/incer, State Department of Health, Albany, N. Y.:
Dkar Rir: — T beor to renort that on September 8th I visited Piermont.
Rockland countv. for the purpose of makine an investication of the alle^^ed
nuisance due to the maintenance of a dump of beater wastes bv the Piermont
Paper Company within reach of tide water, and to the di^harge of sewage
inito a cove loe^ited near the propertv of Mr. Clarence Gr. Tilt.
A complete in vest i cation was made last year bv one of the eneineers of
this Deoartment and reference to the renort of Mr. Theodore Horton, chief
engineer, dated November 8. 1909. ffives the salient features of this case. No
beater wastes have been dumped within reach of the water for almost a year
but the old dump haa not been removed and the action of the waves and
tides breaks oflT small lumps of this waste and carries them into the cove in
question. The amount of the material carried into the cove can not be very
la^'o'e. and. as th>s matter is ertirelv non-T>iifreeriblp. it can not irive ^^^e to anv
nui«anc« in itself. The complainit by Mr. C. G. Tilt, that the material absorbs
the sewage d^schanyed into the cove and thus retains it, allowing it to mitrefy
in the cove, is not based on anv reasonable foundation. The amount of mate-
rial 18 too small to have any annreciable afTpct and the cove is of such a nature
as to retain sewage for an indefinite period. Xo nuisance cfin therefore be
attributed to the presence of Water wasto>* in the cove. ^Nfr. John Muirhead,
Hi|)eriiiteiid<*iit of the Piermont Paper Company, stated tliat an extension
634 State Dbpabtmknt of Health
eighty guests, and is owned by P. Smith of Horicon and (grated by H. W.
S^wart of New York o.ity.
The Palisades hotel is located about midway up the lake on the western
shore. The present building has been located on the present »ite for about
three years and is owned and run by Margaret and William Owen. This
hotel has a maximum capacity for accommodating ninety-two guests and has
an average of seventy-five guestfl during the summer.
There are three large cesspools in connection with the Palisades. These
cesspools are all connected but are not provided with overflow pipes.
The first cesspool is located about 50 feet from the lake and is 14' x 13' x 7'
deep. The second is about 25 feet from the lake and is 7' deep and has an
area of 282 square' feet. The third cesspool i» located about 15 feet from the
lake, is 5' deep and is 25 feet long by 8 feet wide.
These cesspools are inadequate as to capacity to care for the sewage as
shown by the fact that the last cesspool had overflown into the lake a short
time before the time of the inspection and several loads of sand and gravel
had been deposited near the breaJc in order to cover up the filth caused by the
discharge.
While all the hotels and cottages cut their ice supply from the lake the
water of the lake is not used for domestic purposes as far as could be ascer-
tained, except for washing, bathing aud laundry purposes. The water used
for drinking and cooking is supplied from individual springs and wells.
In conclusion, I would say that while the amount of sewage that reaches
the lake from cesspooN along its shores is comparatively small and would
probably not endanger the health of the people living along the lake, at all
times, contamination and pollution of the lake nevertheless exists inasmuch
as sewage or cesspool effluent reaches the lake at least occasionally from one
hotel and one summer house and continually from two of the hotels during
the greater part of the summer.
It appears, therefore, that danger of contamination is always present and
inasmuch as no permits have been issued by this Department to the owners
of these places allowing the discharge of sewage or sewage effluent into this
lake, any such discharge into the lake is in direct violation of section 76 of
the Public Health Law.
I, therefore, recommend that letters be addressed to the proprietors of the
hotels and to G. W. Van Slyke informing them of their violation of the
Public Health Law insofar as they are discharging or allowing the discharge
of sewage or sewage effluent into Brant lake without permits from this De-
partment and advising them to either enlarge their present means of sewage
disposal or if conditions permit to provide for supplementary treatment of
sewage, such as subsurface irrigation or sand filtration, and further that if
the conditions complained of are not remedied the complainants be advised to
bring the matter to the attention of the local board of health, which has full
power and authority under the Public Health Law to compel an abatement of
the in8anitar>' conditions now existing.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer
On September 30, 1910, letters, inclosing copies of this report, were ad-
dressed to Mr. G. W. Van Slyke and to the hotel proprietors, calling their at-
tention to their violation of the Public Health Law by the discharge of sewage
from their premises into Brant lake and urging them to provide for adequate
means for sewage disposal so as to improve the sanitary conditions by pre-
venting the discharge of sewage into the lake. Tlie proper method of caring
for the sewage from their properties was outlined in a general way and they
were advised to secure the services of a competent engineer to work out the
details of the design of any system adopted.
INVESTIGATION OF PUBLIC NUISANCES NOT
ARISING FROM STREAM POLLUTION
[647]
INVESTIGATION OF PUBLIC NUISANCES NOT
AkISlJNG FROM STREAM POLLUTION
Although the pollution of streams is, generally speaking, re-
sponsible for the larger number of what may be considered serioi)s
nuisances, there are on the other hand a great many nuisances
arising from other sources which must be investigated. Many
of them are of minor importance, many are of a more private
than public nature, and most of them are directly or indirectly
cases of appeal from the action, or more often inaction, of the
local board of health.
Frequently these cases can be satisfactorily dealt with through
correspondence and the assistance of the local board of health or
its representative, the local health officer. These local boards have
full jurisdiction to deal with nearly all nuisances in this class
and it seems to be generally overlooked or ignored that nearly all
of these eases should be dealt with by the local boards and not
referred to this Department. When referred to the Department,
however, these complaints are always investigated and if sustained
are either referred to the local board of health for action if the
case falls within its jurisdiction or authority, or they are taken
up indirectly by the Department with the party complained of
through the local board of health if the case falls partly outside
its jurisdiction.
The municipalities of the State where the more important of
these nuisances have arisen and have been referred to this De-
partment for investigation and action during 1910, are as follows:
GREENPORT
Albany, X. Y., September 17, 1910.
Eugene II. Porter, M.D., State Commissioner of Health, Alhanij, N. Y.:
Dear Sir: — I beg to submit the following report on an investigation made
on September 9th by Mr. F. M. Arnolt, inspecting engineer with this Depart-
ment, of an alleged nuisance due to insanitary conditions in a duck and chicken
yard, maintained by Mrs. Anna Pickering at Grecnport, L. I.
[649]
652 State Depabtment of Health
NORTH SALEM
Albany, N. Y., March 9, 1910.
Eugene H. Porteb, M.D., State Commissioner of Healthy Albany , N. Y.:
Deab SiB: — In accordance with your instructions to have an investigation
made of the complaint recently received from Hon. James R. Howe et al., iu
regard to insanitary conditions existing near Salem Center, due to the lower-
ing of Titicus reservoir, I beg to state that I detailed Mr. C. F. Breitzke,
Assistant Engineer, to make an investigation of the comlitions surrounding
the reservoir and of the allegations of the complaint on March 7, 1010, and
beg to submit herewith the following report in regard to the same:
'liticus reservoir is a part of New York city's water supply. It is located
in the town of North Salem, extending east to Salem Center from a point
about a half mile east of Purdy's station on the Harlem Division of the New
York Central and Hudson River Railroad, forty-seven miles from Grand Cen-
tral station in New York city.
The dam was completed and the reservoir was put into operation in 1893.
The middle or main portion of the dam is composed of solid masonry and
contains the gatehouse. The south wing contains a masonry spillway 200 feet
long and ends in an earth embankment with a masonry core wall. The em-
bankment of the north wing is formed on the down-stream side by the spur
of a hill.
It appears from -the 1895 Report of the Aqueduct Commission of New
York city that the elevation of the crest of the spillway is 325 feet above
sea level. The bottom of the reservoir is irregular, varying to 85 feet at
the dam. The reservoir is about 3 miles long and lies in an easterly and west-
erly direction. It has an area of water surface of 1.1 square miles and a
capacity when full of 7,167,000,000 gallons.
Titicus reservoir is located on the Titicus river. This stream has its source
in the State of Connecticut and flows in a westerly direction into the Croton
river. It has a small watershed of 22.8 square miles, most of which is agri-
cultural land and has been stripped of its woodland. Consequently, the stream
is subject to heavy freshets and is reported to frequently run dry in the
summer.
At the time of the inspection water was flowing about three inches over the
top of the dam and the conditions described in the complaint did not exist.
From interviews had with some of the petitioners it was learned that in
the late summer and early fall when the water in the reservoir is drawn
down that at its upper end mud flats are exposed, which are said to contain
numerous stagnant pools which form breeding places for mosquitoes, are
unsightly, and give oflf an impleasant swamp-like odor.
The interviews with these petitioners, one of them owning land adjoining
the upper portion of the reservoir, would indicate, however, that the nui-
sance was not serious, many of them signing the petition only because they
were asked to. In fact, a large number of the petitioners are residents of
Purdy's, Croton Falls, Brewster, Goldens Bridge, and other places removed
from the immediate vicinity of the alleged nuisance and who have no occa-
sion to travel near it.
In order to ascertain the eff'eet of lowering the water in the Titicus reser-
voir recourse has been had to a topographical map accompanying the 1896
report of the Aqueduct Commission, from which it appears that if the water
in the reservoir were lowered 25 feet an area of about 300 acres would be
uncovered, chiefly along the south shore, which is uninhabited and at a dis-
tance from the highway, and at the upper end. ITie slopes in general, how-
ever, are fairly steep which should permit of a reasonably rapid drainage
and drying up of the exposed area.
The petitioners sugsjest that the conditions referred to in their complaint
can be remedied by building '* upper dams that will prevent the making
bare the bottom of the reservoir when the water of same is drawn ofl"." While
such a dam could be built about a mile from the upper end, its constiuction
Investigation of Public Nuisances 653
would be a matter of doubtful expediency, for with the very low flow which
usually occurs in the Titicus river in the sununer time a shallow and stag-
nant body of water would be created which would cover the now, at times,
exposed area, if the reservoir were drawn down. Such a shallow b3(^y of
water would favor the breeding of mosquitoes and the development of ob-
iioxious and unsightly algao growths which would tend to offset largely, if
not counteract, the benefits derived from keeping the area flooded. At best,
it is evident that what slight advantacre would accrue from the creation of
the shallow basin would only be partial, 8ince the main portion of reservoir
would be lowered and a considerable area r^f shores would be exposed as
under present conditions of management.
The construction of the dam, as sugs^ested in the petition, is, therefore,
in mv opinion. « matter of doubtful expediencv. in view of the questi'^naVe
improvement in conditions surroundinsr "the reservoir that might result: but,
aside from this question, there are others of graver cnn«»i^e'*at*on. such as
tlie right of New York citv to utilize the full amount of etoraee in th^s res-
ervoir when such use necessarily involves a fltiotuation of water surfaces
with resulting exposure of shore are^s. This latter question is easert'aHy
a legal one, but, notwithstandine: any complications due to it, I am of the
opinion that by careful management of the gates and ontrol of the fluc-
tuations of the water levels in the reservoir an improvement in conditions
existing from present manngement migrht remit.
It is possible that in the drawinsf down of the re^^-rvoir for utili/.-'tion of
storage the rate at which it is dore miv b? 8-> re^U'^ed that anv c^^e^^i e
area of shores may be giv^n an oT)TX)rfunitv for gradual drvin'r before the
oreation of odors. It is aho possible that, if there are small po:>l8 formed
by the drawing down of this reservoir, the'^e mav b* avrrid-^d bv digging
trenches or outlets to them, thereby draining them as the water level is
reduced.
I should, therefore, recommend that the matter be taken up with the proper
New York authorities with a view of havinor them so mmH'v their m'^thod of
oDerating this reservoir and of draining exposed shoreg along li^e^ su-'g-* tel
aoovp, with a view to improving the sanitary conditions surroimdinff the
reservoir. I believe that thi-i is the tentative stei) that should be first at-
tempted in removing any objection that results at the present time before
any alternative method is attempted, such aa that prrposel in the accom-
panying petition, which would involve considerable expense and. as 8U7ge«ted
above, may be of doubtful benefit or, at least doiil)tful exj)ediency, in view
of possible slight improvements over existinj^ conditions.
I, therefore, recommend that a copy of thi-t report b.» trmsn^itted to the
New York city authorities having coitrol of this reservo'r, wit'' the request
that they give the matter their serious consideration, and with a view to
carrying out the suggested change in operation along lines suggested above, in
order to lessen the objectionable sanitary conditiinis referred to by the
complainants.
Respectfully submitted,
TIIEODOKE IIORTON,
Chief Engineer
In accordance with the recommendations of this report a letter, inclosing
a copy of the report, was addressed to the Commissioner, Department of
Water Supply, Gas and Electricity of X<'W York city, on March 16, 1910,
urging that such action be taken along the lines suggested in the report aa
will cause a removal of the conditions complained of.
654 State Department of Health
PORT CHESTER
Albany, N. Y., September 8. UUO.
Eugene IT. Pobtkb, M.D., i^tatc Commiitsioner of Health, Albany, A'. Y. ;
Dear Sir: — I beg to submit the following report of reiii8i>ectioii of the
sanitary conditions of the so-called Lake street swajnp which was locatei near
the Byram river, between Main and Travers streets, in the village of Port
Chester, Westchester county:
Numerous complaints having been received by the Department, Dr. Fred-
erick C. Curtis, medical officer, made an inspection of this dist ict, in accord-
ance with your directions, on July 5, 1910, wliich showed that the ondi-
tions existing at that time constituted a public nuisance and a menace to
health which should be abated. The local board of health was accordingly
directed to co-operate with the board of trustees and urged to tike immediaie
action toward the abatement of the insanitary conditions then existing.
There seemed at first to be some indisposition on the part of the kcal
authorities to abate the nuisance, owing to the fact that a portion of the
land in question was State property, inasmuch as it was forme ly submerged
during times of high tide and the abutting owners had no title to the por-
tion under water. On August 17, 1^10, however, the health officer of t' e
village reported that the local board had " acoompl'shed a great deal in clean-
ing up the territory l>ing between Main and Travers streets," ani that "the
results were fairly satisfactory, although not perfect." The health officer
also stated in his report that the sura appropriated by the village for this
work had been practically used up and that it might be necessary to ask for
another appropriation to complete the work.
Another complaint was received by the Depiirtment in the meantime stating
that, while the village trustees had exi)ended $200 in filling in the ditch or
stream which passed through the swamp, tliis did not at all constitute a re-
moval of the conditions criticised and tlie Department was asked to take the
matter up further.
The reinspeetion was made by IVIr. C. A. Holmquist of this Department, in
company with Dr. T. C. Elmendorf, president of the board of health, on
August 22, 1910. This inspection showed thuit practically all of the swaimpy
area whicli seemed to be causcnl by the influx of water from the Byram riv<T
during high tide, had been filled in with a gravelly loam to an elevation
slightly above the leN^el of the adjacentt ground, leavuig the greater part of
the area in a perfectly dr>' and sanitary condition. Other portions which
could not be reached with the filling material without removing the buildings
were being drained into an adjacent manhole on the line of the sewer system
by means of drain pipes.
One of the barns which was formerly located over the swamp was being
removed, and the president of the board of health stated the area thus ex-
posed would also be filled in.
It appeared from the ins|)eetion that the work of abating the nuisance by
filling in with soil and draining was being done in a proper and thorough
manner and when completed should place the swamp in a sanitary condition.
I, therefore, recommend that the local board of health be urged to complete
the work of filling in and draining the entire section, removing outhouses, if
necessary, so as to place it in a thoroughly sanitary condition and thereby
avoid any further cause for complaint.
Respectfully submitted,
THEODORE HORTON,
Chief Engineer,
In accordance with the reconunendatioiis of this report a letter, inclosing
a copy of the reix>rt, was sont to the local board of health on September 13,
1910, urging them to complete the work of filling in and draining the swamp.
Investigation of Public Nuisances 655
VESTAL
Albany, N. Y., Septernher 29, 1910.
Eugene H. Porteb, M.D., State Commissioner of Health, Albany ^ N. Y.:
Dear Sir: — I beg to submit the following report on an investigation of an
alleged miipance due to odors from the hogpens and the garbage boiling plant
maintained at Vestal, N. Y., by Mr. George W. Mosher'.
Mrs. C. C. Morse of Vestal. N. Y., recently made a complaint to this De-
partment of in«anitary conditions at this point and on September 24th, Mr.
Fritz M. Arnolt. inspecting engineer with this Department, visited Vestal and
ex<amined into the conditions there.
Mr. George Mosher maintains some hogpens and a garbage boiling estab-
lishment at Vestal, N". Y. There are five or six houses within a hundred
yards of this plant. The pens contained fifty-seven pigs, most of which were
young. The pens w^ere clean and no piles of manure were visible. It was
raining heavily at the time of the inspection and only a slight odor could
be detected in the yards. It is very probable, however, that on warm, humid
davs a serious nuisance due to odors from the yards would exist.
Mr. George Mi)«her feeds his pifirs on erarbaue which he boils in an open shed
on his propertv. This garbage he obtains from Binghamton, and carries it
in barrels to his place and boils it in a larsre iron pot about three feet in
diameter and two feet deep. At the time of the insnection Mr. Mosher was
absent and no foodstuff's or garbage was beinir boiled. Considerable odor,
however, was present and the shed swarmed with flies. Durine boiliner the
pot is evidentlv covered with the loosely constructed wooden cover which was
standing nearby. Three kecs and two pails of trrease or fats were standing
in the shed. This had evidently been skimmed from the boiled prarbas^e.
Four barrels pwrtiallv filled with orarbaffe were stflndin<T iust ont»>de of the
»hed. This garbage con-si^sted of fish, meat, eggshells, fruit, potato peelings
and vegetable wastes. It was thorou«rhly wetted down bv the heavy rain
fallinor at the time and did not cive off any disacreeable odor. Although at
the time of the inspection no foodstuff's or garbaere was beinsr boiled and no
odor tlwit could l)e characterized as a nuisance t<> the neighborinfif dwellers
was present, it is verv probable that at the time the frarbage is being boiled,
especially on warm, humid davs. a serious nuisance due to odors exists.
Xo garbage, bone or animal boilincr o»* rpudering occunation should be car-
ried on in anv establishment not provided with air-tiffht walls, impervious
floors and such facilities as will enable all operations to be carried on with
all cleanliness and freedom from all offent^e and nuisance. The plant at Mr
Mosher's place is crude with no such facilities and will naturally give off
r^onsiderable odor while in onerafion. Moreover it is in close proximitv to
habitation and any odors at the plant or from the pens and yards will quickly
create a nuisan^H* in the neighl>orhood.
Tlie heavy rain fallinsr prevente<l the detection of any nuisance at the time
of the inspection, but the conditions ot the nlace we»'e such as io give rise to
a serious nuisance under less favorable conditions. I should recommend that
the board of health of the town of Vestal take such action as may Ik* neces-
sarv to remedy the conditions existing at the plant so as to prevent any
nuisance,
Res|)ectfully submitte<l,
THKODORE nORTONT,
Chief Engineer
In accordance with the recommendations of this reT>ort a letter, inclosing a
copy of the report, was sent to the board of health of the town of Vestal on
Octolier 10, 1910, urging them to give the matter their careful attention.
656 State Department of Health
WATERVLIET
Ai^BANY, N. Y., April 4, 1910.
Eugene H. Porteb, M.D., State Commissioner of Healthy Albanyj N, Y.:
Dear Sib: — In accordance with your request, I beg to say that on March
31, 1910, I made an inspection of the sanitary condition of Dry river and its
tributaries in the city of Watervliet in connection with the proposed project
of the city for the improvement thereof by a system of storm drainage and
reservoir control, and beg to submit herewith the following report.
On the date above mentioned I met by appointment Dr. J. VV. Burns, health
officer, Mr. John Browne, chairman of the citizens' committee, and Mr. F. J.
Keis, engineering representative of the firm of Solomon -Xorcross Co., of
Atlanta, Ga., and in company with them m^de an inspection of Dry river and
Gas House creek, a tributary thereof, inspecting carefully the sanitary con-
dition of the bed and banks of these watercourses, and had pointed out to me
on the ground the aHgiiment of the proposed storm drains which are to
convey to the Hudson river the waters from this catchment area during
ordinary and flood flows. I inspected also the condition of culverts, the points
of discharge of sanitary sewers now discharging into these watercourses and
visited and inspected the proposed site of the lower reservoir which it is pro-
posed to impoimd and control the flow of Dry river during times of freshets
and flood flows.
Dry river is a stream which rises in the town of Colonic, entering the city
of Watervliet at its westerly boundary (near Twenty-fourth street), and
flows generally easterly through the city to Fourth avenue, thence south-
easterly to its crossing under the Erie canal near Tliirteenth street ; thence
easterly to the Hudson river. A smaller tributary oalled Gas House creek
rises also in the town of Colonic and enters the city at its western boundary
near Fifteenth street and joins Dry river near the intersection of Nineteenth
street and Fourth avenue. •
The drainage area of Dry river, including all tributary drainage areas, la
about five square miles. The topography of the upper portion of drainage
area west of the city line is rather precipitous, is mostly denuded of wood-
land and the character of the soil is partly rocky and relatively impervious.
The portion within the city limits is somewhat more flat and a considerable
portion of it lies in the more thickly settled section of the city, having, with
paved streets, etc., a relatively impervious surface.
It is evident from the topography and character of the Dry river catchment
area that it is a stream that may be classed as flashy, one subject to excessive
flood flow during freshet season and to extreme ^ow flows during the dry
season of the year. The result of these excessive or abnormal conditions are
evidently and very apparently reflected in the conditions which are actually
found to exist along and adjacent to the streams during difl*erent portions of
the year. Thus in the late winter or early spring when rains and melting
enow bring down the precipitation from all parts of the watershed, the flood-
ing of the streets and areas adjacent to the streams is excessive, large areas
being inundated and the cellars and ground of adjacent properties so flooded
as to make them untenantable. Further than tliis the culverts and other
stream crossings were found to be narrow or constructed in cross section, and
this congestion gives rise to a series of ice gorges which still further heighten
the flood conditions.
Again, the low flow during the dry summer season gives views to a very in-
sanitary condition along the course of these streams. It was found that a
number of sewers and old drains discharge their contents into these water-
courses at various points, especially at the culverts built at street crossings.
Many privies are located adjoining or very close to the banks where seepage
adds additional sewage pollution. The stream throughout almost its entire
course within the city limits is, further, used as a dumping place for garbage
refuse and, I was informed, carcasses of dead animals.
Investigation of Public Nuisances 657
It was very evident, therefore, from the results of my inspection of these
streams, the topographic and hydrographic conditions described above, that
sanitary and flood conditions of these streams should be at once improved.
While the sanitary conditions are perhaps more important from the stand-
point of health, there can be no question that the removing of flood con-
ditions is very greatly needed since thev afl'ect indirectly the health of the
citizen in so far as they make hazardous an-d untenantable the dwellings
aloTig the streams during these flood timps.
The proposed improvements of the conditions of this creek, according to the
plans and report of the consulting engineer, Solomon -Xorcross Co., comprise:
1. The construction of two reservoirs on the upper reaches of Dry
creek for the storage and control of the flood water.
2. The construction of masonry storm drains leading from the lower
reservoir and from a point in Gas Houpe creek near Eighteenth street
and Avenue A through the built-up portion of the city wrth outlet into
the Hudeon river at a point on line of extension of Twenty-first street for
the convevance of the waters impounded in the reservoirs and the waters
which fall upon and flow naiturally from the catchment area below the
impounding reservoir.
3. An abandonment and filling in of the present creek along the line
of these storm drains.
Without attempting to discuss the details of the proposed method and
plans of improvement it may be said that this method of storm regulation is
one which is frequently and efl*ectually employed in similar capes elsewhere
and is in accordance with good engineering practice. There are m.any features
and details which involve careful design and expert judgment, but it is my
opinion that this method is one appropriate to apply to this case, and that
if the capacities of the reservoirs and of conduits have been carefully worked
out and the works are well constructed and properly maintained there can be
little question that the objectionable sanitary and flood conditions along these
streams which now exist will be entirely removed.
Attention should be called to additional measures which should be carried
out in the near future in connection with these improvements in the way of
intercepting and disposing of indenendently the sewage which now discharges
into these creeks. It is assumed that these storm drains are not planned to
receive sanitary sewage and it is important that they do not; since with
conduits conveying sanitary sewage the provisions of the Public Health I^w
provide definite procedure \vhich is not being followed out in this case.
In view of the foregoing it is my opinion that the conditions in and along
Dry creek and Gas House creek resulting from the flooding of the banks and
adjacent territory and to the discharge and dumping of sewage, garbage and
refuse into them constitute a public nuisance and a menace to health which
should be removed and remedied at once; and I accordingly recommend that
a copy of this report be furnished the city authorities and that they be urged
to undertake and complete the improvements now contemplated at the earliest
possible time.
Respectfully submitted,
THEODORE HORTOX,
Chief Engineer
On April 6, 1910, letters, inclosing copies of this report, were addressed to
the city authorities of Watervliet urging them to carry out the contem-
nlated improvements at the earliest possible time.
658
State Dkpabtmknt of Health
111 addition to the foregoing, nuisances were examined into in some cases
and advice was given through correspondence in other cases in the matter of
alnitemeiit of nuisances at tlie follo\^iug places:
Akin.
Albion.
Athens.
Aurelius.
Aurora.
Baldwinsville.
Ballston.
IJatavia.
Hrooton.
Brooklyn.
Callicoon.
Canaseraga.
Cato.
Catskill.
Cheektowaga.
C'larks Mills.
Clarksville.
Clifton.
Cohoes.
Coxsackie.
East Syracuse.
Euclid.
Fair Haven.
F aye We.
Favetteville.
Fishkill Landing.
Franklinville.
Freeport.
Friendship.
Fulton,
(icncva.
(irtHH-r.
Harrison.
Honsoiivillc.
Ik'rmon.
Hi<,'hland Falls,
llornell.
Hudson Falls.
Huntington.
Hvde Park.
Jordan,
licwiston.
Lvndonville.
Ala lone.
Mamaroneck.
Marcellus.
Matteawan.
Milford.
Montour Falls.
Mt. View.
Xewburgh.
New City.
Xewfane.
New Rochellc.
Oneonta.
Oriskanv.
m
Ossining.
Pcekskill.
Penn Yan.
Port Henry.
Port Jervis.
Red Hook.
Rensselaer.
Rhinebeck.
Ripley.
Rockland Lake.
Rome.
Rosendale.
Schenectady.
Srhuvlerville.
Seneca Falls.
Sharon Springs.
Sheridan.
Silver Springs.
South Nyack.
Somers Center.
Sfillwatcr.
Stony Ridge.
Syracuse.
Tarrvtown.
Troy.
IMckahoe.
Tiipper Lake.
Varick.
Walton.
Wheatfield.
Whitehall.
Yonkers.
INVESTIGATIONS ORDERED BY THE
GOVERNOR
. 1059]
INVESTIGATIONS ORDERED BY THE
GOVERNOR
Section U of article I of the Public Health Law provides that
whenever required bj the Governor of the State the Commissioner
shall have the power and shall make an examination into nuisances
or questions aflFecting the security of life and health in any locality
of the State. Although, strictly, no executive orders were issued
under this provision of the law, two investigations and reports
were made at the request of the Chief Executive, one in relation
to the prevalence of typhoid fever in the State, and one in refer-
ence to the reconstruction of the Bird Island pier outfall sewer in
the city of Buffalo.
The first of these investigations and reports was requested by
Governor White during the month of October, and since at this
season of I ho year typhoid fever is normally more prevalent this
investigation aiforded an opportunity of emphasizing the fact well
uuderstootl by sanitarians but not by the public at large, that there
is normally a very n>arke<l seasonal variation in the prevalence of
typhoid fever during the year. That thi^ fact is not generally
underst<x)d or appreciated was evident from the apparent feeling
of anxiety entertained by the public and freely circulated through
the press that typhoid fever was unduly prevalent throughout the
State, and in certain localities or municipalities this feeling
reached a state of real alann. The results of this investigation
showed very clearly, however, that through the State as a whole,
typhoid fever during 1910 was some 10 per cent, less prevalent
than the average for the ten-year period immediately preceding,
notwithstanding that in some districts of the State its prevalence
was in excess of the normal. Incidentally the results also illiLs-
trate the false anxiety or alarm frequently evidenced by the public
concerning a strictly scientific matter when important facts and
a knowledge of the subject are lacking.
[661]
662 State Department of Health
TYPHOID FEVER, SYRACUSE
STATE OP NEW YORK
Executive Chamber
Albany, N. Y., October 13, 1910.
KuoENK H. PoBTEB, M.D., Hiatc Vommissioner of Healthy Albany, N, Y.:
My Deab Doctob : — Tlie prevalence of typhoid fever in the State, and
especially the number of cases in Syracuse, lias been a subject of anxiety
and some alarm 'to me. 1 have noted from week to week in the public pres^
the apparent growth of the trouble.
1 have 'been very glad to observe that N-our Department has been active in in-
vestigating the causes of this coivtagion, and 1 wish you would let me hear
from j-ou, giving me your conclusions as to the source of the trouble and
OS to the probable outcome.
1 am especially anxious to know what you think of the condition in Syra-
cuse, and where you think the disease comes from. It is unnecessary, 1 am
sure, to ask you to make every proper eflort "to ascertain the causes and to
see to it that every safeguard to the public health is provided.
With kindest regards, I am,
Faithfully yours,
HORACE white .
Albany, N. Y., October 14, 1 9 10.
Hon. Horace White, Governor of the Htate of New York, Albany, A'. Y.;
SiB: — I have the honor to acknowledge receipt of your communication
of October 13th, to Commisdioner Porter, relative to the prevalence of typhoid
fever in this State, and especially in the city of Syracuse.
Doctor Porter is to-day lecturing at Cornell Lniversity, and I will imme-
diately transmit the contents of your communication to him*.
Regarding the Syracuse situation, I might add that the health authorities
asked this IJepartment for aid this week, and a man has been detailed to study
the situation there for as long as may be necessary. A full report on this
matter will be furnished you without delay.
Very respectfully,
ALEC H. SEYMOuil,
Secretary
Albany, N. Y., October 26. 1910.
Hon. Horace White, Governor of the State of New York, Executive Chamber^
Albany:
Sir: — I beg to transmit herewith the report of the Department on the
prevalence of t^iphoid fever in this State, and especially in the city of Syracuse,
as requested by yo\i. Copies of this report have been transmitted to the mayor
of Syracuse and also to the health officer, with the suggestion that a conference
be held without delay l)etween the officials of the city and of this Department
regarding tlie situation.
I beg to assure you of my active interest in this matter, and my desire to
make this Department of as much service as possible to the city.
Very respectfully,
EUGENE H. PORTER,
Commissioner of Health
Invjistigations Ordered by the Governor
0G3
Albany, N. Y., October 25, 1910.
EroENK H. PoBTEB, M.D., State Covimissioner of IJraJth, Albany, X, Y.;
Deab Sib: — In accordance with your directions, I beg to gubmit the fol-
lowing brief report of an investigation of the prevalence of tA-phoid fever in
the State of New York, with special reference to the prevalence of typhoid
fever in the city of Syracuse.
It is unnecessary to state that a study of such a comprehensive nature could
hardly be made briefly and at the same time with much detail, and I have cou-
se<|uently given, in connection with the statistics for the State, the results
only for the " sanitarj' districts " into which the State has, for the purposes of
convenience, been somewhat arbitrarilv divided. In the case of Svracusc,*
however, both the study and my report have Iwen made in greater detail.
In order to present in concise manner the prevalence of typhoid fever in the
State I have taken the record of statistics of the Department for typhoid
fever for the past ten years from 1000 to 1909, inclusive, and tabulated them
in such form as to show the relative prevalence of the disease during the
months of lOiO. Since the records for 1910 can obvionslv be secured for onlv
a portion of the year it was necessary in this study to tabulate these sta-
tistics by months in order that a monthly comparison can be maile of the
prevalence of the disease for the months during 1910. In addition to tlie reason
for this method of tabulation and comparison is the important reason that
the occurrence of typhoid fever in general follows a reasonable distribution,
being greater than the average during the late summer and fall months of
the year, and less during the late winter and spring months of the year.
In order to show more forcibly the seasonal variation in the prevalence of
typhoid fever the following summary of the mortality statistics for typhoi<l
fever by months for the entire State for the period from 1900 to 1909, inclusive,
together with the statistics for each month of 1910. so far as these statisfics
are available, is given below:
MONTH
Januarv .
February
March . .
April . . .
May . . .
June . . .
Average
1900 to 190D
inclusive
120. 6
107.1
108.2
94.4
92.0
74.4
1910
MONTH
87. 0 July
87.0 August . . .
92.0 ScptemlH»r .
08.0 October . . .
03.0 Xmcni'jcr .
70.0 DfcemlM^r . .
Average
1900 to 1909
i9:o
inclusive
10G.2
94.0
i:)3.9
131.0
192.0
183.0
212.2 .
1 70 . 5 .
loO.l
From these statistics it is evident that the normal variation of t\'phoid
fever during the year is quite marked and follows the general law stated
above. It is further seen that mortality from tx-phoid fevi'r for the State
during 1010 is appreciably Inflow the average for the last ten years, and for
the past three months for which statistics are available, namel}-, July, August
and September, is approximately 10 p<»r cent, less than the normal for this
ten -year pericwl.
Considering now more in detail the prevalence and distribution of typhoid
fever throughout the State, 1 bt^g to say that I have made similar compari-
Hons by '* >*anitary districts" and have sulnlivideil the mortality stati>*tics
in two groups, showing rc^poctiveiy the typhoid fever in the cities and in
the district outside of cities. repres<^nting resp(H*tively tlie urban and rural
population. Without giving in detail the statistics I find the following facts
in regard to each district, presenting the same in the form of a table sh(>w-
ing for each di-strict by plus or minus sign whether the typlM)id fe^^er during
the past three months in 1910 is. in each. al)ove or below the average, or
normal, tvphoid fever rate for the corresponding months of the period from
1900 to 1*909, inclusive:
I'rban Rural
Maritime district . — 4-
Xludson Valley district — —
Adirondack and Northern district -f ^—
664 State Dbpabtment of Health
Urban Rural
Mohawk Valley district • — —
Eastern Central district + -h
Western Central district — —
Lake Ontario and Western district — —
Southern Tier district -f- —
It will be seen from the above table that in the rural population of the
State typhoid fever was in excess in only two districts, namely, the Maritime
and the Eastern Central districts. It was found that in both these districts
the excess was appreciable. In the Maritime district it amounted for the
past three months to some tliree times the. normal, while in the Eastern Cen-
tral district it amounted to an excess of aboui 60 per cent., and this excess
seemed to occur in two adjacent townships in Delaware county.
It will be further seen from this table that in the cities of the State typhoid
fever has, during the past three months, been in excess of the average for the
corresponding months of the past ten years only in three districts, namely,
the Adirondack and Northern, the Eastern Central, and the Southern Tier
districts.
It was found further that of these districts only in the case of the Eastern
Central ddstriot was typhoid fever appreciably in excess. The Eastern Central
district includes the cities of Cortland, Oneida, Syracuse and Oneonta, but
only in the case of Syracuse was typhoid fever in excess. In the remaining
two districts, namely, the Adirondack and Northern, and the Southern Tier
districts, typhoid fever was in excess in seven out of eleven of the cities,
but the excess was in general so slight as to make it relatively unimportant
as to its significance.
While the above is a correct representation of typhoid fever in the cities
of the State, by sanitary districts, two notable exceptions to the general
rule should be noted, viz.: In the case of Yonkers and Niagara Falls in
the Maritime, and the Lake Ontario and Western districts, respectively, in
each of which the typhoid fever is, as with the case of Syracuse, appreciably
above the average for the ten-year period from 1900 to 1910, but notwithstand-
ing this excess, which is offset by a decrease in the other cities of the respective
districts, typhoid fever in these districts, as a whole, is below the average
for the ten-year period. The conditions at Yonkers have only recently been
investigated and reported upon by the Department. The case of Niagara
Falls, notorious for its high typhoid fever rate, has been repeatedly investi-
gated by the Department, and as a result extensive improvements are under
way which should reduce its high rate.
With the above brief outline of the relative prevalence of tjT)hoid fever in
the State as a whole for the past three months before us, and considering
now more in detail the important question of the undue prevalence of typhoid
fever in the city of Syracuse, and of the possible reasons for this prevalence
during the present year, and especially the past few months, I beg to say
that a special and more detailed investigation and study were ma^e of the con-
ditions at Syracuse. In order to do this visits were made by the chief and
assistants of the engineering division, and careful inspections made of the
local conditions within the city and upon the watershed of the water supply,
which is taken from Skaneateles lake, and of the pipe line leading to the city.
A careful study was also made of the reported cases of typhoid fever hi the
city in order to determine any specific cause to which the present excess of
typhoid fever might be attributed. A careful study was further made of the
actual conditions of, and of the records available in connection with, the milk
supply, water supply and other utilities and conditions which might in any
way be factors in the cause of the present undue prevalence of this disease.
From a study of the statistics of mortality and morbidity it was found that
during the months of July to September, inclusive, there was an excess of
typhoid fever in the city of Syracuse amounting to from two to three times
the average or normal for the three corresponding months for the period of
1900 to 1909, inclusive. Although the mortality statistics are more reliable
in regard to the deterra-i nation of the prevalence of typhoid fever in any
Investigations Ordkred by the Governor 665
municipali'ty the study of occurrence of cases is of ranch greater assistance
in the determination of the causes for it, and accordingly a grapliical study
was made of the distribution of cases which have occurred in the city during
1910. This study comprised the charting upon a map of the city by means
of colored tacks the location of all cases of typhoid fever during the present
year.
llils picture of the occurrence of cates of typhoid fever in the city during
the year was very instructive and showed at once that the cases were, with
the exception of one district, rather uniformly proportional to the distribution
of population within the city, the exceptional district referred to being the
one bounded approximately by Grape street, Burnett street, South street and
East Grenesee street. Tliis district, as familiarly known to local residents, is
one in which the general sanitary- conditions are far from being satisfactory,
and which might be considered a fertile soil for an outbreak of any com-
municable disease should this district once become eeeded or infected.
With these facts before us, then, namely, an undue prevalence of typhoid
fever, amounting to from two to three times the normal, with the cases
scattered over the city with general proportionality to the density of popula-
tion, except for one contracted area within the city where the tj'phoid appears
to be in secondary excels, let us now inquire into the actual extent and im-
portance of these cases of typhoid fever which have occurred during the present
year, and as to the possible causes of this general, undue prevalence of this
disease and of the secondary' excess in the small district referred to.
As was stated above, the prevalence from typhoid fever during, say the past
three months, was some two to three times the average or normal for the
corresponding months of the period from 1900 to 1909, inclusive. It was,
however, only about 20 per cent, greater than the t>"phoid fever rate in the
year 1900 and twice what it was in the >'«ar 1901. Expressing it as an
absolute rate of mortality, and allowing for seasonal distribution, we may
say that the mortality rate during the last three months in Syracuse corre-
sponds to a yearly mortality rate of approximately 40 per 10O.000.
This rate, while relatively excessive for the city of Syracuse, is considerably
less than the mortality rate which is yearlv experienced by many cities in the
country at large and a few within the State.* In other words, I wish to
emphasize that whereas the typnoid fever at Syracuse is some two to three
times the normal for the city of Syracuse, it cannot be considered in any sense
as apnroaching epidemic proportions: nor do I wish it to be inferred that the
excess is not sufliciently great or of sufficient importance to be disresjarded.
It is in fact sufficient to cauFc deep concern if not alarm to the city authorities
until the cause for this increase is found and imsasures taken to suppress it.
In searching for the cause that has given rise to this excessive rate, careful
consideration was given to the various general causes which, from the broad
standpoint of epidemiology, are usually found to be responsible for the ex-
cessive typhoid fever in any locality. These include a study of the water
supply, milk supply, ice supply, uncooked foods, oysters and other shell fish,
as well as of a series of more remote causes generally classified under the
head of secondary infection such as contact of persons, infected clothing or
foods, and through such agencies as insects, more especially the insidious
domei^tic fly, now commonly known as the " typhoid fly."
Although a thorough investigation of the milk supply was impracticable,
owing to limited tiine and services available for this investigation, a careful
study was made of the relation of the various milk supplies to the cases which
occurred in the city. The milk is supplied by one large dairy company and a
considerable number of smaller companies or individuals. The typhoid fever
report cards of all cases were carefully reviewed and compared among the
various milk supplies and there was found to be no particular relation be-
tween any dairy or dealer with any appreciable number of cases. It is true
that approxima>tely thirty of the 200 cases in the city, representing approxi-
•Compare with Oswego 44; Poughkeepsie 45; Kensselaer 73; Watervliet 57;
Dunkirk 40; Lockport 57; Cohoes 90; Ck)rning 42; Niagara Falls 135;
Watortown 77; Hudson 04, and Ogdensburg 59.
666 State Department of Health
mately 15 per cent., consumed milk from the large dairy company referred to,
but it was found that this dairy company supplied approximately 15 per cent,
of the milk consum^jd in the city. In other words, this dairy company had
only its proportional share of the cases in the city. The amount of milk
supplied by the other dair>- companies and the number of cases occurring on
their respective routes were too small to establish any close relationship,
although in no instance was any excess of cases found in connection with any
milk supply or milk route.
In view of this lack of association of cases with any particular milk
supply, and in view of the vcr>' explosive nature of a tj^phoid fever outbreak
which is always apparent where milk is the inciting cause, there can be little
question in my o|)inion that in the present instance the milk supply is not
primarily responsible for the undue prevalence of typhoid fever in Syracuse.
Although the information furnished by the typhoid fever report cards on
file with the local board of health does not contain the information in such
detail as would be desired, or as could be secured from a case to case in-
vestigation, the infonnation that was furnished did not point in any way to
any particular or general supply of ice, uncooked vegetables, oysters or other
shellfish. These faotors could not, therefore, be considered as responsible for
any appreciable or undue excess of typhoid fever.
Under the classification of *' secondary infection," however, there was found
to be a condition in the section of the city referred to above, bounded by
Cirape, Burnett, South and East Genesee s-treets, where these infective in-
fluences were active, for in this section there was found an excess of some
twenty-five cases above the normal excess, which could only be accounted for
by the insanitary conditions and practices found in this district. For ex-
ample, this district is a residential district of the poorer classes, where
ignorance of sanitary principles was apparent. Insanitary privy vaults ex-
posed to the action of flies were very numerous. The general sanitary con-
ditions of the premises were also very poor and to the epidemiologist the
sanitary condition of this section presented a picture which could only be
considered a fertile soil for the growth and dissemination of typhoid fever
infection when once seeded.
Discounting, however, the seconilary excess of typhoid fever m this district,
which amounted to say approximately twenty-five cases, there still remains
an excess of t}7)hoid fever over the entire city almost equal to that if these
twenty-five crises were included. In other words, with adequate allowance
for this s*^eondary increase of typhoid fever, presumably resulting from the
seeding of this section from the primary cause, there still remains this
primary cause to be accounted for.
I have so far considered all of the more common causes or channels of in-
fection which are usually responsible for the occurrence of typhoid fever in any
locality with the exception of the water supply, and a most careful con-
sideration must now be given not only to the facts in connection with it but
to the evidence deduced from these facts.
The water supply of Syracuse is taken from Skaneateles lake, at a point
about one mile above the outlet, the intake being in about thirty-flve feet of
water, and the water delivered to the city through two lines of pipe leading
to distributing reservoirs within the city and the distribution system. The
village of Skaneateles is located at the northerly or outlet end of the lake
and is provided with a sewerage system. At the upi^er end of the lake, some
fourteen miles from the intake, is located the village of Glenhaven, which is
provided with a sewage di8[)osal system. Along the shores of the lake are a
number of cottages, which in general are provided with local or individual
means of disposal of household wastes.
The lake and watershed of Skaneateles tributarj' thereto are protected by
" Rules and Regulations " enacted by the State Department of Health, and a
system of sanitary patrol is exercised over the lands adjacent to the waters
of the lake for the purpose of preventing any pollution or violation of the
rules. AlthoiJjrh ])rotection is thus afforded by these rules and a sanitary-
patrol, and notwithstanding that this sanitary patrol is exerciswl in a fairly
satisfactory manner, there can l»e no question that the waters of this lUke are
Investigations Obdebed by the Gtovebnob 607
aiibject to some |)ollutiou; and althougli this pollution cannoit at present be
considered as serious, we cannot ignore the fact that it does occur.
An inspection and careful inquirj' was, therefore, made of the sanitary
conditions around the lake by the assistant engineers of the Department, and
it was found that pollution occurred from two specific sources. One of these
is the pollution incidental to all lakes or bodies of water of this nature where
a resident population exists on any jwrtion of the watershed; and although
only one direct source of pollution was found near the intake, namely, a
sewer drain discharging into the lake, it must not be forgotten that pollution
from surface washings, from occasional bathing and from boats and pleasure
craft must occur, and this notwithstanding a satisfactory enforcement of the
water rules and of a sanitary patrol of the watershed.
Perhaps one of the most serious features in connection with this pollution
is that resulting from the use of a small craft owned and operated under the
water board authorities for the removal of excreta by the pail system which
is in operation at the various cottages along the shores of the lake. To
manage and operate in a sanitary manner free from any danger such a system
of collection of excreta in connection with a lake supply is a very serious
problem. In practice this boat must travel periodically if not regularly from
one end of the lake to the other, collecting pails of excreta in all kinds of
weather and with unskilled labor, and it is not a simple matter to perform
these duties without at times having gome of the excreta spilled into the lake
or washed from the boat during timei) of rain. It is found that at some
cottages it is neeessarj' to bring the pails of excreta on board this vessel by
means of a rowboat. If occurring during windy or stormy weather this might
add to the danger and amount of such excreta reaching the waters of the lake.
Furthermore, it was learned that at least on one occasion recently an em-
ployee was discharged for carelessness in the handling of these pails of excreta.
We cannot afTord, therefore, to ignore that from a practical standpoint a
small amount of pollution must reach the waters of the lake, and if we study
the records of chemical and bacteriological analyses of the lake water which
are made by the city and which are fortunately available, we find this small
pollution reflected in the results. These results of regular and special in-
vestigations that have been made by the city bacteriologist show clearly that
whereas fecal pollution does not in general exist regularly except along the
immediate shores of the lake, and that only at times does it reach out as far
a^ the intake, they show that on one or two occasions this pollution has
reached the intake and under conditions which one would expect it might
occur. It was found, for instance, that following strong southerly winds
<-olon bacilli were found in the higher dilutions at tlie intake, resulting un-
doiibteiily from the well-known phenomena that an undertow takes place which
carries ]^lhition, in this case from the shores in the vicinity of Skaneateles,
by means of subcurrents out into the lake. It wa« found also that following
northerly winds pollution extends out toward the intake, due to the blowing
of tlje surface currents out toward the intake.
I do not wish to Ik; understood as stating that the pollution which does at
times and may in the future reach the intake, is in great amounts nor in
general as to classify the waters of this lake at the intake as among those that
are unsafe. I do wish to point out, however, that ]>ollution in small amounts
does occur and that if perchance it is of infectious origin its presence is an
actual danger. It is for this reason that in some countries, such as Germany,
where central health authorities have control over all water supplies, the
filtration of all surface supplies is required.
Coming now to another phase of the water supply situation, I wish to point
out that during the past two years the city of Syracuse has been laying a new
water conduit from the lake to the city. This auxiliary main, which parallels
generally the old main, was completed and first put in use in February, 1910.
I am informed tliat this main was thoroughly flushed by allowing the water
to flow freely through it for a number of days before it was diverted into the
distribution system. There can be little question but that this main waa
thoroughly cleansed and that any infectious material remaining in the pipe
resulting from the lal»or operations during construction must have been
668 State Department of Health
thoroughly washed out, for no excess of typhoid fever in the ciiy was ap-
parent during the few months following the use of this new main.
Particular attention, however, should be called to the fact that during the
past summer and up until very recently three cross-connections between the
old and new mains have been under construction. This construction was done
by laborers employed under the water bureau, and during this construction it
was necessary at times to shut off the supply and to drain the pipes. The
significance of having a gang of laborers working inside and outside of a
live water main during the prolonged period of months of construction, and
of shutting off and draining the pipes cannot be overlooked, for the possibility
of contamination under the conditions is apparent to any close student of
sanitation. For instance, it might be possible for fifty laborers to be working
promiscuously in and around construction of this nature without contaminat-
ing the inside of the pipe with the specific germ of typhoid fever. One care-
less workman, however, who might have been in close contact with a typhoid
fever patient, or who might otherwise have gotten infected material on his
hands, feet or clothing, or who might be a bacillus carrier, might under the
same working conditions readily infect the supply as to produce an appreciable
increase in the typhoid fever rate of the city. Especially it must not be for-
gotten that such contamination of the principal water supply main of a city,
in active use, is very different from' the contamination of a stream or river
from which a city may take its supply, for in the former all of the water is
consumed by the city, whereas in the latter case only a small percentage of
it may be consumed by the city.
Again, if these pipes were at times shut off, and drained, it is possible that
pollution from adjacent soil, either in the village of Skaneateles or at points
along the pipe line where laborers camps were located, might have entered the
mains through leakage.
Enough has been said in regard to the possible contamination that might
have occurred to the water supply of the city of Syracuse in the past three
months to account for the undue prevalence of typhoid fever that has existed
during this interval. Owing to the difference in these two possible sources of
infection, namely, the pollution of the lake water in the lake itself and the
possible contamination of it along the pipe lines after its entrance into these
lines, it is almost impossible to state which one was responsible. The fact
that typhoid fever is so much in excess of what it has been in any one of the
past few years when we know that better sanitary patrol has been practiced,
would lead to the conclusion that the recent prevalence was due more to the
possible infection of the mains during the work of construction, and the
filling and draining of these mains incident thereto.
One fact which should not be overlooked in the typhoid fever situation is
that the city of Syracuse has recently had under construction a considerable
amount of sewers. Construction of this nature should not and rarely is the
cause of any outbreak of typhoid fever, although under certain conditions it
may be. That it was not in the present case is apparent from the dis-
tribution of cases through the city, which show no localized prevalence of the
disease in the sections of the city where sewers have been constructed. Indeed,
the picture presented by the typhoid fever chart is one which the epidemi-
ologist would characterize at once as a " water supply " case, and since all
other influences and factors have been carefully considered and the evidence
in regard to each carefully weighed showing their exclusion, there can be
little doubt left as to the water supply being the primary cause.
While reaching this conclusion as to the responsibility of the water supply
in the causation of typhoid fever at Syracuse, two facts should, however, be
clearlv kept in mind. One is that the principal source of trouble was in all
probability largely, and possibly entirely, an infection of this supply after it
entered the pipe line and that the sanitary conditions around the lake, though
stiH far from perfect and, therefore, subject to improvement, may have been
only an incidental factor. The other fact is the practical difficulty of main*
taining any surface water supply in a condition entirely free from pollution
unless the watershed is owned outright and controlled by the municipality.
Indeed, this difficulty amounts in some cases to almost an impossibility and
Investigations Obdebed by the Qovebnob 669
the be»t that can be done in such cases, in the absence of corrective measures
such as water titration, is to keep the sanitary conditions on the watershed so
carefully patrolled as to reduce this pollution to a practical minimum.
Much credit should be given the iSyracuse othcials for the ellicient measures
which they inaugurated some years ago, and have since considerably improved,
in the sanitary patrol of i^kaneateles lake. In fact, I know of no similar body
of water in this S^tate, used for water supply purposes, where a sanitary
patrol is so rigidly and ellectively carried out. When we admit, then, that the
conditions aiound Skaneatelcs lake are not perfect, it is in no sense a re-
Hection upon the efficiency or conscientiousness of the city officials responsible
for the sanitary patrol of its watershed.
Iheie remains now to be considered the preventive measures that should be
carried out by the city in order to suppress the present prevalence of typhoid
fever and to strengthen the barriers around their water supply so as to pre-
vent any further lecurrence of the present trouble; and in view of thh facts
and evidence presented above, I beg to make the following recommendations:
1. Ihat in case any future construction or changes are made in the
pipe lines leading from Skaneateles lake to the city or in the diartribution
system, that the most cautious and rigid sanitary supervision be made
of the manner in which the work is done, of the surroundings adjacent to
the constiuction, and of cleanliness and deportment of the laborers during
their work.
2. ihat the one sewer found by our inspection and possibly others which
discharge sewage into the lake m the vicinity of the intake, be cut off at
once and every precaution taken to find and remove any other sources of
direct or indirect pollution of the lake water, especially in the vicinity of
the intake.
3. 'Ihat the boat system of collection of excretal matter along the lake
be abandoned and that in its place a land system of removal of excreta be
substituted.
4. Ihat aggressive and effective action be taken by the local board of
health in a general sanitary cleaning up of the section in the city referred
to above as being the cause of a secondary excess of typhoid fever in the
city.
o. That unless there is an immediate cessation in the occurrence of
typhoid cases in the city, above what may be normally expected, resulting
irom a residual infection, possibly remaining in the reservoirs and dis-
tribution system, that a general notice, or warning, be issued to the resi-
dents of the city to boil all water, or at least that used for drinking,
until further notice.
In matter of the sanitary quality of the Syracuse supply, which must
necessarily be of vital interest to the people and officials ol the city of Syra-
cuse, I wish to point out clearly that this water supply is a surface supply
taken from one of the Finger lakes, as in the case of the cities of Auburn and
Geneva; that in the case of the latter two lake supplies the conditions of
pollution upon the watershed incident to. the population along the shores and
tributary watercourses have reached a point where a further protection of
these supplies by water purification has become necessary and steps are being
taken to provide for it; and that whereas the pollution of Skaneateles lake
has not at present by any means reached a similar degree of danger requiring
filtration of the supply, it is obvious that this requirement for further pro-
tection <by filtration or other means of purification must ultimately come and
at no very distant time.
I am, however, of the opinion that if additional barriers are established
against a pollution of Skaneateles lake and its tributaries and if the water
rules and regulations enacted by the State Commissioner of Health for the
protection of this supply are rigidly enforced, the city of Syracuse may with
reasonable safety still use this lake water without filtration for some years
to come. There will, of course, with an unfiltered surface water supply having
a resident population on the watershed, always remain some danger of in-
670 State Department of Health
fection, if from no other sources than iha/t of accidental or wilful contamina-
tion by careless or incompetent parties.
For the reason thus statetl, the question of ultimate necessity for filtering
this supply should be constantly kept in mind by the proper officials having
supervision and sanitary patrol of the supply, in order that the time when this
filtration is required may be suffieiently foreseen to afford opportimity to raise
the necessary funds and carry out the necessary construc^on of such filtra-
tion works.
Respectfully submitted,
THFX)T)()RE HORTON,
Chief Engineer
Investigations Ordered by the Governor 671
BIRD ISLAND PIER OUTFALL SEWER, BUFFALO
AuiANY, N. Y., October 25, 1910.
Honorable Horace VVniTE, Governor, Ea-eeutive Chamber, Albany, N. Y.:
Deab Sir: — In reference to the reflation of the common council of the
city of North lonawanda relating to the reconstruction of the Bird Island
pier outlet sewer in the city of Buffalo, a copy of which resolution was sub-
mitted to you and at your direction referred to me for attention, I beg to
9tate that I have recently caused an inspection to be made of this work and
am inclosing a copy of the report of buch inspection, which report together
with a letter addressed to the city clerk of North Tonawanda will explain
the situation.
Wrj' respectfully,
EUOENE H. K)RTEU,
CommisMoner of Health
Albany, N. Y.. October 21, 1910.
Mr, Theodore Hortox, Chief Engineer, \cic York tStatc Department of Jlealth,
Albany, A'. Y.:
Dear Sir: — I beg to submit the following report on an examination of the
works now being carried on by the city of Buffalo in connection with the
Bird Island pier outfall sewer of the city sewer system.
This examination was made at your direction on Octol)er loth and was
requested by Commissioner Porter in resi^nse to a resolution of the common
council of the citv of North Tonawanda addressed to Governor Horace White
and bv him referred to Commissioner Porter for attention and on account of a
j)etition from the board of trade of the city of North Tonawanda atldressed
to Governor Hughes and by him referred to Commissioner Porter for atten-
tion, a copy of tliis petition, as well as a similar petition from the board of
trade of the city of Niagara Falls, having also been addres*>ed to Commis-
sioner Porter.
'1 he resolution and petitions above referred to alleged that the city of
Buffalo was constructing a sewer and changing its outlet from tlie Erie canal
to the Niagara river at wh«,t is known as the Bird Island pier. In the reso-
lution and petitions a strong protest was made against what was thought
to Im? a further |H)Ilution of the Niagara river and the aid of the (iovernor
and of the State Commissioner of Health was asked to prevent sr.eh further
pollution and the consequent increasetl contamination of the water supply of
the cities of Tonawan<la, North Tonawanda. Niagara Falls and l.ocki>ort, and
the vill-agts of LaSalle, I^wi>ton and Youngstown.
From an interview with Deputy Engineer Commissioner CJeorge H. Nort:>n
of the department of public works of the city of Buffalo and an insjiection of
the work of sewer construction underway at the Bird Island pier, it was
determined that the work l>eing carried out by the city consists in the lower-
ing of about 4i;0 feet of the Bird Island outlet sewer, the work starting at the
mainland forming the easterly bank of the Erie canal and continuing under
the canal and Black Koek harhor to the outlet of this sewer on the Niagara
river side of the Bird Island pier.
This sectiim of the Bird Island outlet sewer is heing lowered al>out twelve
feet under requirement of the Cnitod States (iovernment in order to allow,
following the necessary dredging, for a t-hannel twenty-three feet in depth a8
provided for in the project for the new ship canal to l>e constructed by the
(Government.
The Bird Island outlet sewer was constructed by the city of Buffalo about
1883 and has been in continual operation discharging into the Niagara river
since that time until the present re<*nnstruction was commenced in December,
1909. No change in the outlet end of the sewer is to be made and the sewer
when reconstructed will cerate as an inverted siphon. When the present
work was started, it was necessary to temporarily divert the flow of sewage
672 State Department of Health
into the Erie caual at the east bank aud this discharge of sewage iuto the
canal will continue until some time in December when it is expected that
the reconstructed sewer will be finished and put into operation and the sewage
will then be discharged, as formerly, into the Niagara river.
This sewer is a circular brick sewer, eight feet six inches in diameter end
the invert of the sewer as reconstructed will be approximately thirty-seven
feet below the surface of water in Black Rock harbor. The sewer serves as
an outlet trunk sewer for the southerly half of the city sewer system and
carries sewage from about one-half the population of the city. All the city
sewers south of Albany street, except such as discharge into Buffalo creek,
are tributary to the outlet sewer described above.
It is evident from the foregoing that the reconstruction of the Bird Island
pier outlet sewer now being carried on by the city of Buffalo involves no
increased discharge of sewage into the Niagara river over that occurring at
the time the work of reconstruction was started, nor does such consrtruction
change the location of the mouth of the sewer as it has existed since about
1883.
Respectfully submitted,
H. B. CLEVELAND,
Principal Assistant Engineer
Albany, N. Y., October 25, 1910.
George L. Beckaich, City Clerk, North Tonawanda, N. Y.;
Deab Sib: — In reference to the reconstruction of the Bird Island pier
outlet sewer in the city of Buffalo referred to in the copy of the resolution
adopted by the common council of North Tonawanda on October 4th, sub-
mitted to Governor Horace White and by him referred to this Department
for attention, I beg to state that I have recently caused an inspection to be
made of the work being carried on by the city of Buffalo and am enclosing
herewith a copy of the report of such inspection.
You will note from this report that the work being prosecuted by the
city of Buffalo will not result in any increased discharge of sewage into the
Niagara river over that taking place when the work was started nor will such
work change the character or location of the outlet into the Niagara river.
In fact this sewer was constructed so as to discharge into the Niagara river
some twenty years before the passage of the act of May 7, 1903, which act
requires that additional discharge of sewage may be created subsequent to
the date of enactment only on the granting of permission for such discharge
by this Department.
As you are aware, I have urged the Legislature for the past two years
to amend the Public HeaWh Law by granting to this Department, subject to
the concurrence of the Governor and the Attorney-General, the right to re-
quire the removal of nollution from the streams of the State in cases where
investigation by this Department should show the need for such action.
As respecting the pollution of the Niagara river by the discharge of sewage
from Buffalo, Tonawanda, North Tonawanda, Niagara Falls, and other places,
I beg to state that I am thoroughly in sympathy with the general movement
that has been started to eliminate such pollution, as far as possible, and
beg to assure you of the co-operation of this Department to that end. The
problem, however, is a very important one and should be worked out in a
comprehensive manner involving, as it does, practically all the municipali-
ties along the river.
Assuring you of my interest in this question and of the continued efforts
of this Department to protect the stream* of the State from pollution,
under such powers as are granted by the Public Health Law, I am,
Very respectfully
EUGENE H. PORTER,
Commissioner of Health
A oommimication similar to the foregoing was also addressed to Mr. George
F. Nye, Secretaiy, Board of Health of Niagaxft Falls.
INSPECTION OF RENDERING PLANTS
[073]
22
3 INSPECTION OF RENDERING PLANTS
BARREN ISLAND
Xew York, N. Y., December 31, 1910.
EuoBNE H. PoBTEB, M.D., State Commissioner of Ilealth, Albany, N. Y.:
Deab Snt; —
The Sanitary Utilization Company. — During the year 1910, this company
received and disposed of 381,350 tons of garbage from Greater New York, this
being taken care of in their Brooklyn and New York buildings. On July 10th
they had a slight accident in the New York building, not stopping any of the
active work of the plant, as it happened while the work of relining the
digestors was going on in the New York building.
During the year they have put in an additional naphtha plant system with
the Peck percolator and are now using the naphtha process entirely in con-
nection with the grease.
They have put in some concealed presses by which they propose to do away
completely with the open process system and thev are rapidly perfecting this.
The chimney erected two years ago now eliminates all complaints against
the plant and makes it more sanitary.
On the whole, this plant with all its new improvements is being kept up to
a very high standard.
White Brothers. — This company has been running its plant steadily, taking
care of the olTals from Manhattan and Richmond boroughs up to July 10th.
After July 10th they started up the former McKeever plant, now known as
the Product Company, taking all the offals to this plant from all the boroughs
in Greater New York.
The approximate number of carcasses removed to the plant are:
Manhattan
Horseg 10,414
Colts 27
Ponies 10
Cows 77
Dogs from public pound 100,044
Cats and dogs from streets 223,162
Bronof
Horses 1,785
Colts 5
Cows 7
Cats and dogs 11,623
Richmond
Horses 662
Cows 20
Cats and dogs 8,142
Brooklyn
Horses 6,946
Cats and dogs 93,918
[676]
676 State Dbpabticeht of Health
Queent
Horses 1,»68
Cows 46
Cats and dogs 810
The original plant is still being used and receives between 50 and 60 tons
of hotel garbage per day from New York and also reserves a number of
digestors in this plant in case of mishap at the new plant.
They have been keeping their plant up to sanitary requirements, using the
necessary disinfeotants, keeping the building perfectly clean and I have had
no complaints whatever.
Product Company, — This company has been in operation, as stated above,
since July 10, 1910. Up to the 5th of October they were running two fishing
boats in connection with the offal disposal along the coasts, gathering fish,
which is all brought to their plant and boiled for the oil and the waste for
fertilizing purposes. This plant was greatly improved with a new concrete
boiler house and the rest of the improvements help to make the plant sanitary
and healthful and I see no reason why in early spring it shall not meet
with all the requirements of this department. They have been shipping filler
south and very little remains any length of time in the plant itself.
Matrin White Company. — This company is running the old Coe plant.
They are using the filler received from the Sanitary and White Brothers
and average about 100 tons of fertilizer per day. The plant is in excellent
condition. They are using a water spray for their acid mixing plant so as to
keep the fumes from rising. As fast as the products are made they are shipped
so that they only have about 500 tons of filler in storage at their plant ai
any one time. I have kept a very close watch on these plants and have
taken note of the various improvements which have been only for the benefit
of the public and they are all more than anxious to comply with all requests
that are made.
Respectfully submitted,
B. F. HAMILTON,
Inapeotor
CHEEKTOWAGA
Buffalo, N. Y., December 31, 1910.
Eugene H. Pobteb, M.D., State Commissioner of Health, Albany, N, Y,:
Deab Sib: — The American Agricultural Chemical Company (Milsom
works) have expended in the past year for repairing and improvements the
sum of $1,300. The improvements consist of installing three entirely new
rendering tanks.
They have now under construction a radial brick stack to be 150 feet high
and as soon as the weather will permit, they will construct two scrub towers
on the east side of their rendering plant opposite the dryer room for the
purpose of condensing all the gases from the dryers. The overflow from the
condensers will go to the bottom of the new stack.
When these improvements are completed, there is no doubt but that they
will be in the best shape possible and will be able to handle all the rendering
material in a very sanitary as well as satisfactory manner.
In the past year they have handled approximately 7,000,000 pounds of
rendering material as follows:
1,672,000 lbs. of tallow and bones from butcher shops and slaughter houses
of the city.
250,000 lbs. of rack bones.
22,000 lbs. of rendered tallow.
9,000 lbs. of grease.
200,000 lbs. of rough tallow.
IiTBPionoN or RsNDiBina Pl,
fiO.OOO lbs. of meat
000,000 Iba. of green bone.
188^09 Ibt. of dead hogs.
72,000 Ibi. of calvei.
200,000 )bs. of flsb.
800,000 lbs. of bwf heads and feet
],1S0 head of horses.
40 bead of cattle.
Id October one of the diyers in their plant burned
■tench and it had to be replaced t^ an entirely new oni
Their plant in general is in first class shape and the]
do anj'^hing they can tu improve it so as to keep with
tlic Tulea and reguktions ot the State Department of 1
The Buffalo Fertilizer Company, have received and re
year the following in their rendering plant:
tjheep
Cattle.'.'.'.'.!
Dogs
Cats
Total .
In their garbage plant they have received and r
109,748,000 pounds of green garbage.
Their wagons for hauling the garbage are kept cle
they are ail built oE iron and are unloaded and tb
immediately upon arriving at the plant.
Tbey have spent several thousand dollars on their
tilizer plant and intend in the near future to put up a I
The rendering building is old and they are very in
one; they have done considerable lixing on the old o
thoroughly whitewashed and use disiufectants quite Ire
spend any more money on it than possible as they want
The low ground around the factory has all been fillt
is very much more sanitary than formerly.
The machineiy and dryers are all in good shape and
The several covaplaints I have received against the;
been partly satiBlled since they built twenty feet on tl
think it would he better if they put on twenty feet
carry any obnonious odors higher in the air.
Have received no complaints against these works fo
appearances, I anticipate no serious trouble from then
there is, wilt take immediate steps to have it remcdie<1
All in all, I think the works have done quite well t
not causing any more trouble than really necessary a
when the new rendering plant at the Buffalo Ferti!
chimney on the fertilizer plant carried up a little big!
little reason for complaint.
Can assure you, tbiJt when at any time there has bee
mediately gave it my personal attention and got it i
factorily to all concerned and now feel that everythini
along in a smooth and satisfaolo^
'onra obediently,
JOHN
678 Statx Dspabtkbnt ov Hxaxtx
ROCHESTER
RocHEBTEB, N. Y., December 31, 1010.
Eugene H. Pobteb, M.D., State Commiaeioner of Health, Albany, N. Y.:
Deab Sib: — The work of inspecting the works has progressed as in pre-
vious years. Under the supervision of Mr. Haag there has been a marked
and evident intention to make conditions sanitary. Visits have been paid
as in the past at such times as was deemed best, without any notification to
the management. These visits have averaged twice a week.
The areaway between the two buildings of the company has formed a low
spot where drainage has accumulated, making it unsightly and unpleasant.
Up to the present time, it was impossible to change this condition, owing to
the fact that a tunnel connecting the two buildings, and a proposed conduit
to be erected would make any improvement only temporary.
Mr. Haag informs me that during the coming season, this entire areaway
will be drained and covered with some non-ab5)rbing pavement, which will
render it entirely satisfactory.
The fly problem was with us last year, and up to the present time no satis-
factory solution has been found. Immense quantities of flies follow the wagons
from the city to the worl^, and of course quickly find a home in the building.
Mr. Haag has shown an evident desire to obviate this condition, and I thim
without question some solution will be found before the warm weather begfins.
The buildings have lately been whitewashed and it is recommended tbiut
this be followed out at least quarterly during the year.
No formal complaints have been received against the works, and relatively
few informal ones.
In my opinion inspection has been very beneficial to this plant, as it is now
under this management and inspection, being conduoted in a much improved
manner over the past. Every suggestion is received with courtesy, ana there
is entire harmony and co-operation between the management and inspector.
Several visits during the year by representatives of the Department have
been very beneficial, as they have enabled some one who is competent and who
approaches from a new view point to give very valuable suggestions. The
last visit of Secretary Seymour was particularly helpful.
I append a report of the work of the company for the preceding year.
MONTGOMERY E. LEARY,
Jnepector
Report of Rochester Tallow Company
Factory No. 1
Tliis factory is given to the rendering of inedible tallow and tankage from
fat and bones purchased from the difi'erent meat markets and slaughter
houses of the city.
The following is the production:
Rendered tallow 1,350,000 lbs.
Tankage 600,000 lbs.
Dried blood 60.000 lbs.
Hoofs 20,000 lbs.
Horns 2,000 Ibo.
Purchases :
Slaughter house fat 1,500,000 lbs.
Market fat 800,000 lbs.
Bones 125,000 lbs.
Suet , . 75,000 Ihe.
Scraps, etc .' . 60,000 lbs.
Factory No. 2
This factory is given to the slaughtering of cattle, etc. (belonging to wbols-
sale butchers) and the cleaning of casings.
Killed during the year:
Cattle 0,080
Calves 8,040
Lsmbs 4380
SPECIAL INVESTIGATIONS
lii:;»l
INVESTIGATION OF SANITARY CONDITIONS
OF CITIES AND VILLAGES
These investigations and studies of the sanitary conditions of
certain cities and villages in the State were begun some three
years ago with the object, primarily, of determining what munici-
palities were apparently experiencing or suffering an unduly high
rate of mortality from communicable diseases and, secondarily, of
determining the causes and influences responsible for these high
rates in order that they may be removed and the mortality rates
lowered. These investigations have covered a considerable num-
ber of the cities and villages of the State, have proved of in-
estimable value to the respective localities, and have in most cases
resulted in the undertaking of extensive improvements which will
unquestionably lead to a lessening of death rates from infectious
diseases in these places.
Since these investigations have in previous years covered the
more important places where improvement seemed potential,
leaving thus a smaller number of places for consideration, and*
owing to the necessity for important lines of investigation in
other directions, there were investigated during 1910 the sanitarj'
conditions of only three municipalities, namely Lockport, Kings-
ton and Oneonta. These investigations were started late in the
year and although only the field inspections and studies have been
made at the close of the year it is expected that the reports will
be completed at an early date.
[«8ll
INVESTIGATION OF ILLEGAL SEWER
CONSTRUCTION
The handicap placed upon an effective campaign against illegal
practices in sewer construction and the discharge of sewage into
the waters of the State resulting from a lack of adequate powers
granted the Commissioner of Health for the enforcement of cer-
tain sections of the Public Health Law, and of the failure of the
passage of bills amending this law, has however not lessened the
efforts of the Department in this direction. This campaign, if
such it may be called, has been carried on along two general lines ;
first a special investigation to determine as to what municipalities
were constructing sewers without the approval of the Department
or were violating any of the conditions of any permit issued for
discharge of sewage into streams; and secondly, the holding of
conferences with local authorities when violations of the law
occurred to enlist their co-operation and compliance with the pro-
visions of these statutes.
Unfortimately there are many cities and villages still openly
violating the Public Health Law in regard to both the construction
of sewers and the discharge of sewage from them into the waters
of the State.. The large number of these cases and the serious
conditions of pollution of some of our streams incident to them,
makes the matter an important one^ so much so that it was re-
ferred to the Attorney-General a year ago for his opinion as Ux
the scope and powers of the Health Commissioner under Article
V of the Public Health Law with reference to sewerage and
sewage discharge, and to his authority in dealing with munici-
palities which persisted in violating the law.
This decision had not been rendered at the time my last report
was transmitted but was received early in 1910. The decision is
a very important one and disappointing in so far as it defines
clearly the narrow limitation of authority and powers and of the
Health Commissioner in enforcement of the provisions of Artide
[682]
Special Investigations 683
V and the relatively greater authority and power of local boards
of health in correcting and removing violations of these pro-
visions. Incidentally, it emphasized the pressing need for a com-
plete revision of these sections of the Public Health Law.
As stated above, however, the efforts of the Department have
not been relaxed in this direction, nor will they be, notwithstand-
ing the present number of continued violations of the law and
the greater diflficulties resulting from the recent decision of the
Attorney-General. It should be stated, however, and with no
little credit to the people and local authorities in the State, that
throughout our work in this direction there has been generally
shown a spirit of co-operation in this movement to correct abuses
of stream pollution and to comply with the provisions of the
Public Health Law.
SANITARY mSIECTION OF SUMMER RESORTS
The work of inspecting the sanitary condition of summer re-
sorts, first commenced by this Department in 1906, has been ex-
tended each year since that time. During the season of 1910
three inspectors were engaged almost continuously on this work
for a period of three months.
The work accomplished in 1910 includes the reinspection of
259 resorts previously inspected, to the proprietors of which re-
sorts letters had been addressed requesting that improvements in
sanitary arrangements at their resorts be made, together with
original inspections of some 170 additional resorts not previously
inspected, a total of 429 resorts, many of them accommodatiEg
several hundred guests, having been visited and inspected by rep-
resentatives of the Department during the year.
As noted in my report of last year, the State has been divided
into thirteen districts in order to systematize the investigation
and to facilitate the work of inspection. These districts are as
follows :
1. Thousand Islands — St. Lawrence district.
2. Fulton Chain — Big Moose district.
3. Raquette, Tupper and Long Lake district.
4. Saranac — St. Regis district.
5. Lake Champlain district.
6. Lake George district.
7. Lake Pleasant — Saratoga Springs district.
8. Western district.
9. Central — Finger lakes district.
10. Otsego Lake — Richfield Springs district.
11. Catskill — Albany district.
12. Southern district.
13. Long Island district
[684]
Special Investigations 685
Reference is made to the accompanying map which shows the
summer resort districts as noted above.
A full description of the various districts and of the scope and
purpose of this investigation is contained in the 30th annual
report of the Department for 1909, and for this reason the work
accomplished in the several districts during 1910 will be but
briefly described although it was possible to extend the investiga-
tion much further during 1910 than in previous seasons.
THOUSAND ISLANDS — ST. LAWRENCE DISTRICT (No. 1)
This district comprises Jeflfergon county and the greater portion of St.
Lawrence county. Of the 37 resorts inspected, 25 were located alon^^ the
shores and on tVe islands of the St. Lawrence river. At thirty-five resorts
insanitary conditions were found, consisting principally of the use of a source
of water supply subject to pollution or the discharge into streams and lakes
of untreated sewnge.
n^LTON CHAIN — BIG MOOSE DISTRICT (No. 2)
This district includes all or portions of the counties of Lewis, Herkimer,
Hamilton and Oneida. Thirty-nine resorts of the 60 originally inspected in
1909 were reinspected in 1910 and it was found that at seven of these resorts
the insanitary conditions criticized had been removed, while at many others
arrangements had been made or work was being done to place the resorts in
proper sanitary condition.
RAQUETTE — TUPPER — LONG LAKES DISTRICT (No. 3)
Reinspection was made at two of the five resorts inspected in 10C9 and it
was found that at both these resorts the insanitary conditions criticized had
been corrected.
Three additional resorts were inspected in 1010 in this district, completing
the work in this section, and at each of these resorts insanitarv conditions
were found.
SARANAC — ST. REGIS DISTRICT (No. 4)
This district includes all or portions of Franklin, Clinton and Essex counties.
Of the twenty resorts inspected in 1909 insanitary conditions were found
at nine and on a reinspection of tlese nine resorts in 1910 it was found that
at four reports the insanitary conditions criticized had been corrected.
Eight additional resorts were insj^ected in this district in 1910, completing
the work in the district, and it was found that at six of these resorts there
were insanitary conditions to be brought to tlie attention of the proprietors.
LAKE CHAMPLAIN DISTRICT (No. 5)
This disitrict includes those portions of Clinton and Essex counties adjacent
to Lake Cliamplain. The sumn^T resorts in this district were inspected during
1910 and, among the fifteen resorts inspected, insanitary conditions were found
at ten resorts consisting principally of the partial u«e of a water supply
subiect to pollution and the discharge of untreated sewage into lakes and
streams.
CENTRAL — FINGER LAKES DISTRICT (No. 9)
Of the ninety -two summer resorts in this district inspected in 1909. sixty-
six required reinspection in 1910 and at twentv-eijrht of these it was found
that the insanitary conditions had been corrected, necessitating further action,
therefore, in the case of thirty-eight reaorts.
686 State Dbpabtment of Health
CATSKILL— ALBANY DISTRICT (No. 11)
At 132 of the 191 resorts inspected in this district in 1909, reinspections
were made in 1910 and it was found that insanitary conditions still existed
at 94 resorts necessitating further action by the Department.
In 1910, also, 103 additional resorts were inspected in this district and
insanitary conditions were found at 75 of these resorts. The inspection of
resorts is not yet completed in this district, although a considerable portion
of the territory has been covered.
SOUTIIERX district (No. 12)
Eleven resorts were rein&pectod in this district in 1910 and insanitary
conditions were found uncorrected at eight resorts.
Two additioiml resorts were also inspected in this district, and conditions
were found at each necessitating further action by the Department.
PROGRESS OF THE INVESTIGATION
As a result of the work of summer resort inspection carried on in 1910
and in previous years, the Department now has full information concerning
the sanitary condition of practically all the summer resorts accomodating
twenty-five or more gue&ts in the above described districts with the exception
of districts 11 and 12.
In the case of many resorts scheduled for second notification and for rein-
spection, partial improvements were found to have been made and it is believed
from past experience that all the improvements recommended will be found
on a second reinspection to have been completed at many of these resorts.
As has been the custom in the past, it is intended that publicity shall be
given in the Department's Monthly Bulletin or the press to those resorts
where the proprietors, after repeated notices from this Department, have failed
to make the improvements recommended to safeguard the health of th^r
guests.
In this connection it may be stated that many requests are received during
the summer season from prospective summer visitors, for information relative
to the sanitary condition at hotels and summer resorts which they are planning
to visit. From the records of recent inspection of summer resorts on file in
the Department, it has been possible to answer many of these inquiries and it
is expected that eventually complete records will be available at this Depart-
ment of the sanitarj' condition of all summer resorts in the State.
r
686
At 132 c
were macJ©
at 94 re&o»
In 101 0,
insanitary
resorts is
of the tex*:
Eleven
conditions
Two a,cl
were fouu
As a T
and in p"
the san i t
twenty- fi^"*
of distri<
In the
speetion ,
from pSLi
on a seo<
As lia-
given J^
where tl
to malc<
guests.
In tHi
the sui^
to the «
to visits
the D^P
is exp^*
ment o^
INVESTIGATION OF SANITARY CONDITIONS OF
STATE iNsrirunoNs
At the last session of the Legislature, section 14 of the Public
Health Law was amended by chapter 92 of the Laws of 1910, to
provide for examinations and reports on the sanitary condition
of such institutions as report to the Fiscal Supervisor of State
Charities whenever requested by him, and for regular analyses
of water supplies of these institutions. A request was accord-
ingly received from the Fiscal Supervisor on May 18, 1910, for
examinations and reports of all of these institutions, and since
that date the work of inspection has been in progress jointly by
the Divisions of Engineering and Laboratory. There are seven-
teen of these State institutions, as follows:
Western House of Refuge for Women, Albion.
New York State School for the Blind, I'atavia.
New York State Soldiers and Sailors' Home, Bath.
New York State Reformatory for Women, Bedford.
New Y'^ork State Reformatory, Elmira.
New York State Training School for Girls, Hudson.
Agricultural and Industrial School, Industry.
Thomas Indian School, Iroquois.
Eastern New York Reformatory, Napanoch.
New York State Custodial Asylum for Feeble-Minded Women,
Newark.
New York State Woman's Relief Corps Home, Oxford.
New Y'^ork House of Refuge, Randall's Island.
New York State Hospital for the Treatment of Incipient Pul-
monary Tuberculosis, Ray Brook.
Rome State Custodial Asvlum, Rome.
Craig Colony for Epileptics, Sonyea.
Syracuse State Institution for Feeble-Minded Children,
Syracuse.
[687]
C88 State Department of Health
Xew York State Hospital for the Care of Crippled and De-
fonned Children, West Haverstraw.
Although no provisions for increai^eil funds were made to cover
the work thus added to the regular duties of these two divisions,
this work has been actively pro.^ccuted and at the close of the
year the examinations and inspections of all of the institutions
listed above have been made and the reports when completed are
being transmitted to the State Fiscal Supervisor and to the Board
of Managers of these institutions.
The report on the examination made at the Xew York State
Hospital for the Care of Crippled and Deformed Children, at
West Haverstraw, follows :
Albany, N. Y., December 30, 1910.
Hon. Dennis McCarthy, Fiscal Supervisor of State Charities, Albany, N. Y.:
Dear Sir : — In accordance with your request and under the provisions of
chapter 92 of the Laws of 1910 I beg to stibmit the following report of an
examination and inspection of the sanitary conditions of the New York State
Hospital for the Care of Crippled and Deformed Children at West Haver-
straw.
This examination and report represents one of a series which will ultimately
include all of the State institutions which now report to the Fiscal Super-
visor of State Charities. The inspection, or field work, was made jointly by
the heads or representatives of the Engineering and Laboratory Divisions who
visited the institution and made an examination and inspection of such
features, conditions and methods of management as might have a bearing
either directly or indirectly upon the sanitation, health and general welfare
of the inmates and attendants.
In order to facilitate the inspection and to simplify the collection of data
and the reporting of results, the work has been taken* up under iha following
headings or topics, viz.: (1) Location and general description, (2) engineer-
ing, (3) communicable diseases, (4) organization and administration, and
(5) vital statistics. Owing to individiml difTerences respecting local condi-
tions or administration at the various institutions investigated, it was not
always found necessary to make examinations under all these divisions; nor
was it always found desirable to take up the work or report the results in the
order given. Wherever it was considered necessary, however, the examina-
tion, as well as the report, was made complete and generally in accordance
with this classification.
Location and General Description
The institution is located about one mile west of the Hudson river and
about half a mile northwest of the West Haverstraw station of the West
Shore Railroad. Some criticism has been expressed as to the wisdom of the
choice of this particular site and it was on account of this criticism that
the bill appropriating $100,000 for new buildings which passed both houses
of the Legislature in 1908-9, was vetoed by the Governor. The State Board
of Charities, however, has carefully considered the objections which have been
made to the site and does not believe them justifiable and as a result of their
findings unqualifiedly approves the request for the appropriation for the exten-
sion to the buildings as at present located. It is estimated that in New York
State there are not far from 6,000 crippled children who ought to be cared
for in a hospital of this sort and it is manifest that one old wooden bouse
with a capacity of forty-five children is totally inadequate. The present
Special Investigations
689
building is on the crest of a liill rising 140 feet above the river and the other
buildings of the institution are on the plateau to the rear of the main building.
Behind tlie barn is a natural depression which in the past has been objected
to because of the swampy nature of the soil and the accumulation of stagnant
water in the spring and after rains. This natural basin has had no outlet
and since the property of the institution is surrounded on all sides by other
holdings, no simple method of drainage is evident. The managers have under-
taken to fill up the depression which has already advanced so that the swampy
appearance and vegetation have disappeared. There seems to be no evidence
or reason for supposing the location to be unhealthful or of a character pre-
disposing to disease of any sort.
Ihe institution is a single large liouse, not originally intended for hospital
services, of old construction and quite poorly adapted for its present use. The
walls are old plaster; the floors of wood, old and somewhat irregular with
large cracks in many places, a kind of construction and room not suitable for
hospital service where any real cleanliness is requisite.
Ihe cellars of this building are utilized for the heating plant, for the kitchen,
for the vegetable storage, for the laundry and coal storage.
The quarters are cramped and quite poorly lighted. The kitchen is very
poorly equipped. The furniture and floors are of a nature practically impos-
sible to be kept with the cleanliness which is attained in more modern
anil suitable buildings for purposes of this nature. Above the kitchen on
the first floor are the two dining rooms, one for the inmates and one for the
employees. The dining room is far too small, so that the inmates are unduly
cramped for suitable care and attention for inmates of this nature while at
their repast.
On this floor is also the entrance ofiSce and ward rooms for inmates.
On the floor above are also ward rooms and the rest of the building is
occupied by rooms utilized by the resident staff and employees. There exists
no laboratory or any equipment therefor.
Wateb Supply
The water gupply of the institution is taken from the municipal supply
furnished by the Haverstraw Water Company, which comes partly from small
streams and partly from wells at Thiells. The watershed of the streams is
now protected by rules of tlie State Department of Health. The analyses of
tlie Department show that this water supply is generally of a good quality,
free from organic matter and satisfactory for drinking purposes. The water
ib supplied through a meter and it is said that the quantity and pressure
are satisfactory. The quantity used amounts to 4.'j,0<)0 gallons per month or
l.OOO gallons a day, not quite thirty gallons per head. The following analysis
has been made by the State Hygienic I>al>oratorv of a sample of tap water
taken in the dining room at the time of the writer's visit.
Free
Albumi-
noid
Aromf)-
nia
NitroRen
1
Ammo-
nil
Nit rite •> Nitratew
1
.002
.042
.001
0.16 1
1
Oxygon
Chlorine! Con-
sumed
Bftcteri.1
per
c. c.
B. CoH.
lOc.c.
I
1 c.c. I 1/10 c.c.
2 75
0.67
600 ' plus ! plus
plus
This does not show as good quality as usual, the bacterial count being high
and colon typt* being present in samples a» small as 1/10 c.c. It is probaUe.
however, that, since the streams receive surface wash, the large number of
bacteria are accounted for in this way. The analyses on some other occasions
have shown this same feature. It follows, therefore, that while the water
may Ik? considered as an averace type of surface Avater, its quality is doubtful
and suspicious and in spite of the record of good health at the institution, the
water is a possible cause of sickness under unfavorable conditions of
contamination.
690 State Depabtment of Health
Pl.UMBINO
The plumbing of the institution is all new, having been installed under the
supervision of the State Architect, within the past seven years. Ko criticism
can be oiTered in this regard and no suggestions for improvement can be made.
Sewerage and Sewage Disposal
The sewage of the institution is cared for tlirough a six-inch pipe which
leads from tlie front of the main building directly to the Hudson river under
the tracks of the West Shore Railroad. On December 6th, 1905, a provisional
permit was issued to the board of managers of this institution for the dis-
charge of sewage directly into the Hudson river upon condition that a sewage
disposal plant be constructed on or before November 1st, 1906, and Mr. O. H.
Landreth of Schenectady, under date of January 26, 10C6, estimated the cost
of a proper system of disposal just below the West Shore Railroad, making
use of a septic tank and continuous percolating filters, at $2,000. This dis-
posal plant was never built and the sewage at present discharges directly into
the Hudson river. Although this is not a reflection on the sanitary condition
of the institution itself since the main sewer is apparently well laSd and a
flush tank at the upper end of the line secures a thorough cleansing of the
sewer weekly, it is nevertheless not in accord with the provisions of the
Public Health Law and the conditions of the permit referred to; and steps
should therefore be taken at once to construct this disposal plant or to pro-
vide some satisfactory substitute method of disposal to be approved by this
Department.
Garbage Disposal
The kitchen garbage of the institution is gathered in a pail and hauled to
a pig pen at the back of the property where from four to six pigs are kept for
the purpose of consuming it. The pig pen is clean and in good order and
without nuisance.
Heating and Ventilation
The building is heated by an efl'ective steam furnace in the basement, the
direct system of radiat'on being used. In view of the fact that a large pro-
portion of the cases committed to this institution are tuberculous in character,
the question of ventilation is not a vital one since the physician in charge
sees to it that practically at all times the wards and rooms are freely opened
to the outdoor air. It is intended that even in the coldest weather a tem-
perature of only sixty degrees is to be maintained in the building and it was
learned that in all but the most severe weather the outdoor pavilions are used
throuo^hout the dav.
Fire Protectign
There are standpipes in each corner of the building with hose attached for
fire protection. There are, however, no hydrants on the outside of the build-
ing. An outside metal fire escape has been provided on the north side of
the building which afl'ords opportunity for egress from the wards on that
side of the building.
Ice
Ice for the institution comes from the Garner Print Works pond, a small
pond west of the institution on the Minisceongo creek. This stream comes
from the hills I>aek of the ins»titution and is apparently free from pollution.
The Eastern New York Custodial Asylum at Thiells gets its water from this
same creek and examinations of its quality have been made in view of this
use of the water.
Hospital Space and Equipment.
It was stated at the time of this inspection that forty-five patients were at
the institution, but that the number lodged and fed in the institution —
patients and employees — was actually seventy- two.
The wards are made up of former rooms of this building, where a number
of intervening partitions have been taken out to make large rooms. The
Special Investigations 691
floors of wood are old and quite un suitable for being kept in proper clean
condition that modern hospital service requires.
The wards in general appear cramped and the general impression of exam-
ininir this institution is that all of the quarters are cramped.
The medical offices are far too small to be at all suited for the work of
lais kind. Ihe wards are so small that the beds appear brought far too near
together. The ceilings are not high, so that the proper ventilation would
require most careful attention and constant ui-e of wide open windows, in
view of the crowded population of these wards.
There is practically no suitable dispensary quarter. The bath rooms,
while perhaps sufficient for absolute requirement of bathing, do not appear
sufficiently sanitary for the use of these inmates.
The medicines utilized in the establislnnent are kept in two places, i. e.,
in a large wooden cupboard, standing in oi>e of the rooms used for a medical
ward (actually dismantled and in proeeFS of repair at the time of inspection),
and also some medicines in a small closet in the room on the fir«at flexor used
as a medical office.
Most of the medicines are in the original packages with which such articles
are bought from dealers. Many bottle;*, for in^tant'e. eantnining liquids, have
cork stoppers, which are more or le^s mutilated upcm l)eing removed at the
first opening of the packages, and are quite unsuitable for permanent keeping
of medical supplies of this na-ture which are frequently used.
It was not apparent that any particular care to keep poisons under the sole
control of the medical officer was utilized.
The operating room on the second floor, also a former room of the house,
has wooden floor of more or less looi^e construction, and the operating room
in general is quite unsuited for an operating r<Join, in which operations
which would require asepsis rouUl In? safely undertaken.
The furnishing of the operating room was meager. A large and expensive
sterilizing outfit was there, but entirely out of order. The instruments for
surgical operations were in good order, and in numbers would scarcely seem
to be sufficient to care for special oi>erations that might be expected in the
class of patients that exists in this hospital. It was answered on inquiry
that relatively very few operations were performed there and, in fact, it
would seem that the surgical services of such a hospital under such condi-
tions would be most successful when employed at its minimum.
In addition to the ward accommodations above referred to there was found
in the rear of the stable a building of rough wooden walls and rough floor,
practically a stable building of the most primitive kind, and in this large
room there were quartered permanently a large number of the inmates.
Ranged in rows through this room were large wroden table^ of rough boards,
and on these unpainted rough boards with no springs and no immediate cover
of any kind were laid the mattrej-scs in cIdsc proximity, and on these mat-
tresses the inmates quartered in this room slept.
There could be no question of ventilation in this very crowded structure.
There was no plumbing in the building, no toik-t. The children were obliged
to use for toilet purposes pails which stood in the corner.
There seems to be no special provision for disinfecting these pails, and
the general condition of the floor, corners of the rooms and the surroundings
of these pails would indicate very little more cleanliness than is usually
maintained in an old carriage house.
There was no provision for privacy during any of tl^e oi)erations of toilet
which might be necessary- for these inmates, and it war, stated that these
inmates did not seem to feel the need of any such privacy.
There seemed to be no systematic or frequent cleansing of the floor, walls
or tables utilized for beds in this room. It was stated that the wash of bed-
ding was issued clean once a week. It was not apparent that there was any
routine method of airing? or cleansing mattresses or blankets here utilized.
There was also on the jrrountls of the institution a further building of
rough board structure, with open sides, of a plan well known for the open-
air treatment of tul>ercular patients. This building was also occupied by
inmates quartered there, aho sleeping upon mattresses laid upon rough board
692 State Depaktment of Health
tables, duplicates of those before described in the preceding building, and
there was the same lack of provision of toilet, and the consequent recourse to
the use of the slop pail for ail of these necessities that were noted for the
preceding building.
Also, by reason of one or more sides always open, through which any
passerby can see the inmates, it was evident to our inspector that there was
no provision whatever for privacy during any toilet operation of the inmates
in that building.
Foods
The food supplies for the hospital are locally purchased by the steward after
estimates have been submitted to and approved by the State Fiscal Supervisor,
and the quality, weights and prices are subject to rigid rules and inspections
of the State Fiscal Supervisor. Ihese supplies appeared to be of good quality
and were kept and stored under sanitary conditions.
The milk is supplied by a local farmer under a satisfactory agreement as
to price and delivery, and according to the analyses of the State Department
of Agriculture the milk is shown to be of good quality.
Under an amendment to the Agricultural Law semi-annual analyses of all
food supplies of the hospital are provided for, and in the case of milk supply
a monthly analysis. These analyses should afford an efficient check upon the
quality of the foods purchased and should aid materially in the careful super-
vision of them.
Laundry
The laundry of the institution was exceedingly primitive, in the cellar of
the old house, where all of the work was done by hand by paid employees.
The room is certainly poorly ventilated and poorly lighted. It cannot be
healthy for the people and is quite unsuited for the use to which it is put.
EXEBCISE AND RECREATION
There are apparently no large recreation rooms or hall for systematic exer-
cise of the inmates and no general meeting room suitable for assembly
exercises.
Quarantine
In addition to the main building there is a small building specially de-
signed and constructed for isolation and quarantine hospital services. It is
a small detached wooden building with three rooms and kitchen, apparently
well isolated, one room from another, ami with outdoor entrances to each
room, permitting accessibility to the kitclien also, so that a very satisfactory
isolation and quarantine service could be maintained in this building. It is
intended for nse of <^onUigions disease.
The'e were-, no such cases in the building at the time of inspection, but ap-
parently any one or more of the rooms could be rapidly equipped and imme-
diately utilized for such purposes when needed.
At the time of the inspection one of these rooms was occupied by one of the
nurses of the establishment, it being stated that it was necessary to have the
nurse living permanently in tliis room by reason of the crowded condition of
the main building not permitting her location with the rest of the employees.
It was not apparent that there existed any system of thorough inspection
of any of the inmates on their first arrival, or that any special effort or care
was taken to insure the complete absence of any contagious disease in a
new arrival.
Co.\CLU8IO.\S AND RECOMMENDATIONS
1. Ihat although the water supply of the institution now furnished by the
Haverstraw Water (^onipany is generally of satisfactory quality and is now
protected by rules and regulations enacted by this Department, which if en-
forced by the water company would make the water more uniformly satisfac-
tory, it is shown by analyses to be at times of unsafe quality; and unless the
supply is improved and made of uniformly safer quality the question of secur-
ing a new and independent supply of unquestioned purity should be seriously
considered.
Spegiai. Investigations 693
2. That a sewage disposal plant be constructed according to the plans ap-
proved by this Department in 1906, or according to new plans to be at once
prepared and approved by this Department, in accordance with the conditions
of the permit issued by the Department in connection with the approval of
plans requiring the construction of this plant.
3. That, owing to the overcrowded condition of the institution, including
donnitonr, dining room and hospital accommodations, additional space should
be provided either by suitable extensions to existng buildings or new build-
ings; and that such extensions, alterations or repairs be designed and made
with a view to supplying not only additional space, but also other omissions
covering conveniences and equipment referred to more in detail in the follow-
ing recommendations:
4. That the use of the quarters connected with the stable be discontinued
for dormitory or ward purposes.
5. That such renovation and repairs be made throughout the institution as
will permit the walls and floors to be maintained in a thoroughly clean and
sanitary condition.
6. That all bedrooms be provided with suitable adjoining lavatories.
7. That suitable and sanitary bedsteads and ward furniture be furnished to
replace existing ones.
8. That a suitable and modern operating room and adjunct room be pro-
vided and that surgical therapeutics be encouraged.
9. That suitable laundry quarters and equipment be provided as will permit
laundry work to be carried on in a convenient and sanitary manner, with
respect to both the health of the people working in the laundry and the char-
acter of the work turned out by them.
10. That a more systematic and complete system of medical inspection and
?|uarantine be instituted to detect the existence of and provide a quarantine
or any contagious diseases among inmates and employees; more particularly
a thorough medical examination of inmates on their first arrival and of em-
ployees on their return from leave of absence.
11. That the quarantine quarters be not used for permanent quarters of em-
ployees of the institution.
Respectfully submitted,
EUGENE H. PORTER,
Cotnmis8ioner of Health
SANITARY INSPECTION OF LABOR CAMPS
Among the special investigations carried on during the year
by the Engineering Division should be mentioned the inspection
of sanitary conditions at labor camps. While the resources of the
Department and the force of engineering inspectors available did
not permit a very extensive investigation along this line, it was
thought best to have an inspector from the Department visit some
of the largest construction camps maintained in connection with
the three important lines of engineering construction being carried
on in the State, — namely, the work of the New York Board of
Water Supply, the Barge Canal and the State Highway Com-
mission. The purpose of the investigation was to examine into
the general sanitary conditions affecting the laiborers engaged upon
the work with special reference to the water supply, the housing
and dormitory accommodations, provision for sanitary con-
veniences and the disposal of wastes and the food supply and to
call to the attention of the contractors and of the local board of
health any insanitary conditions found, notifying them to correct
such insanitary conditions.
Following is a list of the labor camps inspected:
LaboTen
LOCATION. Contractor. Work engaoed upon, emplosped.
Brown Station, Ulster county. MacArthur Broo. Co. and
Winston A Co N. Y. Water Supply. . 8.000
Cartersvillo, Monroe county. Butler Bros Barge Canal 125
Cartbaffc. Jpffcrson county. . . Patrick Murray State highway 00
Cherry Valley, Otsego county. Dorpian City Construction
Co SUte highway 35
Ebcneter. Erie county F. W. Brotsch Co SUte highway 77
Gftjtport, Niagara county. . . . Empire Engineering Corpora-
tion ^ Bute highway 100
Valhalla. Westchester county. J. C. Rogers Co N. Y. Water Supply. . 650
Vischrrs Ferry, Saratoga
county Acme Engineering ft Con-
tracting Co Barge Canal SOO
Weet Brighton, Monroe
county Millard & Supton Co Barge Canal 125
Yonkera, Westchester county. Keystone State Construction
Co N. Y. Water Supply. .
The selection of the camps to be inspected was made by re-
questing from the officials having charge of the New York water
supply extension, the Barge canal construction and the State
highway work, the names of the contractors and the location of the
six largest contracts under their charge. Through the courteflj of
J
SAiaxAST IirsPBOTioif OF Labos Campb 695
these officials such lists were obtained and all labor camps main-
tained in connection with these contracts were visited and in-
spected. Some of the contracts included in these lists were found
to have been completed and at other locations noted in the lists
no labor camps were maintained so that other nearby camps or
camps noted in supplementary lists were inspected.
In all some sixteen inspection trips were made and ten labor
camps were inspected. At two camps the sleeping quarters were
found to be inadequate. At three camps the water supply was
found to lack proper protection from contamination. At four
camps, a lack of sanitary conveniences was noted or privies were
found to be in insanitary condition. At two camps the disposal
of sewage and wastes was found to be imperfect. The insanitary
conditions found were in all cases brought to the attention of the
contiactors and of the local board of health with the request that
the camp be at once placed in proper sanitary condition.
ENGINEERING DIVISION EXHIBIT AT STATE FAIR
[«»7]
ENGINEERING DIVISION EXHIBIT AT THE
STATE FAIR
Perhaps nothing can better or more graphically illustrate the
character and diversity of the work of the Engineering Division
than the display of maps, records and models exhibited as part
of the Department's general exhibit at the State Fair at Syra-
cuse; and for this reason and because a considerable amount of
work was devoted to the preparation and arrangement of these
engineering records and models, mention should be made of it
This exhibit was essentially an educational one and comprised
largely a wall display of plans, charts, profiles, photographs and
other graphical illustrations representing the work of the division
in connection with public water supplies, sewerage and stream
pollution; and a series of working models, in operation, repre-
senting various methods and types of sewage purification works.
Interest centered largely around these working models, and in
connection with the operation of them a member of the engineer-
ing staff was detailed to give brief descriptive talks upon their
constructive and operating feature.
It may be well to mention in connection with these models that
they were made from actual detailed plans, requiring consider-
able time in their construction, and that so far as known they
represent the first working models of sewage purification works
that have been exhibited, at least in this country. A photographic
reproduction of this model is shown herewith.
PROCEEDINGS OF THE CONFERENCE
OF
SANITARY OFFICERS OF THE STATE
[701]
CONTENTS
PAGE
OFBiaifG ADDBE88E8:
Francis £. Fronczak, M.D., Commissioner of Health, Buffalo 11
Eugene H. Porter, M.D., State Commissioner of Health 12
Addbsss bt John S. Wilson, M.D., Medical Officer, State Department
of Health:
" The Public School as an Aid to Public Health Work " 14
At least 50 per cent, of school children are subjects for atten-
tion of school inspector 14
Cost to State and city of defective children 17
If defective conditions of children are remedied during school
life, children become equipped with an increased ability to
do better work in later life 16
Observation of school inspectors establish fact that defective con-
ditions furnish large percentage of truants and delinquents in
school life 16
School a favorable medium for spread of communicable diseases.. . 18
The school nurse — her work in homes of school children 15
Address bt Fbankiin W. Babbows, M.D., Medical Inspector of Schools,
Buflfalo, N. Y.:
" Public School Inspection Follow-up Work " 20
FactofS in the transaction of an ideal follow -up system — the child,
the teacher, the parent, the family physician 22
Medical inspection must be followed up by appropriate measures
for mitigation or control of the defect 20
Medical supervision means conservation of health, of time and of
revenues expended in maintaining our departments of educa-
tion and public health 20
Outline of an efficient follow-up system 27
Address bt Edward Clark, M.D., Medical Officer, State Department of
Health : *
" The Public School as a Factor in Unhealth " 30
Attitude of indifference of school authorities toward defects of
mind and body of child 85
Lack of proper lighting and ventilation of school buildings a
strong factor for unhealth 34
Schools serve as centers of exchange for contagious diseases 35
True function of education 30
Address by Thomas E. Fineoan, Pd.D., Assistant Commissioner of
Education :
" The School and Public Health from the Standpoint of the Educa-
Uonalist" . . •.• *7
Course of instruction in hygiene as now outlined for public
schools ; • • *^
Physicians and health officers can render great service to Education
Department and children by providing proper and adequate
flchool accommodations 88
Responsibility for health work relating to public school system
should always be borne by school authorities 38
[708]
704 Contents
PAOK
Addbkss by WnxiAM G. Bbebsole, M.D., D.D.S., Cleveland, O.:
" Public Health and the Dental Profession " 46
Importance of oral hygiene 49
Influence of the mouth in transmission of contagious diseases 50
Kinty-seven per cent, of the mouths of school children are in an
insanitary and unhealthy condition 47
Tremendous influence for evil of the ** tooth-destroying " micro-
organisms " 48
AODBESS BT A. D. JjAKE, M.D., Medical Oflicer, State Department of
Health:
" The Difficulty of Health Officers as Seen by the Physician ** 60
Cordial relations and co-operation must be secured and maintained
between health officer and other physicians in his jurisdiction. 60
Health officer not a consultant bv virtue of his office 82
High standard now existing in the profession must be maintained
by the health officer 61
Address bt Wk. D. Alseveb, M.D., Medical Officer, State Department of
Health :
"Public Health and the Medical Profession — The Spirit of
Mutual Helpfulness " 65
Boards of health as advertising mediums 70
Health officers should acquire for themselves positions as '* leaders " 67
Inadvisability of enforcing obedience through the courts 67
Popular and illustrated lectures useful to educate the public 71
Possfbility of health officer getting help from his local medical
society 69
A supporting public sentiment essential to an eflfectual quarantine. 6U
Address by John B. Hub£b, .M.D., Medical Officer, State Department of
Health:
" Public Health and the Press from the Health Officer's Stand-
point " 75
Health Officer — journalist alliance would he of enormous benefit
in education of public regarding general nature of infection. 77
Necessary to create a sound and rational public opinion for fur-
therance of our public health work 77
Address bt Mb. F. P. Hall, Jamestown, N. Y.:
" Public Health and the Press from the Newspflper Man's Stand-
point " 80
Informing the public of exact conditions allays alarm while the
opposite course creates suspicion and results in lack of con-
fidence 81
Public always ready to accept an intelligent suggestion from one
in authority 83
Seek rather than repel the co-operation of the press 82
Address bt Eugene H. Porter, M.D., State Commissioner of Health:
"What a Health Department Expects from a Municipality " 86
Contagious diseases and quarantine 92
Mutual knowledge and understanding the first important requisite
for satisfactory relationship between local health authorities
and State 88
Politics must play no part if efficiency of health administration
is to be expected 90
Power of education 91
Water supplies and sewage disposal 93
maM
Contents 705
PAGE
Addbkss by CHARiacfi C. DUBYEE, M.D., Mayor of Schenectady:
" Public Health and Municipal Authorities from the Standpoint
of the Municipal Officer 97
Campaigns for cleanliness, decency and health cannot be effected
without assistance of the citizens of a city 100
Municipal officers should aid the health department by a sincere
and active co-operation 98
Adobxss bt Chables a. Hodoetts, M.D., Medical Adviser, Conservation
Commission, Ottawa, Canada:
" Public Health and the Conservation Movement " 103
Character, personnel, duties and functions of the Commission of
Conservation of Canada 108
Question of health superior to that of politics Ill
Relationship of public health to the conservation movement in
Canada 110
Typhoid fever — relative conditions in United States and Canada
as compared with some European countries 104
Address bt Col. Fbancis O. Wabd, Commissioner of Public Works,
Buffalo:
" Public Health and the Public Purse " 114
Collection of ashes, refuse and garbage in Buffalo 117
General public services most closely allied to the question of public
health are collection and disposal of city waste and water
supply 115
Report of refuse utilization plant for 1910 118
Running a city is a complex business proposition, calling for
competent men 115
Address bt P. M. Hall, M.D., Commissioner of Health, Minneapolis,
Minn.:
"The Ten Commandments for Handling Garbage Without
Nuisance " 119
Elimination of the fly in garbage disposal 121
Methods used in Minneapolis 121
Progress of methods of garbage disposal 119
Ten commandments for handling garbage without nuisance 122
Utilizing garbage for heating and lighting public buildings 122
Addbess bt Cuables Baskebville, Ph.D., F.C.S., Professor of Chemistry
and Director of the Laboratory, College of the City of New
York:
" City Sanitation " 127
Experimental plants a necessity in a growing city 134
Growth of a city causes it to assume corresponding obligations 128
Methods of disposing of street dirt 130
Organization of a health department 135
The smoke problem 131
Address bt Fbancis E. Fbonczak, M.D., Health Commissioner, Buffalo:
"Milk and Foods" 139
Cleanliness of barns a necessity 142
Commercial Pasteurization does not afford security 14f
Conditions which exist where inspections are not made 139
First step in interest of municipal milk is to place all dairies
under the permit system 142
Investigations as to influence of cans on bacterial contamination. . 151 •
706 Contexts
PAGE.
Addbess by Alucn W. FBiacMAN, M.D., Assistant State Commissioner of
Health, Richmond, Va.:
" Rural Hygiene " 150
Education regarding nature and prevention of disease most ef-
fective weapon of sanitary science 132
Lack of organization 163
Problems of North and South much the same ICO
Results possible from effective work IGC
Sanitary conditions throughout the rural districts of the United
States far from what they should be ICO
Addbesb bt Theooobe Hobton, C.E., Chief Engineer, State Department
of Health:
" Pollution of Streams " 174
Direct and indirect pollution defined 174
Organic and inorganic pollution 176
Pathogenic and non-pathogenic pollution 176
AODBESS by W. S. Magill, M.D., Director of Laboratories, State Depart-
ment of Health:
" The State Laboratories " 17J^
Antitoxins and their preparation ^. . . . 178
Functions of the Hygienic Laboratory 181
Laboratory courses for health officers ISn
To whom to supply antitoxin 1 79
Addbess by John A. Amyot, M.D., Director of Laboratories, Provincial
Board of Health, Toronto, Canada: *
" The Laboratory as an Aid to Diagnosis " 187
Clinician must combine the laboratory's report with his clinical
data to make a correct diagnosis in diphtheria 189
Laboratory specially useful in checking effi.-iency of water purifica-
tion and sewage disposal plants 196
Value of public health laboratory 197
Addbess by E. C. Levy. M.D., Chief Health Oflicer, Richmond, Va.:
*' Education v. Compulsion in Securing Reports of Contagious
Diseases " 20 1
Chronological charts make possible a comparison with previous
years 203
Circular letter to each physician, acquaints him with ordinances
and asks his co-operation 202
Control of contagious diseases is the legitimate field of public
health work 201
Outfit box for use of physician in reporting communicable dis-
eases 202
Addbess by William A. Howe, M.D., Deputy State Commissioner of
Health :
" Quarantine, Isolation and Disinfection " 207
Diseases to be reported under the law 208
Disinfection 213
Isolation 212
Outline of plan for quarantine under consideration 209
Addbess by H. W. Hill, M.D., Director of the Epidemiological Division,
Minnesota State Board of Health:
'* The Control of Typhoid Fever " 215
Actual emergency steps to control a typhoid epidemic 216
' Common fallacies regarding typhoid fever 218
J
Contents 707
PAGE.
Addbess by Gardner T. Swabts, M.D., Secretary, Rhode Island State
Department of Health:
" Unattacked Communicable Diseases " 222
Crusade of education necessary at proper time and place 224
How can health boards properly take up the problem 224
Knowledge of these diseases only comes to those who must first
be afllicted * 223
What Rhode Island has done and is doing 227
Address by Db. W. H. Fbost, United States Public Health and Marine
Hospital Service :
" Epidemic Anterior Poliomyelitis " 232
Epidemic poliomyelitis probably transmissible by direct contact. . 247
Importance of obtaining reports of all cases. . . . .' 236
Increase in the occurrence of epidemics of this disease 232
Results of laboratory experiments 234
Seriousness of the disease increases the gravity of the health
officer's responsibility ", 233
Siunmary of facts bearing on its preventability 233
Addbesb by Mb. Cuables W. Fethebolf, Director, Tuberculosis Exhibit,
State Department of Health:
"The Tuberculosis Campaign " 258
Campaign for popular education 260
Fight against tuberculosis means progress 259
Municipal campaign 263
Progress made during last three years 260
Results of campaign 263
Delegates in attendance 265
J
Proceedings of the Tenth Annual Conference of Sanitary Officers
of the State of New York, Y.M.C.A. Auditorium, Buffalo,
November 16-18, 1910
The conference was called to order by Francis E. Fronczak, M.D., commissioner
of health of the city of Buffalo, Wednesday, November 16, 1910, at 11 a. m.
Address of Welcome by Dr, Francis E. Fronczak
Mr. Commissioner and Fellow Sanitary Officers — I con-
sider it a great privilege indeed, on behalf of the city of Buffalo,
to welcome you to our municipality. His honor the mayor, the
Honorable Louis P. Fuhrmann, is unable to be with us here to-
day, and he instructed me to bid you a most cordial welcome.
Buffalo, indeed, feels proud of being able to have you as its
guests. We believe and we know that the sanitary officers of the
State of New York have the best interests of humanity at heart.
They strive and labor for the good of mankind. They endeavor
through human life to increase the happiness of the people living
within this State. It id a great ideal, and T wish to say that no
higher ideal can spur anyone than your ideal of making human-
kind healthy and happy.
I am quite sure that the discussion and the papers which will
be presented here in the next three days will be of great value
to the community and the State at large, as well as the nation.
Again T repeat, on behalf of the city of Buffalo, and on behalf
of the medical profes^sion, T extend to you, ladies and gentlemen.
a most hearty welcome, and wish you godspeed in your labors.
[7091
710 Conference of Sanitary Officers
Reply by Commissioner Porter
Fellow Soldiers — I am sure that, engaged as we all are in
this battle for proper sanitation throughout our great State, we
have been glad to listen to this kindly and most courteous welcome
from the representative of the government of the great city of
Buffalo. It is inspiring to have with us on this plat-
form of our annual meeting a health ofiScer so utterly imbued with
the spirit of public duty and public sanitation that characterizes
Dr. Fronczak, the health commissioner of the city of Buffalo, in
his efforts in working toward that government which leads not
only to the betterment of sanitary conditions, but an elevation of
citizenship. It is an incentive to us in our conference to go ahead
in those matters of highest concern to the State, and strive to
make this meeting one of more than usual mutual benefit.
We have here meeting in Buffalo at the same time with us, a
great organization, known as the National Municipal League. It
is one of the signs of the day, I take it, that organizations of that
kind are in existence. It is in very truth and in the last analysis
a league for the promotion of health. It is a sanitary league;
and yet while it will not have presented to it papers on the same
subjects that we shall consider, yet so far reaching and interwoven
are the threads of sanitary science, so ^ar are they interwoven
in the web and woof of our sanitary life, that I think the work
of the National Municipal League will lead as inevitably to the
end we all desire, as our own meeting will do. And we must not
forget that behind these questions of sanitation, which are in
themselves questions that involve constructive statemanship, there
13 always a moral issue. Were it not for that fact, the impression
we are able to make on our fellow citizens; the sympathy we
encounter, and the advances we make, would never be made. It
is the moral side of this question — the right of it — that appeals
to American citizenship; and it has a direct bearing upon the
rights and the privileges and the freedom of the individual.
Now, in the last chapter, it means freedom from filth and foul
air. It means freedom from infected air and water and epi-
demics, and makes for the freedom which gives health and higher
citizenship.
Openinu Address 711
I need not say, my friends, how glad I am to welcome you to
our annual conference on behalf of the State Department of
Health. I need hardly once more remind you that you are in very
truth a department of health. Imagine for a moment — if you
will give the romantic side of your intellect some play — imagine
a State like ours with health oflScers thoroughly trained and effi-
cient ; with a competent and adequate salary ; with an enlightened
public^ and with efficient and strong health laws to back the
Health Commissioner up, imagine such a condition in the Empire
State and its efiFect in every village and rural commimity through-
out the State. The thought or conception that may come to us this
morning is sufficient to tell us all that should such a condition of
affairs be brought about, sanitation in every aspect would be ac-
complished in our State ; and so it is our duty to labor to bring
a^out that condition of affairs. And remember, that this purpose,
like every other, has three stages or subdivisions: Ilrst, acquire-
ment of the knowledge; second, dissemination of the knowledge
among the people; and third, a strong and efficient health law.
Those are the three things that must support the structure we
are so anxious to build. '
But, I must not interfere with this program. I think you will
6nd it a most interesting program. It is a great pleasure for me
to introduce the first speaker, one of our best medical officers in
the Department, who will address you on the subject of '* The
Public School as an Aid to Public Health Work,*' Dr. John S.
Wilson, our medical officer at Poughkeepsie.
712 Conference of Sanitary Officers
THE PUBLIC SCHOOL AS AN AID TO PUBLIC HEALTT
WORK
By John S. Wilson, M.D.
Medical Officer State Department of Health, Poughkeepsie
As health officers we must be concerned not only with insani-
tary conditions that call for action to-day, but we must ever bear
in mind that the future may be anticipated and safeguarded.
As we continue in public health work, our ideas tend to become
more presbyopic. The time was when boards of health largely
confined their efforts to the abating of nuisances and the quaran-
tining of communicable diseases. Today we have a keener con-
ception of our duties ; we view the situation from a higher plane ;
that which formerly constituted our field of work now lies at our
feet and we look beyond. We scan the distance and observe con-
ditions that must be corrected to prepare the way for the ever
forward march of progress.
It is from this higher viewpoint that we direct our operations
to intercept disease. We prevent the pollution of streams, guard
the water supplies, scrutinize the milk situation, erect suitable
dwellings, distribute antitoxin, inspect schools, etc.
At this time we are concerned only with the problem of " The
Public School as an Aid to Public Health Work.'' •
The period of childhood has its own peculiar diseases and
physical ailments; we may acquire an idea of the prevalence of
these conditions when we consider that at least 50 per cent, of
the school children are subjects for the attention of the school
inspector.
When we reflect that their communicable diseases are prevent-
able, and their physical defects are largely curable, no studied
argument is required to convince us that a great field of pre-
ventive medicine is open, and the importance of the subject com-
mands a deserving place in the attention of public health
workers.
I stated that 50 per cent of the school population suffered from
some defect; at first thought this figure may appear to be high,
but inspectors have placed the figure at all points from 18 per
Public School an Aid to Public Health Work: Wilson 713
cent, to 100 per cent., depending upon the individual inspector's
etandard.
In the New York city schools 1,500 children were selected ai
random, and 85 per cent, and 95 per cent of them needed treat-
ment. These defects are frequently overlooked by parents who
are either indifferent or ignorant or unobserving; but once de-
tected by the inspector, a form noting the trouble is sent to those
parents, with the recommendation that the child be referred to
the family physician for his advice. In some instances, the little
one is so referred, and the physician corrects the defect which has
retarded the full physical and mental development, and impaired
the work of the patient
Following the note into the home comes one of our newer re-
cruits in sanitary work — the school nurse. She needs but the
excuse of the inspector's report to gain an entrance into the
family, and oft-times into the heart of the mother. While ex-
plaining the nature of little Willie's trouble, her observing eye
is taking in the situation, and the conditions under which Willie
is being raised. The baby on the floor, with a piece of bread in
one hand and a sick cat in the other, does not escape her observa-
tion, and calk for her advice. Then she notes and comments upon
the uncovered milk pail, and inquires where the milk is obtained,
and explains the necessity of keeping it cold and protected from
the dust — explaining that the milk kept in the warm room for
twenty-four hours will contain more germs than sewage (Chapin).
Have any of the children ever suffered from milk poisoning?
Milk poisoning was once called cholera infantum, or its symptoms
were referred to " teething " or the " second summer." What
does Willie eat before coming to school in the morning? The
nurse then explains that the father's breakfast, adapted to a man
performing hard manual labor in the open air, is unsuited for the
child who spends the morning in school. She then remarks that
late one night she saw the aforesaid Willie playing in the street
when he should have been in bed ; a boy of his acre should have
ten hours sleep if he wishes to grow up into robust, vigorous boy-
hood. Where do the children sleep ? Why is not the window open
to allow the sunlight and fresh air to enter ? It is not a good plan
to make the bedroom a storage place for vegetables, etc. Surely
714 Conference of Sanitaby Officebs
the dogs are not allowed to sleep in the room with the children.
Perhaps the mother herself does not appear well; timely advdee,
counsel and enoonragement may help her along the weary journey.
The amount of kindly advice the nurse may ofiFer is limited only
by her tact and her interest in the work. We will grant that
often the advice is wasted, but some of it falls on good ground
and will bring forth results.
This sort of work will claim a prominent place in the estima-
tion of any one who has thoughtfully considered its possibilities-
It will be along similar lines that our most efficient work will be
conducted in the great tuberculosis campaign.
We may legislate, isolate, segregrate, fumigate, and variously
amuse ourselves, but the effitrient work that will be worth while
will be accomplished by this heart-to-heart teaching.
Has it not occurred to you that when we place an advanced case
of tuberculosis in a camp or hospital we tacitly admit that a pre-
ventable disease has passed our control ? The time to have inter-
cepted that person's disease possibly was back in his school days,
when there was no visiting nurse to advise his mother concern-
ing his diet, dress, sleep, and his beginning physical defects.
If tuberculosis is a preventable disease, why do we not prevent
it ? We are still consuming too much energy in trying to treat it ?
If we may credit the teaching of the adage — "An ounce of pre-
vention is worth a pound of cure." I believe the earnest, pains-
taking teaching of the school nurse in the homes of the school
children will outweigh some of our more showy efforts. |
While this sort of work is being cared for in the home the in-
spector at school is finding more children with malnutrition, en-
larged cervical glands, chorea, cardiac disease, pulmonary disease,
skin disease, defective vision, defective hearing, defective nasal
breathing, defective teeth, hypertrophied tonsils, post-nasal
growths, etc.
If these conditions can be remedied during school life, the chil-
dren become equipped with an increased ability to do better work
later in life, and are less apt to become dependents.
It has now become an established fact, confirm^ by the observa-
tion of all school inspectors that the children having the above
mentioned conditions furnish a very large percentage of the tru-
^i^
Public School an Aid to Public Health Work: Wilson 715
ants, delinquents and defectives in school life. If the child is
unable to hear well, or can not see the blackboard, or is always
tired because of eje-strain, he loses interest in the class work, he
lags in the race, and requires but little encouragement to absent
himself from school. After a time he becomes a recognized tru-
ant; the end of this is, in the majority of cases, a useless, if not
a criminal life.
Again, if such a defective is inclined to remain at school, he
falls behind his class and fails to be promoted. I have visited
the schools of Poughkeepsie with Dr. F. J. Mann, the school in-
spector, and have seen the diseases mentioned, and have witnessed
the conditions I have attempted to describe. One needs no greater
incentive to preventive public health work than to look into the
upturned, earnest faces of forty children. When asked if there
were any pupils in the room who had been more than one year
in that grade the teacher would present them for examination.
It was then discovered they invariably showed some defect of
eyes, nose, throat, or general nutrition.
We noticed another significant feature of this work — one
teacher would state there were no children in her room who needed
attention — in the same building, in another grade, the teacher
was prepared to name a number who should be referred to the
inspector — thus demonstrating that some teachers are already
alive to the importance of the work and are interested in the
physical as well as the mental welfare of the little ones in her
charge.
I have some interesting figures furnished me by Dr. Mann.
From 660 children examined below the high school, 659 were
referred to the family physician. Of these 122 were one year be-
hind their grade; 62 were two years behind; 41 were three years
behind; 17 were four years behind; and 9 were five years behind.
This means that 254 pupils were in school at an expense to the
State and city from at least one to five years longer than the normal
child. This number, 254, would form six classes^ requiring six
teachers, at an expense of $3,000 to $4,000. It costs us about
$20 per year for each pupil in the grade schools, so these delin-
quents cost us over $5,000 in addition to the salaries of the
teachers. Should any of this number become truants, or develop
716 Conference of Sanitary Officers
into criminals, the expense would be greatly increased. An over-
grown laggard in a class with jounger children has a demoraliz-
ing effect and his presence tends to lower the tone and discipline
of the entire class. '
We have just awakened sufficiently to realize it will be economy
to employ a school nurse, whose duty it will be to endeavor to
reduce the number of children in this class.
The fact that children assemble at school from so many hom^
and varied conditions makes the school a favorable medium for the
spread of commimicable diseases. These little ones, who have
been so jealously guarded at home, are obliged to attend school
and there become exposed to the danger of contracting scarlet
fever, diphtheria, measles, whooping cough and other diseases ;
and thev invariably acquire them along with their education.
If the law compels children to attend school, it is their personal
right to demand that they be protected from the dangers of disease.
If we could bear in mind the children who died in this State last
year from the communicable diseases of childhood, and could
summon before us the greater number who have escaped with some
function or faculty crippled by disease, we might ask ourselves if
an education is of such tremendous importance that the life and
health of these innocents must be risked in order that they may
attain it.
No system of education is rational which does not teach the
hygienic relation of mind and body. It is more difficult to in-
struct adults than children concerning the principles of preventive
medicine; in the school we have an organized, well-disciplined
company of receptive minds whose nature is to receive instruc-
tion, and we shall do well to begin here in our propaganda of
public health work. Time does not permit me to elaborate this
phase of our subject. '
Just as the school lends itself as a favorable medium for the
spread of communicable diseases, it also affords a place where
these diseases may be detected early, and where measures may be
taken to prevent their spread.
In Poughkeepsie, when the health officer is notified of the exist-
ence of such a disease, he in turn reports the same to the super-
intendent of schools, piving the name and residence of the pa-
tient. His records are consulted, and all other children under that
Public School an Aid to Public Health Work : Wilson 717
roof are excluded from school. This precaution at times is un-
called for, but I find it safer and wiser to adhere to one ruling
than to act on each individual case. This period of exclusion is
continued until the health officer issues a permit to the patient to
return to school.
When any of these communicable diseases are prevalent, the
school inspector cautions the teachers and advises them concern-
ing the early symptoms of the disease. When a pupil shows
signs of fever and sore throat, or coryza and cough, etc., the little
one is sent home. Sometimes the teacher's alarm has been im-
foimded, but while she inconvenienced one child, she protected
forty others.
Another proceeding we have found of service is to follow up
the absentees. When a little one is not in his accustomed place
at school the teacher requests one of the class living in his neigh-
borhood to call at his home and ascertain why he is absent, and
if he is ill, the cause of the illness. If the returns are suspicious,
the inspector or health officer is notified. •
By this means we have been able to discover mild cases of
scarlet fever and measles that otherwise would have escaped de-
tection. These measures- surround the school with precautions
that tend to prevent the spread of communicable diseases.
I regret I have been imable to cover the entire field suggested
by the title of the paper. I have touched but a few features that
have come to my personal attention. Others, writing upon the
subject, would approach it from other viewpoints, and develop
equally important phases of the work that I have not brought out.
We all must agree that we have not fully developed the possi-
bilities offered by the public school for preventive health work.
Dr. Warbasse, in his work on " Medical Sociology," says, " When
the medical profession becomes the champion of the strong man^
of the growing youth, and of the lusty babe, as well as it has for
countless generations been the champion of the sick and the dis-
tressed and pimy, then it shall conduct humanity to victories yet
undreamed, then shall the physician be not only helper, but he
shall be leader also.''
CoMifiSBiONfiK PoBTER: The next paper deals with a most important part
of this work. It is entitled, " Follow-up Work," and it will be presented by
Dr. Franklin W. Barrows. Medical Inspector of Schools, in Buffalo.
718 CONFEREXCE OF SaNITARY OFFICERS
PUBLIC SCHOOL INSPECTION FOLLOW-UP WORK
By Frankiow W. Barrows, M.D,
Medical Inspector of Schools, Buffalo, N. Y.
Medical inspection of schools has been on trial long enough to
prove its efficiency in discovering the physical defects of school
children. If statistics of morbidity were all that the intelligent
public demands, there would be little more that the medical in-
spector could do to completely fill the bill. To this function,
however, there is added the duty of excluding from school all
children physically unfit for school work. The result of these
two lines of activity has usually been to drive a considerable
proportion of children out of the schools without making any defi-
nite provision for their return. As one of the boys has expressed
it, ''The doctor chases the kids home and then the truant officer
chases them back to school again." That even this crude practice
produces good results in ridding the school of contagious diseases,
we will all grant ; but it is imperfect in that it wastes many daya
of the pupil's time, and that means a waste of the resources of
the school and of the health officers concerned. A little experi-
ence of this sort is enough to convince any community that medi-
cal inspection must be carried further; that once the inspector has
discovered a pupil with any sort of defect, it must be his busi-
ness to follow up the discovery with appropriate measures for
the mitigation or cure of the defect In other words, medical
inspection is but one function in a system of medical supervision.
Medical supervision includes medical inspection, as the greater in-
cludes the less. Broadly speaking, it is a part of our great policy
of conservation. It means conservation of health, of time, and of
the revenues expended in maintaining our departments of edu-
cation and public health.
Dr. Qulick, of New York city, in a recent magazine article
(World's Work, August, 1910), states that the number of gradu-
ates from our public schools is equalled annually by the number
who drop out of school without completing the course. He adds
Public School Inspection Follow-up TFobk: Barrows 719
that 16 per cent of these children drop out of school because of ill
health. Even those children who persevere to the end are greatly
retarded by removable physical defects, making their schooling
longer and more expensive to their parents and to the taxpayers
than it ought to be. This is only a part of the argument, if argu-
ment is necessary, for the following up the many abnormal chil-
dren in our schools to the end that they may be restored to their
normal health, or, at least, raised to a higher degree of physical
and mental efficiency. There is reason also for promptness in
remedial measures, for every physician knows that a serious
physical defect has a tendency to become aggravated by n^lect,
and that, notwithstanding the too prevalent notions as to the out-
growing of the afflictions of childhood.
There was a time, not long ago, when the medical inspector
fondly believed that it was merely necessary to request the parents
to place their children under suitable medical care and all would
soon be well. But such Utopian hopes were quickly dispelled.
At once the laity exhibited a most surprising confidence — not
in the doctor, but in the vis medicatrix naturce, although they
did not call it by that name. I remember a pathetic example
coming under my own observation. A boy in one of our parochial
schools was suffering from a chronic inflammation of the eyes.
The parents were asked to do something for his relief. To my
great astonishment the mother replied that one of her neighbors
had assured her that her boy would entirely outgrow the dis-
ease when he was twenty years old. The lad had only ten more
years to wait. Every medical inspector could tell a similar story
— a story of ignorance, neglect, prejudice, inhumanity. The
fact is that in Now York city up to about three years ago less
than ten per cent, of the parents receiving official notices reported
any action in behalf of their children. In the hope of devising
a more systematic plan of action, the authorities bethought them-
selves of the school nurses. Three schools were selected in dif-
ferent parts of Manhattan, and with the aid of the nurses a six
weeks campaign was inaugurated in behalf of the children need-
ing medical attendance. I will quote the results as given in the
report of the Bureau of Mimicipal Research (A Bureau of Child
720 CONFEHENCE OF SaNITAKY OFFICERS
Hygiene, page 6) : " The parents who did not respond promptly
to the department's customary postal notification that their chil-
dren needed treatment, were interviewed either at school or at
home, with the result that over 95 per cent, either took action or
requested the department's nurse to act for them. In three-
fourths of the cases only one interview was necessary, while the
cost in nurse's service per pupil treated was only about sixty
cents. Even this figure could be considerably lowered in well-
established work.
Before taking up in detail the features of an ideal follow-up
system, let us review the difiFerent factors in the transaction and
find out who's who? First there is the child. Let us not forget
that the child is the center around which all our system revolves.
The State sees in the child a future citizen. The State brings
all good influences to bear upon the child in order that the fathers
and mothers of the next generation may be adequately prepared
for the requirements of life. We must bear in mind that we are
dealing with children not for the glory of the Department of
Health nor the dignity of the Department of Education, but just
for the sake of the children themselves. Montaigne has said, " We
are taught to live when our life is well-nigh spent." Modem
education is ambitious to reverse this principle and to prepare for
life at the very threshhold. In our official work, therefore, we
cannot afford to get out of sight of the child. We may take warn-
ing from the observation of the good Dr. MacKjnzie, who has
been identified with this work in Scotland, that "as in
public health, so in medical inspection, there are some signs that
the living child is beginning to be lost in the maze of dead
figures."
' Then there is the teacher. She is a confederate whose help is
most essential at every step in conserving tha. welfare of the child.
So much reliance is placed on the teacher in our present system
of medical inspection that some critics have thought they could
ridicule it by calling it " teacher inspection." Very well, let them
call it what they please; but they will find that no system of
medical inspection of schools, however elaborate, can ever succeed
without the whole-hearted co-operation of the teaciiing staff. It
is the teacher who first observes the ailments and defects that
PoBLic School Inspection Follow-up Work: Barrows 721
interfere with the nonual progress of the child iu bis school work.
Imperfect vision and bearing, mouth breathing, coughs and colds,
speech defects, mental defects, and a hundred other variations
from the normal standard attract the attention of the observant
teacher before the child comes within reach of the medical inspec-
tor. The teacher inspects the school every day and should be on
the alert, as she usually is, to detect those who need medical care
and bring them to the notice of the proper officer. Moreover, the
teacher is generally the custodian of the records of physical ex-
aminations in her class room. As keeper of these records, it
should be made a part of her duties to assist in following up the
cases that need medical care and to see that the results are prop-
erly credited on her accounts. You will rarely find a teacher who
will not imdertake this work with entbueiasm. You will fre-
quently find that the teacher or the principal is the very best
"xirson to confer with parents and persuade them to secure proper
medical attention for their children. Indeed, yon will fail mis^
erably in the work of medical supervision if yon allow the least
feeling of antagonism to mar your relationship with the school
tuthorities. The medical inspector must realize that his own
work is nothing if not odncational. He will then recognize the
teachers as an army of colleapmes.
The next important factor is the parent — the crwx of the
situation. If the schools could only teach the parents the things
that they are teaching their children, if the medical inspectors
could only remedy parental defects — then the pathway of public
education and public health would be strewn with flowttrs in
fragrant and magnificent bouquets. But alas, too many of the
parents of this generation are characterized by unfitness for their
function, and many, very many of the children require other care
than that wliicb their homes affc"" "* '"=* *"- » ^i^<,t ,.»,-* ^f
the time. Parents who fail to t
very skeptical couceming the alle
remember calling upon a mothe:
her to relieve them of adenoid
breathe tbrongh their mouths, am
mother herwlf bad the typieal
was never closed except to swallo
722 Conference of Sanitary Officers
that I had to say, but blurted out in a voice that was thick and
indistinct, *' Yes, I guess I know what youse all want. The doc-
tors was after me too, when I was young; they said they wanted
to cut something out of my t'roat but we wouldn't let 'em; an*
you can look at me now and see what I am to-day." I did look
— and fled!
But, whether wisely or unwisely, the parent controls the situa-
tion and in all our eflForts to improve the physical condition of
children, the parents must be met, persuaded, conciliated. In
our medical work we shall be successful in the highest degree if
we avoid all flourish of authority and act in an advisory way. If
parents are suspicious of our motive and if they distrust our
judgment it will take a great deal of tact and wisdom to swing
them into line with modem medical and sanitary progress; it
will require a persistent campaign of education. But in our deal-
ings with fathers and mothers as they are to-day, let us not forget
that the school nurse of New York city holds the record of per-
suading 95 per cent, of a possible 100 per cent, to take definite
action as directed by the inspectors, and that in three-fourths of
these cases the nurse had only one interview with the parents.
I now approach with some timidity the subject of the family
physician, realizing that as an attach^ to the Department of Health
it is one of my chief functions to exalt the members of the medical
profession in my commimity. But our records show that there
are doctors and doctors, and I am sorry to add that it would be
easy to be present documentary evidence here to show that a few
of our doctors are inclined to obstruct rather than to advance the
work of medical supervision. They claim the right of way for
themselves, and therefore they want the whole road, whether they
are going or standing still. Lest I might imintentionally say
something unjust of the practitioners in our own commonwealth,
I will say nothing. Let us rather hear what an English physician.
Dr. Hogarth, a medical officer of the London County Council,
has to say about the situation in London (Med. Insp. Schools,
page 231) :
" It is remarkable that, in certain matters affecting the public
health, many members of the medical profession appear quite
devoid of conscientiousness. They constantly certify children as
PiBLic School Inspection Follow-up Woek: Barrows 723
free from infectious and contagious disease, and as fit to attend
school, when they are obviously suffering from ringworm or
scabies ; and sometimes even in the case of diphtheria their action
is not above suspicion. For example, out of 240 certificates of
freedom from ringworm, no less than 234 were proved to be in-
accurate on microscopic examination of specimens from the af-
fected cases."
Commenting on this statement. Dr. Kelynack, in his recent
book on the Medical Examination of Schools and Scholars, says
(page 228) :
"Objection (to school clinics) is raised by general medical
practitioners. In the past, at any rate, they have proved them-
selves unequal to the task of keeping the children in good health.
This has probably been due to some extent to neglect on the part
of the parents, but there has also been some fault on the part of
the doctors."
There are inspectors in New York State who can testify that it
is discouraging to the point of vexation to send a child to the
family doctor for treatment and then to be met with their brief
answer that there is nothing at all the matter with him. But
these annoyances, after all, are only such as must be met with
at the banning of any innovation — and medical inspection, from
any other point of view than that of the public health service,
is an innovation in school life. To the credit of the medical
profession in general it should be said that they are supporting
the innovation loyally. Many of our private physicians were
insistent for years on the establishment of this service, and it is
due to their efforts in very large degree that we have medical
injspection in our schools to-day. We hear little of the old objec-
tion that the school doctor is depriving the family doctor of his
living, for facts have long since proven the contrary. There is,
therefore, less excuse now than ever for indifference or opposi-
tion to medical inspection on the part of the profession. The
medical inspector ought to meet all physicians as colleagues in
the important work of child salvage, and in recommending medical
treatment for school children he should beware of being too fussy
and thus courting the unfavorable criticism of the family doctor.
In matters medical, the habitual alarmist is cheap and undig-
nified and his appeal is disregarded by thinking people.
724 CONFEBENCE OF SaNITABY OfFICEES
The school nurse is an indispensable member of our working
force. Wherever she has come into the work of medical inspec-
tion, she has come to stay. In fact, many if not most of the
existing systems of medical inspection of schools have had their
beginnings in the volunteer work of some district nurse who has
demonstrated to the public the need of systematic inspection and
the way to supply the need. When all our forces are lined up
for action, the nurse will be found especially suited for field work.
Her tact and her powers of persuasion are put to most excellent
use in visiting reluctant parents and inducing them to attend to
the needs of their children, ^e can also give instruction in
the simple rules of hygiene which are so frequently ignored or
violated in the homes from which our weaklings come to the
school. She will aid overworked and careless mothers in the neg-
lected task of cleaning their children and keeping tliem clean. In
fact, the school nurse is a teacher just as much as the woznan who
spends all her time in the class room, and she has the added
privilege of teaching the old as well as the young. We have
mentioned only a few of the lines in which the school nurse works
to the best advantage — the nimiber of different ways in which
the nurse can be of service in a well organized system is limited
only by the number of nurses and the size of the field in which
they work.
Our survey of the field would be incomplete without a few
words as to the medical inspector himself. He makes
the inspections of which we have been speaking. He decides. what
cases are to be recommended for medical care and treatment, but
he does not treat the cases himself, neither does he dictate the
mode of the treatment or the physician who is to have charge of
it. He must take an active interest in following up all cases that
he recommends for medical treatment; otherwise much of his
routine work will prove to be useless. Cases of contagious disease
coming to his notice he must follow up himself until they are
quarantined. He is not a truant officer in any sense of the word
and when he is sent to the homes of absentee pupils, as is often
the case, he should not be expected to usurp the f auctions of the
truant officer. He will find himself obliged, however, to divide
his time between the school and the school district. I cannot do
Public Scuool Inspection Follow-up Work: Barrows 725
better than to read some observations which Dr. Hogarth makes
on this point (Med. Insp. Schools, page 151) :
'^As soon as the doctor begins his work in the schools, he will
find it useful to obtain first hand knowledge of the social con-
ditions of the people in the district where the schools are situated.
It is impossible fully to appreciate the life and home conditions
of the children whom he inspects, unless he imderstands not only
the ignorance, the apathy and the neglect of the parents, but also
their poverty and the wretched conditions under which they live.
In the poorer quarters of the town he meets the neglectful, the
criminal and the apathetic parent, as well as the honest, hard-
working underfed laborer, and the thrifty housewife who can
scarcely keep her home together. Each of these sends a different
type of child to the school, and the doctor must be able to under-
stand and recognize each type; otherwise he cannot diagnose the
case, and each must be treated on its merits. In another part of
the town there may be congregated the spoiled, the pampered and
neurotic children of different social status. In the rural districts
also he must know the parents and their ways. This first hand
knowledge is not easy to obtain except by living among the people.
It is, however, possible to acquire reliable information from the
teachers, and the school doctor must not hesitate to instruct him-
self in this way in the absence of personal knowledge."
In accordance with these opinions of Dr. Hogarth, I do not
hesitate to say that the medical inspector should be a practising
physician who gives up a part of his time to this work and has
his own professional interests to look after also in the community
where he works. I believe that in this way he will serve the
schools better than the man who is hired to give all his time to
medical inspection and is inclined to look at everything from the
official point of view. Finally, one very essential qualification
of the doctor is the habit of following up himself and bringing
his own work up to the standard, for no one who lacks this quality
is capable of following up the work of other people.
In conclusion, I wish to present a mere outline of an efficient
follow-up system. It will combine some of the best features of
methods now in successful operation. The finer details of the
work will have to be devised, of course, to meet the needs of each
community.
1. The child is inspected by the medical inspector and his
defects noted in la permanent record. If treatment seems advisable
726 Conference of Sanitary Officers.
a notice is sent at once to the parent. If the child is mentally
defective or physically unable to attend to his work in the r^ular
grades he is a candidate for one of the special schools, viz. :
2. The fresh air school and the ungraded school for mental
defectives. In theee two schools the pupil is under the direct
supervision of the inspector and his regime is subject to change
and regulation by the inspector; he is followed up every day.
3. Parents who do not respond to the first notification within
a reasonable time receive several other notices at r^ular inter-
vals. For this purpose the postal card used in several cities is
cheaper than a personal call and just as effective for the prelim-
inary work.
4. When notices are of no more avail, the case is referred to
the school nurse and she visits the home for the sake of answer-
ing questions, meeting objections and educating the parent to a
sense of responsibility.
5. Cases of special obstinacy combined with special need on the
part of the child are reported to the head of the service and dealt
with on their merits. In this work the charitable organizations,
societies for protection of children and other philanthropies are
often of great aid.
6. To insure the greatest efficiency, the greatest economy of the
time of a staff of salaried doctors and nurses, this work should
all be directed from a central office where there is sufficient cleri-
cal help to receive reports from the field and to follow up the
record of each child until his case is settled. This office can at-
tend to mailing notices to parents and assigning daily work to
nurses, and to some extent, to the inspectors.
7. Cases of skin disease, pediculosis, and occasionally other
ailments that are not likely to make rapid recovery in the home
may be treated by the nurse, either at home or in the school. Ex-
perience has shown that this work does not encroach on the prov-
ince of the practitioner, and that it does save to the child
many precious days of school attendance which would be squan-
dered if the child were to be excluded from school until well.
Indeed, this work of the nurse has been so productive of good
results that many schools are equipped with the appliances for
treating simple ailments, and the nurse has her regular days for
Public School Inspection Follow-up Woek: Baheows 727
tbe work. Iq Eogland and other European lands and in some
American cities this agency has developed into the school clinic.
Special clinics for the care of th« teeth, for the eyes, etc., are also
maintained with excellent results in some cities.
I think I hear from some quarters the cry of " Fatemalism ! "
The man who wants more free medicine for his hogs and cattle
is likely to be shocked at the expenditure of money by the De-
partment of Health in the interests of another man's children.
Let UB remember that no true service that we can render to a child
will ever hare been performed in vain. The men of the future,
when they come to pass judgment on our present work, will not
condemn us for having done too much for the child. They will
wonder why this generation could not have treated its children
more liberally — more wisely — more in keeping with our pres-
ent knowledge and opportunities.
COUUIBSIONEB POBTEB: There will be & clioic to-morrow afternoon at 2
p. u. There will be some very interesting cases of tuberculosis shown, and
there will be a demonstration of the diagnosis of incipient tuberculosis.
This very inatructive and stimulating paper to which we have listened on
school woric will be followed hj a very important paper on school hygiene bj
Dr. Edward Clark.
I take pleasure in presenting Dr. Clark.
Da. Edvabd CLiiRK: I want to offer a word of explanation. Dr. Porter
asked me lo prepare a paper, and he suggested as a topic, tbe " School as a
Factor in Unhealth." J thought tbe matter over a few days, and I wrote and
asked if he bad aay objection to the title " School Hygiene and School
Diseau." Well, tbej say a fool never changes his mind, but a wise man does.
I changed my mind and went back again to the original suggestion, so that
the title of the paper I shall present to you is "The School as a Factor in
Unhealth," as suggested by Commiesioner Porter.
728 Conference of Sanitaky Officers
THE PUBLIC SCHOOL AS A FACTOR IN UNHEALTH
By Edwakd Clark, M.D.
Medical Officer, State Department of U.ea)tli, Buffalo
The true function of education is to develop the ideal citizen ;
not a citizen with an overtrained mind in a poorly developed body,
but an all around educated citizen with a sound and well-trained
mind in a sound and well-trained body. That such a citizen is a
valuable as*ot to a nation was fully recognized more than two
thousand years ago in the schools of Ancient Greece; in those
schools ** the training and care of the body was regarded as of
equal innportance with the training of the mind. In the Greek
world physical education was a reality. It was a natural educa-
tion of the child's body directed in part to securing healthy growth
and strong physique, and partly to create a favorable reaction
upon the child's mental and moral activities."
" Man/' to quote Mr. Freeman, " was a whole to the Hellenes,
and one part of him could not be sound if the other parts were not.
A school which trained the minds only, and neglected the bodies
of the pupils would have been inconceivable to a Hellene." This
was regarded as good school doctrine six hundred years B. C. It
is a somewhat long stride from 600 B. C. to 1910 A. I)., but
how much have we advanced in these matters since then i Has
school advancement and school hygiene kept pace wath other de-
partments of advancing civilization? On the contrarv', have we
not retrograded concerning the true and proper methods of edu-
cating the young and growing minds and taking proper care of
the young and growing bodies of our school children ? Since the
early Grecian times there has been no adequate system of national
education, and school hygiene is the newest and youngest branch
of state medicine. Until quite recently the study of school
hygiene had been confined to a few advanced thinkers.
In the seventeenth century " ComerduSj the father of modem
education, evolved an educational system in which school hygiene
certainly foimd a place. He constantly urged the necessity for
The Public School as a Factoe in Unhealth : Clabk. 729
physical trainings and emphasized the importance of providing
airy school rooms and pleasant playgrounds. He insisted that
educational methods should be in accordance with nature. More-
over he was fully aware of the importance of adapting the school
routine and curriculum to the physical and mental needs of the
children."
Here we find the father of the modem playground, the fresh
air school, and the schools for the mentally and physically defec-
tive. Oomenius lived and taught in the seventeenth century,
nearly three hundred years ago, and yet it has taken from then
until now for his doctrine to begin to bear fruit. Modem civil-
ization is just awaking to the importance of the truths he taught
regarding school hygiene.
Now, speaking of school hygiene, I find in the Atlantic Monthly
for June, 1908, an article by William H. Allen, which sets forth
my ideas on the subject so much better than I can express them
myself that I cannot forbear quoting from it.
" Until quite recently the term school hygiene stood for one idea,
namely, compulsory instruction in physiology and £ygiene, more
particularly in the evils of alcohol and nicotine. In the near
future school hygiene will suggest practice, not precept; not
class-room recitation by pupils, but control of school environ-
ment by school authorities ; not ideas to be conveyed to the brain
of the child, but protection to be given to the child's body. While
it is true that heretofore but a small number of men have seen the
need of this new definition of school hygiene, those few men are
now proceeding with such thorough and skillful educational meth-
ods, and with such profound conviction, that the school world is
bound to respond to their leadership."
There are many evidences that the time is ripe for recognizing
as an important factor in hygienic instruction the hygiene prac-
ticed at school bv janitor and teacher, and bv curriculum and
building-makers. Chicago is enthusiastic over its Bureau for Child
Study; Cleveland, over its Department of School Hygiene; Phila-
delphia, ^Memphis and Utica, over examinations for defective vis-
ion ; Detroit, Montclair and the Oranges, over their school nurses ;
and Massachusetts, over its Medical Inspection Law. Several hun-
dred representatives of charities and correction from all sections of
the United States and Canada, meeting at Minneapolis last June,
730 Conference of Sanitajry Officers
gave special atteutiou to the limitations of the present hygiene.
The second International Congress of School Hygiene, which
met in Ix^ndon last August, gave a week to various phases of the
new hygiene. Even more direct and more continuous results are
promised by the American School Hygiene Association, organ-
ized by a group of representative educators, physicians and social
workers in May, 1907, to secure for all schools of all states what
Dr. Luther H. Gulick so aptly terms '^ biological engineering.''
I might add to the above that almost all of the large cities in
the United States are rapidly coming to realize that there is some-
thing radically wrong so far as school hygiene is concerned, and
are getting wise to the fact that there is great room for improve-
ment. I am informed by the Wess reports that a couple of open
air schools will be a reality in this city in a very short time.
This is news that can be hailed with much joy, for it is one of
the harbingers of a new era of reform, better late than never. Let
us hope that in a short time public spirit may be so much aroused
that the United States, which leads the world in the education of
the masses, may in the near future, be found in the front ranks
of progress in this important and enlightened reform.
We are all very proud of our common schools. We call them the
bulwarks of the Nation. We pay liberally and cheerfully for their
maintenance; in them the large majority of our future citizens
receive their only scholastic education ; in them our boys and girls
spend from ten to fourteen years of their young life, when the body
and mind are in the formative state, and when they are much more
liable to lay the foundation for good or poor health than at any
other period of life ; when they are more prone to diseases which
make for chronic invalidism than at any other time. In view of
these facts is it not our imperative duty to enter into an analysis
of the school question, and to carefully determine whether all is
being done that can be done to produce the best possible results
lx)th physical and mental from the hygienic standpoint, and to
determine just what position the school occupies as a factor in
unhealth.
So much by way of preface. I now crave your indulgence for
a few moments in order to set forth a few things which to my
mind make the schools an important factor in unhealth.
The Public School as a Factob in Unuealth : Clark. 731
First, I 1 ave always held the belief that the school year, espe-
cially in the grammar schools, is too long. These schools ought
to close at least by the first of June. It would do no harm to have
them closed until October 1st, so that the pupils can spend the
most delightful months of the year out of doors in the parks and
meadows, storing up health and energy, and getting acquainted
with nature and mother earth ; the poet sings, *^ What is so rare
as a day in June," and the teachers and pupils of our modem
schools can say what is so distressing as a day in Jime, when one
is confined within the four walls of a schoolroom, when all
nature cries aloud to get out of doors. My friends of the peda-
gogic persuasion would say in answer to this, that if we shorten
the school year we must shorten the curriculum. I say, let us
shorten the curriculum by all means; for what shall it profit a
boy or girl if they gain the whole world of knowledge and lose
their health ?
There are more things in the modern curriculimi than were
ever dreamed of in our philosophy, and many of them could be
dropped to the benefit of the child. I am persuaded that a boy
or girl would gain more of permanent value by spending the
sunny June days in the open air, than by spending six hours a
day for five days a week in a schoolroom, trying to learn and
remember what emperors or rulers led the seven different crusades
against the infidels in the Holy Land ; whether King John in the
twelfth century had a right to name the Archbishop of Canterbury*
as against the Pope's wishes; trying to extract the nth root of
.T^ times y to the nth power.
A short time ago in a lecture to Cornell students, our very
eflBcient Commissioner, Dr. Porter, speaking of tuberculosis,
made this statement : " No other disease produces so much
poverty or distress. One-seventh of all deaths are due to this
disease. One-third of all deaths among adults and one-half of all
the sickness is due to tuberculosis. At the present rate of mor-
tality from tuberculosis in ten years we shall lose 2,000,000
people. This is more than we have lost in any of our wars."
He might have added that a very important factor in the pro-
duction of all this disease and sickness was the confinement for
732 CONFEEENCE OF SaNITABY OFFICERS
80 many hours a day, and for so many months in the year of
weak, poorly fed and poorly nourished children in crowded and
poorly ventilated schoolrooms.
Many of our school buildings are a strong factor for unhealth
due to lack of proper lighting and ventilation. The subject of
proper ventilation of school buildings is still an unsettled prob-
lem, and its proper solution in the future will depend to a great
extent on expert engineering skill. Some of the more modem
buildings are pretty well provided for in this direction, but we
do not have to go far afield in any of our large centers of popu-
lation to find many eohbol buildings where it is frequently neces-
sary to open windows and doors during school hours to regulate
the heat and fresh air supply.
Another factor which makes for unhealth is the dry sweeping
practiced in many of our schools. Of course while this is going
on all the windows of the rooms are supposed to be open, but I
have found on inquiry that this is not always the case. After
the dust has settled the windows are closed, and some hours later
the desks and furniture of the room are dusted off with a feather
duster or a dry cloth. In this dry sweeping and dusting, of
course, many of the disease germs contained in the dust are
blown out of the windows, but how many are left to get into the
noses, mouths, throats and lungs of the pupils I leave for your
imagination to determine. '
I am informed by the educational department of the city, that
when the schoolrooms are being swept, sawdust soaked in oil and
colored with paris green is used on the floors as a dust absorbent
and disinfectant. I cannot find that any antiseptic is ever used
in the water with which the floors and other woodwork are
scrubbed. I cannot find that the desks are ever scrubbed or
treated to an antiseptic bath; no vacuum sweeping is employed
in any of the schools in this city. I made some inquiries from
janitors at the suggestion of the department, and learned as fol-
lows: that schoolrooms are swept every night; halls are scrubbed
once a week; other rooms once in three or four weeks. I asl^ed
the question, "Are all windows of the room opened when it is
being swept?" Answer, "Part of them." I was told that the
The Public School as a Factoe in Unhealth : Clark. 733
desks and other furniture of the rooms were dusted twice daily,
at night with a feather duster, in the morning with a cloth.
Another potent factor which makes for unhealth in the school
is the attitude of indifference on the part of the school authorities
toward such defects of mind and body as might materially affect
the chances of success and happiness of the child, unless sueh
defects were of the more alarming nature of contagious diseases.
*' The lockstep " has been the rule in physical matters as in the
realm of the course of study. All the children have been re-
ceived on an equality, and have been treated equally, no matter
what their mental endowments or physical condition. The quick
and the slow, the soimd and the sick, have been grouped together,
and he who could not keep pace in his studies has been as unihesi-
tatingly left behind as has he who through illness could not retain
his place in the school.
Years ago and in some schools recently, the backward child,
the one who seemed stupid and restless, and unable to learn, re-
ceived a dose of the rod. To-day far better results are obtained
by copious doses of fresh air and sunlight, together with proper
nourishment. The proof of this is shown in the results obtained
in various schools where teachers, who have tried the above
methods, prove by figures that backward children show an in-
crease in weight, lessened absences from ill health, and far
superior mental tone and brightness. Overcrowding, which occurs
to a greater or less extent in many of our city schools, is another
element which makes for unhealth. It is as unhealthy as it is
unnecessary, in fact such overcrowding as I have observed in
some schools is nothing short of criminal.
Finally, let me say that the schools play an important part in
unhealth by serving as centers of exchange for contagious dis-
eases which pass from pupil to pupil. This fact is recognized
occasionally by closing public schools in times of serious epi-
demics. Notwithstanding the fact that the schools serve as
centers for the propagation and spread of contagious and infec-
tioxis diseases, the occasional closing down and the rare fumiga-
tion have constituted the sum total of preventive measures, with
the single exception of the commonly insisted on requirement of
vaccination.
734 Conference of Sanitaby Otfiobbs
Now, I want to quote an editorial which appeared in this
morning's Express. It is entitled ''Worthy Movement," and is
as follows:
"Health Commissioner Fronczak recommends that a dentist be
appointed to make regular examinations of the teeth of school
children. He believes that it would be possible for one dentist to
visit about three schools a day and, in addition, to give helpful
lectures, showing children how to care for their teeth. The in-
troduction of a dentist among the medical school examiners in
this citj' would be in line with what is being done in other cities.
" It has long been recognized by educational authorities that a
large part of the inferior work which is done by some children
can be traced directly to physical defects in the pupils. It may
be the general condition of health, poor eyes, poor teeth, growths
in the throat or nasal passages or any one of a number of other
defects. It has been proved by abundant experience that the re-
moval of the defect tends to make the child normal. Further
than that, much of the trouble with juvenile offenders has been
traced to these defects."
" The public-school system was organized to train children into
good citizenship. It is obvious that anything which interferes
with reasonable work in the schools interferes with the develop-
ment of the child along normal lines. If the schools are to serve
their highest purpose, it is necessary that there be supervision of
the health and physical condition of pupils as well as of their
mental development."
CoMiiissiONEB Porter — I am sure I voice your sentiments when I say we
are glad indeed to welcome to our platform a distinguished representative
of the State Department of Education. Dr. Finegan has always taken a
sharp interest in our work, and I think it is only fair to say it is due to
his energy that we have an increased inspiration in public health and hygiene
in many of the schools.
It gives me great pleasure, gentlemen, to introduce to you Dr. Thomas E.
Finegan, Assistant Commissioner of Education.
The School and Public Health : Fineoan. 735
THE SCHOOL AND PUBLIC HEALTH FROM THE
STANDPOINT OF THE EDUCATIONALIST
By Thomas E. Finkgan, Pd.D.,
Assistant Commissioner of Education
iln. Chairman, Ladies and Gentlemen — I esteem it a great
pleasure as well as an honor, to have an opportunity to say just
a few w^ords to this representativ^e body of physicians and health
officers of the State of New York. 1 nuist confess at the outset a
feeling of emharrassment, because it was not my understanding
that prepared papers would be submitted. I have not, therefore,
followed the excellent examples of the gentlemen who preceded
me and prepared a paper on Uie subject assigned by the president
of this conference. I have listened with much interest to the
papers already presented, because of the same views expressed in
them and the care and intelligence shown in their preparation.
Perhaps I should also say at the outset that the views expressed
by the speakers who have preceded me have in most cases my
hearty commendation. Of course, you cannot expect a pedagogue
to agr(*e absolutely with all the views expressed by three physi-
cians upon the questions which have been before you for con-
sideration.
I shall speak very briefly upon three or four divisions of work
which are t elated to the general questions under consideration
and in which t»he Education Department is vitally intereste<l.
First, the question of meilical inspection of school children. In
^7 judgment, there can l>e no serious doubt as to the advisability
of this inspection. The law of the State, however, is not ex-
pressive npon this point. There is nothing mandatory in the
general statutes about it and the only law relating to the subject
is that found in many of the local charters or local acts govern-
ing the several cities of the State. Nearly all of the citiee aro
making suitable medical inspection in the schools and in as sat-
isfactory form as could be expected under present conditions.
At the request of Dr. Porter, the Education Department ex-
736 Conference of Sanita&y Offiosbs
pressed willingness to co-operate with the Health Department in
the adoption of a plan of medical inspection of pupils in all
union free school districts and in villages of 5,000 and more
population. That plan has been in operation for three years or
more, so that at the present time all children in attendance upon
school in the union free school districts, in villages employing
superintendents and in cities, have undergone an annual exam-
ination and inspection as to the condition of the eyes, ears, nose^
etc. Of course, this plan of inspection has not been as thorough
and on as broad lines in the union free school districts where the
examination has been under the direction of teachers under in-
struction from the Health Department as it has been in the cities
where the examination has been conducted by health physicians
under the direction of the Board of Education. Upon this point
there is one question fundamental to all school inspection, which
should be strictly observed in every school district and in every
city of the State where medical inspection is undertaken. It
must always be understood that the schools in every particular
are under the control and direction of the school authorities.
When physicians or members of the Health Department go into
a public school for the purpose of making an examination of
pupils, such physicians should always go under the direction of
the Board of Education. There should be no division of respon-
sibility for any of the work directly related to the public school
system, and this responsibility should always be borne by the
school authorities or the Board of Education.
The second topic upon which I wish to say a word is the sani-
tary conditions of school buildings. There is no class of men in
the State who should be able to render the Education Department
and the children in our schools greater service in providing
proper and adequate school accommodations than the physicians
and health officers who make up the membership of this body.
The law now provides that no public school in the State, outside
of cities of the second class, shall be constructed, remodeled, r^
paired or added to until the plans and specifications therefor are
first submitted to the Education Department and have the writ-
ten approval of the Commissioner of Education- The heating,
lighting and ventilation must conform to a certain standard be-
TjIK S( ilOOl. AM* Pi liJ.lC IIkaLTU; FlNKGAN. Y^JT
fore tbey will be approved, and what is now regarded as the best
methods of heating, lighting and ventilating must be adopted. In
order to prevent local school authorities from violating this law,
the statute provides that the Board of Education shall not have
legal authority to issue a tax list to raise funds to construct, re-
pair or remodel these buildings until it has secured the approval
of the plans therefor from the Commissioner of Education. The
statute formerly provided that no building should be constructed
or no addition made at a cost of $500 or more without the ap-
proval of the Commissioner of Education. It was found that
local authorities would often try to beat this provision of law
by voting to repair a building when in reality they were con-
structing an addition; but as the statute now reads, all plans
for the repairing or remodeling of buildings must likewise be ap-
proved as in the case of original construction or additions.
A Department Inspector found some years ago in one of our
thriving villages one of the most dilapidated school buildings in the
State. The board of education was informed that the building
did not conform to the statutes, that it was insanitary, that it did
not provide adequate school accommodations for the district, that
it was not worth repairing and that a new building ought to be
erected which would be expressive of the progressive spirit of this
enterprising village. The question of voting proper appropriations
came before the voters of the village at several meetings, and it
took three years to get that community to vote a suitable appro-
priation for the construction of a school building affording ade-
quate and sanitary accommodations to its children.
The physician or health officer in a community is usually a man
of influence. He can exert great influence over his fellow citizens
in bringing them to that frame of mind where they will cheerfully
sustain sufficient appropriations to provide adequate school
accommodations in the community. It frequently occurs
in (omniunitios where a contest is on relative to in-
creased or ]>etter school facilities that some man of local
influence will sav in a public meeting or in an articlf»
over his signature in the local paper that the school
building is as good as it was when he attended school, and that if
it was good enough for him and his children, it is good enough for
24
7i>S CoNFKKKNCK <>K SvMTAKY OfFK'EKS
the children of the present time. When such a statement. is made,
or when such an article is written, there ought to be no man in the
community who can exert a greater influence in formulating public
sentiment upon this question than a reputable physician or health
officer. It is your duty in such a case to immediately point out
the error in the statement presented and set forth your views for
the reason why the school building should be repaired or remodeled,
or a now building constructed and you should avail yourselves
of every opportunity of this kind to not only render a great ser-
vice to the children and people of your community, but to the
State as well.
We have on the statute books of our State a law which provides
that all children between the ages of 7 and 14 in cities and villages
of 5,000 inhabitants or more shall be under instruction from the
time schools open in such cities or villages until these schools close
for the year, and that outside of the cities and villages, or in what
we term the rural districts, all children between 8 and 14 years of
age shall be under instruction from October 1st to June 1st follow-
ingy and that unless such children are employed in accordance with
the labor laws of the State they shall be under instruction between
14 and 16 years of age as well. Now if the laws of the State are
to require that these children must be put into schools and kept
there every day when the schools are open, why should not our laws
reach out and require with the same force that these children,
required to be in school, shall be properly protected by being
afforded school buildings which afford sanitary and comfortable
surroundings ?
While I was greatly interested in all papers which have been
presented, I was particularly interested in the paper of Dr. Clarke,
because he made the statement that we had not yet reached that
point anywhere in this country where we gave instruction in school
hygiene. I have in my hand here an elementary syllabus, prepared
by the Education Department for the use of the public schools of
the State. It went into operation September 1st last When a
boy in the public schools I remember having been taught that
there were a certain number of ribs in every man's body and I
always believed that what was taught me in this respect was the
truth, and yet within the last month a leading surgeon in the State
has made the statement that about 20 per cent, of all people have
TiiF. School and Prituc Ukaltii; Fixk(;ax. 7-30
either a greater or a less number of ribs than the boys twenty
years ago were taught each human body contained. I do not
know of what particular value it may be to a child to know that
he has twenty-four ribs, or a greater or less number, to protect him
through life, but I do believe that the time which has previously
been devoted to teaching facts of this kind to the children of the
State has been wasted and that we can give them instruction along
certain lines which shall be of a real service to them throughout
life. Of course we must remember that under the law of the
State we are compelled to give instruction on health with special
reference to the effects of alcoholic stimulants and narcotics on the
system. The teachers throughout the State are conforming to the
spirit of that law and giving such instruction. That law was so
framed that it is necessary to divide our instruction in physiology
and hygiene, or school hygiene, as we may now call it, into three
courses. We must also consider the fact that there are about one
and a half million children in the public schools of this State and
that only about one hundred twenty-five thousand of these chil-
dren go into institutions of higher learning and that probably 50
per cent, of these children leave the elementary schools at the end
of the sixth year and receive no further- instruction. The im-
portance, therefore, of providing proper instruction in hygiene and
sanitation which may be given to this million and a half children
in the school and brought within their intellectual grasp within
the first six years of our school work can readily be recognized*
The first of these courses is for the children in the first, second
and third years. The instruction given during these years is oral
and consists of two lessons a week for not less than ten weeks, or
an equivalent. The second course covers the fourth, fifth and sixth
years' work in school and the law requires that in this course in-
struction shall be based upon an elementary text book. The third
course covers the seventh and eighth years.
I shall not read to you the outline in these courses of study, but
I do want simply to refer to some of the subjects as they are
treated in this syllabus so that you may form a better idea of the
character of instruction which is to be given in the future in the
subject of physiology to the children in attendance upon our public
schools. The instruction is on subjects like these : " The body, the
740 ('OM'KRENC'K OF SaNITAKY OfFK'KUS
blood, flesh." " The growth of the body.-' " The need of food,
pure air, pure water, exercise and rest." " The necessity of com-
mon sense in the use of these things." ^' Food, and its use in the
body." ** Care and preparation of food." ** Oiir meals." "Air,
and its use in the body." " Breathing." ** Water, and its use in
the body." '' Care of the body." " The voice." " Contagious
disease." "Accident and emergencies." " Exercise, rest and
sleep." " The joy of health and strength."
All of these topics come within the first year's instruction and
the foregoing are suggestions and directions given to the teachers
and of course are much elaborated in the syllabus.
At the beginning of the fourth year, the second course is taken
up with the use of text books and while many of the same topics
are considered in this course which were considered in the first
course, the instruction given is in more advanced form. In this
course we have these subjects : " The body." " Food, and its uses
in the body." " Digestion." "Air, and its uses in the body."
" Breathing." " Water, and its uses in the body." " Organs of
excretion." " Blood and circulation." " The nervous system."
" Care and protection of the body." " The voice." " Contagious
diseases — their spread and prevention." And in this connection
we have not forgotten to make war upon that detestable of all
creatures, the common house-fly.
In the seventh and eighth years we have a third course still more
advanced than either of the first two courses which I have just
outlined, and upon the same general subjects. Of course in all
this instruction there is a sufiicient amount relating to alcoholic
drinks and narcotics and their effects upon the human system to
conform to the requirements of the law in these particulars.
But with adequate school buildings properly constructed and
with the pupils in these schools under the instruction outlined, the
work will not be successful unless the teachers have been trained to
efficiency in the presentation of these particular topics. The in-
struction, therefore, given in physiology and hygiene in our State
Normal Schools, in the city training schools and in training classes
where teachers are prepared for rural schools, is based upon the
outline of instruction which is to be given in this subject in the
curriculum of the public school.
j.^
TiiK School am) J^iiuluj llK.M/rrr ; FixKiiAx. 741
The elementary syllabus also coutaius an outline for instruction
in what is known as " Household Science." Instruction in this
subject is to be given to all children in the seventh and eighth
grades who are in attendance upon the public schools. Some of
these subjects relate to ^' Food and its preparation;" " The prepara-
tion and serving of meals;" *^ Homo nursing," etc.; ^* First aid,
treatment, and care of the sick ;" " Cleansing agents ;" " Household
sanitation;" " Water supply;" " Necessity for cleanliness;" " Use
of disinfectants," etc. Of course it is not possible, nor is it ex-
pected, that all of this work will be immediately begun in all the
elementary schools of the State. Work of this character is being
done now at Buffalo, in other cities of the State, and in some of
the villages. This is a starting point. It will not of course all
be accomplished in one, two, or perhaps five years. It must of
necessity be a question of gradual growth and development. You
can render a great service in the adoption and advancement of this
work in the public schools of your several communities by assuming
an interest in this subject and co-oi>erating with your school au-
thorities at home. By -so doing you are putting into operation the
ideas which have been frequently expressed here this morning and
thus justify the existence of this admirable organization.
Commissioner Porter — I think we have aU enjoyed the very pointed
and eloquent address of the Commissioner of Education, and I know that
we are aU ^l^d to hear that sanitation in puhlic schools has taken its
place and that we shaU have a common-sense teaching of such matters,
and that wiU train our children to be better men and better women in
their public health.
Discussion on these papers will be opened by Dr. John L. Hazen, of Brock-
port.
Dr. John L. IIazen, Brockport — The men who have spoken on these
subjects have left little to say. However, I will say something as to the
relation of the health oflicer to the schools in towns like my own where we
we have not a visiting nurse nor a systematic inspection of schools. The
only way we can pet at the school is through the teacher and the public.
The teachers of voiir schools will, if vou ask them, refer to vou anv child
• • • •
that does not act right, who coughs or seems languid or stupid, and that
is my only instruction to the teachers; and that report of the teacher gives
U8 an entrance into that particular family for that child, and we can get
track of what causes the trouble.
We hope at some time to have visiting nurses in all of our schools, and
to have systematic inspection; but until that is done we shall have this
half-way inspection, and the intelligent teachers are glad to co-operate.
In regard to teaching the public a more particular personal hygiene. T
may say that I am in a town with a normal school and Mr. Finearan's plan
is an excellent one. We are going to send to every country district a com-
missioner of prophylaxis: that is. a commissioner of |>ersonal hygiene, a
highly trninea perf«»n \vl»o will take the chiMreii and teach thorn along
thoMo linos in regard to contagions <liHoase« and diseases of the nose and eyea.
742 COAFEUEM'K OF SaMTAKY OFFICERS
and those things which in the past we have not been able to get at. Mental
defectives will be classified early, and if they come from physical defects
th^ will be remedied.
The schedule outlined by the commissioner will cover this whole field
eventually^ but we must get at tliese children with the co-operation of
their family physician and their school teachers; and if we do, we shall
soon be able to relieve many of these children who suffer physically and
mentally.
Deputy Ck)MMissiONEB Howe, presiding — Is Dr. John L. Hughes, of
Mt. Vernon, here? (No response.)
Then we will pass further discussion on this paper at this time and pro-
ceed with the second number on the program.
I want to impress one thought on the minds of the health officers and my
other hearers, and that is this: That just in proportion as we possess good
teeth are we apt to possess good health; and that in just the same pro-
portion as we possess good health, so do we possess the resisting power
to communicable disease.
It is a fact that the question of oral hygiene is rapidly assuming one
of the most important positions in our sanitary work, and it is a pleasure
to the State Department of Health and to the health officers of the State
of New York to welcome to its conference a set of men who are doing a
magnificent work in that particular field. We are certainly fortunate in
naving with us the speaker who will first address you, and it is With
particular pleasure that I present Dr. William G. Ebersole, Doctor of Dental
Surgery of Cleveland, Ohio, to speak to you on the subject of " Public
Health and the Dental Profession."
riHi.K' llEAi/ni AXT) TJiK Dkntal Pkofessiox ; Ebersole. 743
PUBLIC HEALTH AND THE DENTAL PROFESSION
By WiLxiAM G. Ebeesole, M.D., D.D.S.
Cleveland, O.
Mr. Commissioner and Gentlemen of the Health Department of
the State of New York, Ladies and Gentlemen : I wish to thank the
Commissioner for the introduction he has given to the question I
am to discuss.
Permit me to say that I feel highly honored indeed at being in-
vited to come before the Annual Conference of Health Officers, of
the great State of New York. It is my belief that this is the first
time in the history of medicine and dentistry that a dentist has
been called upon to address the members of a State Department of
Health, in even the smallest State in the Union, to say nothing of
a great State like New York.
Therefore, I say to you that I consider it a great honor and a
great privilege to be permitted to talk to you upon this occasion.
I fully understand that the courtesy which you have extended to
me comes not because of the fact that I am a member of the medical
profession, but because I am also a member of the dental profes-
sion ; and because it was from the latter profession that you wished
to hear.
I wish to say to you, gentlemen, that in recognizing the dental
profession, you do honor and credit unto yourselves. You do honor
unto yourselves by thus proving the broadness and progressivenees
of your organization in recognizing the great need for dental ser-
vice; and yon do credit unto yourselves by being the first State
organization composed of medical men to recognize and seek in-
formation upon the " Relationship of Public Health and the Den-
tal Profession."
It is particularly fitting that the health officers of the great State
of New York should be the first to extend a place upon their
program to a dentist to be present and discuss with you this phase
of sanitation and health ; and, your so doing comes as a recognition
and reward for the great amount of work which has been done
within your State by the dental profession, with the ultimate end
744 CoXFEUEM K OK SaMTARY OkKR EI^S
in view of having your honorable body give full recognition to the
importance which oral hygiene bears to general hygiene and sanita-
tion.
To the Rochester Dental Society belongs the credit of having
done more successful work in the oral hygiene field than any other
city in the universe; and, my being here this morning to discuss
this question before you is due more to the interest of the oral
hygiene men of Rochester than to any other cause.
It is particularly gratifying to me to know that two of the great-
est disciples of oral hygiene in your State are to follow me in the
discussion of what I am to say to you.
By the way, gentlemen, I would call your attention to the fact
that the names of the three dental men, who are to discuss this
question this morning, begin with " William." Over in our town
we have a habit of saying, " Let George Do It." I see by your
program that over here in New York State you sometimes have
" William " do it.
But to business, gentlemen ; the time allotted to me is short and
I do not wish to impose upon the courtesy extended to the dental
profession.
The question of " Public Health and the Dental Profession " is
one which for years I have considered of vital importance.
Years ago, as a law student, my health failed and I was led to
give up my legal studies and was for a time employed to introduce
to the dental and medical profession the then newly discovered local
anesthetic " cocaine." My duties brought me in close touch with
dentists and their patients, and the conditions which I found in the
mouths of the laity at that time were simply appalling. I found
that thousands of people were practically physical wrecks as a result
of faulty oral conditions. Young and old alike were struggling
through life with a fearful oral handicap.
So thoroughly impressed was I at that time that I became con-
vinced that a man who would educate himself in such a way as to
be able to educate the people to a point where they would realize
the true value of healthy oral conditions, would fill a greater
want than in any other profession. For twenty-three years, five
years as a layman, five years as a student, and thirteon years as a
member of the profession, I have l^eon turning much of my time
f^nd my attention in that direction.
pLHLKj Health and the Dental Pkoi'essiox ; Ebeksolj:. 745
Within the past two years it has been demonstrated beyond any
question, that 96 to 97 per cent, of the school children of this land
are in need of actual care and treatment from a denta] standpoint.
In other words, gentlemen, 97 per cent, of the m'ait'as ^^f tie school
childreu of this country are in an insanitary a.id 'm' ;;i:: y con-
dition.
What is the meaning of such a condition as this?
For years the health organizations throughout the country ha\'e
been spending millions of dollars in their efforts to bring to the
human family food stuffs and drink free from micro-organic life
which would produce pathogenic conditions within the consumer.
I repeat, millions have Leen spent for this purpose. Much good
has been accomplished, to be sure. But, let me ask this body of
intelligent and scientific men how much we have gained when we
have brought this thoroughly sanitary and hygienic food stuff and
drink to the consumer, at this tremendous cost, and then before it
can reach the source for which it was intended, that is, the nour-
ishing of mankind, it must pass throutih grinding machines, 97
per cent, of which are filled with pathotrenic micro-organic life,
there to have thoroughly mixed and incoi^Dorated with them the
very class of germs which your valuable organizations have been
fighting to destroy or eliminate from these necessities of life?
I again ask, how much have we gaiiuM] { I am willing to con-
cede that a great amount of good has been accomplished; but that
which has l)oen accomplished is so infinitesimally small as com-
pared with that which might have Ix^en derived had a few of the
millions which have Ix^en spent in k(x*}>in!]^ food stuffs free from
pathogenic micro-organic life, been s])ent in giving to humanity, or
in teaching humanity how to have, food gi-inding machinery
which was healthy and free from pathogenic micro-organic life.
With 97 per cent, of the people with diseased or defective
mouths, every one of which is a harbinger of pathogenic micro-
organisms, I would ask if we linve not overlooked and neglected in
our search for sourcos of infc<"tiou, the greatest producer, and at
the same time the widest disseminator of pathogenic micro-organic
life.
I need not tell this scientific body that in the one hundred and
fiftv and over, of raicro-onranisms which have been found to in-
^ I /■>
4() C()XFERKN< E OF SaMTAUV OfFUKR?
habit the human mouth, many of those pathogenic organisms
which you hare been fighting for years, are constantly found. In
addition to this, I wish to call your attention to the fact that the
mouth not only contains, but breeds and disseminates pathogenic
micro-organisms, which are to-day wielding a stronger detrimen-
tal influence to the human family than those which you have been
so nobly fighting for all these years. I refer, gentlemen, to the
streptococcus media, which produces caries, or decay of the teeth.
Caries, or decay of the teeth, is the most prevalent disease known
to modern civilization.
You are familiar, and thoroughly conversant with the manner
and means whereby the organisms which produce typhoid fever,
scarlet fever, diphtheria, pneumonia and tuberculosis, are trans-
ferred from one individual to another; and know only too well
the tremendous havoc these organisms are capable of producing
when unrestrained. But I want to say to you, gentlemen, that
the micro-organisms which produce carie§, or decay of the teeth,
are just as readily transferable from child to child and from
adult to adult as the other organisms just mentioned; and, are
wielding a far greater havoc in the human family than all the
others put together.
I am well aware, gentlemen, that the words just uttered will
lead some of you to say that the speaker is either crazy or a fool
to make such statements, but I can assure you that neither is
the case.
When you have given as much thought, time and consideration
to the study of this question as the speaker has given, you will
then begin to realize something of the tremendous influence for
evil these '^ tooth-destroying" micro-organisms are wielding in the
human family. '
In support of my statement, let me quote from Prof. Osier, a
man from your own ranks, who was sufficiently well posted in
this direction to make the following statement before a body of
dentists and dental students a couple of years ago. He says :
"You have one gospel to preach, and you have to preach it
early and late, in season and out of season. It is the gospel of
cleanliness of the mouth, cleanliness of the teeth, cleanliness of
the throat. These three things must be your text throughout life.
Public Health and the Dental Profession ; Ebeksole 747
Oral hygiene, the hygiene of the mouth — there is not one single
thing more important to the public in the whole range of hygiene
than that.' •
It is but reasonable then that a dental man should make such a
statement as I have made when there has been enough in this
question to meris Dr. Osier's statement.
Let us consider for a moment. We have told you that 97 per
cent, and over of the mouths of the people of this country are
diseased; and, that in every one of those 97 per cent, the " tooth-
destroying" micro-organisms are found. And, in every mouth
where the " tooth-destroying micro-organisms are found, we have
a pathogenic condition, and in every mouth where these organ-
isms are permitted to become active, the best possible breeding
places are found for the pathogenic micro-organisms with which
you gentlemen are so familiar.
Not only do the " tooth-destroying " micro-organisms aid in
producing breeding ground for other pathogenic micro-organisms,
but they, by their action, produce two of the most favorable con-
ditions for possible infection.
First, by their activities around the necks of the teeth they
produce softened and bleeding gums, which offer an excellent
opportunity for infection. But, worst of all, by their inroads
into the tooth substance, they destroy the dental tissue until the
dental pulp is exposed, producing the best and probably the most
frequent means of infection which takes place in the mouth.
A tooth with an exposed pulp, or more particularly one with a
dead pulp; the cavity or pulp chamber of which is filled with
pathogenic micro-organisms, becomes the best possible means for
infection, because in the chewing of the food, the pulp chamber
acts in the capacity of the barrel of a syringe, and the food stuffs
forced into the s'ame act as a piston, thus forcing the contents into
the soft tissue at the apex of the tooth.
The percentage of infection which takes place from this means,
no man can estimate. But when we consider that of the enormous
74 S CoXFEKKNTK OK SaNITAUY OfFICKUS
number of months that have dental lesions at le^t 50 per cent, of
them show teeth which contain exposed or putrescent pulp, we may
be able 'to explain many of the heretofore '^ not understxx)d "
sources of infection.
During the past year, it has been my privilege three times to
occupy and speak from the same platform with that gifted and
tremendous force in ithe sanitary world, Dr. W. A. Evans, Com-
missioner of Health of Chicago. The last time we were together
he spoke on the subject of *^ The Dentist and the Public Health,''
a subject almost identical to that assigned, to me this morning.
Dr. Evans has given considerable thought and attention, during
the past two years, to this phase of sanitation and hygiene; and
has been working hand in hand with many of the leading mem-
bers of the dental profession in his city, and I therefore desire to
quote some of the statements he made upon the occasion above re-
ferred to. He says:
" In the first place, the mouth is regarded now more and more
as of relation to contagious diseases. About a month ago I was
at the meeting of the American Public Health Association held
in Milwaukee, and great stress was there put on the relation of
the secretions of the mouth, of the cavities accessory to the
mouth, to scarlet fever, to diphtheria, and to measles, to which
with perfect propriety can be added consumption, pneumonia,
and common colds. In times past in considering the care of the
person who has had scarlet fever we paid great attention to the
skin. It is but recently that we have come to understand that
the skin was of minor importance in spreading scarlet fever, if it
was of any importance at all, and after cases had been held for
the customary six weeks or thereabouts in the hospital, had been
held until all scaling of the skin had ceased, and then had been
returned to their homes, had been returned to the family circle
in which there were children susceptible to scarlet fever, that a
certain percentage of cases would occur as a result of those con-
tacts. Later we came to understand that the child supposed to
be clear of contagion, in reality was spreading contagion or car-
rying contagion back into that home, and then we came to know
that the means by which contagion was carried was the secretion
Public Health am) the Dental Pkofessioa ; Euersole 749
of the mouth and the accessory cavities of the car, the nose, the
naso-pharynx, that contagion was held in the crypts of the tonsils,
in recesses in the mucous membrane, in the naso-pharynx, in the
secretions of the ear, and then we came to know the possibilities
around the teeth that had not been properly cleaned and in cavi-
ties that were filled with organic matter of various characters,
that there might be elements of contagion; and what is true of
scarlet fever is probably still more true of diphtheria. That the
baccili capable of infection lurk in the crypts of the tonsils, in
the mucous membranes, around the roots of teeth, around the
gum borders of teeth, in cavities in teeth ; and after these things
we have been watching have been proven to bo clear and we have
allowed the children to go among the other children of the fam-
ily, that contagion is carried to them through these means of
carrying hitherto overlooked. Probably of greater consequence
still is the possibility of the spread of contagion in the cases of
pneumonia, common colds and consumption. The dental profes-
sion, the work of the dental profession, teeth cared for and teeth
uncared for, is, therefore, a matter of great concern in the pre-
vention of the spread of a contagious disease."
\Vhen a man of Dr. Evans' caliber, who has given less than two
years' thought and study to the influence the mouth may wield in
the transmission of contagious diseases, has been sufficiently im-
pressed to call forth the statements which I have just read in your
hearing, I would ask what must be the impression upon the
mind of one who has given years of thought and study in this par-
ticular direction; and, in the light of one who has so studied and
investigated J I wish to repeat that the micro-organisms which pro-
duce caries, or decay of the teeth, are just as readily transferable,
patient to patient, as any other micro organisms, and are wielding
far greater havoc than all the others put together.
Thus far I have si)oken of the mouth and the influence it wields
for good or for evil from the hygienic standpoint.
In the medical profession, we have specialists who devote their
time and attention to every other part of the body, save the mouth.
The medical men have sidestepped here and left the mouth to the
dental men. The medical men have considered the dental men
tfAa^^
750 Conference of Saxitauy Officers
the oral specialists and the dental men, almost to a man^ have until
recently failed to grasp the full responsibility which rested upon
their s'houlders and realize that upon them rested the importance
of proper oral conditions.
Most dental men have been tooth specialists instead of oral or
mouth specialists. It is only when the dentist realizes his respon-
sibility in the latter capacity that he assumes his true relation to
the public health in his community.
With oral conditions as we find them, and with the influences
they exert upon the public health and general welfare of the hu-
man family fully recognized and the dental profession alone oc-
cupying the field of oral specialist, it is to this profession that we
must turn for the correction of the faulty conditions which here
exist. To him belongs the mission of teaching prevention, and
practicing correction of dental lesions. In teaching prevention
he must do so from two standpoints: First, he must teach that a
clean tooth never decays, and must therefore instruct his patients
in the perfonnance of a correct sanitary dental toilet. He must
also teach that " a lazy tooth becomes in time a rotten one.'* He
must therefore teaoh when and how to properly use the teeth that
they may not only perform their full duty as related to the general
digestive tract; but, that they may in turn, by their proper activ-
ity aid in their own self -preservation.
And, last and least, it is his, when the dental lesions occur, to
correct or repair the same.
Too often with the dentist of the past the last has been first and
the first has been last ; but, to-day, thanks to the activity of the
few, the many are awakening to the importance of, and giving full
thought and consideration to, prevention, while correction and re-
pair is assuming its proper position in the scale of importance,
that is, that of being secondary to prevention.
To the dentist then belongs the mission of teaching how, and aid-
ing in keeping the mouth in the condition and for the purpose for
which the Creator intended it,
PrBLic Health and the Dental Pkofessiox ; Ebeksole Tol
With the dentist res|>oiLsiblc for the condition and use of the
mouth, it becomes' ncoessary, in order to establish the true relation
of the dentist to the public health of the community, to show what
influence the mouth boars in that caj>acity.
I know of no illustration of what an important part the mouth
plays in the health of the individiial, than that which has been
shown by the activities and research work done by ^fr. Horace
Fletcher. This man, who at the age of forty was a ph^-sical wreck,
being on the scrap heap, as he called it, denied insurance by the
insurance corporations; and condemned to an early death by the
examining physicians, has, by the proper use and care of the oral
eavnty, produced from a physical wreck at the age of forty, a man
who at the age of sixty is able to practically double the greatest
feats of strength and endurance performed by the best athletes of
the leading colleges of the world.
Xot satisfied with the experience of one individual, the speaker,
in the name of the Oral Hygiene CJommittee of the National
Dental Association, has undertaken to prove the actual value of
the proper use and care of the mouth upon the working efficiency
of forty children, selected from Marion School, Cleveland, Ohio,
as having the worst oral conditions out of an enrollment of 886
pupils.
In selecting these children a complete and careful examination
of the mouths were made and the historv and class records of the
children taken for six months preceding the time treatment was be-
gun. Two psvchological tests were made to prove the actual work-
ing efficiency of the children at the time they were received for
care and treatment. They were then placed under the instruction
and care of a nur^<? to teach them how to use and care for their
mouths ; and dental service was furnished to correct all faulty oral
conditions. The majority of these children were repeaters, and
some of them were only kept in school by the truant officer.
Special meals were served fo feach the cbildren bow to properly
use their teeth,
752 CoNFEUKXcr: ok Sanitary Officeks
It is yet too early to state just Avlrat results will be shown by
the experiment conducted with this class, owing to the fact that
we ^re just in the midst of our work an<l our records wnll not be
eom,pleted until after the first of June, 1911. .But, we have pro-
gressed sufficiently far to he able to say to you that the most
marked improvement has been shown.
The work with this class was begun the first oi June, 1910, and
from that time down to the present, there has not been a single
ca^ of illness of anv member of the class, and the school records
in scholarship, effort, attcndianco, and conduct, show wonderful
imiprovement. So much so indeed, tlrat not only the principal of
the school, but, every one who has* had any opportunity to know
and be familiar with the class, speaks in the most glowing terms of
the resnlts which 'have been accomplished.
The work has progressed far enough, gentlemen, for me to make
the statement that when the final results are com,piled, they will
be of sufficient importance to command and hold the attention of
every mian who is interested' in the general welfare of humanity.
The importance the mouth then bears, gentlemen, to the general '
physical condition of mankind, enititled it and those who lare devot-
ing their lives to its needs, to full recognition and consideration
by those organizations, municipal. State and I^ational, which have
to do with the physical welfare of the human family. Every or-
ganization which hias health for its consideration, should have not
only in its council, but in its inspection department as well, mem-
bers of the dental profession. And, just as sure and as certain as
I stand before you this morning, those organizations which are
the mc^t progressiivo and successful in the handling >of public
health questions, will have the dental profession well represented
in every active department. Think not that there is no need for
dental representation in connection with health boards or bureaus ;
and think not tlnat the medical men can successfully handle this
important phase of hygiene and sanitation, for such is not the case.
Conditions are so appalling, and the dental lesions so distressing,
and the physical condition so impaired by faulty oral conditions
r.
VvniAv Mem/vu AM) THE Dkntat. Profession; Ebeksole 753
that oiilv dental activities of tho most forcHiil kind ("an wield suf-
fioient weight and influence to produce a psjchologieal impression
which w^ill in a measure lead to a full nnderstanding by the indi-
vidual of the obHgation -and duties he must perform if conditions
are to he met and corrected.
The people must be taught to know and do tliose things which
will produce and maintain perfectly healthy oral conditions; and
to the dental profession alone belongs this duty and this obliga-
tion, and they must fulfill them if humanity is to come into its
own.
I recommend, therefore, to you, gentlemen, that members of
the dental profession, not only be invited to work with you ; but,
that they be given appointments and recognition in connection
with your various departments of public health and inspection if
you would do the greatest good to the greatest number. For, to
the health organization which first takes this step, will be given
the credit of being first to read the " signs of the times " and rec-
ognize the importance of a great reform movement which is
sweeping throughout the world.
Believing that the Health OflBcers of the great State of Xew
York here assembled will not only see the importance of such a
movement, but will pass a resolution recommending such action,
I close.
I thank you.
Deputt Commisbio'er Howe — \Vc will now take up the discussion of
this paper by Dr. Ebersole. I will first call on Dr. WTiite, an ex-president
of the State Dental Society, who has been active in prosecuting? this work, to
say something to us on this point. It is with pleasure that I call on
Dr. White.
\V. A. White, D.D.S., Phelps — J/r. President, Ladies and Gentlemen:
This is certainly a new paper for the consideration of a body of this kind,
and it is a golden opportunity for a dentist to be able to stand before such
a representative body of the medical profession. You have listened to an
able presentation of the relation of the public health and the dental pro-
fession. My remarks in discussing this paper will be very short, and will
be devoted more to a consideration of the child and its mother.
Dr. Xetter. a physician, through microscopical research has revealed the
a>*toundincr fact Hint tlio diplococci of pneumonia and the bacillus of typhoitl
and diplitlMTiu, as well an the micro-organisms of erysipelas, anthrax and
754 Conference of Samtaky Officeur
thrush exist in the mouths of fifteen per cent, of that class of bodies which
are ordinarily classified as healthy. If these, then, exist in the mouths of
those known as healthy subjects, what must we expect to find in the mouths
of those subjects who use no tooth brush or dentifrice or prophylaxis?
Recall the cases where a child is constantly using up energy and the tissues
which enter into the formation of the structure of the child's body. What
must be done? What can be accomplished? And how shall we restore the
tissues carried off in this form of activity by the child? The builder in con-
structing his building seeks out good material, and various kinds of material,
to compose his structure. He selects for its base or foundation, stone, brick
or other suitable material. And so on throughout the building. So the
child must have the various elements which enter into the various parts of
its structures and tissues of its body incorporated there. If the builder
places poor material in one part of his building, he has a weakened struc-
ture. And so it is with the child, unless proper assimilation taJces place^
there is a weakness, and in order to produce proper structure, we must have
thorough assimilation of the food, and thorough assimilation of the food re-
quires thorough digestion; and in order to have thorough digestion, we must
have good teeth, and thorough mastication of the food in the mouth.
Prof. Michael, of Germany, says that mastication consists of two different
acts. First, the canine teeth, tear pieces of the food and cut it up, and
second, the food in turn must l>e ground, ground and ground by the molars,
until, with proper insalivation by uncontaminated salivtt, the food is carried
into the stomach. Under such conditions we have thorough assimilation,
which we cannot have without thorough mastication and digestion.
Now, when we take into consideration the fact that ninety-seven per cent,
of the school children are in need of dental attention, with seventy-five per
cent, of this number unable to have such attention. I ask this body of medical
men, is there any greater avenue through which our efforts may be directed,
which will yield greater results for the physical betterment of mankind, than
by instructing the children in our schools the manifold blessings resulting
from a thorough knowledge of, and how best to exercise, this knowledge?
It cannot be truly said by physicians that the condition of the mouth and
the absence of teeth have no bearing on the development or the nourishment
of the child or other individual, neither can it be maintained that an indi-
vidual can live just as well and with the same amount of vitality without in-
salivation of the food. It is evident, therefore, that insalivation must take
place before we can realize a normal digestion and have our food valuable.
Thoroughly masticated white bread; twenty-four per cent, of it is converted
into soluble sugar in one minute, and thirty-nine per cent, of it in five
minutes. Then, as this food passes into the stomach, the saliva-ferments are
active for from ten to twenty-four minutes in the stomach, until they are
neutralized by stomach acids. This proves the great importance of insaliva-
tion, especially in starch food. And on this point we must remember that
the eye specialists admit that decayed teeth cause indigestion, and indigestion
causes eye-strain.
How many of you gentlemen have seen a child sent to school with a sore
face and an aching tooth, wholly unfit to accomplish the work set before it?
The swelling soon passes off, and the mother and the child assimie that the
trouble has all passed away; but you gentlemen, and particularly those of
the dental profession, know that the trouble has not gone, but an abscess is
forming in the tooth. A fistula develops and the discharge vitiates the saliva
of the mouth, and contaminates the food entering the stomach, and there
the trouble begins. The assimilation which should take place there is inter-
fered with by tbp wi>hf>4ilthy conditjoii pf the food lying in the phiW'l
Plblh lIi':«\LTn and the Dkxtat. Profession; Ebeksole 75.")
These things can be overcome only by a thorough knowledge of oral hygiene,
and I believe no greater favor can be granted, or extended to the mothers
and the children than for the Department of Health of the great State of
New York to have in connection with its work, a Bureau of Oral Hygiene,
and then every mother will bestow a blessing on the State Department of
Health, and by so doing it will withstand the ravages of storm, time and
temper.
Now, in regard to this instruction of tlie mothers, I can do no better than
to read to you the words of Daniel Webster, who said, when he addressed an
assemblage of ladies:
" It is by the promulgation of sound morals in the community, and more
eFsentially by the training and instruction of the young, that woman per-
forms her part toward the preservation of a free government. It is generally
admitted that public liberty and the perpetuity of a free constitution rest
on the virtue and intelligence of the community which enjoys it. How is that
virtue to be inspired, and how is that intelligence to be communicated? Bona-
parte once asked Mme. de Stael in what manner he could best promote the
happiness of France. Her reply was full of political wisdom. She said,
* Instruct the mothers of the French people.* Mothers are, indeed, the affec-
tionate and effective teachers of the human race. The mother begins her pro-
cess of training with the infant in her arms. It is she who directs, so to
speak, its first mental and spiritual pulsations. She conducts it along the
impressible years of childhood and youth, and hopes to deliver it to the stem
conflicts and tumultuous scenes of life, armed by those good principles which
her child received from maternal care and love.
** If we draw within the circle of our contemplation the mothers of a
civilized nation, what do we see? We behold so many artificers working,
not on frail and perishable matter, but on the immortal mind, molding and
fashioning beings who are to exist forever. We applaud the artist whose
skill and genius present the mimic man upon the canvas; we admire and cele-
brate the sculptor who works <nit that same image in enduring marble; but
liow insignificant are these achievements, though the highest and fairest in all
the departments of art, in comparison with the great vocation of human
mothers. They work, not upon the canvas that shall perish, or the marble
that shall crumble into dust, but upon mind, upon spirit, which is to last
forever, and which is to bear, for jjocmI or evil, throughout its duration, the
impress of a mother's plastic hand."
I believe that the future holds great possibilities for the dental profes-
sion, that its duty of preserving and promoting the public health will make
it one of the greatest public forces, if we but use our best effort to encourage
and foster the teachings which we advocate. The influence of such work can-
not die, but will go on and on for years to come, as a rich inheritance for
those who follow.
I thank you for the opportunity you have given me in the name of the
National Dental Convention and Dental Society of the State of New York, for
this recognition which you have extended to myself and to the other gentlemen
of the dental profession who are here.
Deputy Commissioner Howe — This is a new branch which is coming to
gtay — the question of the care of the teeth. I want Dr. Belcher, of
Rochester, to speak to you a few moments in discussing this paper.
W^ W. Belcher, D.D.S., Rochestei* — A clean mouth is a safeguard against
disease. A clean mouth turneth away trouble is just as gooa a proverb ft8
" » eoft answer turneth away wrath."
75G CoxFKUEXCE OF Samtauy Officeus
The full significance of these facts have not been understood by even the
dental profession until a comparatively recent time. Dentists have been
practicing preventive medicine but knew it not.
Not unlike many other great truths, tlio wonder is that we should not
have recognized it earlier.
How delightfully simple. At leajst 75 per cent, of all our diseases «.re
introduced through the mouth. If this be true, what scrupulous care should
be taken to keep it clean and free from contagion.
As a matter of fact, how little care has been exercised by even the average
rea89nably neat person; they have given more attention to the cleanliness
of their feet than this vestibule of life, the human mouth!
That a dirty mouth with its wealth of micro-organisms should spread
disease nixl cause numberless ilia seems quite simple; that such diseases as
diphtheria, croup, and all respiratory troubles should be very much worse
and many times caused by an imhygienic mouth seems equally true. That
a child doubling his weight and at the school age assuming the added
burden of his mental development needs a good chewing equipment, and that
it is absolutely essential to his future welfare seems, in the light of to-day,
an undebatable truth. Why didn't we recognize this fact earlier?
A tuberculosis patient must have a good dental equipment if be is to make
a successful fight against the " Great White Plague," and cannot recover
if he be burdened with a filthy mouth harboring infection and uncleanliness,
with the possibilities of constant reinfection to the human economy and the
accompanying digestive troubles associated with this condition; and yet we
have, in the past, practically neglected this important help. That the per-
centage of cures have been so low is not surprising, as that there should
have been any at all.
How could we ever have expected a child with twelve to fifteen of its
twenty teeth decayed, with exposed pulps, with teeth discharging their dirty
slimy pus into the stomach and mixed with every mouthful of food, impair-
ing the digestive fluids and burdening the body with poisonous toxines to
keep up its studies at school or remain in good health.
Children in the past have survived these conditions; have lived in filth,
and, in spite of these handicaps, have attained to their mental and physical
equipment; how did they ever do it? God only knows. How many of these
children have been whipped and misunderstood at home, apologized for at
school with a reputation for a bad temper for being obstinate and dull when
the whole trouble was that the^r had to figlit a diseased condition produced
by a deficient and uncared for dental equipment with the poisoned and con-
taminated and poorly chewed food that refused to build healthy tissue and
brain matter.
Can you wonder at this child with a diseased mouth and all its associated
troubles, with adenoids, unable to keep his place in school, shunned by his
companions and no place in their childish sports, becoming discouraged? He
is told that he is not " bright," he loses faith in himself and looks with
envy on those more favored. He plays " hookey " and finds congenial com-
panions outside his school life and ofttimes becomes a physical and moral
degenerate.
Xow we cannot escape this responsibility. The child of to-day is to be the
ruler of to-morrow; the lawmaker and the governor of our large cities and
the nation. The law of the statute book is the law made by public opinion,
and public opinion is being largely shaped by men and women of improper
mental and physical development; by men from children grown who did not
have a square deal in our schools and who labored under a physical and
mental handicap: they were never "free and equal" and this is part of
the cost that every community is paying for poorly developed children.
Public Health and thk Dkxtal Profkssiox ; Ebkksole T.'iT
>
Do you think this picture has been overdrawn? How many children whom
you know have entered school full of promise and from some unknown
cause have solely drifted from bad to worse — lost their place and degen-
erated physically and mentally?
'Dr. Gulick, after some time investigating this matter, says that two de-
fective teeth in the mouth of a child will retard him for half a year in his
studies.
What are we doing for these children in this land of ours? Why, prac-
tically nothing. We have plenty of money to fight doodle bugs, foot and
mouth disease among our cattle and infectious diseases among our hogs and
money for forest preserves and a Barge canal. Don't you think it would be
economy to spend a little of this money on our greatest national asset, the
boys and girls of to-day who are so soon to be our rulers and lawmakers?
Uow long, Oh Lord, how long shall the blind lead the blind?
These statements as here presented you may or may not believe, but truth
is strong and must prevail. Dentistry has a most important place in the
practice of preventive medicine. You must accept this. Any other attitude
in this year of our Lord is harking back to the Voodo doctor and the dark
ages. Let in light!
Deputy Commissio:«e:r Howe — We will now take a recess until 3 o'clock,
and we will ask you all to be prompt in returning so that wc may resume
our program where we left off and complete the balance of the forenoon
program, as well as the afternoon program, during the afternoon session.
Recess until 3 P. m.
758 Conference of Sanitaky Offk eks
WEDNESDAY, NOVEMBER i6, 3 P. M.
Second Session
De. Hjlls Cole, Temporary Chairman — I am not the proper presiding
officer at this function, but as head of the bureau of publicity, which is
responsible for getting up the program, I feel that it is my duty to see that
the program is carried through, and inasmuch as no executive officer is
present I will take the liberty of calling the Conference to order.
We will first take up that part of the program whicn had to be omitted
this morning and we will have a discussion on the topic of public health
work and public health officials and the medical profession. We shall
treat that from the standpoint of the health officer as he experiences difficul-
ties among his brethren m the medical profession, and then we shall have
it treated from the standpoint of the general practitioner and his trouble
with the health officer, and I hope out of the discussion we shall have much
mutual profit.
We shall now have the pleasure of listening to Dr. Lake of Gowanda,
medical officer of the State Department of Health, who will speak to us on
the " Difficulties of Health Officers as Seen by the Physician."
Db. a. D. Lake — Mr. Chairman, Ladies and Gentlemen — The forenoon
session has been to me, as I know it has been to all of you, an exceedingly
interesting one; and we have had for topics matters not pertaining to our-
selves but to others. We now come to that part of the program in which
we are permitted, to a certain extent, to speak of ourselves and our medical
associates and that is the substance of my paper.
THE DIFFICULTIES OF HEALTH OFFICERS AS SEEN
BY THE PHYSICIAN
By a. D. Lake, M.D.
Medical Officer, State Department of Health, Gowanda, N. Y.
In discussing the various functions of the health officer, it is
apparent that in the largest measure, the attainment of the best
results, in his official capacity, must depend upon the cordial
relations existing between him and all the physicians with whom
he must come in contact in the fulfillment of his duties to the
public. To secure to the people the protection, which the creation
of his office was expected to bring about, he must have the co-
operation of all the physicians in his jurisdiction.
It then becomes a question of the greatest importance, how such
relations are to be secured and maintained. It is a fair inference
that the first qualification, both in education and ethics, demanded
by the physician of the health officer, is that he should measure
tarn
DlFFlrrLTIKS OF HeALTII ()fI H'KRs AS SeEX BY PlIYSt('rAX 759
up, ill attainment, to the high standard now existing in the profes-
sion of medicine. It is expected that he should seek to con-
tinually inform himself along the special lines of work called for
by the duties of his position.
In the vast field of sanitary science and preventive medicine,
in which such rapid advancement has been made in recent years,
the physician looks for the health officer to stand in the fore-front,
an earnest, industrious student, a careful investigator, a tactful
administrator, always mindful that he does not exceed his lawful
authority. To reach this point of excellence is not an easy task,
nor, in most instances does it bring much of other reward than the
consciousness of weU-doing. If, however, he fails in these require-
ments, demonstrating his ignorance of the things he ought to know,
the result is surely unfortunate, and possibly disastrous.
Within the reach of the health officer is the most extensive
literature, largely of a character particularly demanded by the
character of his work. There is also the school of sanitary science
and the annual conference, both maintained by the State Depart-
ment of Health. It is reasonable to suppose that both physicians
and the public expect health officers to avail themselves of these
opportunities of obtaining information.
The sphere of knowledge in sanitary matters being more largely
in the province of the health officer, the physician may consistently
look to him for information and instruction. Here, however, the
official should not err in an attempt to demonstrate his acquire-
ments in an intrusive or offensive manrer, or under circumstances
where such information is not demanded. It would not be at all
difficult to find a place on the program, at every meeting of the
various medical societies, which should be filled by a paper from
some health officer, containing practical ideas and suggestions, the
result of his special work and study. The development of this
plan would be likely to bring us more in touch with the profession
in general, and might go far in obtaining more complete returns
of vital statistics and repK)rts of the existence of infectious dis-
eases.
The State medical societies as well as those of the several coun-
ties have standing committees on public health. It would seem
very proper indeed that health officers should largely interest
760 CoNFERENC'K OF SaXITARY OFFICERS
themselves in the work of these committees, and be prepared,
whenever invited to do so, to assist in their beneficial efforts.
Assuming that the health officer is in possession of the neces-
sary educational requirements, we may ask what are the relations
which should exist between him and the attending physician in
the presence of infectious and communicable disease ? It is
realized that in some instances this may become quite a delicate
question. The case must be reported to the health officer, and it
at once becomes his duty to put in operation measures to protect
the public from further infection. To do this effectually he must
visit and inspect the premises, instruct the family as to the means
necessary to confine the disease to the individual cases reported,
and establish a quarantine. To ae<^omplish all this it may or may
not be necessary for him to see the patient. In either instance it
would seem best, if possible, that he should first seek an oppor-
tunity to interview the attending physician, obtaining from him
such information regarding the history of the case reported as he
may be able to supply. It will be found, very often, that the
latter himself has investigated as to cause and origin, and will be
glad to communicate the result of his research, if asked to do so.
If the inspection can be made in the presence of the attending
physician it should be in aid to the health officer in gaining the
confidence of the family, and, in many instances, bring to his con-
tinued support the help of the physician. In this connection it
should be maintained that the health officer is not a consultant, by
virtue of his office, and he should never assume to act as such
unless requested to do so by the attending physician.
In his inspection it is most important that his demeanor and
his language be circumspect, carefully guarding the interests of
the physician, and never intruding suggestions as to treatment.
If a question as to the accuracy of diagnosis should arise, the
views of the health officer should first be presented to the physi-
cian, and not in the presence of others. When the matter has been
decided, if the diagnosis is to be changed it would be wise that
the announcement be made to the family by the attending physi-
cian rather than by the health officer. In the opinion of the
writer, after many years' experience as health officer, such matters
can be amicably settled, with the best results to all concerned,
DiKKirrr/riKs ok TlKAi/ni Okkickks as Sekn hv Piiyskiax 701
nothing being necessary to bring this about except that the health
officer avoid the temptation, which the occasion* may afford, to gain
the reputation of being a better diagnostician than the attending
physician.
A most unfortunate condition arises when infectious diseases
are not reported by the physician, with a case coming to the knowl-
edge of the health officer through other sources of information.
In most of such instances it is to be assumed that the neglect is
due to carelessness or forgetfulness rather than from any intent
to evade the law. Taking this view it will not be difficult for the
health officer in a tactful interview with the physician to so ar-
range matters that pleasant relations may still be maintained be-
tween them.
The health officer comes to his duties armed with somewhat
arbitrary power. This authority should never be manifested ex-
cept in the rarest instances, either toward the physician or the
public. The best results here, as elsewhere, will always follow
the exhibition of tact, diplomacy and kindness.
A matter of considerable importance, affecting the interests of
both physician and health officer, is the question of compensation
which the latter should receive for his services. All must agree
that the amount generally paid is entirely inadequate, and not at
all commensurate with the work required. Each year the respon-
sibility and the labor of the office is increasing, and it is not easy
to explain why municipalities should not properly compensate
these officials for the performance of their multitudinous duties.
Doubtless this will be done when physicians demand it, and when
they discourage any attempt to secure such services except on a
fair basis, as compared with work in private practice. It would
s(»em eminently proper that n«) competition should ever exist,
either between physicians or health officers, as to fees of this char-
acter.
The physicians may rightfully expect the health officer to be
alert and ready for action, whenever his services are required.
Under present regulations he is to look to him for certain sup-
plies, very necessary in the proper management of some of his
cases. It h therefore important that the health officer always
have at hand vaccine virus, antitoxinos, culture tubes, the solution
762 CoNKKKKNCK OF SaMTAUY OfFK'EKS
for prophylaxis in ophthalmia neonatorum, disinfectants, sputum
cups, etc. lie should be ready, at all times, to forward water to
the proper places for analysis. He is justly subject to criticism
if he neglects these important duties, and fails to respond
promptly to the call of the phy^sician. On the other hand if his
oflScial acts are characterized by honesty of purpose, enthusiasm
in his work, and a sincere interest in the public welfare, there is
little doubt he will gain the respect and support of his profes-
sional associates, and the laity as well.
COMMISSIONEB PoBTER — The other side of this discussion will now be
presented by Dr. Alsever, the medical officer of the State Department of
Health at Syracuse.
Prr.Mc Health and the ^Iedual Pkdfessiox ; Alsevek 70*)
PUBLIC HEALTH AND THE MEDICAL PROFESSION
— THE SPIEIT OF MUTUAL HELPFULNESS
By Wm. D. Alsevek, M.D.
Medical Officer, State Department of Health, Syracuse
If each one lived according to tlie golden rule, a discussion of
" The Spirit of Mutual Helpfulness " would be uncalled for.
But such lives are not lived, for each of us is human and has
human vices. In the stress of life each of us is strongly tempted
to gain advantage by the use of unfair methods. Xone of us
always resist this temptation, most of us usually resist it, while
a few of us succumb frequently. That is to say, most men are
honest, only a minority are dishonest.
In sanitary matters we must remember that we are dealing
with both the honest and the dishonest, and that our object is
not primarily the improvement of the morals of the i>eople nor
the prosecution of law breakers, but the improvement of the pub-
lic health.
In considering how health officers and doctors can better work
together to accomplish that result, we must, I believe, keep two
facts constantly in mind — first, that we are dealing with all
kinds of men, and, second, that it is residts we are after.
I am indebted to about fifty of my friends, living in various
parts of the State, for frank expressions of their opinions on
this subject, and what I say is based in part on their statements.
I have endeavored to find out whether the average health officer
and the average doctor are honestly desirous of promoting the
public health. The majority of those who expressed an opinion
on this subject agree with me that these men, as a rule, wish to
promote the public health. That health officers are ardent in
their duties is very gratifying for usually they are underpaid,
they hold office subject to the wish of politicians, and they work
with the knowledge that progressive or unusual methods will cer-
tainly antagonize a considerable part of the community on whose
good-will they must depend to earn a livelihood at tho practice
of medicine. I believe it is a fact that health officers have the
7r.4 C'o.NKKitKXiK t>i' Sanitaky Okku'eks
health of their commuQtties at heart aud are but i*arely the medical
castoffs who are unable to make a living in the profession and seek
office for the salary only.
The aid given by praetieing physicians to all public health
matters is evidence that they have such matters at hoart. The
prevention of disease must necessarily be bad for the business
of the doctorg. The establishment and enforcement of quarantine
with its accompaniments of great inconvenience and expense to
families is a burden which the doctor, for business reasons, is
tempted not to undertake; and this temptalion is greatest if the
sickness is either mild or atypical. The removal of patients to
hospitals if they are thereby lost to the attending doctor may
naturally enough be against his wishes, especially if he is young
and needs the business. Evidently a mercenary practitioner has
very little reason to actively promote public Iicallb, The part
which has been taken in sanitary mattera by the doctors of New
York State, both individually and through organizations, is' con-
vincing proof of their unselfishness.
AfttT all, why shoidd either general practitioners or health
officers, who are but temporarily drafted from the profession,
have a monopoly on sincere support of the Department of Pub-
lic Health. They have been educated in the same schools and
have practiced in the same communities and mast, in the aggre-
gate, have similar ideals. I r^ret to say that the contrary
opinion has been expressed, but I believe a study of the facta
proves my conclusion. It is inconceivable that health officers and
general practitioners can work together for the public health
unless each freely acknowledgee the fundamental honesty and
sincerity of the other. That either could work successfully with-
out the cordial support, or with the avowed opposition of tlie
other, is evidently impossible.
Hc-alth officers have a considerable amount of power and may
through process of law attempt the enforcement of quarantine,
for example, bu.t if this should be the only method used and the
disease were at: all prevalent, the conimimity \vould become
antagonistic, quarantine would become impossible and tlie disease
would bo unconti-ollcd. A supporting public sentiment ift esson-
tiul to an ofTfvtual quarantine. Without it all molliods fail us
Prjti.ic IIkaltii AM) THE ^Iki>hai. Pkokkssiox; Alskveu 705
and we do not get results. Examples of this faot are common
among our ignorant and foreign speaking communities. The
greatest moulder of public sentiment on health matters is the
family doctor. The State Departmenit of Health is accomplish-
ing much, but if its efforts were met by the outspoken opposition
of the family doctor they would not be very fruitful. The in-
terdependence of health officials and general practitioners is quite
evident. There must be *^ mutual helpfulness " in order to get
results.
There are two ways by which health officers may attempt to
secure the co-operation of practicing physicians. One is by the
strict enforcement of law through the police and the courts. The
other is by tactful and intelligent moulding of opinions so that
doctors will want to co-operate. Many doctors are now actively
and willingly co-operating with thie health authorities. The great
majority of doctors can be induced to do so. There is a small
minority of doctors who are actively antagonistic, some because
of disbelief in or ignorance of modem sanitary methods, some
because of fancied or real grievances against health officers, and
some because of selfish and mercenary motives. There is no
doubt that doctors frequently break the Public Health Law either
wilfully or through ignorance. If the first method of dealing
with them is followed and they are convicted and sentenced for
violation of law, they will be less likely to do things which will
lead to further arrests, but the Department will have made some
bitter enemies. By influencing their friends and patients against
sanitary measures these men will usually put more difficulties in
the way of the Department than they did before their arrest
made them angry and revengeful. Americans are intense in their
love of personal liberty, probably too much so, and the applica-
tion of force without an appeal to reason is likely to result in a
less effectual enforcement of law. One of our foremost citizens
has recently explained the difference between a boss and a leader
— the leader leads and the boss drives. I submit to you that
doctors are easily led, but driven with extreme difficulty. Health
officers should studiously avoid being forced into the position of
'• drivers " of general practitioners — they should rather acquire
for themselves positions m "leaders." I believe that arrest or
70() C!<)NFKUK.\(E OK SaMTARY OlFIOKKS
the thr.eat of arrest of doctors for violations of the Public Health
Law will, except in isolated instances, do more harm than good,
notwitlistanding however salutary the immediate effects may ap-
pear, i do not believe that any considerable number of practicing
physicians will violate a law if they understand it.
Having thus called attention to the cordial support given to
sanitary measures by both health officers and general practitioners,
and to the general inadvisability of enforcing obedience through
the courts, it is proper for us to consider how the mutual help-
fulness of these men can be increased.
The principal difficulty is that doctors and health officers do
not fully understand each other. The ignorance of general prac-
titioners on the letter of the law, the reasons for the law and the
results which are hoped to be obtained, is astounding. Of course,
they should know these things and ignorance is not a legal defense
for a violation of the law. However, prosecuting a man because
of ignorance is not a good way to get his co-operation in matters
of public health. Many times an interview between the health
officer and an offending doctor would result in showing the doctor
his mistake and establishing such good feeling that the doctor
would become entirely cordial in his support of the Department.
If doctors were familiar with the reasons for and the expected
results from the various health regulations, in most cases they
would not forget to do their part nor would they do it unwillingly.
This seems to be largely a question of education. Unfortimately
our medical schools have never properly trained their pupils in
public health matters. The average graduate knows too little
about the practical details of the preservation of the public health,
and" he appreciates too little his own responsibility to the State.
Much of this would be corrected if the State examination in
hygiene was made more stringent. An interne on being ques-
tioned recently regarding the possible sources of infection in some
typhoid cases replied that he had not looked into it, for that was
the business of the Board of Health. '
The Monthly Bulletin of the State Department of Health has
done much to educate us. Its articles are so ably written and the
conclusions so reasonable that a reader becomes more enthusiastic
in his support of the work of the Department, Unfortunately,
PlHLH' llKAI/ril AM) TIIK MkDITAL pRoFKSSIOX ; At.SKVKR TOT
the Bulletin does not reach everyone nor does evervi>ne who re-
eeives it read it. However, its influence extends through its
readers to the entire community. It is difficult to appeal directly
to the doctors who are more or less indifferent and to the people
in general. Evidently it is nearly as important to educate the
people as to educate the doctors, for, when the people demand
better sanitary measures, doctors hasten to supply that demand.
Therefore, to obtain the greatest degree of mutual helpfulness
we must teach the people of the State about sanitation.
One of my correspondents expressed the idea well by saying:
" I think the greatest trouble in the past with local health de-
partments and with the State at times, has been the lack of ad-
vertising. I mean of showing the local men what the Department
is trying to do to help them, showing them that the Department
hasn't got horns and is not trying to steal their cases, but is work-
ing with them as consultants and giving advice gathered from a
wide field by the State." Various methods of advertising might
be employed. At all meetings of local medical societies, the
health oflBcer or some representative of his department could re-
port on sanitary conditions, laying especial emphasis on the diffi-
culties with which he has had to contend since the previous meet-
ing and the methods used to overcome them. The discussion fol-
lowing this talk might sometimes be helpful to the health officer,
but surely the practitioners would get information which would
make them less likely to hamper ignorantly the work of the De-
partment. Both health officers and practitioners have made many
complaints against each other, but I am firmly convinced that in
most cases the disagreement is due to ignorance or to their failure
to discuss their misunderstanding. A committee was once ap-
pointed to codify the rules for quarantine in scarlet fever, there
having been so many instances of doctors advising their patients
to do certain things which were later prohibited or criticised by
the health officials that considerable antagonism had developed.
It was proposed to put in the code a rule which all agreed was
suitable, but which one, an ex-health official, objected to as unneces-
sary, saying everyone ought to know it, and that if anyone vio-
lated it, the health officers should " get the law after him." The
objector was then reminded that the object of the committee's
T(>>^ (N».\FKIJEN<'K or Samtauy Oi'IMC KliS
work was to anticipate and prevent differences and that it was
hoped that it would be unnecessary to '* get the law " after any
one. If a health officer should form a cabinet composed of lead-
ing doctors he might sometimes get helpful advice, but he surely,
through unifying their ideas on sanitary problems and stimulat-
ing their interest, could develop a force of almost unlimited power
in moulding public opinion. I have spoken of the possibility of
a health officer getting help from his medical society or his cabinet,
for, I believe it should be only a possibility, and that a health
officer should be so equipped by education or by experience or
by both that he will be looked upon as the local authority and the
natural consultant in sanitary problems. The State Department
offers some valuable courses and there are few doctors who would
not be benefited by further training in practical bacteriology.
The least a health officer can do is to attend the Sanitary Con-
ferences. If a health officer is to be recognized as the local con-
sultant he must adhere to the rules of professional etiquette,
otherwise he will not be given the opportunity to help in the diag-
nosis and prescribe the treatment of doubtful cases.
Another method of advertising which is useful when a disease
appears in the community is the distribution of leaflets detailing
what is known about the disease in question, its diagnosis, etiology,
transmission, general treatment and above all, specific directions
regarding prophylaxis. Most of these leaflets would be read.
Boards of health might be made good advertising mediums if
they were properly constituted and conducted. If they met fre-
quently and if health problems were clearly and tactfully pre-
sented to them by the health officer, they would not only support
him much better, but each meml)er would become a focus for the
dissemination of information which would make the work of the
health officer less difficult. This would be easier to accomplish if
each board of health contained at least one doctor. Sometimes a
board antagonistic to modem sanitation is chosen, and they ap-
point a health officer who is inefficient. Under such circumstances
strained relations must soon develop. To illustrate how bad such a
situation may become, I wiir quote to you what two doctors living
in a small village have said to me. One writes — '^ I l>elieve
that our doctors do their duty in public health matters as far as
Public Health and the Medical Profession ; Alsever 769
able, handicapped by a village health officer who does not be-
lieve in the germ theory of disease, who does not believe in the
use of diphtheria antitoxin and tells his and other physicians'
patients that it is injurious, and who does not believe in vaccina-
tion and tells his patients so, and has allowed his boys to grow to
manhood without being vaccinated. You will see that the phy-
sicians in our village are handicapped." Another doctor in the
same village, after saying " Our village officer is the most ignor-
ant, ill-trained and careless doctor in the village," describes the
health board as follows : " Three years ago we had a health board
consisting of the following, an old and respectable man of nearly
eighty, another old man equally respectable and equally behind
the times, of about seventy-five, and an unusually bigoted, er-
ratic and ignorant house painter. We now have the house painter,
a poorly educated carpenter, who is energetic and would be of
use if properly directed, and an intelligent and energetic moulder
but very little enlightened in sanitary affairs. Imagine the effi-
ciency of such a board working with such a health officer." Here
is a village in which surely it would pay to advertise. The health
officer, health board and entire community need enlightenment.
If this community were taught to want better things, they would
soon get them. There can be little mutual helpfulness between
health officers and doctors in this village until the health depart-
ment is reconstructed. One of the doctors told me he had tried
to bring about a change, but without success. Whether the doc-
tors are doing all they might to develop public sentiment may
well be doubted, although it must be admitted that a campaign
carried on by the doctors should be most tactful or its good
eflFects would be counteracted by charges of personal ambition or
jealousy.
One way of educating the public which has been found very
useful in tuberculosis campaigns is through popular and illus-
trated lectures. This method might be applied to all infectious
diseases.
Practitioners would be less critical if they always realized
the difficulties under which health officers labor. Being political
appointees, the actions of health officers will sometimes be modi-
fied because of politics. Of course this is wrong, but it is also
^5
770 Conference of Sanitary Officers
human. Sometimes a health oflScer's duty leads him to force on
a community that which is good for it, but which it does not want.
When his duty is antagonistic to his interests as a practitioner, he,
being human and underpaid, is likely to protect his own interests
and let the community have what it wants. Every health offi-
cer who is also a practitioner is a business rival of the other doc-
tors and consequently cannot maintain ideal relations with them.
When all of our health oflBcers shall be well paid, shall be doc-
tors of public health, shall be forbidden to practise medicine and
shall be appointed for long terms in such a manner that local
politics cannot affect them, we shall have wonderfully efficient
health officers and much of the discord between them and practi-
tioners will end.
Doctors seldom have good reasons for disobeying the law or for
antagonizing health officers. Yet it is necessary for the health
authorities to make it as easy as possible for doctors to co-operate
with them, because of the great difficulty of enforcing obedience,
and because of the absolute need for their co-operation. There-
fore, in the spirit of mutual helpfulness, permit me to call at-
tention to some causes for irritation which might be avoided. If,
on receiving the report of a contagious case, a medical officer of
the Health Department makes the first visit at the house, investi-
gates the patient and the surroundings, prescribes the quarantine
rules for the case, and if he has any suggestions to make r^ard-
ing diagnosis, removal to hospital, etc., makes them to and through
the doctor, little offense can be taken. But if a non-medical in-
spector is sent, who, acting on his own judgment, establishes the
plan of quarantine and takes up any questions directly with the
family, much unnecessary antagonism is engendered. After an
obstetric case a doctor is usually very tired or very busy or both.
Many doctors know no good reason why they should be required to
file a birth certificate within thirty-six hours instead of attending
to their accumulated and perhaps important business, and getting
their much needed sleep. Some of them have frankly said that
in case they found it a great hardship to file a certificate within
thirty-six hours they proposed never to file it, for they considered
the chances of discovery were less than the chances of trouble from
being late. As we all know, this law is not being enforced, and
that fact is a great argument against its justice.
Public Health and the Meihcal Puofession; Alseveb 771
The requirement that doctors shall file death certificates, includ-
ing information which they are not at all likely to have and the
obtaining of which may necessitate a drive of several miles into
the country or other great inconvenience, also seems unfair. The
information, other than that relating to the sickness and death of
the patient, could be obtained by any intelligent person, and as
other people, notably the undertakers, must visit the house after
the death occurred, it would seem proper to require them to
obtain and report this information. Unquestionably doctors fail
to appreciate their full duty to the State and also the importance
of records. If the State continues to make these requirements,
the number of faked death certificates and suppressed birth certifi-
cates will greatly increase. Would it not be better to relieve the
doctors of these irksome and seemingly imnecessary tasks and
instead to insist more strongly on the reporting and proper care
of contagious diseases. Would we not thereby obtain more com-
plete co-operation from the doctors, a greater spirit of mutual
helpfulness, and thereby conserve the public health of the State.
After all has been said, this question of mutual helpfulness re-
solves itself into one of education coupled with tact and kindly
forbearance.
Commissioner Porter — This discussioD seems to be flatting right down to
the point. It wiU be continued by Dr. Charles 6. Clowe, of Schenectady.
I take pleasure in presenting Dr. Clowe.
Db. Charles 8. Clowe, Schenectady — When I received this program
and found that I was down to open a discussion on these two papers, I natu-
rally began to stir my brain, as well as to see what ideas I had on the subject.
^ow, when I come to get up here I find myself in a predicament which I
should have anticipated, for the reason that the papers have so thoroughly
covered the ground that little remains to be said.
When I read the first title, "The Difficulties of Health Officers as Seen
by the Physician," I supposed that meant as seen by others than health
officers. I find that is not true; but for the difficultira of the health
officer, I see a remedy in the title of the second paper, which we have just
heard, entitled "The Spirit of Mutual Helpfulness.'^ I am willing to take
that as my side, for I think I can talk best from that point. This reminds
me of the trombone player who said to a friend, " I am the best trombone
player in America."
"How do you prove that?" said his friend.
"I don't have to prove; I admit it," replied the trombone player; well,
so it is the same witn me; I admit it. I will say that it is so because it is
so; and what I mean by that is this: That when I first came to the health
department in our city I was fortunate enough to follow a gentleman in that
work who was possessed of such an amoimt of medica;l ability and tact in
handling the medical profession and the public that greatly to my surprise
the difficultiea of the health officer were almost nil. That is the proof of my
772 Conference op Sanitary Officers
stfttement, that if we cariy out the education of the general public in a
Bpirit of mutual helpfulness the physician will find that the difficulties
vanish.
CoMMissioNEB PoBTEB — We wiU now hear from Dr. O. W. Burhyte, of
Brookfield. Is Dr. Burhyte present? (No response.)
In his absence we will proceed to the next item on the program, " Public
Health and the Press" — from the health officer's standpoint. There is a
most direct relation between the public health and the press. It should be
and often is our strongest all^, and its value is beyond measure in our cam>
paign of education. I will introduce to you Dr. John B. Huber, medical
offi^r of the State Department of Health, of New York city, who will speak
on that point — from the health officer's viewpoint.
Public Health and the Peess; Huber 773
PUBLIC HEALTH AND THE PRESS FROM THE
HEALTH OFFICER'S STANDPOINT
' By John B. Huber, M. D.
Medical Officer, State Department of Health, New York City
The average citizen gets all kinds of circulars with every mail
— asking him to vote for Jones, to try Brown's tooth powder, to
help support a maiden ladies' home for ill-treated cats; all these
he is likely to throw into the waste basket unread and unappre-
ciated. But should he come upon the same matter in the columns
of his morning newspaper, he will assimilate it with due interest
and respect; and this is true also of weeklies, magazines and like
literature. Before coming up here I read one of Mark Twain's
statements, " That the public press has its faults, but you cannot
waken a nation that is asleep or dead without it." It is logical,
therefore, that the journalist who is willing to disseminate public
health information should prove an indispensable ally of the
health officer in the maintenance of the commimal health. To me
is assigned the consideration of how this salutary alliance may be
established and improved.
In the first place, every one will upon reflection agree that the
most important of all public work is the preservation of the public
health ; wherefore news concerning such work should be fully pre-
sented and well headlined in the press. Especially will the editor
be anxious to have such news correct ; and generally one finds it
so in the newspapers. The average editor, in fact, gets all the
statements in his columns as precise as is humanly possible, if
for no other reason than that his esteemed contemporaries would
make life infinitely dreary for him if this were not so. I think
that the information offered concerning the public health in most
newspapers is safe and sane. In the large cities, I make no doubt,
medical men are retained to vise such matter, to the end that it
shall be without error. But I imagine all the seven hundred news-
papers in this State cannot afford such Olympian luxury. So
that from time to time some fairly heavy breaks on medical sub-
jects appear. And I submit that one advantage in a cordial co-
774 CONFEEEKCE OF SaNITARY OFFICERS
operation between the health officer and the newspaperman would
be the elimination of such error; the former could when asked,
review the journalist's copy, and correct any mistakes natural to
the unprofessional mind ; on the other hand the health officer could
oftentimes get printed matters of vital importance to the com-
munity.
In my experience such an alliance has been altogether whole-
some. During my work as a coroner's physician I was nearly
every day asked for information by newspaper men. I was always
able to diflferentiate between matters the public should know and
the strictly private concerns which inevitably came within my
ken; and I never from first to last had any difficulty in making
the journalist grasp the difference, and in getting him to make
public only such information as was intended to be such. This
was fifteen years ago; and pretty much the only agreeable recol-
lection I have of that work is of my relations with newspaper men.
I would here counsel the medical health officer, in his alliance
for the public weal with the newspaper man, either to prepare
a rough draft of his observation, or to write a paper — something
short and crisp — detailing the medical facts he wishes to impart ;
leaving to his newspaper confrere the business of transforming
it into good newspaper copy. In such presentations the health
officer should acquire the knack of translating medical terms into
such as can be understood by the man on the street and the woman
at the cooking stove — the sort of people for whom the informa-
tion is intended.
This is a knack not usually to be acquired without some prac-
tice; which the health officers should be willing to undertake by
reason of the large salaries that are assured them. No layman
will know, for example, what is meant by acute anterior polio-
myelitis ; but he will imderstand what infantile paralysis means.
To write that someone died of asthenia de senectute would sug-
gest to the laymen that one of the new-fangled diseases doctors
are always inventing had done the business. It were better to
write that it was just old age took off the victim.
' And why should not the health officer prepare a weekly letter
or article on public health conditions peculiar to his locality?
This should make excellent and most interesting copy, which the
PiBLic Health and the Pkess; Huber 775
editor would no doubt welcome cordially. There could certainly
be no matter of more vital interest to the community. Here, as
in all phases of the communal welfare, the Health Department
of our State stands ready to furnish whatever scientific material
would be needed for incorporation in such articles.
And may I now address especially the newspaper man :
There is one aspect in which the health officer-journalist alli-
ance would be of enormous public benefit ; and that is, education
regarding the general nature of infection. There should be clear
explanation that not all infections are uniformly deadly, nor all
transmitted in one way; that whilst some infections are most
serious, others are comparatively innocuous. The public here
sadly needs discriminative knowledge. There is a vast amount
of occasionlessy inhuman and. indeed pitiable pathophobia or
senseless fear of disease abroad; such one sees from time to time
in the savage attitude of people toward the consumptive, who is
absolutely harmless, so long as his sputum is properly disposed of.
Such ignoble pathophobia makes itself obvious in fanatic objec-
tion to dispensaries and hospitals for consiunptives, which insti-
tutions are absolutely the community's best safeguard against
this disease.
No editor indeed could be more beneficently engaged than in
the dissemination of right information upon matters concerning
the public health. Here, as in life generally, the things that arc
to be feared are those which are not comprehended ; and here, as
elsewhere in life, terror almost invariably disappears in the pres-
ence of knowledge. The citizen who is made to understand the
dangers, the sources and the nature of such diseases as are inim-
ical to the body politic, will come not to fear them, and then ho
will the more readily do his part in the rational prophylaxis
against them. '
And such education is especially essential to the progress of
public health work on our American communities, because, under
our republican form of government, no laws, sanitary or other-
wise, can get themselves adequately enforced without the backing
of public opinion. We have thus got to create a sound and
rational public opinion for the furtherance of our public health
work ; and to this end the local health officer and journalist, with
776 Conference of Sanitary Officers
the ovcp-ready help of the State Department of Health, should
earnestly address themselves. And such endeavor cannot but
potently interest the citizen, immediately he comprehends that it
has to do with matters intimately affecting his very life and that
of his family, and the preservation of his home.
While on this phase of my subject, I venture to note that both
the practicing physician and the health officer are in no slight
degree hampered in their woric, by reason that many journals
(not nearly so many as formerly, however) print advertisements of
manifestly misleading and baneful character; it is odd, indeed,
that such advertisements have especially been favored by pro-
fessedly religious journals, which should have the highest regard
of all for the truth. Such advertisements have been particularly
unfortunate and frequently of fatal effect upon the poor consump-
tive. A specimen of this kind has been " Kochine," a bogus con-
coction, in connection with which the name of the great father of
preventive medicine was most perniciously exploited. Many
remedies, alleged to be alcohol* free (which the most of Ihem
certainly are not), are advertised as recommended by statesmen
and clergymen.
I do not know whether you have heard of the following testi-
monial: '
"Dear Doctor P. Eooney — I find your medicine excellent.
After taking throe bottles I was cured of the worms, but now I
see snakes." (Laughter.)
In view of the fact that alcoholism is a most potent predis-
position to consumption, such advertisements as the following can-
not be too stix)ngly reprehended: Blank's ITalt Whiskey (an
endorsing clergyman's picture). " Cures coughs, colds, most forms
of grippe, consumption, bronchitis, pneumonia, catarrhs, dys-
pepsia and all kinds of stomach troubles," etc.
Indeed, no greater benefit was ever done to the cause of the
public health and sound journalism than in Samuel Hopkins
Adams' divulgence of the Great American Fraud in which such
wickedness is pilloried. '
Finally, I want to quote from a paper by Dr. L. L. Lumsden,
of the United States Public Health and Marine Hospital Service :
Public Health and the Pbess : Huber 777
" In some instances the attempt may be made to conceal the
facts about health conditions in a city for fear that if the condi-
tions become known, the business interests will be injured. It is
just about as easy for a community to succeed in such conceal-
ment as it is for a man to conceal the fact that he has a broken
leg, by making efforts to run. The tactics are bad and the results
usually disastrous. It certainly seems more in accordance with
sound business principles for a city to know its health conditions,
to improve them, and then to use the improved conditions as a
basis for legitimate advertising."
It is thus evident that there can be no more beneficent outcome
of an alliance between the health officer and the newspaper man
than the mutual pursuit of an absolutely honest course, whenever
a grievous epidemic has imhappily come upon a community. Here
no concealment should be countenanced, no matter what pressure
may be brought to bear by the local boss or the vested interest;
and here the press should hold up the health officer's hands in a
manner immistakable bv the most obtuse or the most selfish unit
in the body politic.
My friend, Mr. John A. Kingsbury, of the State Charities
Aid Association, made a statement which I think desires to be
repeated. He said to keep the newspapers constantly at it is the
most important, simple and least expensive single thing which
may be done in promoting the cause of public health.
CoMMissiONEB PoRTEB — After aH, the public press is to most of us some-
thing of an abstraction. There may be times when, after one reads one's
favorite newspaper, and discovers some article on the delinquencies of phy-
sicians or the vagaries of the Health Department, that he views it somewhat
in the concrete. It is possible to see a single editorial writer biting off his
quill in his sanctum, but it is quite impossible to conceive 700 editors dis-
tilling wisdom from their editorial rooms.
We do not often have the public press, as we cannot catch it. We have
it with us this afternoon, and it is able and amiable.
It is a pleasure to introduce to you Mr. F. P. Hall, of Jamestown, N. Y.,
who will address you on one of the divisions of this subject, namely " Public
Health and the Press — From the Newspaper Man's Standpoint."
He will tell us something about what he knows of the newspaper press,
and I am afraid he may tell us something about wtiat he thinks he knows
about us.
78 Conference of Sanitary Officers
PUBLIC HEALTH AND THE PRESS FROM THE NEWS-
PAPER MAN'S STANDPOINT
By Mr. F. P. Hall
Jamestown, N. Y.
From the viewpoint of the newspaper man the public health,
important as it is, is only one of the many important problems that
bring the public and the press into close relationship. The news-
paper man regards his community as his parish and every subject
of human concern as rightly belonging to his domain of influence.
I appreciate that there may be exceptions to the rule — but if so
they are rare — where the newspaper is not ready and willing to
join forces with every moment which has for its object the advance-
ment of the best interests of the human family without regard to
class, creed or nation.
The newspaper men have taken to themselves as literally as have
the preacher and the priest the command, " Go into all the world
and preach the Gospel," and they are striving to give a good
account of the talents their Maker has given them. The newspaper
is found in the advance guard of civilization, and at any point on
the face of the globe where men and women gather the newspaper
of the day goes with them to entertain and instruct.
The co-operation of the press is as necessary for the advance-
ment of any cause as is electricity for propelling the electric motor.
The car may nin down grade without power, but when it strikes
the hill or the hard places the electric current is necessary or the
force is quickly spent. Any proposition may find advocates and
devotees, but no cause can long endure that does not have the power
of the press behind it.
If the newspaper fails at times to advocate that which is for
the best interests of the community in which it is published, I
believe the fault more often is with the leaders of the movement
than it is with the newspaper man. These leaders have failed to
take him into their confidence; they have failed to acquaint him
with the real situation and with the real needs of the community
and of the cause which tbey may be upholding with zealous ardor.
Public Health and the Press: Hall 779
I am glad to say that the old policy of keeping information from
the newspaper man, compelling him to go to unofficial and often
unreliable sources for his news, is rapidly passing away among
intelligent public officials. The time was — and not so very long
ago — when the heads of the police departments of our cities de-
clined to give information to the press as to crimes that had been
committed. But it is recognized to-day that publicity is of the
greatest aid in the detection of criminals. The time was — and
not so very long ago — when physicians and health officers either
declined to give information to the press as to epidemics in their
communities or suppressed part of the facts, and when newspapers
were frowned upon for giving news of the development of a small-
pox or diphtheria epidemic.
To-day the usually accepted policy of the guardians of the public
health is to give the fullest information on these subjects, finding
that when such information is full and complete the public shares
with the sanitary officer and the board of health the responsibilities
of the situation. It is found that when the public is informed of
exact conditions it has a tendency to allay alarm, while the opposite
course creates suspicion and results in lack of confidence in the
guardians of the public health.
To-day the State and national governments maintain press bu-
reaus for sending out the earliest and most complete reports as to
actual conditions in all departments of public service. But too
often city officials still retain the old policy of attempting to keep
the public in ignorance as to what they are doing, but it is generally
with discredit to their administrations and with the loss of confi-
dence of the people whom they serve.
The work of the Health Department of the Empire State occu-
pies an important place in the administration of State affairs. No
other department of government comes quite so close to all of the
people as that which you sanitary officers represent. The manner
in which you carry forward your work means life or death to many
of our citizens ; it means either health and comfort or sickness and
sadness ; it means progress along rational sanitary lines or it means
carelessness upon your part and the part of the people of the vari-
ous communities where your work lies.
Let me urge that in this work you seek rather than repel the co-
780 CONFEEEXCE OF SANITARY OfFICEBS
operation of the press. Any reasonable request you make of the
newspaper man will be complied with, and any reasonable request
he makes of you should have a ready response. The newspaper
stands between you and public opinion ; you cannot override it and
you cannot suppress it. Then why not work with it and let it work
with you and for you. While you may find it difficult to work the
newspaper, you will always find it easy to work with it.
This is one field of co-operation that has always brought good
returns upon the investment. I know that our efficient Commis-
sioner, the man who stands at the head of the New York State
Department of Health, fully appreciates this sentiment. In my
acquaintance with Dr. Porter as a public official I have found that
he has learned the real value of the newspaper as a factor in the
good work that his department of government has been able to
accomplish. Never before were the reports of the State Health
Department to the press of the State so complete and accurate and
crisp as they are to-day.
That which Dr. Porter has done for New York State in this
respect you, the sanitary officers of its many communities, can do
for the places you represent. Your work in the community is occu-
pying a more important place than ever before; your responsibility
is greater at the present time than it has been in the past ; more is
expected of you and your opportunities for serving the people are
greater to-day than they were yesterday, and as the years come and
go they will increase.
Let the newspaper men preach your sermons on cleanliness and
sanitation; give them the information upon which the lessons
which every community must learn can be prepared. Moses made
Aaron the mouthpiece for his messages to -the people, but you have
the mouthpieces for your official or professional knowledge to
which the public is entitled at your hand. The press of your com-
munity is ready to serve you if your service is for the public good ;
it is ready to aid you in creating a more wholesome apprecia-
tion of the importance of better sanitary conditions and the observ-
ance of the rules that experience has laid down for the protection
of the public health.
Speaking from the standpoint of the newspaper man, as I have
been asked to do, all that we ask is the opportunity to co-operate
^
Public Health and the Press: Hall 781
with you in the great work that lies before us. We do not wish
to dictate to the sanitary and health oflScers, nor will we accept
your dictation as to what we should do and what we should leave
undone. If you tell us candidly the conditions which exist and
the remedies which should be applied, you will find the newspapers
as true a mouthpiece as Moses ever found Aaron. If there are
reasons why certain legitimate news items should not be published,
you wiU find the newspaper man ready to recognize them. But the
facts should be given to the press together with the reasons, if there
are any, why they should be temporarily or permanently withheld.
That would be the intelligent and effective way of handling an
annoying or embarrassing situation.
Our experience has been that the public is always ready to ac-
cept an intelligent suggestion from one in authority. It is much
easier to educate your constituency as to proper sanitary precau-
tions than it is to drive an uneducated constituency to adopt them.
The conflict between sanitary officers and the public generally
comes from a lack of appreciation of the value of the regulations
which the officers have formulated. It is rare indeed when there
is any formidable revolt against compliance with health r^ula-
tions, and if there is, then, in all probability, it is because the health
officers have attempted to ride roughshod over the long-standing
habits and prejudice of the people without having taken the trouble
to remove these prejudices and correct the habits which a little
printers' ink, judiciously used, might have done.
Let me advise you as public officials to take the newspapers
into your confidence, and through them you can quickly reach
the confidence of the people whom you serve. A suggestion, with
reasons therefor, is often much more effective than an arbitrary
command with reasons withheld. With all of his progress and
advancement the average American citizen has not yet reached
that stage where he will willingly take orders from our public
servants unless he knows why the order is given and what effect
it is to have. I appreciate that you have the law on your side;
that if taken into court, what you say goes, and you should ap-
preciate that when you find that course necessary^ it would
probably be advisable for you to go also. If you want intelligent
co-operation with your public, then your public must be educated
782 Conference of Sanitary Officers
to the necessity therefor. You might better spend half an hour
every week in writing a short, crisp sanitary suggestion for publi-
cation in your local newspapers than to spend an hour a day in
arguing the matter with some individual who refuses to be con-
vinced.
CoMMissioNEB PoBTEB — I Baid that the public press was an abstraction
before Mr. Hall started. We have seen it now in concrete form, and we have
more of the public press here, and it is also substantial, in the presence of
one of the leading editors of central New York — a man of force of character
and clear conviction — and it gives me great pleasure indeed to present to
you Mr. Milliken, of Canandaigua, who will discuss these papers.
Hon. Chables F. Milijkbn (Canandaigua) — Mr. Chairman and Gentle-
men of the Conference — Permit me to congratulate the members of the Con-
ference in having as your presiding officer an official who has endured with-
out investigation or removal the white light that has enveloped all the
State departments throughout the two terms of the Hughes administration.
I wish that I might almost have been introduced in an official capacity,
because the remarks of one of the gentlemen who has preceded me under
another heading brought the thought that the Civil Service Commission
might render to the State Health Department an additional help. And the
fact that you, or one of your representatives, admit that you are the creatures
of the politicians and subject to their will, in large measure, leads to the
suggestion that the time may come, and perhaps ought to come, when the
health officers of the State will be brought under the protection of the State
Civil Service Law, and in that way their efficiency secured and their tenure
of office secured through a length of time determined by efficient service.
But it is as a newspaperman that I am expected to say a word to-day.
I asked Dr. Howe, the Deputy Commissioner of the Department of Health,
what he wanted me to say, and he told me that he thought I ought to urge
^ou to enlist the aid of the press in your work as health officers, and bring
the press into co-operation with yourselves.
Now, I submit that the press has been the pioneer in some of this move-
ment for the public health. What movement for reform of any sort, eituer
in your department or any other department, has not in a sense been
pioneerea by the press? It may be important, as one of the speakers has
said, to keep the newspapers everlastingly at this campaign, but I submit
it is the province of the newspaper to keep you everlastingly at it in this
work; and I think we are doing our part to-day.
What crusade against dirty streets or garbage piles or offensive smells or
contaminated water supply has not had the support, the ardent support
of the press? I admit that the newspapers have had faults, as was pointed
out, especially in regard to their advertising columns. It is true that we
have admitted most nauseous and improper (from my point of view) adver-
tisements to their advertising columns. But remember that the newspaper
is a business enterprise, and it must be supported in some way. And also
there may be urged an apology for the course the newspapers have followed,
but I think with very decreasing custom, in the fact that through some sort
of erentlemen*s ag^reement amonp: the physicians, they are deprived of the sup-
port of the profession in the way of advertising — and they feel H.
But, lay joking aside, it is important for the newspapermen and the public
health officials and physicians generally to get together in any crusade for
the public health. Certainly in such a crusade the newspapers have an
opportunity and a duty, as they have had in many other spheres of reform
and public improvement. Note how they are helping, how their aii is
solicited and secured by Commissioner Pierson in his work, by Dr. Reich-
man, the State Superintendent of Weights and Measure, in his crusade
against dishonest retailers, by the State Board of Charities, and you will
recall that the chief executive of the State, when he wanted to overthrow a
Public Health and the Press : Hall 783
discredited political machine, appealed to the public through the newspapers,
rather than attempt to fight fire with fire, and set up another machine. It
is certainly the most etlective agency for the promulgation of any reform or
movement for the betterment of the public.
Together we may move mountains of fly-producing dirt. Together we may
dry up or cover with oil lakes of mosquito-producing water; recognize the
newspapers as your friends. Give them your confi£nce, as Mr. Hall has
said, and aid them with suggestions, bupport them in every way possible.
Visit the editor in his sanctum, be it the autocrat of the great city paper or
an out-at-the-elbow country editor. Visit him in his sanctum and ^ve him
your confidence and your help. The newspapers are ready to help in every
practicable way, as you, and certainly Dr. Porter, know. There are oppor-
tunities of which the newspapers «re availing themselves, of printing week
after week prepared articles of practical value to the public health. It has
occurred to me that that system might be followed to an extent that it is
followed by every political organization. During every campaign they send
out in plate form campaign arguments, and something of the sort would be
appreciated, I am sure, especially by the country editors.
'Ihe newspaperman will give you his aid regardless of selfish considera-
tion. Certainly that is true in Buffalo. Certainly it is true in clean, com-
fortable Canandaigua, and certainly it is true in most communities of the
State, that the editor will not count his personal interests in the matter, but
will aid the public cause.
I read some time ago that the fourteenth and fifteenth centuries were
notable as being prolific of new diseases. I think the nineteenth century
was not laggard in the matter; but let us make* the twentieth century famous
for abolishing some of the old diseases, famous for the recognition of the fact
that we are keepers of our brothers' health, all of us sanitary officers, phy-
sicians and newspapers.
CoMMissioNEB PoRTES — We gave a greeting to Mr. Milliken as he came
to us, as " The Distinguished and Wise Editor. We hail him as he departs
from the platform as the astute and farseein^ president of the Civil Service
Commission of New York State. And let us indulge in this hope, that tliose
folds of his official garment may soon envelop us so that with adequate
salaries and life tenure of office we may perform those duties that a grateful
public throws upon us.
The discussion will be continued by one of our own number. Dr. Snyder,
of Newburgh.
Db. Wm. H. Snyder (Newburgh) — As I listened to the discussion of this
subject, the public health and the press, it seemed like a sweet dream; but
my experiences have been a sort of nightmare on the subject, and I think I
would leave it where it is — that is, with the Commissioner.
COMMISSIONEB PoBTEB — It is much easier, I find by experience, to introduce
a speaker and then leave it to him than it is to leave it with yourself on an
occasion like this. However, there are one or two things I would be glad
to say concerning public health and mimicipal authorities and what a health
department expects from a municipality.
784 -COITFEBENCE OF SaNITABY OFFICERS
WHAT A HEALTH DEPARTMENT EXPECTS FROM A
MUNICIPALITY
By Eugeke H. Pobteb, A.M., M.D.
state Commissioner of Health
It has been said that this is an age of science and ours a na-
tion of science. Observation has matured in measurement and
passed from the qualitative to the quantitative, generalization is a
habit and precision is becoming a commonplace in current life.
More than all else the course of nature has come to be investi-
gated in order that it may be controlled and redirected along lines
contributory to human welfare; invention has become a step to-
wards creation, and is extending far beyond the merely mechanical
and into the realms of the chemical and vital.
The advance in sanitation is an index of the progress of modern
civilization. The development and application of sanitary law is
the result of an increasing altruistic knowledge.
Behind every movement for civic improvement, back of every
effort for social or economic betterment, may always be found the
moral impulse that stirs to action. Sanitation, with all its wealth
of scientific achievement, with all its earnest and able workers,
would never had made such rapid advance without the aid of an
aroused and partially emancipated public sentiment. When many
men thinking independently come to the same conclusion, action is
likely to follow, and when men so thinking demand facts and care-
fully weigh the evidence there is likely to be action along right
lines. Education is the dynamite of our civilization. It has broken
some of the follies of superstition and ignorance and will break
many more.
So education in sanitary science had not progressed very far
before it was perceived that a great door had been opened for
general betterment. Not merely stamping out of epidemics, the
disposal of sewage or investigation of water supplies, important
and urgently necessary as these are, but that wider field that
embraces all that makes towards the absolute prevention of all
misery and disease came clearly into view.
What a Health Dbpabtmbnt Expects 785
And so there came into being that great and increasing number
of societies and organizations devoted entirely to changing the old
order of things, working always for clean cities, clean homes,
clean air, and also, therefore, for clean morals.
These societies that look after proper playgrounds, sufficient
parks, decent tenements, pure food, clean streets, efficient factory
supervision, protection of child labor, care of working women,
pure water, tuberoulofiis^ and many other things are all playing
a most important part in the great struggle of the new against the
old— of knowledge against ignorance. Deprived of the aid and
strength of these auxiliaries sanitary science would have halted
and stumbled much more than it has. These societies are almost
always composed of laymen and not of trained sanitarians. This
is most significant, for it shows how rapidly education in sanitation
is progressing.
If it is true that at times the enthusiasm of some of these lay
workers remains im tempered by judgment, and that they seem to
prefer occasionally to work against rather than with the health
officials and so miss the greatest possible effectiveness, yet that
should count but little against the immense amount of good work
they are doing. Their appearance and continuance is one of the
most significant signs of the times.
But after all, if we are to have this real sanitation, the sani-
tation of a wider view, we must widen the vision of the people.
For the great problems before us in sanitary science must be solved
by experts. The question then is not what will our laws do for
us, or our Legislatures do for us, or our courts do for us ? The
question is, what will our schools do for us ? It comes to that in
the last analysis. For if we are to reach our final goal we must
have a greater efficiency, a greater sense of justice, a greater self-
sacrifice that must come from a high type of citizenship. So the
duties and responsibilities of a health department are not only
changed, but they are very greatly increased and constantly chang-
ing.
To cause the citizen to do the things he can and ought to do,
and then do for him the things he can not do, but should be done,
is the duty of the State.
The entire system of health superviaion and control is insep-
786 CONFEBENOE OF SaNITABY OfFIGEBS
arably bound together. The highest efficiency can only be ob-
tained by co-operation. The basis of this co-operation must be a
general sympathetic and intelligent comprehension of methods
adopted and results desired. This is precisely the relationship
that should exist between the local health authorities and the
State health authorities. When it is clearly seen that one cannot
hope to fully succeed with the other; when it is cordially recog-
nized that interests are mutu'al; when antagonisms bom of igno-
rance are replaced by the confidence that comes from widor vision ;
when political domination is stamped out ; when none but compe-
tent and trained sanitarians possess authority in health matters,
then will come that perfect adjustment and inter-relationship of
local and State health administrations that we are anxious to at-
tain. Now I believe that the local health officers in nearly all cases
and the local board in some instances are anxious to work in
harmony with the State Department of Health. This would be
indeed the expected and most natural thing for them to do. But
experience teaches that in some cities and towns harmonious re-
lations are difficult to establish or maintain. It has seemed to
me that in most of these cases the difficulty lay in a lack of
knowledge of the purposes and plans of the State Department on
the part of the local authorities and at times doubtless the De-
partment failed to get the right angle of vision when it viewed
the local situation. And so I would put down as the first import-
ant requisite for a satisfactory relationship between local health
authorities and State health authorities —
(1) Mutual knowledge and understanding.
The experiences of the Department in cases where its plans
were not understood and where, as is generally the case, there
existed a profound ignorance of the health law, have been both
ludicrous and vexatious. We have been accused of violating the.
law in enforcing sanitary measures and we have been charged
with gross neglect of the law under exactly similar conditions;
the Commissioner has been termed a Czar and despot in some
localities and in others while trying to effect the same results as
in the first, he was called inefficient and spineless. Some cities
have welcomed reports on their sanitary condition and adopted at
least some of the recommendations, while others have resented
What a Health Department Expects 787
these reports as " attacks " and vigorously opposed their publica-
tion. Most cities and towns welcome our aid in times of trouble
but there are and have been some who seem to think that our
only desire was to cause them trouble and expense. This lack
of understanding and consequent want of co-operation is a most
deadly thing — it costs lives that could and should be saved, bo-
sides the always increased expense.
In one case out of many, where the Department had made
repeated investigations and inspections of a threatened water
supply, and report after report and letter after letter urging
immediate action had been sent to the health and other officials
of that town — without result — typhoid fever came. Over one
hundred cases and twenty-five deaths. The day will come when
such n^lect of plain, sanitarj' duty, neglect that causes unneces-
sary and preventable death, will be looked upon and called by
its right name — murder.
But I must not tarry. The first thing then is to get together —
to find out — to imderstand. '
2. Politics and Waste.
I spoke just now of those towns that are fearful of the expense
involved in any effort to better conditions. Economy in health
matters is generally parsimony, bom of ignorance and selfishness.
This reluctance to expend reasonable sums for the public health
is not a flattering reflection on our vaimted modem civilization.
But we are learning. We have learned that if we allow our
neighbor to dwell in foulness and filth some of us go with him
over the great divide when the plague rages. But it is still true
that in many places there is a strong disposition to hide the pres-
ence of contagious disease — to conceal the visitation of small-
pox, diphtheria, typhoid or scarlet fever. This also is vanity
and is the child once more of ignorance and selfishness. Igno-
rance that prompt action by efficient health authorities would limit
and conquer the outbreak ; selfishness, since before business inter-
ests could be allowed to suffer imaginary damage,, innocent visi-
tors and equally innocent citizens are exposed to the dangers of
a contagious disease. In the end the cost is greatly increased by
the policy of concealment.
788 Conference of Sanitary Officers
And yet we iniist recognize thai; there exists some reason for
this state of affairs.
Tho evidence is conclusive that in municipalities; counties,
states and the national government itself there is a vast and grow-
ing amount of extravagance, mismanagement and waste in the
administration of public business that is now a burden to the
country. The bonded indebtedness of American cities as a whole
is increasing much more rapidly than municipal assets, and the
taxes for operating expenses are becoming more burdensome each
year. In 1902 the percentage of the revenue of all the cities in the
country to their debt was 37.3. By 1909 this i)eroentage was
decreased to 25.9. The net public debt of forty-nine cities, in-
cluding New York, increased 47.71 per cent., while during the
same period tho increase in the assessed valuation of all the tax-
able property in the>se cities advanced but 12.66. It is certain
that this course if continued will result in intolerable conditions.
Many of our towns are now bonded to the limit.
These are some of the reasons why appropriations for public
health are diftieult to s(x?ure, but they are not reasons to*be proud
of. Inefficiency in public service resulting in shameful waste
of public funds is a burden the weight of which public health has
in part at least to bear. I am not charging that dishonesty in-
variably exists in governmental affairs, but I do say that there
is incapable busine.-^ nianaginuent, and that, in large measure,
is the fault of the system and not of the men. So there is not
enough money for the health departments, playgrounds, clean
streets, pure water supply, proper sewage disposal and other
n-eeded sanitarv reforms. '
Turning away from further consideration of this question, we
stumble over another burden of which we must rid ourselves if
we would hopi^ for desirable results. Polities must be driven out
and kept out of every health department, national, State or mu-
nicipal. If the efficiency of health administration is to be ex-
pected, polities must play no part. The men to serve the public
health nin?*t lie trained men. They must have had special and
technical teaching fitting them for the duties required by the
science of sanitation. The men to serve public health must be
experienced men. They must be experienced in the praxjtical
What a Health Department Expects 789
workings of an actual health department. Laboratory methods and
field investigations must b© among their more familiar scientific
acquisitions. The men to serve the public health must be studious,
honest and energetic men. It is evident that, however well-mean-
ing a politician might be, he would not very often be able to nomi-
nate for a health position a man possessed of the necessary
qualifications.
' The tenure of office in a health department should be dependent
on efficiency and good behavior, and on these alone. Should poli-
tics dominate the policies of local health authorities, or should
the State authorities be controlled by politicians, harmony of
action would be impossible. The spirit, the essential and living
force, would be dead and progress impossible.
The second point then is: to endeavor as citizens to lessen
administrative waste so that health authorities may secure more
adequate appropriations. Let our motto be : Fewer laws and better
laws. And then eliminate all politics, for unless this is done the
most efficient harmony of action is impossible.
The Power of Education
But the combined administrative strength of all our health
divisions, both State and municipal, will never reach its fullest
efficiency — will never gain an entire cordiality of support from
our people, until we invoke the power of education in sanitation.
We are jusrt; beginning to realize the lack of trained men among
us. This is shown by the great difficulty of finding capable men
to fill responsible positions. The preliminary training is wanting.
When we turn to our schools throughout the country at large, we
find we have a great educational machine that does not train.
It does not train men in the things related to the lives they must
lead. TIkx great mass of our citizens begin life's work when oad
where they can. They bring to this work a smattering of knowl-
edge, very little of which is in any way directly applicable to
the every-day facts and practicalities of life. So the boy or girl
in the country learns nothing of the science and art of agriculture,
tie thing that most deeply and vitally concerns their future lives ;
the boy in our city schools learns substantially nothing of the
fundamental principles of the mechanic arts ; and neither country
nor city child is taught anything concerning disease and lieaUL
^
90 Conference of Sanitary Officers
Wlien wo stop a moment to consider what wide significance of
meaning, what great scope of utilitarian activities, is embraced
to-day in the term public health; when we remember that its
every-day applications touch life at every angle, we are justified
in demanding that our schools give this necessary life training.
These are some of the things our boys and girls need to know
and must know not only to save their own lives, but still more
important, in order that they may, as trained and intelligent
citizens and sanitarians, save the lives of others.
The work of any health department to-day is regarded with
cold indifference by a majority of our citizens. Public sentiment
is often opposed to very urgent and necessary sanitary measures.
The present generation — untrained, uninformed and so in unre-
generate contentment with present evils — is inert and unre-
sponsive. The trouble is they do not understand. We can let
the light shine on some of them, but it is the children that we
must get after. Teach the children of to-day and the fathers of
to-morrow will enlist in the army of progress. '
So in this campaign of education, the State health authorities
and the local health authorities meet again on common ground.
• By joiniijg forces, both together could do more effective sanitary
educational work in one year than could be done by either alone
in five. I have no time for details, but in such work the local
authorities could take full charge of local arrangements, including
places of meeting, advertising, speakers, etc. The State depart-
ment would furnish expert lecturers, give illustrated talks, pro-
^dde circulars, pamphlets, and in short do all it could to promote
the success of the campaign. It is a great field and we should
not delay its cultivation.
So the third point T would make is: that we demand that sani-
tary science and public health be adequately and properly taught
in all our schools and that we begin at onoe our own campaign
of education among our i>eople.
Contagious Diseases and Quarantine
The State Health Department is at present striving to build
up and perfect a Division of Communicable Diseases to the end
that contagious diseases throughout the State, but especially in
What a Health Depaktment Expects 791
OUT smaller towna and villages, may be promptly and eflSeiently
dealt with. The chief thing that hinders is lack of money. But
while we cannot as yet cover the entire State, we are ready to
respond to calls for help. Once more we stand upon the same
platform. Our common aim is to suppress commimicable dis-
eases and to do it swiftly.
In the case of an epidemic in any city, our services and
resources are entirely at your disposal, if you need them. If the
effect of our moral support is needed, it is yours; if in emer-
gencies toxins or antitoxins are urgently needed we will furnish
all we can; if you desire aid in conducting investigations as to
cause of disease or reports on existing conditions, we will give all
the help within our power. It seems very clear to me that tJie
State and local authorities should work earnestly together in
every instance of outbreak of contagious diseases. And so my
next point is : unity of effort in the suppression of epidemics.
Wateb Sn»PLiEs AND Sewage Disposal •
If there are any questions the solution of which requires the
hearty co-operation of both State and local authorities, it is the
adequate protection of public water supplies and the proper
disposal of sewage. •
These problems are not limited by the boimdaries of particular
localities. They may and generally do affect, in their solution,
nimierous other communities, in addition to the locality of origin.
For the pollution of a stream may and often does affect people
living along its banks for himdreds of miles. In certain cases it
becomes an interstate question — as in the case of the pollution
of the Delaware. In the final determination of these questions
the State Health Department, with its State-wide outlook, its
special information of the particular conditions existing in the
various communities, should be able to give most valuable and
timely assistance. It has seemed to me at times that in no other
line of health work has the attitude and policy of the Department
been so raisimderstood or so persistently misrepresented. Of
course the misrepresentation in the main has been because of lack
of knowledge ; but based on t4iis very want of information infer^
ences were drawn, and the sublimed postulate is that publication
of inferences is not justified in equity.
TJ2 Coxferbnce of Sanitary Officebs
Almost every town in the State of New York is to-day dis-
charging raw sewage into some stream or laka All the mills ajid
manufacturing establishments in this Sliate are disotharging their
waste products in our streams, and our streamB are burdened with
more than they can take away. This is the present oomditioii.
Xow we know what should be done in order to prevent the con-
tinuance of such dangerous and obnoxious pollution. Sanitary
science has after many years of researcKh work and experimenta-
tion afforded us a solution; and there is no longer any need or
excuse for a municipality to discharge its raw sewage where a
menace to health or a nuisance can be thus avoided. To make
clear the position of the Department I will quote very briefly
from two addresses of mine given in 1908 and 1909 respectively.
In the former address I said :
" Before any intelligent or coherent steps in direction may be
taken concerning the purificatimi of any stream, the entire water-
shed to which it belongs must be thoroughly studied.
" The sources of water, character of soil, number of villagoa
and towns, population of such, conditions of sewage, conditions
of water supply, manufacturing establishments and their various
wastes, maximum and minimum flow of the main river and its
tributaries, all these things and many more must be learned be-
fore it can be intelligently decided whether the single town above
referred to shall or shall not be required to put in a sewage dis-
posal plant. In other words, this work of the purification of our
streams must proceed along broad and comprehensive lines.
Otherwise it will make no permanent and satisfactory progress."
In the latter:
^' Well, let us see about removing this pollution to-morrow —
that was the point I wanted to speak of. It seems to me that
this is a problem not to be solved in a moment. The follies of a
century can not be corrected in a year. Municipalities now
bonded and taxed almost to the limit can not, in a single day,
undertake the installation of extensive sewer systems and sewage
disposal plants. Mill owners who have invested millions of dol-
lars, manufacturing establishments that employ thousands of
people, upon whose industry whole towns depend, cannot be ex-
pected to make such a total change in their process of manufac-
tures as to get rid of waste in a day when we are utterly unable
to tell them what to do with it.
" The pollution of our streams and our lakes must stop. Yes
— it must stop — in time. In the meantime let us remember
that time is the greatest factor in the solution of this problem.
What a Health Depaktment Expects 793
" In 1875 the Eoyal Pollution Commission was appointed in
England because they became aware then of the conditions and
realized the danger in the pollution of their waters, and in the
last report gotten out by this learned commission or the successor
of it, you will read that they passed a resolution that they felt
that now the time had arrived for a thorough and systematic
study of the situation. We learn from them, do we not, that
time is a factor that enters into this. Massachusetts said that
after twenty years of effort that the streams that were polluted then
are polluted now, and that what had been done so far was to
prevent an increase of pollution."
This states clearly enough, it would seem, the policy of the De-
partment With a full realization of the enormity of the present
pollution of our waters, with an earnest determination to prevent
further pollution, it also clearly recognizes the difficulties in the
way of an immediate removal of the present discharge of wastes.
Each municipality fffesents its own particular problem. Ko
two are precisely alike. I believe the wisest way to solve these
questions is by the cordial co-operktion of State and local health
authorities. The Division of Sanitary Engineering and the Divi-
sion of Laboratory Work both well equipped are entirely at the
disposal of municipal authorities. They will in all cases give their
best expert judgment and advice as promptly as possible.
The purpose of the bill designed to regulate pollution of streams,
introduced during the last session of the Legislature, ^as widely
misunderstood. It was prepared after several years of study ; the
laws of all other states and of foreign countries were carefully com-
pared and the results attained noted; the conditions existing in
our own State were thoroughly considered and the bill as drawn
was the result. It had the approval of the leading sanitarians and
sanitary engineers in the country.
Now this bill provided that after an investigation and after a
hearing for all interested, the Commissioner of Health might issue
an order requiring a town or a mill owner to cease discharging raw
material in streams or waters of the State. But this order was un-
operative unless approved by the Governor and Attomey-<3eneral
of the State. I believed and I think that you do also, that there
must be somewhere a restraining and controlling power, and that
this power should be itself surely held witibin reascmabld limits.
This I believe the bill provided.;
194: Conference of Sanitary Officers
bill would be to bring about closer relations between local and State
health authorities, a joining together of resooirces and a mutual
solving of difficult problems. In my judgment very few orders
would ever be issued under the provisions of this bill. The point
I would make here is then — the heartiest co-operation of mu-
nicipal authorities and State health authorities in the protection of
public water supplies and of sewage disposal.
Finally let me emphasize the fact that the business of the De-
partment of Health of New York iState is to aid in health matters
in every way possible. Our experts are yours ; our laboratories are
yours ; our experience is yours. Let us get together and profiting
by each other's knowledge, turn our combined wisdom to the benefit
of the people of our State.
Commissioner Pobteb — The next paper is "Public Health and Munici-
pal Authorities — From the Standpoint of the Municipal Officer;" and on
this subject we shall have an experienced and valuable municipal officer to
talk to us. I am pleased to introduce Mayor Charles C. Dmyee, of Schenec-
tady.
Mayor Charles C. Durtee — Ladies and gentlemen, I am the last to
speak to-day, and the only merit I shall claim for what I have to say is
that it is brief.
Public Health and Municipal Authorities: Duryee 795
PUBLIC HEALTH AND MUNICIPAL AUTHORITIES
f^EOM THE STANDPOINT OF THE MUNICIPAL
OFFICEE ^,
By Charles C. Duryee, M.D.
Mayor of Schenectady
The health oflScers of the State of New York occupy a more im-
portant position in the mind of the people than perhaps those of
any other State in the Union. The spectacle of forty-two out of
forty-nine cities in the State being represented at a convention
held within the year for the specific purpose of discussing only
matters pertaining to public health, is one that is indeed inspir-
ing and encouraging to those workers who are striving for ideal
public health conditions. It is questionable whether before this
Conference some of the mayors realized they had a health depart-
ment, or, if they did, they regarded it a department that was neces-
sary for use only in times of epidemics and dire public health
danger; but the discussions and addresses brought home to the
executives and public officials of many of our cities and villages in
the State of New York, the fact that the health department of any
locality is one of its most important assets, and that it is constantly
and consistently working at the keystone of the arch of municipal
safety and comfort.
Many other activities in this State have conspired to increase
the importance of health departments, notably the campaign
against the great white plague which is being waged so success-
fully throughout the State ; the movement against the pollution of
our rivers, lakes and streams so admirably and justly conducted
by our State Department of Health ; the spread of the knowledge
that diseases that were formerly considered noncommunicable, are
now known to be communicable, and an increasing and better
understanding of the manner of transmission.
Slowly but surely the importance of the Health Department is
increasing in the public mind ; its duties are becoming amplified,
its responsibilities greater, and the growing confidence in health
officers and health departments is becoming more evident day by
day. In view of these circumstances the health officer should do
T96 CONFEBENCE OF SaNITABY OfFICEBS
more than heed the wishes of the comnmnity in whidi he lives.
He is to-day a leader, not a servile follower of .public sentiment.
He is a creator of public opinion. It 'becomes, therefore, the duty
of every municipal officer to render such assistance to the He^tli
Department as he may be able, to bring about t]p conserviation of
public health in his commmunity and compel the community to
keep step with the drum beats of progress.
In the first place the municipal officer should aid the Health
Department by a sincere and active co-opemtion. I include in
this the officials of all the departments and bureaus of cities and
all other similar agencies in towns and villages.
The police department can be of great service to tie Department
of Health in co-operating in the observation of conditions and the
enforcement of laws and regulations. The patrolman as he covers
his beat comes in contact with m-any conditions that might not
otherwise be reported to the Health Department, and the mere fact
that the patrolman is paying attention to those things that make
for better public health is an inspiration to the citizens along his
beat.
The fire department, too, in many ways can contribute not alone
to the removal of unwholesome health conditions but by precept
and example may assist in spreading the health propaganda.
The bureaus of the department of public works can aid by ac-
tively co-operating with all the movements toward the betterment
of public health, as for instance in the proper cleaning of streets,
sanitary care of public buildings, proper disposal of garbage and
sewage and the maintaining of a pure and wholesome supply of
water.
The executive of a city should extend a sympathetic and helpful
support. The mayors of cities and presidents of villages have
within their hands the greatest power to enhance and increase in
value all the activities of a health department.
The duties of the health officer should be viewed by all municipal
officials as being practically the same as that of an inspecting offi-
cer in the army. In fact there is not a depvartment or bureau in
the city, executive, legi<slativc, charitable, public safety or pub-
lic works, in which some part of their duties does not touch
shoulder to shoulder those of the health officer. Every public
Public Health and Municipal Authobities: Duryee 797
official in some way is a health conservator, with the health officer
as the leader. It therefore seems to me that the attitude of all
municipal officials toward the health department should be more
than casual and should reveal a sense of co-operation as wide as
the conditions may permit. The health officer should be looked
upon as an expert in conservation of public life whose advice on
many of the subjects that tend to make a city fit to live in, may be
wisely and frequently solicited.
Kecently I said that :
" When we realize that it is probable that within a short time
fifty per cent, of all diseases will be placed in the column of pre-
ventable diseases, it should be clear to us that the attention given
to public health matters should bring to the health department its
true and proper position ; that the best talent, both scientific and
executive, should be placed in the control of such departments,
and that niggardly and insufficient appropriations to the depart-
ments of health should be no longer tolerated.
" No one who has watched the generous appropriations ac-
corded the police and fire departments of municipalities will re-
gret such liberal assistance. Important as are these departments,
the great bulk of their work is directed toward the preservation of
property and protection of society. The police department is,
perhaps, the oldest of all municipal activities, and is as ancient as
government itself.
" The health department in any organized and permanent sense
is one of the youngest of municipal activities. The health de-
partment must deal more directly with the conservation of human
life. Its equipment should be broader and. better. The money
appropriated for its use should not be extravagantly expended,
but no consideration of mere money should stop the saving of the
infant and child, and the preservation of the family during its
period of greatest productiveness, and the protection and preser-
vation of life on its downward way.
" It is, of course, impossible to make any accurate measure-
ment of the value to the community of these three departments ;
all are admittedly essential. A question which would doubtless
arise in the mind of most persons upon hearing this topic is
whether the oldest of these departments, by virtue of its age and
by reason of the strength of tradition, may have retained an un-
due importance in the matter of facilities, men, and appropria-
tions, as compared with the younger departments. How does the
work of those two departments in its value to the community and
708 Conference of Sanitary Officers
the duties imposed upon them by statute, compare with the equip-
ment, men and means placed at their disposal, respectively?
" Compared with the two other departments, the health de-
partment is woefully undermanned and underequipped. Its aim
is the protection of the comumnity from evils that are wide-
spread, ever present, and comparatively little understood. The
economic waste arising from the loss of human life through pre-
ventable disease, which our health departments could overcome,
is vastly greater than the economic loss arising from crime and
disorder, or from fire. Laying aside for the moment the ques-
tion of sentiment, questions as to the value which should be
placed upon human life, questions as to our duty individually
and socially to take all practicable steps for the protection of
human life, irrespective of its economic value, is it not clear that
purely as an investment of public funds the health authorities are
entitled to a much larger proportion of the City's resources ? We
are apt to forget the actual money value of human life."
In this way and by these means all municipal health oflScers
should seek to 'bring about a wise application of the recent knowl-
edge which has been so potential in promoting the health of com-
munities in this country, in order that the division of municipal
government which is so important to the creation of conditions of
public health and comfort, which are the essential features of a
modern city, may be accomplished. The city in the future will
depend to a greater extent than now on municipal health control
for the preservation of human life, the greatest of all national as-
sets, and should therefore make it the aim to give greater consider-
ation to all efforts for the promotion of efficiency along these lines.
The ideal city is not one in which the ibeautiful alone is con-
sidered, but one in which there is a combination of health and
beauty, and this can be obtained only by what we may term team
work on the part of all municipal officials, with the health officer
as the leader, backed up by an enlightened and edaicated public.
For without the assistance of the citizens of a city and their moral
support, no campaigns for cleanliness, decency and health can be
effected. The competition along cities is to-day of such a char-
acter that no city may expect to be successful without giving ample
consideration to all the conditions that tend to promote its public
health. Co-operation of officials should be voluntary and active;
co-operation of the people can be easily obtained by education.
Public Health and Municipal Authorities: Duryee 799
I have thus indicated briefly some of the ways in which all mu-
nicipal ofiicers can lend their powerful aid in raising the standard
and solving the problems of the living conditions in a community.
If this .plan is carried out, it will make for greater economy of
energy in the administration of public affairs by avoiding duplica-
tion of effort.
CoMMissiONEB PoRTER — When we adjourn now we will adjourn until
8:00 P. M., to meet again in this room for the evening meeting, which is our
" Public Meeting."
I hope to see you all present.
SOO Conference of Sanitary Officerb
WEDNESDAY, NOVEMBER i6, 1910, 8 P.M.
Third Session
PUBLIC MEETING
Presiding: Deputy Commissioner Howe.
The Chaibman — There are some good things in store for you to-night.
We have the double pleasure of having not only one of your residents, a
man who has done things for Buffalo, but we have a neighbor, a man who
is doing things across the big line; and our interests are mutual in many
ways, because, residing in the city of Buffalo, there are many who were bom
in his native land, where he is now accomplishing such splendid results along
the line of health.
If there is anything which is admirable in either a man or a woman, it
is the ability to accomplish things. The man who is capable of leading and
interesting others, and inducing them to follow, is the man who leaves an
indelible mark behind him.
The first speaker to-night is a gentleman of those characteristics. He is
a man who is now shaping, and who in the past has shaped, the health work
in the province over which he presides, and whose record will go down in
the annals of that province as one of the most brilliant — yes, the most
brilliant — in its history; and it is with more than personal pleasure — it
is as representing the Department of Health — that I have been asked to
present to this meeting to-night, our first speaker. Dr. C. A. Hodgetts, medical
adviser of the Commission of Conservation, of Ottawa, Canada.
Del C. a. Hodgetts — Mr, Chairman, ladies and gentlemen — I did not
catch all of the words of our Chairman, but I fear he has been altogether
too flattering in his introductory remarks. I am simply a health worker
like yourselves. Tlie only difference is I am free from political or municipal
environment, which I wish you all were. I have been there, and I hope that
the day will come when in the length and breadth of this great continent,
not only of the United States, but in Canada, the health officers will be free
from municipal and political environment.
I have the honor of serving the Conservation Commission of Canada. I
suppose to copy is not a discredit. We have copied one of your great
American citizens in respect to conservation, and to-day the Conservation
Commission of Canada, by act of Parliament and Senate, is a living organiza-
tion, looking toward the conservation, not only of the natural resources, ab
regards our forests, streams, mines, etc., but in regard to the conservation of
the public health of the people. 1 only wish that condition of affairs now
existed; but when it does, I shall look forward to a great advancement in
public health work over here.
Now, sir, as you will not consider me in any way touching upon political
lines, as I am a Canadian (of course, we have no politics in Canada), I have
to congratulate you all in this great republic upon all being republicans. Of
course you have your political leanings, but I only trust that the work be-
gun in the Empire State of Xew York, and a work which personally I have
had the pleasure of viewing for the past six years under the Commissioner
of Health, I only trust that good work, notwithstanding the changes which
have taken place in tlie past few days in your State and in your coimtry,
I hope the good work begim, and which has be^ carried on with such great
interest and advantage to the people of the State of New York, will be con-
tinued free from any political environment.
Public Health and ConsebvationMovembnt: Hodgetts 801
Ab health officer of the province of Ontario, it has been my privilege to
attend four or five meetings of this Conference. I have not appeared promi-
nently among you, but I have always been interested in the Conference of
the Health Cheers of the State of New York, and I have viewed with interest
year by year the improved condition of the officers of New York State; and
I trust the good work begun will long continue under its present regime.
PUBLIC HEALTH AND THE COXSERVATIOX MOVE-
MENT
By Charles A. Hodgetts, M.D.
Medical Adviser, Conservation Commission, Ottawa, Canada
Although so m\ioh has been written and spoken in regard to the
conservation of national resources on this continent during the past
year or two, there yet remains much more to be said and infinitely
much more to be done before one can speak with assurance of the
movement taking that prominence in the life work of the nations
that its importance justifies.
During « century and more there has gathered together upon
this continent an aggregation of people of all nations and languages
such as the world's previous records can never compare with.
This exodus from the older and more densely populated lands
of Europe still continues and will progress notwithstanding the
most severe and rigid immigration laws which can be enforced.
" Westward the march of Empire " is more true of the twentieth
than of the previous century. Why they leave home and kindred
and how they come are not considered here. Come they do like
sheep, and the majority without a guiding shepherd, turned loose
by the hundreds of thousands in a continent, once a rich store
house abounding in natural resources which our forefathers
deemed to be unlimited and which we, in our greed for gain and
wealth — reckoned by dollars and cents, have ruthlessly despoiled
and destroyed and in some instances nearly annihilated.
We have in the past wisely encouraged and fostered this seeking
of homes on this continent by the people of Europe, but it cannot
be said we have done it well.
In the development of the natural resources by the extension
of trade and commerce, we have not only been killing the goose
that lays the golden egg, but we have permitted to grow up around
us in our cities, towns and even rural districts, conditions which
26
802 Conference of Sanitary Officers
have gradually tended to the detriment of those we have encour-
aged to come here^ as also to our own kith and kin.
While seeking for temporal wealth, we have forgotten the im-
portance of health, and as a result, some few have got the wealth
while the multitude of toiling millions have what results from the
neglect of the enforcement of the laws of health, viz. sickness, dis-
ease and death, with all that the mind can associate therewith.
For who can say that we in America are to-day, with all our
boasted advantages, one whit better in the important matter of
public health than are some of the countries from which have
come large numbers of our present citizens? The figures are
against us. The results of all our efforts as compared to those of
some of the European countries are against us.
Take one concrete example — typhoid fever. What are the
relative conditions in the United States and Canada, as compared
to some of the European countries, as shown by the latest mortal-
ity records in the accompanying diagrammatic chart? When we
consider that within the area represented by the group of states
known as " the Atlantic " comprising 18 States of a total area
of 430,723 square miles, with Iowa, Wisconsin, Illinois, and
Arkansas, and Missouri thrown in ; or, in Canada, represented by
all the provinces as far west as Manitoba, there is crowded in no
less than 178 million people, or twice the present population of
both countries put together, the object lesson is made more promi-
nent. The foreigners (as we are pleased to call them) have much
better chance of living free from this dread disease by remaining
at home than emigrating to this continent. This should not be —
indeed would not be if we had been wise and provided proper
health laws and enforced them years ago. And what applies to
typhoid fever conditions appliee with similar force to tuberculosis
and many of the other evils, sanitary and social, which we have
permitted to grow up with us and which surround us to-day on
every hand.
Have we not, as sanitarians, been striving at the gnats of public
health work and permitting the people, young, middle-aged and
old, to be swallowed up by the camels?
We have now come to the time of a national stocktaking, and
fortunately, man has been counted into the national balance sheet
d
TYPHOID FEVER
ANNUAL DEATH RATE PER 100000
62
SCOTLAND
1901-1905
76
GERMANY
I90I-I90S
112
ENGLAND and WALES
1901-1905
168
BELGIUM
1901 'I90S
199
AUSTRIA
1901-1904
283
HUNGARY
1901-1904
S5 2
ITALY
1901-1904
555
/- AKIADA
460
-
S04 COXFEICBXCE OF S ANITA liY OFFICERS
— and certainly it is high time he should be considered as a
national asset. He has been plajed with long enough, put off by
a public health act^ now, in many instances, old and musty and as
much out of date as the old fashioned stage coach, when com-
pared with the dectrical means of locomotion now at our com-
mand.
Did ever a Minister of Agriculture stop in his efforts in im-
provement of all that appertains to our farming wealth by the
passing of an Animal Contagious Diseases Act ? No, he has gone
ahead, spent thousands upon thousands in research work, in ex-
perimental work, in educational work of all kinds with the earnest
hope of getting the best out of what nature has given man to toil,
cultivate and develop.
Not so with man. Legislatures have required his education
along lines of mental development, until to-day it would appear
that some of our children must be mental monstrosities if they are
to be what some of the educationalists would have them — in
other words, physical wrecks, derelict before they are launched on
the ocean of life.
The results of the shortcomings and mistakes of the past are
not hard to find; they are apparent on every hand in city, town
and countryside. Some of these mistakes have been framed in
costly asyliuns for the insane, in massive prisons, in institutions
for the deaf and the blind and in the still more recent addition to
the already expensive gallery of misapplied national and State
shortcomings — the sanatoria and hospitals for consumptives.
We can sadly reflect over the errors of the past. We can see
now " what might have been " had we been wise and taken counsel
from the experience of our elders. But in the lamenting let us
be spurred on to activities hitherto unthought of and do the right
as nations, lest we fall into the sin of omission, which will in the
long run, prove more heinous than the sin of commission.
If the public of any nation could hope to conserve the lives and
the health of its inhabitants by asking those entrusted with its
government to maintain an army and navy for the preservation of
the health of the people and the prolongation of their lives against
apparently insurmountable and often unforeseen but relentless
foee which, up to the present time, have been unvanquished —
Public Health axd Conservation IfovBMENT : Hodgetts 805
perhaps there would be some hope of an early, successful and
generous response. But the armaments asked for are of quite a
different character; and we as sanitarians, know if the aid asked
for is but given that a natitmal victory will be assured. And
following in the wake of the victory there will be no dark tales of
woe, horror and desolation to be recounted; there will be no tears
of the sorrowing for the vacant places in the homes of our country,
no funeral biers, no call for the payment of pensions to the heirs
of fallen comrades, even to the fourth or fifth generation; no
colossal, national debt to be faced with a diminished nation of
workers and blighted commercial conditions to make good the
dollars and cents. No, we have quite the reverse to offer — a
nation being daily blessed, while the battles with disease are being
fought, sickness and death prevented, sorrowing, suffering, penury
and crime lessened ; the babe spared to its mother and the mother
prolonging the life of the babe; the laborer giving better service
to his employer by reason of improved health, and the employers
bettering the condition of their employees, because it is right and
proper. The body corporate acting in the interests of the tax-
payers, carrying on works having for their object the improve-
ment of the environment of the city, town and rural dweller.
The State providing the trained men — the rehabilitated medical
officer of health — now no longer a general practitioner of medi-
cine and dependent on the public for his livelihood, but the State
officer of preventive medicine. Not that the curative side of
medicine will be abolished, but the curative will be made secondary
to preventive medicine, the practice being along the lines of
therapy, somewhat different to those now followed. This class of
practitioner will be aided by the State providing biological
therapeutic remedies which will be necessary, and possibly in
other ways.
The national governments will be training or directing the edu-
cation of the preventive forces, keeping the ranks provided with
properly educated men, many of them trained it may be in a
national school with well equipped laboratories for the carrying on
of research work for the study of disease, both as to cause, preven-
tion and cure.
This is conservation, and surely no higher, no nobler work was
806 CONFEEKNCE OF SanITABY OfFICEES
ever suggested by mortal man in the interests of bis country and
bis people. It is the essence of Christianity — the truest ideal
of statesmanship — and the perfection of citizenship ; and if prop-
erly carried out will prove of the greatest blessing to the nations
engaging therein.
The suggestion of the conservation of natural resources upon
diis continent was made by Col. Theodore Roosevelt, while Presi-
dent of the United States, and was actively taken up in Canada
by Hon. Clifford Sifton, subsequently appointed first chairman of
the Commission. In 1909 the House of Commons of Canada
passed an act creating the Commission of Conservation, which act
was further enlarged and amended in 1910.
The following is a brief outline of the character, personnel,
duties and functions of the Commission, as outlined by the chair-
man in his inaugural address.
As constituted, the Commission consists of twenty members ap-
pointed by the Governor in council, and at least one so appointed
from each province shall be a member of the faculty of a univer-
sity within such province. The ex-officio members are " The
Minister of Agriculture, the Minister of the Interior, the Minister
of Mines of the Federal Government and the member of each
provincial government who is charged with the administration of
the natural resources of such province."
The chairman is the administrative head of the Commission,
and directs the work of the permanent officers.
Under section 9 of the act, no fees or emoluments of any kind
can be received by the chairman or the members.
In regard to the duties of the Commission, these cannot be more
tersely stated than as set forth in section 10 of the act:
" It shall be the duty of the Commission to take into consider-
ation all questions which may be brought to its notice relating to
the conservation and better utilization of the natural resources of
Canada, to make such inventories, collect and disseminate such
information, conduct such investigations inside and outside of
Canada, and frame such recommendations as seem conducive to
the accomplishment of that end."
For working expenses, Parliament sets apart the sum of fifty
thousand dollars, and now the work is actively going on.
Public Health and Coxservatiox Movement : Hodoetts 807
That the master mind of the movement in Canada was fully
seized with the value of human life as a national asset was evident,
for in his inaugural address, Mr. Sifton spoke in regard to public
health as follows:
^' The Dominion spends hundreds of thousands of dollars in.
eradicating the diseases of animals, and the work, it is pleasing
to know, is being done with thoroughness. But no similar effort
is made by Province or Dominion to meet the ravages of diseases
among human beings, such as tuberculosis. * * * It is
probable that Parliament would readily consent to the necessary
appropriation for undertaking to deal with the evil. This, how-
ever, is one of the subjects upon which Federal and Provincial
jurisdictions overlap, and in which any effective action will re-
quire to be carefully worked out and agreed to between all the
Governments concerned. A sub-committee from this Commis-
sion, representing, as it does, all the Governments, might well be
able to work out an acceptable and useful plan which would re-
ceive general assent."
No doubt as a result of this, one of the committees of the
Commission is that on Public Health, the chairman being Mr.
E. B. Osier, M. P., Toronto, who takes a deep interest in
the work.
The duties of the Commission are not in the least executive.
They are simply advisory to the governments of Canada. This
was clearly set forth by the Hon. Mr. Sifljon in his opening
address, as follows:
" The Commission, it is to be noted, is exceptional in its char-
acter.
" First, it is not a portion of the ordinary governmental ad-
ministration for which the Government is politically responsible.
It is a Commission created bv Parliament and entrusted with cer-
tain duties, upon the performance of which it is to report from
time to time. The funds necessary for carrying on the work,
must, it is true, be procured by application to the Government
of the day, which will introduce the necessary estimates; but,
otherwise, the work is totally independent of the ordinary admin-
istration of affairs.
" The Commission is not an executive or an administrative
body. It has no executive or administrative powers. Its con-
stitution gives it power to take into consideration every subject
which may be r^arded by its members as related to the conser-
vation of natural resources, but the results of that consideration
808 CONFEREXCE OF SanITARY OfFICEBS
are advisory only. In a sentence, the Commission is a body con-
stituted for the purpose of collecting exact information, deliber-
ating upon, digesting and assimilating this information so as to
render it of practiced benefit to the country, and for the purpose
of advising upon all qu^tion of policy that may arise in refer-
ence to the actual administration of natural resources where the
question of their effective conservation and economical use is con-
cerned.
" The effectiveness of our work will depend upon its own mer-
its. We can only study, investigate and advise. The Govern-
ments concerned must take the responsibility of accepting or re-
jecting what we recommend."
As an initiatory step in the work, a Conference was held in
Ottawa, October 12th and 13th, of the officers of the Dominion
government now engaged in public health work and the health
officers of the several provinces. The findings of the Conference
were summed up in four resolutions, which findings will be con-
sidered by the Commission, and it is expected will he subse-
quently acted upon. '
The importance of the subjects discussed and the decisions
arrived at by the Conference are of greal; national importance in
themselves, but the fact that the Conference will be continued
annually is of still greater moment, for it opens up an avenue
which can be made of inestimable value in the shaping of federal
and provincial health laws and the co-ordination of the same
It will at once be seen that the relationship of public health
to the conservation movement, in Canada at least, is of the
closest character;, indeed, it is an integral pant of the work of
the Commission. This being the case, it comes at once in touch
with the people in their daily life — the individual and his
environment. •
First, the individual ; during his prenatal exisftence ; his birth ;
his rearing; his school life; all through youth, manhood and
womanhood, until he shuffles off this mortal coil.
Second, his environment (in its broadest sense); the home;
the school; the workshop and office; and his amusements, exer-
cises and sports. '
It has to do with the health of the various groups of individ-
uals, such as we find them massed together in either cities, towns
Public Health and Conservation Movement: Hodgetts 809
and villages, and in the more widely scattered groups of townships
or districts.
It has to do with the greater geographical groups of our people
as provinces, dealing with ihem through their lawnnakers, the
l^ifilatures.
It has to do with the people of the Dominion of Canada,
advising the Senate and the House of Commons upon the larger
matters, those of national importance which can only be dealt
with by a federal government
The movement deals with qu€stion3 which come home to
each individual and these questions are of as great import, indeed
greater import than the building of a railway, the extension of
the fire department, or any of the many matters which are
dealt with either by the municipal coimcil, the legislature or the
federal government, and in each of which he now takes more or
lees interest by recording his vote in favor of this or that particu-
lar candidate seeking his suffrage. Once convince the individual
that the prevention of disease and suffering can be brought about
to the improvement of the health of his wife and family and to
the community in which he dwells, and when you have done this
by the wholesale there need be no fear for the future. For legis-
latures will enact the proper laws and provide the necessary funds
for the carrying on of the work in just the manner as they have
for the care of the cattle and hogs of the country; for they will
then have realized the truth of the motto in the Monthly
Bult^btin of vour State that "The first wealth is health."
The question of health is superior to that of politics. It is one
of statesmanship, and if we have not the men in public life to-day
who will rise above partyism, and in their representative capacity,
whether in a coimcil, a legislature or federal government, pro-
nounce imequivocally for sound and rational laws for the pre-
vention of disease and the conservation of the lives of the people,
then it is your duty and mine to educate the public as to Uie
necessities of the case, and while educating, to work with all our
energies for the early consummation of what we desire.
In conclusion, to follow the example of the model man, I would
figuratively set a child in your midst and seriously ask what
are the two nations doing for that which is our best, our most
precious national asset ?
810 Conference of Sanitary Officers
The answer will doubtless be made, we are providing for the
child's education — true — but is that all ? Is that enough ? What
of the years which elapse from its birth until the little child
reaches the age when the State 3teps into th3 home and claims a
say in its life's career ? For these are the years of the greatest im-
port to the physical condition of the child, — yea, even of the very
life itself.
Do we as nations take the interest in the child that we should ?
Many of us neglect even to record its birth, although states, pro-
vinces and national governments carefully register in well kept
stock books the births of hogs, sheep and cattle, and furnish pedi-
grees as elaborate as those attached to a royal potentate.
What of our milk supply which is the staple food of infants —
what of the housing conditions and home sanitation? Are the
environments of the homes of the town, city and country child
what they should be ? Let the nations improve these and they will
save the lives of millions of little children who die before they
reach the school room door. The land beyond the great divide is
too full of babies and little children — an eternal monument to
the sinful ignorance of mankind, while our cemeteries are over-
loaded and the ground encumbered with infants' remains, and yet
we keep on in the extension and elaboration of these useless ap-
pendages of our socalled high class civilization. We must as na-
tions cherish and care for the children, conserve them in our own
interests by the introduction and the careful enforcement of mu-
nicipal, state and national health laws of a sound, practical char-
acter. The task is great and ideal, but it is not beyond attainment.
The Chatbman — Dr. Hod^tts, in thanking you on behalf of the State
Department of Health, I want to express the wish that these able words bo
rapidly spoken mi^ht be put in the hands of every citizen of the United
States and Canada who might be able to read and digest them.
It seems to me, ladies and gentlemen, as if such an appeal, so forcibly put,
should arouse in heart and mind of each of us a determination to wage a
constant warfare of extermination on those diseases which are yearly destroy-
ing so much valuable life.
Those of us here who are so closely associated with this tremendous work
of public sanitation feel at times as if we could hardly hold ourselves when
we see child after child, and man after man, and woman after woman
stricken down by conditions which are preventable, and which should be
prevented. And that condition will prevail, my friends, until the time comes
when you and you (indicating) and you and I and all the rest of us. and
all our neighbors, every man and woman on this great continent unite in
that great war of extermination of disease. And the time is coming; and
we are boimd to win in this great fight for the life of humanity.
As I sat and listened to that graphic word picture I could feel my tempera-
Public Health and Consbbvation Movement: Hodgetts 811
ture rise as I sat there; and I only wished that I oould be given a new lease
of life. I felt as if I would like to live 100 years hence to join hands with
others in this grand fight for the existence of the human race, and 1 want
to congratulate you, doctor, on the magnificent address you have brought to
us, and as a citizen of this country and of this State, I want to promise you
that as long as my life shall be spared I am in this fight for the life of the
people of this State and country.
It matters not to me whether my friend is democrat or republican, or
Canadian or English, or what-not, I want to place my hands of approval on
him when he is engaged on this magnificent war of extermination of disease.
I am not supposed to be a speaker this evening, but when I listened to such
thoughts as we heard, I felt as if I wanted to say **Amen '* at every second
or third sentence.
Now, we have another man with us to-nisrht, a man of the same blood and
flesh, and he, too, has done things, not in Canada, but right here in our own
State, and in this beautiful city of Buttalo; and it is to his efTorts more
than to any other man who has labored on such lines in years that is due
much of tie credit for the magnificent results already accomplished.
It is with particular pleasure that I present to you the next speaker of
the evening, Colonel Ward, who will address you on " Public Health and
the Public Purse," which is indeed a timely topic
812 CONFEBENCE OF SaNITABY OfFICEBS
PUBLIC HEALTH AND THE PUBLIC PURSE
By Col. Fbancis G. Wabd,
CommiBsioner of Public Works, Buffalo
My remarks must necessarily be confined to practically the
subject of sanitation in construction, tJie accomplishment of such
engineering projects as the financial possibilities of the city of
Buffalo would permit
In the city of Buffalo, by its charter, the board of health is
composed of his honor the mayor, the health commissioner and
the commissioner of public works, a wise provision of the charter,
which thus combines the chief executive, chief medical oflacer and
the chief of construction in the service of the department of
health.
The powers granted this board are paramount in case of emer-
gency or epidemic. To-day, no greater question confronts our
people than that of solving the problem of a successful form of
city govemmenit in all of its branches.
Each of our large cities has gathered within its limits many
people of all nations with every attribute of the different races.
To formulate the best system of governing these, with considera-
tion for the greatest good for the greate&t number, is one of the
problems involved.
We have no sure precedent by which we can be guided in
covering ideal methods of city government. Modem inventions
have done much in brining these conditions about. We have
been pioneers in a new field; we have made mistakes, and we
have profited by them, and with an honest united effort we shall
secure the ideal method of administering the affairs of our great
municipalities.
Mr. Brice, years ago, in writing of our cities even then con-
cluded :
" No one who studies the municipal history of the last decade
will doubt that things are better than they were twenty years a^o.
The newer frames of government are an improvement on the
older. Bogues are less audacious. Good citizens are more ac-
tive. Party spirit is less and less permitted to dominate aim!
pervert municipal politiot.''
Public Health ahd the Pitblio Purse: Waed 813
Buimmg a cit^ is a complex business propositioa oalling for
competent men. '
With the question of cost of sauibation eoltering into every
branch of the city's service, the latest practice and besrti methods
are sought to reduce the maintenance with a rational installation.
From the collection and disposal of city waste, cleaning of
streets, pavements, lighting of streets, to sewage disposal and
water supply, every effort is made to give the best sanitary
aornce at the lowest cost, recovering ait the same time all by-
products that can be disposed of. '
As the form of and systems by which mimicipal charters are
created and operated under, vary m«teirially in this country, it
is difficult to obtain satdafactory ct^nparisons of cost between
cities without close study of each and every service, local oondi-
tiona rightly governing to a large extent.
T3ie ideal engineering plan frequently must give way to the
available financial resource.
Undoubtedly the general public services most closely allied to
the question of public health are the collection and disposal of city
waste and water supply; but their relative value to the inhabitants
of a city is perhaps in the inverse of the order as named.
The collection and disposal of ashes, refuse and garbage follows
the introduction of water and sewers.
Situated as Buffalo is, Lake Erie furnishes an ideal supply from
the new or Horse-Shoe reef intake 330 days in the year. Periods
of possible minor contaminations exist only during the period of
storms in the early spring and late fall, when the whole body of
water is distiurbed.
The Health Department makes a bacteriological examination
daily, and the city chemist a chemical examination weekly. The
examination shows from 200 and -120 ibacteria per c.c. to 800
normall;
The c
for the !
in Taloe
surplus
been issi
take anf
arenne.
814 Conference of Sanitary Officers
The water bureau finances itself for this $5^000^000 issue by the
payment from its receipts annually into a sinking fund for fift^
years the sum of $860.50 per $100,000 of bonds issued; which
sum compounded at 3 per cent, per annum will provide sufficient
funds to retire the bonds when due.
The water rates in Buffalo are as low, if not the lowest, in this
country.
Buffalo is undoubtedly the largest user of water per capita in
this country. This is of no benefit except possibly the dilution of
its sewage and cleansing of its sewors. The city is not metered,
having only 2,500 meters in servic<% less than 4 per cent of the
taps. The department as an engineering and economic proposi-
tion recommends meters, but public opinion has at all times been
naturally adverse to them.
Unfortunately the man who dares to propose anything, even
though it be a great -benefit to the populace of the city, that re-
quires a great expenditure of money, is considered a man who is
endeavoring to inaugurate something that will penetrate far into
the future for the purpose of bettering solely his own condition,
financially or politically.
Buffalo has met the requirements of a proper water supply.
Up to 1885 the city of Buffalo followed no definite policy as to
its sewer system, and naturally districts became congested at their
outlets.
In 1885 by act of the Legislature, the Trunk Sewer Commis-
sion was created. The Swan and Genesee street intercepting
trunk sewers were constructed, and with their various extensions
and laterals have cost the general fund of the city $2,246,922.75.
Taken with the 500 miles of district sewers paid for by assess-
ment on property benefited, amounting to $9,100,000, grand total
of 507 miles of sewer system is $11,546,922.75.
The average system in the city of Buffalo is the " combined,"
carrying both surface drainage and dry weather flow.
To-day it is necessary for the city to provide again for the future
in the construction of new and enlarged intercepting trunks with
proper sedimentation, screening and purifying basins.
This improvement is variously estimated to cost according to
the scale of work to be done at from three to five millions of dollars.
Public Health and the Public Puebe: Waed 815
Collection of ashes, refuse and garbage : The three separations
are maintained in collection and disposal. This service is ren-
dered by contractors except the disposal of refuse.
Ashes are collected from all buildings where produced from
heating service, and are disposed of by the contractor for founda-
tions or fills.
Grarbage is collected and hanled to a reduction plant outside of
the city limits owned by the contractor where it is reduced to
grease and fertilizer.
Refuse is hauled to the city refuse utilization plant, where it is
all handled over a traveling belt, and the valuable portion of the
same recovered, the balance conveyed by belt to the refuse furnace
and destroyed by incineration.
The financial statement for the three years' experience to July
1, 1910, is as follows:
fS Balvnci Shbbt of Retcsb UraiZATioN PL.iirr, Jult 1. 1910
Dr. Or. Loss. Gi>ia. A«eta. UiHIIticfl
Cbpttal 150.000 00 $50.000 00
Furnkbed by dty til Buffalo.
Plant 150.000 00 150.000 00
Sakt 97.316 91 $07.316 91
Steam power 8.985 21 8.985 21
Suimlies, aukiotenaDoe
and repairs 19.802 26 $19,802 26
Supplies, new eqmpment. 3.606 00 3.006 00
Interest 4.000 00 4.000 00
Payroll 73.019 45 73.019 45
losiirance 200 00 200 00
Aeeountf receivable 2.633 80 2.633 80
Babnce witb city tress-
tirer 3.440 61 3.440 61
Accrued interest i. 600 00 1.600 00
Qain 8.080 41
Surplus 8.080 41
$156,502 12 $156,502 12 $106,502 12 $106,502 12 $59,680 41 $59,080 41
The largest source of revenue is from mixed papers and news-
papers sold to paper board mills. Then tin cans, bottles, metals,
rubber and leather.
Of all the refuse collected and hauled to the plant 40 to 50 per-
cent, is susceptible of recovery and sale.
The city is now constructing new furnaces which will destroy
the garbage in its cells, and save the expensive haul of the same
to the country reduction plant. Tliis saving is $1 per ton.
The garbage disposal plant (incineration) may be made abso-
lutely sanitary, may be made to pay its way in disposal of the
city's waste, and at the same time be one of the greatest examples
of municipal conservation.
816 COXFEKEXC E OF SaNITAUY OFFirERS
I will now read to you a statement or report of our refuse util-
ization plant for the fiscal year ending June 30, 1910 :
Expense of pay roll, $28,938.75; maintenance and repairs, $6,085.85; in-
terest on bonds, $50,000; cost of plant, new equipment, $3,606; total of
$38,530.
We sold 5,882 bales of newspaper, a total of 2,656,010 pounds, for which
we received $10,020.39.
We sold 13,865 bales of mixed paper, a total of 6,438,950 pounds, for which
we received $20,187.38.
Sold 1,121 bales of manilla paper, a total of 427,100 pounds, for which we
received $2,880.23.
Sold 421 bales of rags, a total of 192,305 poimds, for which we received
$1,121.98.
Sold 05 bales of flour bags, a total of 00,^9 pounds, for which we received
$580.43.
Sold 58 bales of charcoal bags, a total of 16,895 pounds, for which we
received $159.69.
Sold 13 car tins, a total of 256,450 pounds, for which we received $503.90.
Sold 60,670 pounds of scrap iron, for which we received $60.
Sold some old rubbers, etc., for which we received $65.
Sold 10,552 beer bottles, which brought in $195.52.
Sold 1,904 mixed bottles, for which we received $530.94.
Sold 967 half-gallon bottles, for which we received $19.34.
Sold 4,453 ammonia bottles, for which we received $22.28.
Sold broken glass — 20,000 pounds of it — for which we received $20.
Ten bales of old shoes, a total of 8,2/0 pounds, for whicn we received
$28.16. Making a total of the entire list of $36,395.24, less deductions for
moisture, etc., which amoimted to $21.90, or a total of $36,37<3. Steam fur-
nished Hamburg Pumping Station, 4,003% hours, at 70 cents, or $2,802, or a
net total of $39,175 actually received.
This is the first plant of this nature operated on this system.
The steam generated is used to pump sewage from low level to
trunk sewer.
The services just enumerated are those that relate most closely
to the sanitaijf department, but Buffalo can well »be proud of her
miles of streets and pavements, for on January 1, 1909 (exclusive
of park system), there were 234 miles of asphalt; 2-2 miles of
brick; 13 miles of macadam; 15 miles of block stone; 80 miles of
second class stone, a total of 364 miles of paved streets.
The public purse, gentlemen, will be open at all times to the
public official who gives definite results for the public funds ex-
pended.
Thb Chairman — Colonel Ward, in thankinff you for your instructive re-
marks, it seems that no better assurance of tne interest taken could be ex-
pressed than the close attention which has been given to you by your hearers.
I want to thank you, however, personally for the Commissioner of Health,
as well as on behalf of myself and your audience.
The remainder of the evening will be given over to Dr. Fronczak, com-
missioner of health of this city, who will display some lantern slides which
you will find instructive and interesting.
(Dr. Fronczak exhibited a number of lantern slides, at the conclusion of
which the meeting adjourned until Thursday, November 17, 1910, at 10 a. m.)
Handling Garbage Without Nuisance: Hall 817
THURSDAY, NOVEMBER 17, 10 A. M.
FouETH Session
SECTIONAL MEETINGS— CITY HEALTH OFFICERS
Chairman: FbANas E. Fbonczak, M. D., Health Commissioner of Buffalo.
Db. Fbonczak — Gentlemen, 1 have been delegated by the State Commis-
sioner of Health to act as the chairman of the city health officers and before
we proceed with the program I desire to read the following letter which I
received this morning:
On behalf of the Entertainment Committee of the University
Club of this City, I write to ask that you extend to the members
of the Sanitary Officers Association and its guests the freedom of
the University Club during their stay in this city. We should
be glad to have all those in attendance at the convention avail
themselves of the privileges of our Club while they are here.
Yours very truly,
LOUIS B. BOTSFORD
This club is now at the corner of Delaware avenue and Allen street They
have plunges, bowling alleys and other things pertaining to such clubs and
you are invited to avail yourself of these privileges.
The first paper of the morning is by Dr. P. M. Hall, the health officer of
the city of Minneapolis, on " Garbage Disposal."
THE TEN COMMANDMENTS FOR HANDLING GAR-
BAGE WITHOUT NUISANCE
By p. M. Hall, M.D.
Commissioner of Health, Minneapolis, Minn.
From the earliest time animal and vegetable waste commonly
called " garbage " has been considered a nuisance — a nuisance to
be gotten rid of as a sanitary necessity. The stuff itself was a
nuisance and became more of a nuisance the longer it was kept
around. Desire to get rid of it, to get it out of the way, if not
out of sight, was the first and most natural impulse.
The methods of garbage disposal have progressed from dump-
ing on land and at sea, to pig-feeding, then to reduction with utili-
zation, and finally to incineration with utilization. No thought
818 Conference of Sanitary Officers
was given at first as to how it should be gotten rid of, nor to sani-
tary methods. It was so foul that all eflFort was expended upon
simply getting it out of the way.
When methods of disposal began to be evolved, they were con-
sidered generally as engineering problems — too much so, in fact,
when they should have been and should be now the result of the
combined wisdom of the engineer and the sanitarian. The engi-
neer, who knew little about garbage, built the garbage disposal
plant, and the health oflBcer who knew less about engineering,
operated it. Is it any wonder that in the course of time the health
officer tired of the work, and the contract system came in ? The
demand of the contract system is that it get the material and the
more the better — anything to increase the tonnage. Little care
is taken regarding the necessary sanitary steps from kitchen to
can, from can to wagon, and from wagon to disposal plant. The
question of sanitary handling is certainly of as much importance
as final disposal. Why prate about internal temperatures and
noxious gases at the disposal plant, when the heat of summer and
improper handling of the garbage can make a nuisance around
thousands of homes? The indictment against the garbage can,
in the average city, is that it is a foul, maggoty mess of putrefac-
tion and a fly-breeder, and it stands self-convicted on both counts.
Putrefaction arises from the decomposition of animal and vege-
table matter. " It is the result of the activity of certain organ-
isms. It can, therefore, only take place when the conditions are
favorable for the life and growth of these organisms. A tem-
perature of from 60 to 80 degrees Fahrenheit, a moderate degree
of humidity, and limited access of air, are the conditions most
favorable to putrefaction." All of these conditions exist in the
garbage can as usually kept.
Animal and vegetable matter attracts flies, and then what fol-
lows? We need not ask the naturalist. Any intelligent, observ-
ing housewife will tell j'ou that she has seen " germs '' in her
garbage can. Garbage disposal should begin at the kitchen and
end in the ash-pilc. Why not begin at tho kitchen, then, to retard
putrefaction and eliminate the fly? How?
Drain garbage of all moisture, then wrap it in paper before
putting it in the can, and it will neither smell badly in hot
AM
/
Handling Gaebage Withoct Nuisance: Hall 819
weather, nor freeze and stick to tte can in cold weather. Do tbiB
and have a clean can at all times.
Heat, moisture and the &j, are all eliminated. There is plenty
of air space between the packages of wrapped garbage, and the
conditions favoring putrefaction are removed. Bearing in mind
the same conditions that favor putrefaction, the can should be
free from holes, and have an over-lapping self-locking cover. Now
that you have the garbage drained of moisture and wrapped in
paper, keep it protected from heat, moisture and the fly. With
this end in view, and governing each step of the process, the gar-
bage goes on to final disposal.
The garbage wagon-box should be so constructed that it can be
lifted off the truck. There should be no unnecessary handling.
There should be no dumping of the load excepting directly into the
hopper for final disposal. From the picking up of the can at the
rear of the house, until the residue of fine ash is taken from the
ash-pit at the disposal plant, there should be no handling by hand.
For three and one-half years the city of Minneapolis has been
handling garbage in this way, and it is without nuisance at the can,
in the wagon, upon the street, or at the disposal plant. The gar-
bage is first drained of moisture and wrapped in paper, then
placed in the can. The paper used is that brought by the grocer,
the butcher and the baker with their wares. The garbage is thus
reduced in bulk and putrefaction so much retarded that collections
of once a week are often enough, even during the summer — a
great saving in the cost of collection.
The garbage is collected in stcd tanks of 100 cubic feet capacity
and lianled to a central t^an^^fc■r station, where the tanks are
lifted off the wapoii truck by moans of an electric hoist and placed
upon flat cars for transportation to the disposal plant. At the
plant the l>o.\c'? arc lifted from t''" ""-'• ^"- " ti--™- -"^t — Bi^t-:«
hoist. This pennit^i of handling
inff them di'roctly into the firo.
platform, conveyor or floor, or i
reetly through the hopper into lli
where about the building except
upon the lire.
Through the burning of the
820 Conference of Sanitary Officers
enough steam to operate all of our machinery, and to heat and
light the group of workhouse buildings, the superintendent's house,
the tuberculosis hospital, and the two green-houses. It is the in-
tention of the city to place near the crematory, all of the infectious
disease hospitals, that they may be heated and lighted in the same
way.* One of these hospitals of 130 beds, for advanced tuber-
culosis, is already imder construction. This service of heat and
light is furnished to the city at a cost of 8 mills per horse power
(equivalent to 30 pounds of water evaporated) for heat, and 3
cents per kilowatt for light.
We have thus been able to handle garbage without nuisance from
kitchen to ash-pile, and to do something in the way of utilization
besides. This method of handling garbage has been a growth.
The objects sought have been entire absence of nuisance at every
step of the process and economy of operation. The rule regard-
ing draining of moisture and wrapping in paper was carefully
thought out and when adopted, rigidly adhered to, until now, the
people seeing the benefits of the " cleaner way " cheerfully comply.
At the disposal plant, garbage was first delivered to the in-
cinerators by means of a conveyor, but this was abandoned as be-
ing a nuisance and insanitary, and the present clean method of
over-head dumping directly into the fires was substitute. The
cost of collection and disposal has been very low. For the year
1909, the per capita cost to the citizens of Minneapolis was
19 5-6 cents. This figure also includes the cost of collecting and
handling ashes, and represents the gross cost without deducting
anything for the service of heat and light. Estimates based upon
tonnage are usually unreliable, but the total expenditure for such
service is easily obtainable, and the per capita cost is consequently
more accurate.
The recapitulation has been put into the form of
"The Tkn Commandments for Handling Garbage Without
xuisance."
I. Drain-oit Moisture!
Use detachable sinkstrainer.
• The best evidence I can give you that this crematory is not a nuisance
is the fact that the city has placed these institutions around this plant.
Handling Gakbaoe WixHorx Niisance: Hall 821
II. Wrap in Paper!
Keeps garbage from heat and flies, prevents freezing
and sticking to can in winter.
III. Use Metallic Cans!
Non-corrosive metal, over-lap self-locking cover, and free
from holes.
IV. Use Painted Steel Wagon Boxes !
Constructed water-tight and to be mechanically dumped.
V. No Dumping on Floors !
Box mechanically elevated, and contents emptied into in-
cinerator hopper without nuisance.
VI. In-Draught at Hopper!
Prevents escaping smoke and odors.
VII. Mechanically Charged Incinerators!
Eliminates the nuisance of exposed garbage and the
emanation of foul odors.
VIII. Good Draught!
Creates rapid combustion and high temperature, burning
everything of obnoxious nature.
IX. No Residue. Left Over!
Nothing to make a nuisance around the plant — nothing
left but ashes.
X. Generate Steam!
For self-operation and sell surplus heat, light and power
to make plant self-sustaining.
The movement for cleaner cities, cleaner methods, has but just
begun. The campaign for pure water, pure milk, for dustless
homes, for well-ventilated schools, is a popular one. Sanitation
is but education and the people are learning. In the handling of
garbage and city waste, can we longer aflFord to tolerate anything
but the cleaner, better way ?
Db. Fbonczak — Gentlemen, we have heard a very interesting paper and
I have to compliment Dr. Hall, for he covered the aublect very thoroughly.
The discussion of the paper will be opened by Dr. William D. Peckham of
Utica.
Db. Peckham — Mr. Chairman and gentlemen — The question of the proper
collection and disposal of garbage is one that may give a city health Apart-
ment very much trouble. In Utica our j\ '
tractor who collects the garbage ud to th«
hire is naturally of a not YWf '^^li.j
8^2 Conference of Sanitary Offioebs
UBually are dail^ failures to collect reported to our office. The contract
which we have with the garbage collector allows the health officer to impose
a fine of two dollars for failure and this it has been necessary to impose
several times. Just at present we have him so afraid of the wrath to come
that he will call the office up two or three times a day to find out what
failures have been reported.
Our garbage disposal plant is a reduction plant- and is run in connection with
the fertilizer plant, which has a capacity of about thirty-six tons daily. There
is no waste — nothing that will create a nuisance from the garbage after it
is put into the digestors. After it is taken out of there it is put in the
hydraulic press. The remnant is run into the condenser and used in ferti-
lizer so that the only waste is steam.
One thing that impressed me very much in I>r. Hall's paper was the direct
dumping into the tanks, because at our plant it is rather a roundabout way
from the wagon to the digestor, so that really there is a little garbage always
around the plant.
Db. F. S. Swain, Corning — I would like to ask Dr. Hall how the cans
are kept clean. What procedure or process they have for that purpose?
Db. Hall — You follow the rules about draining your garbage and wrap-
ping the garbage in paper and the cans will keep themselves clean.
I^ F. J. Mann, Poughkeepsie — I would like to ask Dr. Hall about the
self -locking device. What is that?
Db. Hall — There is a little slot on the side of the can with a contrivance
I cannot describe exactly on the lower part of the cover so that when the
cover is put on the can and turned it locks itself so that it is not easily
blown ofif and cannot be 'pushed off by dogs. That can is on the market.
Db. F. S. Swain — If I may be permitted to say a word or two on this
garbage matter. Dr. Hall's plan is, no doubt, an excellent one for cities
of large population, and perhaps would be very efficacious in the smaller
places. However, it seems to me that in the cities of fifteen or twenty thou-
sand it would be quite an expensive way. In my home city we have adopted a
garbage plan this year which is on a line as follows: We have let a con-
tract for the collection of garbsige to be done under the direction of the
health department at least once a week, or oftener, if necessary. The can
system is used. The cans are to be uniform in size, namely, thirteen inches
at the bottom and fourteen inches at the top and twenty-four inches high
covered with a tight cover. These cans are left, as I said, once a week, and
each week the collector goes about with a wagon that will bold fifty-two cans.
He leaves a clean can and takes the full one. That is taken to his garbage
disposal place, which is upon a farm where he has facilities for washing
and boiling the garbage which is fed to hogs. After the can is emptied it
is cleansed and disinfected, ready for use again. The cost to the consiuner
is this: they deposit $^ per can for a use of five years and they
pay ten cents per week for collecting that garbage. Therefore it costs really
— the city in a direct way, nothing; the consumer, ten cents a week. He
is sure of clean, wholesome cans, and the garbage emptying into the wagons
in the street, a disgusting method, to my mind at least, is disposed of.
Db. Louis Van Hoesen, Hudson — I have seen in Hudson the same experi-
ence Dr. Peckham has in Utica. The difficulty is to get the contractor to
do his work which, he says, is not his fault, but on accoimt of the nature
of the work it is difficult to get reliable and ready people; but Dr. Swain
gave us a very good remedy for some aspects of the case — that is the
removal of the garbage in the original can. There is something I would
like to have Dr. Swain explain. He says the cans are all of uniform size
and the wagon will contain fifty-two. Now we have a number of hotels and
also a number of large families who would fill the cans much oftener than
once a week — possibly once a day. There would have to be other wagon
trips. Then you would have families where the ten cents a week would be
hard to collect. I would like to inquire who collects that.
Dr. Swain — 1 would say that the health department has nothing whatever
to do with the collection of the fees. The contract is let to the garbage collector
for a very nominal sum, and where they have the larger quantities of garbage
Ha>^dling Garbage Without Nuisance : Hall 823
they Bimply meet that situation by leaving more cans, or they can collect
oftener if they want to.
pa. A. J. Bennett, Lakewood — I would like to ask the gentleman from
Utica, if it is not out of order, about how it would affect the people in the
rural communities; the people in the country — would it not be endangering
their health to some degree in dumping the garbage upon their land? We
admit there are a greater number in proportion of people affected by dump-
ing it upon the lands in the city. Carting it in the summer on a wagon
away into the country a long distance, is it not just as right to demand
that the health of the people in the rural conmiunities be protected as well
as it is in the cities?
It would seem to me that Dr. Hall of Minneapolis has given a solution
of the whole problem.
Dr. Chables 0. Qbeen, Homell — The health board of Homell have a
system like Dr. Swain's at Corning. Ihe trouble we have is with the citi-
zens — to get them to put the garbage in the can. They claim they don't want
to pay the ten cents or buy the can. We also have wagons that go and
pick it up, and some of them feed it to swine, some plow it in on the farms.
Inhere are seven or eight that have a contract to collect this. But the great-
est trouble we have is to get the people to put it in the cans and keep it
covered up. The cans have to be clean when brought; when full, the can
is taken away. If they need emptjring more than once a week they have to
come as often as necessary.
Dr. Hall — Speaking of reduction plants, it is not true, as many suppose,
that a reduction plant is barred from handling garbage wrapped in paper.
I stopped yesterday at the Chicago reduction works and spent the day there.
Mr. Turner, who is in charge of the plant, simply voiced his experiences,
and they date and go back to that same garbage can. They cannot get the
stuff in the winter time. The cans freeze up solid. They are obliged to go
out to other parts of the country. He is nuiking efforts now to go out by
rail to get garbage in to keep their plant going. He welcomes this propo-
sition of draining garbage ot moisture and wrapping it in paper because
it will give them the garbage in winter time. It is just as much of a
nuisance in the city in the winter — just as much of a nuisance — because
these same cans, frozen solid, remain there to thaw out in the spring. Now
the can is just as clean at all times in the summer time as it is in the
winter time. Wrapped in paper it will roll out just as easily in the winter
as in the summer time. Another thing, it preserves the life of the can. We
do not permit our drivers to use a crowbar or pick of any kind. If the con-
tents are frozen the can is simply not taken and the family are required
to thaw it out, and after they have done that once they learn. We employ
just as many teams in the sununer time as we do in the winter, so the solu-
tion of sanitary handling of garbage must go back to the condition of the can.
Another flaw in the reduction without the paper is this, whether it be in
the large or small city: They have the three-barrel collection. Three-barrel
collection means more money in the case of collection — garbage, rubbish,
ashes. With the two-barrel system which we use, all rubbish — everything
that will burn — goes in the garbage can, so that we have but two separa-
tions. Speaking about the cost of this service in Coming, as I understood
the gentleman, that it cost ten cente per week per family. I want to say
right here if there is ever a reform that is necessary it is for a city to
get away from the contract system and do that work itself. It makes no
difference whether a texpayer pays it out of his pocket or indirectly in
taxes; it comes out of his pocket just the same. Now this service ooste the
citizens of Minneapolis nineteen and five-sixths cente per capite per year,
figuring the average family at four people.
Db. Swain — That is what it costs to collect the garbage?
Db. Hall — Collection and disposition.
Dr. Swain -—What did it cost you to erect the plant?
Db. Hall —
Db. Swain — _^^^^^^^^^^^^^^
Db. Haia— IM^^^^^^^^^^^^^^^hitaPOM of lOO tons at ilM
824 Conference of Sanitary Officers
present time. We have a capacity of 50O tons, ao that the present plant
will take care of the sarbage of the city for a number of years. Hie plant
cost, all told — with the machinery for operating the electric light and fur-
nishing heat, less than $60,000. Now I sav the contract system is against
the mimicipal system. This costs — the collection and disposal (and if you
notice in the paper I gave you, gentlemen, that it also includes ashes as
well as garbage) costs the citizens of Minneapolis nineteen and five-sixths
cents per capita — the average family being say four — it costs the family
about seventy-seven cents per year as asainst $5.20. Now it makes no differ-
ence how he pays it, it comes out of bis pocket just the same whether be
pays it directly or, in the shape of taxes, indirectly.
Speaking of the question one of the gentlemen raised about the difficulty
of getting the people to put the garbage into the cans. I supposed, of course,
that evety city had regulations that they could compel the citizens to do
that, or at least arrest them for throwing it out.
I think I have covered all the questions that I noted down. If there are
others, I will be glad to answer them while I am here.
Db. Swain — I don't wish the doctor to think I am objecting to the system
in Minneapolis, but that system, to my mind, is not applicable to the smaller
places. We are here for information. Now you say your plant cost in the
neighborhood of $60,000. It costs nineteen cents approximately for a year for
collection and disposal. Now does that include the cost of running your
entire plant and —
Db. Maix — Rimning the entire collection system, the entire disposal
system, and we do not deduct anything for what accrues to the department
for heat and light. It was the gross cost. I said that the system of heating
by the plant gave a credit last year of nearly $6,000. Now answering the
question about the small cities. This is just where it does apply. Places
like Edmonton, Duluth, Mimcie, Ind.; Tampa, Fla., have all similar systems
and they are all smaller towns and operating just as cheaply per capita as
we are.
We don't allow any water emptied into our cans at all, so we don't have
any freezing there. The garbage, as ordinarily collected, will contain from 75
to 80 per cent, of moisture.
Db. Swain — Do you find that the people will put the garbage into paper
and you don't have to oblige them to?
Db. Hall — We find that they do, but we don't collect it if they don't.
We refuse to take it and they are hauled into court and fined.
Db. Swain — What do you do with the garbage in the meantime?
Db. Hall — Make them haul it themselves and deliver it to us. It is
simply adopting a system and adhering to it. It has worked out beautifully.
At first they told us ** it is a fad, out and out. You will want us to wrap
it in paper and tie it in blue ribbon," but we have simply adhered to it and
it has worked out perfectly.
Db. Swain — Where does your money come from for your collection?
Answer — Taxation.
QueBiion — A revenue from the plant?
Answer — Right into the city treasury.
Db. Swain -r- Where do you get the revenue?
Db. Hall — We charge it up to the board of charities and correction, who
operate these places.
Question — Do you get any products from the refuse?
Answer — No, only in the shape of steam for heating and lighting.
Question — No fertilizer or anything of that sort; simply a matter of
destruction ?
Answer — Yes, and to go a little further we utilize at the present time
only about one-sixth of our power and get a revenue of about $6,000 a year.
In other words, we can operate the plant with 600 horse-power where we are
using 150.
i>B. Fbonczak — The next paper will be by Professor Charles Baskerville
on " City SaniUtion.''
CiTT Sanitation : Baskbbville 825
CITY SANITATION
By Charles Baskeeville, Ph.D., F.C.S.,
Professor of Cfaemistry and Director of the Laboratory, College of the Citj
of New York
Great cities have grown and passed out of existence. The
enormous increase in urban population in very recent years has
produced even greater cities, which may also in time cease to be.
In fact, aside from the possibility of local or cosmic calamity,
this is sure to occur, unless due attention is given to the applica-
tion of the principles of chemistry in our daily, personal and
commimal life. London, Paris, Bombay, Rome, and New Or-
leans have had their scourges in the past to testify to the fearful
penalty of ignorance and neglect.
Indications point to an urban growth and development, the
conception of which taxes the imagination. When we see New
York as it wa3 200 years ago, and then 100 years ago, and as it
is now, we may well wonder what it may be fifty years from now.
Ill fact. New York city to^ay, which may be taken as an exam-
ple, has as many people within its 326% square miles as are dis-
tributed over the States of Maine, Vermont and Massachusetts,
combined, with their 47,070 square miles of territory, or were
within the entire country at the end of the Revolutionary W-ar.
It has been calculated that in 1920, New York may have 7,000,-
000 of people. The growth of the smaller cities in the United
States has been equally marked, but perhaps not so striking.
It has been predicted by a close and conserv-ative student of
sociology that two generations may see the eastern part of our
coimtry mainly composed of contiguous cities. In 1790, 3.3 per
cent, of the population of the United States was urban. It was
33.1 per cent in 1900. The problems of the state and county
become closely interwoven with those of the city. The city will
no longer be merely an accumulation of human beings in a par^
ticular locality, with its local problems and influencing the state
mainly in a financial way, but the city will have become the state.
The individual needs fresh air, pure water, good food, safe
826 Conference of Sanitary Officers
shelter, and should have a clean body and something beautiful to
look at. When he associates himself into a city his needs are
not lessened, but emphasized. The growth of a city causes it to
assume^ willingly or no, corresponding obligations. The inhab-
itants must breathe, they must be fed and watered, its wastes
muet be got rid of, facilities for the safe coming and going of its
people at all times must be provided, as well as protection from
fire or other adventitious circumstances which concern the welfare
of the citizens. The needs thus simply stated are to be met by
obligations which become more and more complex with the in-
crease in population. In fact, most of the city's problems are of
comparatively recent date.
With your permission I shall address my remarks to certain
specific matters which have come under my observation in
Greater New York, and to which I have given some special study.
No doubt these matters have already been considered in some of
your conferences, but the public expression of the independent
point of view of one unhampered by oflBcial ties may serve one
good purpose, ^namely, of provoking discussion, which can be
made profitable.
The consideration of the air of cities involves not only the
principles of ventilation, which will not be considered here, but
the construction of the streets, means of transportation, the dis-
position of wastes, and the handling of the more unusual contam-
inants, which vary with conditions.
There are more than 2,000,000 miles of public roads in the
United States outside of municipalities. These roads in many
cases are essentially the same as we find in the outskirts of our
larger cities, and are the roads of the smaller towns. The town
roads are traveled very much more, so the actual facts at hand
for the average road are applicable to the town roads for which
no satisfactory data are available. Cushman has calculated that
500,000 tons of dust are raised on the public roads per day, or,
taking 100 dry days in the year, 50,000,000 tons of material are
taken by the movement of ordinary vehicles from places where it
is needed and placed where it is undesirable. A discussion of
economic principles of road conservation is not germane to our
subject Suffice it to say that the modem motor driven vdiicle
City Sanitation: Baskebville 827
IS not a du8t maker, but a dust raiser. " The dust problem did
not begin with the introduction of the automobile, although it has
undoubtedly been accentuated by this mode of travel. There are
sections of our country at the present time where the roads have
been rendered practically dustless, and neither horse-drawn vehi-
cles nor automobiles can now deposit the dirt of the highways in
the gardens and houses of abutting property owners. This con-
dition of affairs did not exist before the introduction of the auto-
mobile, but has been arrived at in answer to the demand whidi
has followed its use. In short, there are many suburban com-
munities in which life to-day is far more agreeable, pleasurable
and possible than it was before automobiles came into use.*"
Why may we not have this in every city ?
Aside from the personal discomfort from flying particles of
solid material, whatever be its nature, these particles are the bac-
terial aeroplanes. Sedgwick has shown that ten liters of air
taken five feet above a macadamized street in a dust storm may
contain as many as 200,000 micro-organisms.
" There is a natural fouling of the street surface and an un-
natural fouling. The natural comes from excrement from ani-
mals,! detritus from wear of pavements, soot and dust from the
air, leaves from the shade treed, and the grindings from tires and
shoes. The unnatural, or, rather, avoidable sources are: refuse
thrown or swept upon the airoets from buildings, refuse thrown
by careless usei-a and refuse spilled from vehicles carrying mate-
rials through tlie streets. The latter causes are supposed to be
prevented by the operation of ordinances which are honored in
the breach, and these causes result in the greater cost of clean-
ing,! as the sweeper has considerable work in collecting litter be-
fore attacking the dirt, and the material is bulky."
Commissioner Edwards says in Municipal Chemistry that
• Ciishman, " Municipal Chemistry," McGraw-Hill Publish injf Co.
tOne thousand horses will, in every working day of e^ght hours, deposit
about 500 gallons of urine and 10 tons of dung upon the pavements. " On
the T^tilization of Stable Waste." see Birchmore, Journal of the Society of
Chemical Industry, 1900, vol. 19, p. 118.
t For cleaning all the boroughs in Greater New York of garbage, ashes,
refuse and street sweepings the board of estimate and apportionment allowed
an appropriation of $7,418,299.20 for 1909. and this amount was divided
among the boroughs, Manhattan receiving $4,230,441.70; The Bronx, $560,-
371.30; Brooklyn, $2,492,491.20; and for general adminlBtration, $135,006.
828 Conference of Sanitary Officers
" There are two general methods for disposing of street dirt;
namely, it may be picked up, swept up, or shoveled up, and then
hauled away, or it may be washed into sewers through the agency
of water, or there may be a combination of these methods.* I
may state that some of the papers I have mentioned are given in
full in the work entitled " Municipal Chemistry,'* which I ex-
pected to have with me to-day, but it will be ready from the Mc-
Graw-Hill Press the first of December — treating in various dis-
cussions the different problems of how to keep a city clean and
how to make it beautiful. As a rule, a considerable portion of
the dirt is conducted away during rain storms, and some cities
have especially constructed their sewers with the view of conduct-
ing off all dirt which can be reasonably emptied into them; in
fact, it may be said that many municipal engineers consider that
the sewerage system of a city should be constructed in such a -way
that it will carry off a large portion of the fine dirt from the
streets."
I will go further and say that the streets should either be made
dustless or wet down with dilute chlorine water, that is, a solu-
tion of bleaching powder or other disinfecting fluid. Both meth-
ods have been used with success and are within reasonable cost
The topography of a district in which urban population has
massed itself will, in a measure, regulate the mode of growth.
Although improved methods of rapid transportation have over-
come the necessity of concentration, yet business and other causes
continue to make for centralization, with consequent elevation in
the value of land, whose acreage is increased only by vertical ex-
pansion. The modem subway comes as a result The air from
the streets is sucked into these human mole holes. It is to be
hoped that the Public Service Commissions will allow the con-
struction of no more subways except that the tracks be separated
by partitions, or that the tracks of trains going in opposite direc-
tions will be kept in different compartments. For, although much
street air enters the tunnels in New York at present, a large por-
tion of the air is simply churned by the passing trains and not
quickly and properly replaced.
• Very, " Munioipal Ohemistry^" McOraw-HiU Publiahing CompAny.
Vacuum street cleaners have so far proved too expensive.
City Sanitation: Baskeeville 829
There are many incidental impurities in city, air that are local
and more or less evanescent. 1 have shown that in the city of
Xew York about thirteen hundred tons of sulphur dioxide ai'e
poured into the air daily in the combustion of coal. This is a
sad annual economic waste of a most important chemical, some
millions of dollars in value, which we do not know how to avoid
at present.
The smoke problem has conironjted every city where coal is
used as the main fuel. Civilized nations are only beginning to
awaken their "conscience of fuel." Our methods of utilizing
coal give us a return of only 5 per cent, of its energy when
burned, and only 1 per cent, when we convert that energy into
electric light in the city. '
Good firing is admittedly an important factor in smoke pre-
vention, and it has even been regarded as the main factor of the
problem; * but many authorities favor the distribution of gas as
a means of at least alleviating the smoke nuisance.!
There have been many complaints against some of the railroads
running out of New York City, because of the nuisance caused
by their use of soft coal. Some of Uie suburban towns have taken
legal action to prevent this. The solution of the smoke problem
on the railroads reduces itself to the use of hard coal or oil fuel,
as the application of mechanical stokers and smoke consuming
devices to locomotive engines has not proved to be a success, or
better still in electrification. The last is proceeding with grati-
fying speed. '
The theory of EayleighJ for dispelling fog, and with it smoke,
by electrification is interesting and is demonstrable in a beautiful
way on a laboratory scale, but the expense entailed and practical
difficulties involved preclude its favorable consideration.
"One of the worst smoke nuisances about New York during
the past few years has been caused by the garbage and other
reduction plants at Barren Island. § During this process of
reduction, oil and grease are extracted from the animal and
_
• Cabome, Jour, Roy. San. Inst.^ 21 y p. 142.
t For example, Lodge, Des Voeu^, A. J. Martin, and A. S. E. Ackerman ;
in this connection, see Jour, Roy. San. Inst., 27, pp. 42, 64. 80, 85.
tJour. Roy, Ban, InaU, 20, p. 42; and Elec, Rev,, 47, p. 811.
S ParBons, Municipal Chemistry, McGraw-Hill Publishing Company.
830 C!oK7£BXNCE OF Saihtaby Offioebs
v^etable matter, leaving a dry residue, which is used as a base
for the manufacture of commercial fertilizers, the discarded resi-
due being burned in the plant as fuel. •
'^ At another plant on this same point the carcasses of the
larger dead animals, which are transported by a regular line of
boats, are burned. When the immense number of carcasses or-
dered removed annually by the New 5i^ork Department of Health
is taken into account, it is not surprising that the smoke given off
with the accompanying odors should give otfense to residents for
miles aroimd. The number removed during the past year in-
cluded 19,0U0 horses and about 380,000 dogs and cats, besides
about 1,000,000 pounds of condemned meat, about 80,000 pounds
of too '' gamey " poultry, about 3,500,000 pounds of fish and
about 5,000,000 pounds of off al." *
This nuisance is, of course, preventable by mechanical devices
which bring about perfect combustion. •
The necessity for a suitable supply of potable drinking water
is now well recognized in every civilized community, and it is
usually provided in the city, often at great expense, yet an
appalling degree of ignorance is still encountered in the country
districts that is difficult to overcome. A large percentage of urban
population, and it is most desirable that every single individual
in the city should, enjoy a few days or weeks in the country in
the summer. The ignorance of coimtry habits is proverbial with
the urban citizen, who takes certain matters for granted. It is,
therefore, not infrequent that these outings, picnics, etc., which
should make for the better health, are the direct causes of unneo-
eseary illnesses attributable directly to the drinking water, for all
the liquid refreshments on these occasions are not limited to the
national German beverage.
This is largely a matter of education. Every teacher of chem-
istry has a splendid opportunity to drive these simple matters
home, and I never fail to do it with the five or six himdred young
men who sit under me every year. But every citizen does not
listen to lectures on sanitation, although frequent opportunities
are given by the various lecture bureaus. Popular builutins, such
as those splendid sheets which come so regularly from Dr. Evans'?
• Parsons, loe. oit.
City Sanitation: Baskervillb 831
office in Chicago, can do much good. The press, when appealed
to, will render great assistance. •
The public is inclined to believe that when an ample potable
water supply has been pro\'ided, all that is necessary has been
done. Sanitarians know that the contrary is the case. They
may point out to the citizens that sewage disposal is quite as
important. They may cite the story of Dantzic, which had good
water in 1869, but the typhoid rate did not decrease materially
until 1872 when sewers were added. Vienna had good sewerage
and bad water up to 1874; the death rate was 340 in 100,000.
That year good water was supplied and the rate dropped to 11 in
100,000. With good water and no sewerage the soil becomes satu-
rated with refuse matter, a hot-bed awaiting the planting of
pathogenic bacterial seed. Sedgwick, referring to cholera, figur-
atively states that " Pettenkoffer has given the key to the whole
situation by saying that filth is like gimpowder, for which cholera
is the spark. A commimity had better remove the gunpowder
than try to beat off the spark; for in spite of their efforts, however
frantic, this may at any time reach the powder, and if it does,
is sure to blow them to pieces.'' The next great problem that
[N'ew York City must solve will be that of sewage disposal. It
will involve an expense vastly greater than the colossal sum now
being spent for the magnificent new water supply.
Half the cost of living goes to pay for food. The centralization
of population requires its transportation to the centers, but it does
not enforce its exposure, uncovered in the streets or shops, where
it collects tlie dirt and attracts flies. For a century it has been
known that certain kinds of food could be preserved for later con-
simiption without injury to health. There is no objection now
to the preservation of food provided it is done in the proper, that
is, harmless manner. The adulteration and sophistication of food
are outgrowths of the development of the city and the improved
means for world-wide transportation, coupled with the degen-
eracy of those who live by bartering and their desire for luxuries.
The chemist has been the Cartouche and Sherlock Holmes in the
abominable business. Yet ignorance and disregard for the con-
sequences so long as gain resulted have been behind the supply
of one particular food, milk, whir»h is the main support of the
832 CONFBBBNCE OF Sa>-ITARY OfFIOEBS
weak and helpless. The govemmeiEit has formulated satisfactory
laws against the adulteration of the coin of the realm and enforces
them vigorously. We have food laws now, but they are not satis-
factory, nor are they always properly enforced. In fact, they
cannot be fully enforced as long as they admit of constant
quibbling as to the meaning of common words in our language.
^o doubt these objections will be removed, for it is a time of
fuller awakening to the conscience of our civic value.
Clothing which has been exposed to such infectious diseases as
diphtheria and smallpox, is now destroyed or duly disinfected, at
least theoretically. This is not the case with clothing, either
second-hand or new clothing, made in the sweatshops, where we
know tuberculosis is rampant. Clothing thus serves as a means
for the spread of infectious diseases. This can be stopped by re-
quiring new clothing to be thoroughly disinfected before allow-
ing it on the market, or, ^better, by applying the old Mosaic law
enjoining the strictest cleanliness. Moses really anticipated our
modern sanitary laws, for cleanliness is the beginning and the
end. The existence of sweatshops in cities is one of the dark blots
on our vaunted civilization.
The problems of city sanitation no doubt can all be solved with
unlimited means and unrestricted legal power and the machinery
for exercising it. Practically, however, the economics involved
affect the situation. Successful manufacturing enterprises usu-
ally begin with experimental plants and, furthermore, keep them
constantly in operation afterwards as an economic means of im-
proving their efficiency. Some cities have appreciated this prin-
ciple as shown in the Lawrence Experiment Station at Boston.
But these things cost money and all know what influence " taxes "
is made to play in all political campaigns. It appears not unfre-
quently that the excuse is offered on the part of budget commit-
tees, or similar regulating bodies, for not apportioning appropria-
tions, " we cannot afford research." No political party, if it went
out of existence, could leave a more lasting monument than the
establishment of the principle that a great city cannot afford not
to establish such experimental stations. If the leaks are stopped
there will be plenty left not only to establish bureaus of investi-
gation, but some to save as well.
City Sanitation: Baskerville 833
A progressive manufacturer does not hesitate long in substi-
tuting more efficient machinery. He also knows that his people
are more efficient and happier in good sanitary s-urroundings. So,
even if the leaks are stopped and ^ the cost of running mounts up,
the community is the better able to bear the burden and does it
more cheerfully. The average American doesn't mind paying a
suitable price for a satisfactory article — in fact, of late he has
become somewhat accustomed to paying a little more than he
should.
The complications arising from the growth of cities call not
only for " the employment of well-trained, tactful, honest, ener-
getic, and fearless health officials," but also lay a responsibility
upon all forms of educational activity to bring about a " better ap-
preciation by the ^people at large, of what is conducive and what
a menace to public health," and individual safety.
Xow I recognize that what T am going to say in closing is liable
to be interpreted to the end that fools rush in where angels fear
to tread, but I have my opinion about it and it is only a statement
of opinion that provokes discussion. Minds are made to be
changed and I am ready to change mine, but I am very thoroughly
convinced of what I am going to say and I trust it will be taken in
the right manner. It is in regard to health officials. I do not
think because a man has the M.D. he is a health official. His
training in sanitation has been limited, is incidental, purely in-
cidental. I do not think a man should have charge of the health of
a community who is an M.D., but he should be a trained sanitar-
ian, and have the M.D. incidentally.
I cannot refrain from expressing an opinion bearing upon the
organization of a health department. The numerous details, es-
pecially financial, should not be thrown upon the head any more
than the captain of a warship should look after the details of the
ship's larder. The chief needs every particle of his well-trained
brain and energy to deal with the great problems of the city's
health. He should be provided with a financial coadjutor, as it
were, a man of absolute rectitude, and as well trained as himself,
but along another line — a man who will see that the purchasing
power of the city's money is equal to that of a private corpo]
The terms of office of these directors, technical and
27
834 Conference of Sanitary Officers
fihould be limited to the period of normal human efficiency, decent
pension provisions being made for them when that period shall
have ended. They would thus be unhampered by any political, re-
ligious, or social associations, in the conduct of the Department.
I recognize that such a proposition is somewhat radical, and sounds
a bit Utopian, but I am glad to say that my confidence in my fel-
lowman is such that I am willing to give such large powers to him.
Our democratic government breeds men worthy of such confi-
dence; if it do not, then it is a failure, and we are not willing to
acknowledge or to accept that verdict.
Dr. Fbonczak — Professor Baskerville certainly deserves our most sincere
congratulations on his paper. It is interesting in every detail, and I have
no doubt that a most interesting discussion will follow this paper. The dis-
cussion will be opened by Dr. W. L. Coons, of Yonkers.
Db. Coons — I feel more than embarrassed* to open discussion after such
an able paper, but I would just like to emphasize a few of the thoughts of
Professor Baskerville. In speaking of the energetic health officer — when I
was appointed by the health commissioner of the city of Yonkers I took my
position with the idea I was going to accomplish great things, carry out
some great ideas I had, but so long as the position of health officer of the
different cities and communities is not divorced from politics we are more
or less hampered, as you all know. The appropriations and the backing
that you get from the commissioner of public safety is influenced entirely
by the influence it has on the taxpayers and by the amount of money ex-
pended. The beautifying of the city of Yonkers has been going on rapidly
for the last few years. Even the poorer people are moving into the better
and more sanitary localities, which is an incentive to the property-owners
to rebuild and reconstruct their insanitary tenements. This improvement
is going on. We have, of course, a condition in the outlying districts of
cesspools overflowing constantly and the exorbitant charges of the scavenger
to the small property -owners makes it difficult and hard for the health officer
to enforce these matters strictly. But we have made some progress in that
direction and have accomplished much good.
Referring to the smoke nuisance. We have succeeded in getting some of
the large manufacturers in Yonkers to adopt the smoke-consumer apparatus.
This relieved to some extent that nuisance in our city. The New York Cen-
tral railroad has co-operated to some extent and we are frequently receiving
promises from them to burn hard coal while passing through the city and
they do do so for some time, but when we release our efforts they continue to
burn soft coal.
The spreading of contagion through the means of clothing was taken up
by our department last winter and we required the people connected with
churclies and charitable organizations to discontinue their rummage sales,
and I believe in different localities we saw a decrease in the number of
cases of contagious disease. This year I have been tempted to allow them
to proceed with the precaution of finding out pretty definitely where the
clothing came from; whether from any infected homes or homes which had
been infected recently. W^e shall never, in Yonkers or in any of the large
cities, accomplish things we would like to accomplish until the position of
health officer is divorced from the political situation. While we are able
to get on and do a great deal, the question comes up of the influence. Eight
years ago I was appointed on the board of health under the former charter
of the city of Yonkers and I took some action against certain persons and the
defeat of our mayor at that time was attributed to me. It ran along for seT-
City Sanitation : Baskerville 835
eral yeai;^, and our present mayor liad the authority to appoint me under the
secoad-cla&s charter. I have, of course, his support as far as possible.
We have a stream passing through the city of Yonkers which is a continua-
tion of the water supply of Yonkers. After passing through the supply of
Yonkers it flows into a stream where it is contaminated and where refuse
is constantly being thrown in, and we are trying to have that made into a
public sewer. We have tlie opposition of the property -owners. We also have
the question of expense, but we hope to be able to accomplish that ultimately.
Db. George E. Ellis, Dunkirk — I may say that I have enjoyed this very
able paper very much, and I do not feel capable of discussing it. There are
many- things which apply not only to New York city, but to the smaller
cities — ^8»*ticularly the garbage question and the city water. In our little
city ot Dunkirk we are not troubled with subways nor the lack of air. We
have plenty of lake breezes up through our streets most any time, especially
in winter, but I often think you can compare cities to a house. You un-
doubtedly, all of you who practice medicine, have entered a house where
everything was spick and span in the front of the house — the parlors were
dustied and everything arranged nicely, the dinner table was set — but if
you went into the kitchen to get a glass of water you found out how they
lived. I think it is the same way with cities. W'ith our own city we have
a small place, about 20,000. We have possibly as many or more miles of
pavement as any cities of the State, and they are well kept. We have our
city well sewered — we have one portion of the southern end of the city
not sewered because they have no place to sewer it, but the main part of
our city is well kept and perfectly sanitary. But with all our sewer system
rnd houses suitably connected with it, they empty into the lake and from
that lake we get our drinking water. A few miles above us is a village of
Fredonia, which is immediately or almost exactly over our intake where we
get our water supply. To add to this we contribute our sewer system,
which goes into the Crooked brook, and this indirectly through a cesspool
which goes directly into this creek, gets in above our supply and comes down
and contributes io the Fredonia sewage which we drink. The other sewage
goes down into the bay, making the whole bay a cesspool. A nice north-
wester sends it aroimd the end of the breakwater and sends that also into
our intake. So when the winds are favorable we have both food and drink.
Now this is a question that applies to other places — Buffalo, I think, as
well as Niagara Falls. I often wonder how Niagara Falls strain their
sewage; whether they have a wire fence to catch the coarsest or how they
arrange it, but they certainly do con tribute a great quantity of it. But we
hope at some time to remedy this.
Dunkirk is every man's town. Yor. can count the people who are worth
$100,000 on your finger tips almost; most of the citizens are laboring men
who own their homes, and you hesitate to tax the people sufficiently to
remove this liuisance. As an estimate of what we want to do, I think it
will cost sonictliing like half a million. It is quite a sum to raise in a city
of our size, but we are working and intend to remove all this sewage from
our lake. I understand the authorities at Albany say th^y will make Fre-
donia take theirs out when we take ours out, so we live in hopes.
The garbage question is a sarious one in our place. We have no regular
system. "We had a man who collected this in wagons and fed it to hogs
in the country, and this became so bad that we made him give up the con-
tract and at the present time a man is hired by the day to draw this garbage
into the country. But this is not sanitary at all, and we are working on
some plans and hope to have them completed as soon as we can dispose of our
garbage.
Now in regard to the special sanitary officer I agree with the speaker that
he should not be dependent on the public for the practice of his profession
for hiB living, for we all know that if a man lives up to what he believes
to bo right as health officer he won't have much practice. I found that out
to my sorrow. I have been health officer of the city for about ten years.
There was a time when they used to come out with guns and order me off
their places. They don*t any more. We find it very hard to get everybody
836 Conference of Sanitary Officers
to put their garbage into a pail. They are more apt to put it in the back
yard. While all these things are to be worked out, at the present time
we have not been able to do so.
Dr. E. H. Codding, New Bocbelle — In regard to the health oflScer's posi-
tion and as to his tenure of office, it was my good fortune to serve mv city
for a number of years as health officer. Alx»ut a year ago the political
situation changed and they attempted to make me go, and the man who was
to take my place come up against the civil service and as he could not pass
the examination he did not get the appointment. We have a new charter
in New Rochelle, and in that charter we have a provision that the health
officer is removable only for cause and that is a step in the right dipection.
I believe everyone here could, if he used his energy, have his charter changed
in that respect.
Dr. p. R. Bowdish, Cornwall-on-Hudson — I hope it won't be out of order
for me to speak of the transmission of typhoid fever and other like diseases
from country places or summer resorts to the cities.
I think that is one point where cities are largely defective. Cornwall is
on the Hudson river in the vicinity of West Point. ITiere are in our neighbor-
hood about seven fresh air farms run by the missions in New York city.
There are times when typhoid is found among these children and is taken
back to New York, but strange as it may be, we have no typhoid in Corn-
wall. There is seldom a comparison between the typhoid cases that come
out of our summer resorts and those in the summer resort itself; and yet
people all acknowledge that there is no immunity against typhoid. In other
words, if typhoid existed in rural communities, if the people took it home
from our summer resorts, it would exist amongst us. But it does seem to
me that there is a point of laxity, and that is the lack of supervision of
the cutting, storing and handling of ice in the water on the railroads, boats
and sometimes within the limits of the city. I don't know what method is
used now, but I do know that a few years ago a large part of the ice that
was stored was stored in horse manure. I do know that along the Hudson
river men coming from the county almshouse, almost invariably suffering
with latent tuberculosis, are employed to cut this ice; I do know — because
T am traveling on the railroad constantly, going into Wechawken at least
three times a week — I do know that really sick men are handling this ice
in their bare hands, placing it in the tanks and then washing off their hands
at the spouts that are draining into the pails in which they carry the water.
I think this is a point which should be carefully looked after by the
municipal authorities.
Db. Fronczak — ProfesBor Baskerville will close the discussion.
Pbofessor Baskerville — I don't know that anything is reiiUired to be
said except to regret that there was not more discussion. However, I am
very appreciative of the courtesy extended and the opportunity given to asso-
ciate with those who are looking after the welfare of what I regard as the
chief asset of the nation, namely, the health of tlie nation.
Dr. Fronczak — Will Dr. Codding take the chair.
Dr. Codding — This honor is so unexpectedly thrust upon me. I want to
say what was not announced before — this evening at 7 o'clock there will
be a meeting of the New York State Sanitary Ollicers' Association in tlie
auditorium here. I presume all here had the postal card notice to call their
attention to it, and I simply announce it now to remind you again.
The next paper is by Dr. Fronczak, our health commissioner here, of
l^uffalo. He needs no introduction from me.
Milk and Foods: Froxczak 837
MILK AXD FOODS
By Francis E. Fronczak, M.D.
Commissioner of Health, Buffalo.
Milk, with the exception of wheat, is the most universally used
of all foods. From the fact diat it is the main stay of infancy and
childhood, the dependence of the sick, the adjunct and nutrition of
the well, and that it is a fluid of very peculiar characteristics, it
has ever attracted the attention of investigators and sanitarians ;
and, at the present time, there is probably no other article of food
which is receiving more study, or concerning which we arc in a
better position to know regarding its possibilities for gopd or for
evil.
Up to the past summer, the milk supply of Buffalo, outside of
the city, had received very little attention from the health de-
partment. In reorganizing the department the milk industry was
placed under closest surveillance. It was then discovered that the
source of supply of the milk coming into the city was, as a general
thing, very much more highly contaminated than was justifiable,
and that the public health was materially jeopardized. This in-
dicated the necessity for the inspection of the source of supply at
the dairy farms ; so at my direction, the bureau of food and drugs
organized a dairy farm inspection service which was equipped
with five inspectors.
At that time, the bacterial count of the milk, which is a sanitary
index, was excessively high, the average count being more than a
million. The work was organized by assigning an inspector to each
railroad bringing milk into the city, by classifying the names of
the shippers at each particular station, ^nd by having the in-
spector go from one station to another and at each place inspect
all the dairy farms which shipped from that place.
After a reasonable period of this work, the conditions upon
which the contamination of the milk depended were plainly found.
The features disclosed were so interesting and 80 fnpTflltj' «|^retd
throughout the section of the
very fair picture of the
throughout the State
838 Co^iFEKE.xcE o¥ Sanitahy Offickrs
As regards the cows, while they appeared healthy, none, widi
a few exceptions, had ever been tested for tuberculosis by the tuber-
culin test. Inasmuch as at least 30 per cent, of the cows in all
the herds are more or less affected with tuberculosis, even though
they appear healthy, this single fact has much significance.
In a few instances, cows w^ere discovered with inflamed teats,
which, of course, contaminated the milk with streptococci.
Secondly, the barns were found, with a few exceptions, from being
dirty with dust and cobwebs, to being Utterly splattered from top
to bottom with dried manure; from being defective in construc-
tion by having cracked walls and open seams, to having rotten
floors with pools of filth upon them from defective drainage. When
it is consideretl that the cows are in these barns *1from five to six
months of the year, it is not difficult to see one leading source of
contamination by filth. Thirdly, the barnyards were found filthy
in a large proportion of the cases. It is not to be expected that
barnyards are to be clean places, but it was expected that they
would not be veritable pools of filth with accumulations of man-
ure. Like the conditions in the barns, this explains a part of the
contamination. Cows cannot be surrounded by environments of
this kind without being soiled. Fourthly, it was found that a
large proportion of the dairy farms had no milk house. The ob-
ject of a milk house on a well-kept dairy farm, is to handle milk
away from the possibilities of the stable. In the absence of a
milk house, it was found that the milk was being cooled and
manipulated in the open air in the summer, and only protected by
a shed-like structure, or was cooled in the barn or in a shed with
its equivalent possibilities. Again, it was found that a number of
milk houses adjoined barns and communicated with them by doors
so that the milk apartment and the cow stable were practically
one room. Another source of contamination which was found was
that a certain proportion of the milkers milked with wet hands —
one of the most disgusting of all forms of milking. It was re-
corded also that few, if any, of the milkers took special pains about
having their clothing clean during milking time, which was an-
other cause of contamination. Another feature which was ob-
served was the keeping of horses and cows in the same barn. Much
surprise was expressed by the farmers, and objection made to oui
Milk and Foods: Fkoxczak 8.39
reqiiiriijg horse? and cows to -be stabled separately, until it was ex-
plained to them that there was twice the number of animals and
twice the ainoimt of manure in relation to the amount of milk
produced ; that milk produced by twelve cows had the manure of
twelve animals only to be contaminated by, whereas additional
horses doubled the amount.
One feature which, throughout the inspections, was found to
be well done, was the cleaning of utensils. All dairymen seemed
to be impressed very thoroughly with the necessity of having their
utensils well cleaned. Undoubtedly, this was partly the result of
the fact that the cans were being returned to the farmers in a
verj* unclean condition, so that they had to clean tliem in self-
defense.
After recounting all these conditions which were found, and
before referring to the manner in which they should be corrected,
it is proper to state the significance or the bearing which they
have upon milk, as I assume that a part of my audience is non-
professional. These unsanitary conditions may be summed up
in the one word, dirt ; and when dirt enters milk, it carries witt
it bacteria. It would be a simple matter in the interests of good
milk, if by removing the dirt, the milk would again become pure.
Unfortunately, this is not the ease. Every particle of dirt which
enters milk carries bacteria, and, even if the dirt is removed, the
bacteria remain and will multiply and contaminate the milk.
This brings us to the question of bacteria.
Milk, when it is first drawn from the cow, theoretically has no
bacteria, but, as a matter of fact, even the milk which is drawn
iinmediatelv from the teats is somew^hat contaminated from the
little germs which are in the milk ducts, so that germless milk is
almost unknown. Xature never intended milk to see the light
of day, but intended that it should pass directly from the teat to
the alimentary canal. As soon as milk Ix^came a commodity, it
became contaminated, and in the present state of the milk indus-
try, the product is exposed to contamination from the time it is
produced until it reaches the consumer. It is, therefore, tlie duty
of the sanitarian to minimize or eliminate these sources <^.
lamination wherever it can be done.
The conditions which were found from inspect!]
840 CoNFEREXrE OF SaNITARY OKKirERS
Western Xew York explain the contamination at the dairy. Their
correction, therefore, is in having and maintaining the bams and
accessories in a perfectly clean manner.
The first step, possibly, in securing a better condition at the
dairy in the interest of municipal milk is to place all dairies un-
der the permit system, requiring a permit from every dairyman
who wishes to sell milk in the city, and not to issue a permit
unless the equipment and methods are entirely satisfactory. The
second step is to give publicity to conditions and so excite a spirit
of rivalry in attaining excellence, and by practically showing the
dairyman that sanitary excellence means financial profit. If the
milk from insanitarv dairies is excluded from the city when it
becomes accidentally contaminated, the city milk man suffers loss
of his milk and thereby of his trade. He therefore prefers to
get his milk from a farm which is properly managed and is not
liable to have its milk shut off. So the product of the well-man-
aged farm being desirable, there is competition to obtain it, and
with competition, there are better prices. This is very cogent at
the present time, inasmuch as it is not believed that the average
farmer is getting a sufficiently high price for his product to pay
him in maintaining the degree of sanitation which authorities
desire.
The individual features of the dairy to which experience shows
special efforts should be directed are, first, that the cows be ex-
amined by the tuberculin test. If it is a fact, and we believe it
IS, that this is a prominent source of tubercular infection, par-
ticularly in childhood, and if tuberculosis in the bovine species
is transmitted to man, the elimination ojf the tubercular animal is
a necessity. The difficulty, however, is in securing it. Herds
should be examined yearly, but it is an expense and a rather ex-
acting one on the dairyman, who can see no direct return from
it. In the present crusade against tuberculosis, the State should
make provision for eliminating tuberculosis among cattle, par-
ticularly among dairy cows, and in keeping it eliminated. This
can be done through periodical examination and testing. The
State should assume this expense.
Next to securing safe cows, cleanliness of the barns where they
are kept is essential. Inasmuch a? a large majority of the dairy-
Milk and Foods: Fhoxczak 841
fanners cannot build new and up-to-date barns, it is of practical
importance to know in what manner the present structures can
be satisfactorily made sanitary with the least possible expense.
We have found that defective ceilings, through which dust fil-
ters down, which is strongly objected to, can be made tight by the
use of builders' paper, aflBxing it over and between the rafters
with strips of wood. We have found that the walls of bams for
a space of six feet, the area of principal contamination, can best
be made cleanly by lining them with galvanized sheet iron. We
have found that defective floors, once repaired, can be kept clean
and in better condition by careful regular cleaning — neglect
means decay. So, with sealed ceilings, bright galvanized iron
wainscoting, sanitary whitewashing, and clean floors, we have the
interior of the bam in such shape that it is not only satisfacto-
rily clean, but is attractive to the eye as well. Many of the
farmers whose bams have been so protected have been enthusi-
astic over the appearance, as well as the condition.
The disposition of manure is an important factor. It is usu-
ally the custom among farmers to throw the manure out near the
barn and to leave it there, hauling it away at a subsequent time to
distribute over the fields. It is rather laborious for them every
day to haul the manure to a distance of fifty feet or more, as it
should be done. To minimize this labor, many farmers have
taken advantage of a suggestion to erect a little carrier on which
the manure can be run oif quite a distance and dumped with very
little effort. This has been done in a sufficient number of cases
to show that the method is of practical efficiency and to warrant
its being adopted more generally.
It was gratifying, in the summers work, to notice that in but
very few instances, the .farm water could be said to be a menace
to the integrity of the milk. The farmer generally seems to have
a keen sense of appreciation of the status of his water. If he
were as well informed and as particular about his milk and its
being clean, as he is about the water, it would lessen the work of
the sanitarian materially.
Another surprise noted was the absence of recent contagious
disease on any of the farmB^ and also the absence of tuberculosis
among the farmen A|^|||gfl|MHlMBMlMUMft^ tuberculosis
_.4_
842 CONFKREXCK OF SaMTARY OFFICERS
in a farmer has been reported. This is not strong corroboration
of the communicability of bovine tuberculosis to man. In the
main, we believe these factors are correct on the almost 2,000
farms which have been inspected, inasmuch as the inspectors who
did the work were medical men and were especially directed and
had data to obtain in regard to them.
Cleanliness, temperature and age being the three factors which
bear upon bacterial growth, the question of temperature l-eceived
consideration. Jt was found that the instances where the dairy-
men used ice in cooling milk were exceptional, and that they
almost uniformly cooled their milk by immersing the cans in
spring water and allowing them to stand tliat way over night.
In this manner, with real cold well water, and in the absence of
the Sim, the milk vvas found to be cooled dowm. to sixty degrees
and sometimes a little lower. From the time tlie milk was taken
from this cooler, no further attempt was made to preserve the
temperature until the product reached the city. A few dairymen
used covering in wagon transportation, but generally the protec-
tion on the wagon, at the stations, and on the cars, was devoid
of any consideration of temperature. The cooling of the milk by
the farmer and refrigerated transportation by the railroads has
become a close matter. It was found that milk was arriving,
during the summer seascm in Buffalo, at a temperature ranging
from seventy to eighty-five degrees, which was far above that
which was acceptable; and that the milk was brought in, in cars
having a temperature as high as ninety degrees, which was incon-
sistent with milk integrity. Negotiations were opened with the
transportation companies with the view of obtaining refrigeration
on tlie cars during the summer season. One of the argiunents
used by the railroad companies was that Qiej did not wish to cool
the warm milk from the dairy farms. This was a valid objection
and appealed. In furthering the interests of better transporta-
tion, it was determined to secure better cooling at the dairy
farm, and to that end the dairvman was notifie<] that next season,
wherever practical, he must secure ice to chill the milk properly
before putting it on the cars. The department can, and wi<;h(>s tn,
state to the railroad companies that, inasmuch as they do not wish
to cool the warm milk of the dairymen, the dairymen do not wish
to heat their cold milk in the hot railroad cars.
•
Milk and Foods: Froxczak . 843
One of the dairyman's contentions in the matter is, not that ice
is difficult to obtain, but, interestingly, that ice-cooled milk does
not keep cool as long as that which is cooled by spring water, and
that it sours sooner when the temperature rises. We have no
means of knowing the truth of this statement, but it is a fact that
it is the general opinion among dairymen who have ice as well
as spring water to cool with.
To bring the milk of Buffalo to the standard of quality it
should have, improvements must be made throughout the indus-
try. Some of the more important features and those connected
with its protection have been referred to. An equally important
factor is th^of transportation, and the exj>erion('e of the depart-
ment &o far in this connection has l>een as follows:
Oommimication was sought with the railroad officials, but from
the fact that the men in charge were not l(X»al, delay was encoun-
tered from the beginning. Jn reply to letters sent in reference
to the matter, all of the officials preferre<l to have a conference,
which meant more delav. At the conference finally held, the
department presented the following facts:
That milk transportation was unisatisfartory, out of date and
did not meet the requirements; that milk arrivcnl in Buffalo at
a temperature so high as to be detrimental to the pr<Hluct and to
the public welfare; that this rise in temperature occurred l)etween
the dairy and the Buffalo platform*. Records of temperature
taken, experiments and investigations made, together with a
kiiowledge of existing methods and circumstances, were also pre-
sented. Methods adopted in other cities were referred to, and
plans for refrigerating cars at a low cost were suggested and
explained.
The railroad officials showed an attitude not entirely respon-
sive, though verbally willing, ami wished to look into the matter.
After some time the railroad companies presented their side of
the case, which was as follows:
They claimed that the fault was with the farmer in not icing
his milk at the dairy; and they suggested correcting the high
temperature there. They also claime<l that refrigerator cars were
not adapted to frequent stops as is necessary in the milk terri-
tory; that to have more than one kind of car in the milk service
844 Conference of Sanitary Officers
was not feasible; and that the low freight rates recently fixed by
the Public Service Commission were a burden.
The department answered that time, not distance, was the
important factor, the average train time being three hours, with
often an hour or more added because of delays; that many ship-
ments were received from branch roads where the milk had
already been in transit; that it was not complete refrigeration
which was wanted, but only such as would maintain the tempera-
ture of the milk; that the department had no direct interest in
freight rates, and, while it believed that the railroads should be
properly compensated, it held that a commodity which was so
intimately associated with children, infant mortality^aickniess and
health, was entitled to consideration other than that of profit
and loss.
The department also presented a device for installation in cars
to procure refrigeration. This device was readily adapted and
comparatively inexpensive.
After further delay, one road submitted a report of experi-
ments made, showing a record of temperatures of cans placed on
the cars at various stations. These temperatures ranged from
55 to 08 degreos, showing that the average rise was 1.47 a can,
which, it was claimed, did not justify any change in the method
of transportation. Another road made the same statement and
quoted the same rise in temperature, 1.47, as if it had been made
from their own personal investigation, — (it was undoubtedly
borrowed from the other road on a mutual understanding).
But the railroads' attention was called to the fact that, while
all cans put out at the high temperature of 58 and 70, only rose
1.47 to the same temperature as the car, because it could not rise
any higher, the temperature of the car and the cans then being
equalized. Attention was also directed to the important fact that
all cans which were placed on at 55 and under, which is the
proper temperature of milk, arrived at from 8 to 10 degrees
higher, or at the same temperature as the warmer cans; showing
that if all cans were put on at a low temperature, they wotdd
have the same rise of 10 degi'ees and more. In this respect, the
railroad companies' exhibits corroborated the contention of the
department.
Milk and Foods: Froxczak 845
The department insiafted all the time that the subject was a
simple proposition, and that its intention was to correct the pre-
vailing unsatisfactory conditions. Although the matter has not
yet been definitely settled, the railroads, no doubt, next season will
accede to our contention.
It is not to be expected that all the trouble and all the work in
obtaining milk integrity have been those which I have alluded to.
The subject of the city milkman is not without indications for
betterment. I will state, however, if in any city of this country,
the milkmen are so uniformly alive and well informed on the
matters pertaining to milk, as they are in Buffalo, it would be
well; and if there are any facts or instances to the contrary, it
can be said that they are largely the result of commercial cupid-
ity, and not to ignorance. But very little has occurred, and it is
with satisfaction that the department can testify to the almost
uniform willingness of the Buffalo milkmen to do everything in
their power to maintain, improve, and protect the integrity of
our milk.
Many features in connection with their end of the industry
have been improved. One fault has been that the city man did
not remove his milk promptly from the depot after the arrival of
the milk train. Simple as this may seem, it is a more important
matter than it would appear to 'be. Leaving the cans at the depot
means exposure to sun, heat, dust, tampering, and what not. The
milkman comes down to the depot for his milk after a half night's
work in delivering, and is rather fatigued. He would rather defer
the moving of the milk until later, hence the delay. The depart-
ment has realized throughout all the proce<lure5 of milk correc-
tion that action and example were necessary, and that notifica-
tions and the like, while having their value, were not as effective
as a demonstration. The department adopted the policy of de-
stroying the milk where neglect occurred after notification had
been given. This was for example to others, as well as to the
party at fault. When milkmen failed to remove the milk promptly
from the depot after one of two notifications, and the product was
found standing in the sun for some hours, the milk was thrown
out. That milkman never left his milk again, and the example
was salubrious to others.
846 Conference of Sanitary Officers
The subject of milk destruction brings up the question of milk
interdiction, because of bacterial contamination. Boston was the
first city to adopt a standard of bacterial contamination beyond
which milk would not be accepted in the city. The limit was placed
at 100,000. Since that time twenty-five or thirty cities have like-
wise adopted a standard. While a legal standard of bacteria nxim-
oer cannot be adopted with milk as with its chemical composition,
1 certain count can be adopted as an index to sanitation. Buffalo,
this year, adopted 500,000 as a limit beyond which milk would
not be accepted, and that which contained colon bacilli was like-
'ouse excluded. When contamination showed that milk contained
chis number of .bacteria or colon, the dairyman was notified that
his sanitation was defective and to make correction. A second ex-
amination of the milk was made within ten days. If it showed
no improvement, the milk was interdicted. Experience showed
that when this action was taken, improvement usually followed.
Where certain dairymen did not respect the interdiction and con-
tinued to ship milk, it was dumped. Knowledge of this new pro-
cedure on the part of the authorities became disseminated, and
the interdictions were respected, and, additionally, cleaning up and
sanitary improvements were inspired. Action would appear to be
the keynote of successful sanitation.
As illustrative of the effect of cleaning the dairies and interdict-
ing the milk which was contaminated, it can be said that the aver-
ige bacterial count of the milk after three months of this kind of
lemonstration has dropped from the millions to the present aver-
ige of 300,000 and less, and with twenty per cent, of the dai-
ries supplying the city, the count is equal to that of some of our
;ood Pasteurized milk.
The limits of this paix^r do not permit of but a casual allusion
to the subject Pasteurized milk. It is proper, however, to refer to
the fact that our department investigated the Pasteurizing of milk
in this city. It found that concerns which were Pasteurizing milk
were receiving their raw milk in a highly contaminated condi-
tion, and, subsequently, although Pasteurized, the milk was going
forth in a more or less non-Pasteurized state; and one instance
was found where contamination was greater after going through
the Pasteurizer than before. It is to be considered in explanation
Milk and Foodsi Feonczak 847
of this that such an instaiuie was an incident and not ouBtoiuary,
and it was explained by unusual conditions which were in evidence
at the time the milk was subjected to examination. It does illus-
trate the fact, however, that commercial Pasteurization does not
afford the security which it is generally supposed to give. The gen-
eral impression is that Pasteurized milk is not only pure and bet-
ter milk, but absolutely safe milk. This belief, in part, comea
from the name given to the process, which is not explanatory, and
being that of a distinguished investigator, conveys the impression
of security. As a matter of fact, the name should 'be changed to
" heated " milk. A criticism which can be made regarding Pas-
teurized milk is that it is prepared by the various milk concerns,
not in the interest of the public health, but in the interest of com-
mercial economy. Pasteurized milk keeps longer ; old milk can be
Pasteurized and preserved until sold, and the name additionally
adds to its salability.
The Department, in the near future, proposes to have all Paa-
tc-urized milk labeled with its age, the date, and the temperature
and duration of the heating, and so offset any liable misconception.
The Department also proposes, in connection with the labeling of
Pasteurized milk, possibly to label all milk during the summer sea-
eon' with a label giving pertinent information regarding the best
method of keeping milk for the householder to use, and a few brief
remarks concerning its relation to infantile diseases.
In other words, it is proposed, during the heated term, to make
the milk bottle not only a carrier but an educator, and daily to
carry into the household certain truths pertaining to it — truths
which, if followed, will not only maintain better milk hut will
tend to prevent sickness. These labels, of course, will ^be printed
in the various languages in certain sections of the city.
Another feature, which ■- — • ^''^ '• "- ■' -' — '-^ '■-
concerning Pasteurized m
milk which is not Pasteur
is generally practiced. It
germs grow better in hot
germicidal properties of m
ganisms do not have to st:
the raw product. The que;
848 t\)\FERENCE OF SVMTARY Ob'FICERS
is concerned, is not a cogent one, and commercial Pasteurization
is not really necessary in the interest of public health.
The bureau of food and drugs in the health department of Buf-
falo, in its administration of the inspection service, both with re-
gard to milk and the other food industries, has adopted the score-
card system. All inspections from groceries to milk houses are
under the score-card method.
It has been found to be extremely satisfactory and, in so far as
the milk industry is concerned, it has excited a spirit of rivalry
and comparison in securing excellence among the dairy farmers.
It has removed an undesirable factor in all inspection work in
eliminating the personal factor as much as possible, and makes the
work approach exactness. In the coming year, in the dairy farm
inspection service, the Department proposes to leave a copy of the
acore-card with the dairyman.
The price of milk is a matter often under discussion at the pres-
ent time. Milk in Buffalo is sold on the average of seven cent?^
a quart bottle. The farmer receives from eleven (11) to fourteen
(14) or fifteen (15) cents a gallon, depending upon the season of
the year. With sanitary requirements essential to milk integrity,,
it is not practical for the farmer to produce milk and make a small
margin of profit at these low rates when consideration is takeA of
the price of labor and the price of feed.
Milk is the only article of food which has not risen in price, and^
while we do not advocate a high price for milk, we believe the price
should be a little higher and the same as that in other cities of this
size. Washington pays eight cents; Xew York seven to ten cents,
etc. It is peculiar that raising the price of milk one cent a bottle,
which means thirty cents a month to the average family, shouM
create so much opposition. If it were only known that cheap milk
means unsafe milk, or dirty milk, it is doubtful if the extra cent
would be looked upon so strongly.
No feature connected with the business is of any greater im
portance than the cleanliness of the utensils, and of all utensils —
the milk can, because it is in the milk can that the product remaiucv
the longest. Dairies may be clean and individual effort may be
praiseworthy, but if milk is placed in dirty cans, everything is.
offset.
iliLK AXD Foods; Fboxczak 84ft
The department's attitude toward dirty caiia is merciless and its
inspectioa as rigid and extensive a3 its abilities permit. Kvcry
milk can cannot be inspected every day, but it is the aim of the
department to inspect all the cans every ten days. The system of
notifying the owners of dirty cans to give more attention to their
procedures, while moderately effective, does not bring the return
which should be expected. But when a dirty can is destroyed it
makes 'an impression. When milkmen are negligent in cleaning
their cans they are notified to keep them cleaner. If after one^
and rarely two, notifications, they continue to be derelict, their
dirty cans are destroyed. One demonstration of this character has
been found to be sufficient.
Milk cans, after carrying milk for some time and being left
to stand for some time with a little milk in them, soon become
offensive, and, even when cleaned, an offensive odor can be de-
tected. The only way to make cans reasonably safe is to sterilize
them, and but few of the milkmen possess steam for this purpose.
It has suggested itself that the municipality might, under certain
conditions, establish a steam disinfecting plant near the depots
which fortunately are close tc^ther in Buffalo. Empty cans
could be left, on the way to the depot, to he sterilized before being
returned to the country.
The details of such a scheme have been looked into, and it is
believed to be perfectly feasible. The features of the operation
would be that the cans could be left at the plant, sterilized and
subsequently sent to the country. This could be accomplished
with only the delay of missing one train and at a cost of a cent
and a little over for each can sterilized. If the city were to es-
tablish a steam plant of this character, which could be done very
reasonably — certainly under $4,000 — and the milkmen paid
for the sterilization at the rate of one cent a can, the iiLint would
pay for itself and would, it is believed, materiallv reduce the
bacterial count.
Investigations madf
terial contamination f
Numerous illustrati
in each of eight or ten
all produced under thi
850 Conference of SANixAnv Officers
no other explanation for the difference than that it is due to the
condition of the container.
From the amount of prominence given the care and attention
to milk it might be inferred that it was the only article of food
which is carefully watched or which has dangerous possibilities.
Meat, however, is scrutinized with fully as much care and pos-
sesses dangers equally serious although not so imminent.
Xo meat is eaten in Buffalo without its having been examined
several times from the time when the animal is brought here until
it reaches the consumer.
Examinations are made on the hoof and all tubercular, bad,
lump jaw and staggered cattle are shot and removed to the render-
ing works. All others are subjected to a post-mortem examina-
tion, and none are permitted to reach the market for human food
unless they come up to the standard. The carcasses are also exam-
ined in the coolers and in the public and private meat markets
and in the food factories. The general features of meat examina-
tion are doubtless well known to you.
There is one phase of the industry, however, in Buffalo which
is more than an ordinary menace. Buffalo is at the edge of a
large dairying section, and periodically the weeding out of unfit
cattle causes large numbers of them to be thrown on the market
here for cheap food purposes. These cattle, known as trimmers
and Cahners, are, very largely, tubercular. They produce a low
grade of meat and are generally used for sausage. It has taxed
the energies of the department to minimize this factor, but it
appears to be an ever-present one, and will be until the State makes
some provision for eradicating unfit animals and making some
compensation for them to the owners. The percentage of tuber-
cular cattle in these shipments sometimes averages as high as 75
per cent, in a car.
The only impression which has been made upon the traffic has
been through rigid inspection in causing extensive condemnations,
thereby making it a rather unprofitable venture. In the past ten
years there does not seem to have been any diminution in the
relative number of tubercular animals condemned on the hoof.
I regret that I have not the figures with me, but it can be shown
that there is no appreciable diminution in the number. This does
Milk and Foods: Fbonczak 851
not speak well for the State's efforts in eliminating tuberculosis
either here or in those States where the cattle are shipped from.
There is no way of determining, by any direct method, the
security afforded against tuberculosis from cattle, but it is be-
lieved that the system of inspection in Buffalo does give security.
If, in the case of actinomycosis, its rarity in man, its prevalence
in cattle, and its being a transmissible disease, are evidence of the
efficiency of inspection, it can be stated that the inspection service
in vogue here is satisfactory, and has some features in detail which
could well be adopted and emulated elsewhere.
No system of food protection would be complete without giving
attention to the various food industries, bakeries, confectionaries,
restaurants, etc.
In our comprehensive system in Buffalo these are not omitted,
but are inspected with regularity, systematically and under the
score card system, so as to eliminate the personal factor. With
this system it is believed that no city has cleaner industries in
this line than the citv of Buffalo. With the new ordinances which
have been passed, bakers are required to wear clean, washable out-
side suits and caps and suitable dressing rooms and toilet facilities
have been provided. All water-closets and prohibited openings
have been removed from the bakeshops and violators have been
punished.
The remaining feature which is now under consideration is the
stamping of bread with its weight. There is considerable diffi-
culty in bringing this about and some oppK>sition, on the ground
that the bread stamped at the time it is baked suffers considerable
loss of weight afterward by evaporation. It has been found that
0
a large proportion of the loaves placed on the market are under-
weight and that the majority of the contents of the containers of
crackers, cakes, etc., alleged to weigh a pound do not weigh that
much. From these and other facts it is believed that some regula-
tion is a necessary requirement.
The matter of having bread wrapped in paper containers is also
under consideration. The trade custom of handling bread is not
as offensive as it has been in the past^ but themaimer in which
loaves are thrown about on ooMlMMHlHHHIHBUHiliUvead
baskets makes it a mu<
S52 CoXFERENCE OF SaXITARY OFFICERS
The place where we eat is always a matter of interest The
former application of the dictum, ** Where ignorance is bliss, it
is folly to be wise," does not apply extensively to Buffalo restau-
rants any longer. They have been thoroughly cleaned; water-
closets in them have been removed; provision has been made for
the washing of the attendants ; and extended facilities have been
provided for the washing and keeping of utensils. A step farther
is now being taken by inspecting all dishes and eliminating those
which are chipped and cracked, especially those which are used
for drinking purposes.
In the whole range of food inspections, there are many minor
details which woxdd be interesting to the sanitarian and which can
beet be appreciated by seeing the work as it is done by the niuner-
ous inspectors throughout the city; and any who are interested
will honor the department by calling at the office where they will
be gladly shown the system, methods^ and results of the work in
Buffalo in detail. The bureau of food and dnigs, in carrying on
its work, has an extensive system of blanks for the purpose of
checking and notifying the businesses under its jurisdiction.
These blanks are considered to be of considerable excellence, and
so much so that sets of them are in almost constant demand by
schools and health departments of other cities. This is not re-
ferred to in the spirit of pinning medals on ourselves, but merely
to call attention to some of the features which are in operation
here and which might be of interest to some of the gentlemen who
are in attendance at this conference.
I regret that very many unexpected duties have fallen uix)n me
at this time, and that this paper has of necessity been of a
desultory character. It was my intention to have presented some
of the statistical features of our work, but the responsibilities
which I have referred to have precluded that.
Dr. ( odding — I think we must congratulate Dr. Fronczak on his very
complete and clean-cut handling of a most complex subject.
Dk. Totman. — I think that listening to Dr. Fronczak's paper has shown
that the subject of milk and foods is no small matter in health work. ^ I
wish to congratulate Dr. Fronczak on the presentation of this paper which
is so full of bristling facts, and when we get the opportunity to read this
paper over carefully and digest it I think we shall have material for very
many serious thoughts upon the subject of milk and foods, especially of milk.
Now in the city of Syracuse, nearly five years ago, when I was first ap-
pointed health officer — and I wish to say that I had served five years pre-
viously or I never could have assumed the duties of the health officer i»
Milk and Foods: Feonczak 853
any way to be considered without those five years of previous experience —
some years elapsed between the two services — the first problem that I
attempted was the milk problem. I was fortunate in having as my superior
officer the commissioner of public safety, a broad-minded, capable, willing
man to work, so one of the first things that I brought to his attention was
the need of doing something for our milk supply. An investigation and a
pretty accurate knowledge showed me that the conditions were not much
better than they were possibly when Noah established some method of sup-
plying milk when he came off the ark. They were simply abominable.
Dr. Fronczak has given us a picture of what he found around* Buffalo. The
same conditions were found around Syracuse. I never saw fouler conditions.
It was impossible under those circimistances to produce any milk of any sani-
tarv value.
T brought this matter to the commissioner's notice and he took it up with
me. They were having great discussion in New York city about the milk
problem. Many of you probably rememlier Dr. Darlington's work and the
oppositions he met. The commissioner came to me and he said : ** Doctor,
we must not take any action in this matter of protecting our milk. It is
too big a problem. \fVe shall be whipped out of it." The matter was in the
paper and the farmers threatened that they would get off the farms. The
commissioner said : '' We don*t wish to disturb the farmers. We shall have
a fight on our hands.'' I said to the commissioner, '* We will take the first
step." And he said: ''What is the first step?" I said, after considering
the matter very carefully, " Let us, first of all, get a dairy inspector." Well,
gentlemen, he said : " Go ahead and see if you can find one." I went to
Cornell and had a man recommended to me there and laid the matter before
him. He was working in the laboratories there and teaching some. I laid
the matter before him. Commissioner Pearson, our Commissioner of Agri-
culture, was at the head of the department and recommended the man.
He came to Syracuse and looked the matter over and declined to serve.
He said: ** The problem is too large for me; I don't want to tackle this job."
I looked about me and found finally a Scotchman, Hfty-four years of age;
a successful dairyman, a dairyman supplying the city of Syracuse with milk
for years, and he had been successful at it. I got him to do the work and
he has been dairy inspector since. I think the whole country can't find a
better dairy inspector that Mr. James Leeds. I measure him against any
dairy inspector in the United States to-day. He is a man who is able to
deal with the dairymen.
?^Iy first hope was to educate the dairymen, so Mr. Leeds went out. I
went out with him. We got others to go. Jt wasn't but a little time before,
by the aid of posters of the United States Agricultural Department, we had
made score cards and we began the education of dairymen. We had a great
help in one thing. We had the Tully farms which were supplying certified
milk as an example. We used that farm as an example. We encouraged our
farmers and dairymen to go out and see the Tully farms, and many did. We
furnished conveyances sometimes to take the farmers out there. Little by
little that knowledge spread among the dairymen. So the work has gone on.
We established in our Sanitary Co<le the 600,000 bacterial count. We find
that that is too high. We are now about to introduce into our Sanitary Code
that the bacterial count shall not exceed 250,000, or possibly le»*<*. I would
favor 200,000 as the highest. H we can adopt 250,<H)0 that will In* a great
gain. We find it possible to compel the farmers to furnish milk with a low
bacterial count and it is successful.
In addition to that, we have compelled the farmers to erect milk houses
separated from the barns. That has l)een an equally successful matter. We
have compelled the farmers as far as possible to ice their milk. We are to
demand a milk fiiniislied to the city with a temperature of fifty degrees —
the dairymen must ire tlii'ir milk immediately. Now we find that it is
feasible, and the milk should be iced. We have established this work out
on the farms.
Our dairy supply Ave years ago reprcsenti*d something like 317 dairies, and
now we have about 500 dairies supplying the city with milk. The farmers
854 CONFEREXC E OF SaMTAKY OFFICEHS
did not go out of it. They have gone into it, anA our dairymen have in-
creased their herds and have taken np this work. Tliey have made their
dairies good; they have made their cows good, and with the increase in this
work we find now that instead of having less than 5,000 cows supplying the
city with milk we have more than 7,000, nearly 8,000 cows supplying our
city with milk. The price of milk has gone up. " Our milk runs from seven
cents for good milk, and many of our farmers sell their own milk in the
city, bringing it in ice and delivering it for seven cents. They are making
a good profit on it and are very much pleased with it. Other milk is sup-
plied at nine cents and ten cents, and our certified milk from the Tully
farms is twelve cents a quart, and that milk is used by many of the citizens
of our city.
A year or so ago when the commission appointed by the Canadian Parlia-
ment came into this country investigating the milk problem they came to
Syracuse. They had been told they need not come to Syracuse, we didn't
have anything. We didn't advertise the matter very much. Well, you have
seen their report. I won't say anything more about that.
We have been successful in immensely increasing our milk supply in
sanitary measurements, and no city need hold back in the attempt to increase
the standard of their milk supply. It is well worth while.
Now I have all my life, from earliest years, practised medicine and made
a study of milk, and I have a subject that I use on occasion wherever pos-
sible. One of the best places that I can talk is in 'the nurses' schools where
1 have an audience of something like forty or fifty nurses to talk to. I
can talk an hour on the subject of milk and I caii present to them ideas
about the purity and about milk as an article of food they had never
dreamed about, and I believe if I had the time to talk to you an hour I could
tell you a few things about milk you have never dreamed about, never thought
of having considered. I am going to state one and I am going to give it
with a foundation which reaches as far back as Hunter: that great eminent
surgeon who established and taught the fact that the blood is a living tissue.
One of the things I preach is that the milk is a living tissue, that it has
vitality, and I was glad when Dr. Fronczak spoke of it in his paper, that
the milk had a vitality. You don't destroy that vitality without destroying
the integrity of the milk. I advise health oflicers as a body to study this
subject, to get ideas into your head that you can talk to people in a sound,
common-sense way about milk, the 'care of it, the production of it.
And to the consumers, that is not the least part of it. The care after it
comes into the hands of the consumers is really only beginning in this matter.
In the city of Syracuse it is an enormously big problem. Tlie more I see of
it the more difiiculties there are in it.
Now this question of tuberculosis in the herds. It is an important one.
I think that as health officers we should stand with a bold front to the State
authorities, compelling them to take a share in that work, the elimination
of tuberculosis from the herds. We accidently found in one herd that a
dairyman had sold two cows to a man who kept a meat market, an Italian.
The physician attended the Italian's family and he thought it might come
from the meat which he saw in the market and which the children had
handled. The physician traced the matter and found the Italian had bought
two cows from a dairyman — an old cow for $10, and the dairyman to be
sure of the bargain had put in a young cow with it for $20. Tlie doctor
and the dairyman came to me and we had the cows examined and they were
f und tubercular and were sent to the reduction plant. The dairyman came
to me asking my assistance to got back the thirty dollars for his two cows.
We got on to the fact in this way.
The State department took the remainder of the herd of twenty-eight
cows — two he had sold to the Italian — and there were twenty-six left.
Twenty-five were found tubercular and were taken to Home and slaughtered.
The farmer went down with them and after he had seen what was done, he
said if they would put the cows together and make them alive he would not drive
tnem home. Twenty-five cows, making twenty-seven he had lost out of his
ierd. What followed is worth knowing. He went and bought ten cows and
Milk and Foods: Fronczak 855
lie told me these ten cows gave more milk than his previous cows had and
they ate less even than the tuberculous ones did. He could not get enough
feed for his tuberculous herd. That meant more money out of his milk a»
he has only a small herd.
I buy the meat for my own family — was trained into that from my boy-
hood — so I buy the meat for my family. This week, in the market I saw
a nice shoulder of a pig. I told him I thought I would take that. " What
are you going to do with it? " " Sausage." He said, " Well, that is a good
way to get sausage. I wish the markets would furnish sausage like that.
You know what we would have to charge a pound for that kind of sausage?
Twenty-five cents a poimd, for that is real pork sausage." Sausage was sell-
ing in that market for twelve cents a pound. Now I have talked to a man
who is a manufacturer, who knows how sausage is made, and I was utterly
astonished, the preservatives which are put into sausage. That is an ex-
ample of our meat supplies. I wish no articles in the press about what I
have said about sausage, I might get into trouble. I have had more trouble
than that. If I can't speak to you about foods for the welfare of the people
without being threatened with removal, removal would come only too quickly.
I am not afraid of being removed as health officer. I am like Dr. Goler of
Rochester. Remove 'me if you can, you will be smart if you do it.
Now, the health officer to-day is occupying what I call an exalted position.
If he has courage, efficiency and ability he can do something. He can have
a following, and men will not throw him down; I say that with our modem
city government, with constant changing of the administration, the election
of mayors who know absolutely nothing about health matters. I could go
into the common schools and pick out boys fourteen and sixteen years old
who would have more sanitary knowledge than the men elected mayors.
They appoint a man as conunissioner of public safety who knows nothing
about health matters and he is the head of the health department. The
health officer has mountains of loads to carry, and impassible barriers to go
through.
Db. F. 6. Pabke, Elmira — I will ask to be excused from the discussion, as
it is 12 o'clock.
Db. John H. Grant, Buffalo — I have listened to the paper read by our
health commissioner of Buffalo, which I find is very interesting. Some
thirteen or fourteen years ago I was connected with the health department
here, and have since co-operated with it in the department I represent —
the State Department of Agriculture. I realize, regarding the source of milk
supply in the large cities, that the health departments have a great problem
to solve. A beginning has been made here, not only in Buffalo, but through-
out the State, and it will take time to evolve a system that will Btand and-
be satisfactory to the producer and the consumer. We have in Buffalo be-
tween five and six hundred sources of milk supply. Out of that number 110
were refei'red to me by the health department as containing a large number of
bacteria. Most of them more than a million per c. c. Those 110 farms
have been inspected by the inspectors of the department of agriculture here
in Buffalo and a great many insanitary conditions were found. "We have a
system outlined for dairy inspector which an ordinary inspector without very
much technical knowledge can fill out. Of course our inspectors are not as
a rule doctors, but they are men who have been engaged in business for a
great many years and are all civil service employees. They are interested
in their work and I find from my ten years* experience that they do good
work. Out of these 110 dairies, about 100 have been made to put their
places in sanitary condition and 10 of them refused to, or nes^lected to do
anything. We threatened to take these people into court, so they went out
of the milk business. We were very much pleased that they did.
Regarding permits. We have, as Dr. Fronczak has said, regarded permits
to producers who nell milk in cities as a very good thing. 1 think some
system of that kind should be brought to the L^islature giving ^Ue» the
authority to require permits to sell milk in the oiii«l— -J""^^ * '■■ ■""*'
the cities from outside the city limits, j - - - - -*--
856 CoxFKRExcE OF Saxitary Officers
department of the city will have more authority over them than they have
now and they know from whom the milk will be received.
I find the manure conditions on the several farms is another problem.
Manure is generally dimiped outside the window and lies against the side
of the barn and flows under the floor and creates insanitary conditions,
especially in the spring and summer. As to the dump cart referred to in
Dr. Fronczak's paper, I have found in my travels through my division that
several have already adopted the dump cart and they find it a very con-
venient method of disposition of manure from around the barnyards.
Regarding sterilization. We find that the process leaves nothing in the
milk but dead bacteria. My own experience is that that milk will not keep
as long as the ordinary raw milk under careful conditions. So I don't believe
in the sterilization process without regard to what it may take away from
the bacterial count of the milk itself.
As to cans being returned, especially in large cities, to the producers. I
think in Buflfalo we have condemned about 1 per cent, of all cans being re-
turned. That is, they have been condemned so that they cannot be used again
for that purpose. As regards their cleansing by hot steam, if you have
«eams in those cans you cannot possibly sterilize them with steam. Becaiise
within those seams you will find a large accumulation of bacteria which the
steam does not reach, so to have a can capable of sterilization you must
have one without seams.
Rural Hygiexe: Freeman 85T
THURSDAY, NOVEMBER 17, 10 A. M.
Fourth Session
SECTIONAL MEETINGS— FOR RURAL HEALTH OFFICERS
Presiding: Deputy State Commissioner Whliam A. Howe, M.D., Chairman*
CoMHissioNEB HowE — Gentlemen, I want to welcome you again to this
fourth session of our Conference. I want to congratulate you on being here
and on being rural health officers of the State of New York, interested in
matters pertaining to the health of the rural communities. It having been
my privilege for fifteen or twenty years to serve in the same capacity as
you are serving, I think probably I have a keen sense of the difficulties that
confront you as rural health officers.
1 want to state that, as in the past, the State Department of Health pro-
poses to use its every resource to aid the rural health officers in improving
the service which is being rendered to your people. I want to say to you
further that the service is being increased almost daily. There is no ques-
tion about the fact that the health officer of to-day is far more in advance of
the health officer of ten years ago than is the physician of to-day as compared
with the physician of ten years ago. You are progressing aloilg rapid lines,
and the Department stands ready to lend you every assistance in its power.
I want to present to you this morning and have you take by the hand
one who has one of the warmest hands of good fellowship which it has ever
been my privilege to grip, and I know that if each of you could meet per-
sonally Dr. Freeman it could but result in your profit and his pleasure.
And I want to ask you personally to endeavor to meet Dr. Freeman, and
in doing so you will meet a gentleman of fine personality and one whose ac-
compli shments in health matters in a southern State are known throughout
the nation. It is a particular privilege that we, the health ofl[lcers of this
great State, have in being able to listen to Dr. Freeman, of, Richmond, who
will speak to us on *' Rural Sanitation."
RUEAL HYGIENE
Allen W. Fbeeman, M.D.
Assistant State Commissioner of Health, Richmond, Va.
In discussing the subject of rural hygiene I need not remind
so experienced a body of health oflScers that we are treating a
topic which has been much neglected in the past. Because we
have believed that our efforts were most needed and our field most
fruitful in the cities, we have given little attention to the country,
and until recently have failed, I think, to realize either the needs
or the possibilities of rural sanitation. How our views have come
to be changed on this subject, what the needs of the situation are
858 Conference of Sanitary Officers
and what we may expect from careful work are in the brief the
matters to which I would call your attention.
1 think it may be assumed without argument that sanitary con-
ditions throughout the rural districts of the United States are
far from what they should be. It is true that this general premise
is based upon the studies which have been made in the Southern
States, where the prevalence of such diseases as typhoid fever and
hookworm has made these studies imperative, yet my observations
in the North and West, though somewhat limited in their extent,
have not revealed any great difference in the sanitary habits of
the people or in the sanitary situation. Indeed, the more I study
the subject the more I am convinced that our problems and condi-
tions are much the same, North or South. Of course, we have
been led to believe that the undue prevalence of typhoid fever and
hookworm disease in the Southern States marked a distinction in
the sanitary problems of the two sections. Yet I believe the prev-
alence of these diseases is due more to the added factors of a
warmer climate and the presence of the negro rather than to any
fundamental difference in the habits of the people. The country
people of the eastern part of the United States are for the most
part descendants of the original stock from the British islands
and the north of Europe. The sanitary habits brought with them
are those of a people accustomed to a northern climate. These
habits have proved fairly adequate to those dwelling in the north-
em part of our common country, but they have failed utterly
among those living under southern conditions.
We of the South have come to realize that our long summers
and our negroes rather than ourselves or our habits have made us
dwellers in a subtropical climate and that the problems which con-
front us are subtropical problems for a temperate people — prob-
lems from which the North is spared by shorter summers and
fewer negroes rather than by constitution or habit. Our under-
lying beliefs and constitutions are identical with those of your
people; our problems are different in degree rather than in funda-
mental character, are aggravated merely where yours are modi-
fied. I make this comparison because it justifies, I believe, the
ap])lication to your conditions, in part at least, of the remedies we
EuRAL Hygiene: Fbeeman 859
are employing in the South and brings home to vou the problems
which are common to North and South.
If we turn for a moment to the census reports for 1908 we shall
have no diflSculty in ascertaining the particular problems which
confront us in working for improved rural sanitation. Tj-phoid
fever, diphtheria and tuberculosis stare us in the face.
The following table from the census reports for 1908 shows the
prevalence of typhoid fever in various areas of the United States :
Registration cities 25.8 per 100,000
Cities in registration States 24.5 " "
Rural parts of registration States 24.3 " "
When we consider that in most cases the inhabitants of our rural
districts are not subject to milk infection, to food infection in gen-
eral, or to any great extent to water infection with typhoid, the
fact that they suffer practically as severely from typhoid fever as
the residents of our cities indicates that the other factors, flies,
filth and contact, must be unduly active.
In diphtheria, notwithstanding the fact that close crowding and
intimate association are lacking, that milk and food infection are
usually out of the question, we find the following report from the
same source :
Death rate from diphtheria, 1908:
Registration cities 25.5 per 100,000
Cities in registration States 27.9 " "
Rural part of registration States 17.3
a a
It would seem that even the most rudimentary precautions
under the usual conditions of rural life would prevent the spread
of diphtheria in the absence of the factors mentioned above, but
we find that the inhabitants of our rural districts suffer quite
severely from this disease.
In tuberculosis we have another disease from which we would
expect the inhabitants of the cou'ntry districts to be much less
heavily infected, living as they do without close associations,
escaping the dangers of street du«t, street cars, railway trains
and public places, and exposed in fact practically to only the two
factors of house infection and milk infection.
8(iO (\>NFEREN('E OF SaMTARY OFFICERS
From the same report we obtain the following figures :
Death rate from tuberculosis, 1908 :
Registration cities 170.1 per 100,000
Cities in registration States 169.1
Rural parts of registration States 117.3 "
Bearing in mind the favorable factors mentioned above, we
must conclude that this death rate although lower than that of
the cities is far from satisfactory for the conditions which should
surround the inhabitants of country districts.
We must, therefore, face the fact that the sanitary adminis-.
tration of our country districts is for the most part not efficient
in the Xorth, South, East or West. We must recognize that,
notwithstanding the fact that theoretically the prevention of dis-
ease should be far easier in country districts than in cities, in
practice -we only realize a slight advantage, and that the possi-
bilities of prevention in rural life are for the most part not
realized.
The causes for this condition while varying in detail in any
two given localities depend fundamentally on the same factors in
every locality, and may be summed up briefly as lack of educa-
tion on sanitary maWers and lack of organization of sanitary
forces.
Lack of Education
We have just come to realize that education, or rather popular
information, regarding disease, its nature and prevention, is the
most effective and easily available weapon of sanitary science
to-day. Against ignorance, and stupidity, preventive medicine is
helpless.
If we are to realize the benefits which the sanitary advances
of the last generation have made possible to our people, we must
Secure a widespread comprehension by them of the fundamental
truths underlying sanitary work, and a reasonable belief at least,
in the efficiency of modern methods of prevention.
This comprehension and belief cannot be brought about in a
day, a year, or perhaps in a* generation, but even a beginning
toward this end marks an advance in sanitary progress and a
great aid in sanitary performance.
RuKAL Hygiene: Fbeeman 861
The general means of education of our country people have
been so thoroughly covered on so many occasions^ and are so
familiar to you, that they need not be reviewed now. It is suffi-
cient to say that every avenue through which the people are
accustomed to receive their general information should be used
for carrying to them information along sanitary lines.
In addition to these means we have found in Virginia that
the district inspector is a well nigh indispensable agent of educa-
tion. Working first with the physicians and then with the
people, discussing the well and closet with them on the ground,
showing them actually the means by which well pollution takes
place, and by which infection is brought to the house from un-
protected excreta, the inspector becomes a teacher and demon-
strator whose labors are always fruitful.
In the hookworm work particularly we find that a personal
visit to the farm with an inspection of its sanitary surroundings,
the immediate microscopical diagnosis of any cases of hook-
worm which may be found, and a discussion of the whole farm
as a sanitary unit, supplemented by literature which may be left
at the time of the visit, is of the greatest value in convincing
the people of the magnitude and importance of the work which
we are trying to do.
I repeat, whether we depend on schools, newspapers, bulletins,
lectures, exhibits or individual visits, our end cannot be ac-
complished until we have secured the real comprehension by at
least a majority of our people of the principles which underlie
our work and a real belief in practical preventive measures.
Lack of Obganization
While of the two causes for present unsatisfactory rural con-
ditions, lack of popular education is by far the most important,
the careful student of conditions is forced to recognize the fact
that there are certain fundamental defects in our present plan
of organization of country health officials. The plan of organiza-
tion varies of course with the various States, no two, perhaps,
being identical. All, however, have certain features in common ;
all have certain common defects and all st-and in need of certain
reforms, without which efficient organization is impossible. As
862 Conference of Sanitary Officers
I Bee it, ihere are three chief faults in our present systems, or^
to put it in another form, there are three needs to be suppliedv
The first of these defects, and the one certainly found in every
State, is the part-time employment of practicing physicians for
health work.
No one recognizee so well as a State Health Officer the vast
amount of work for the prevention of disease done by such men,
done usually, too, in the face of popular prejudice, without ade-
quate compensation, under trying technical difficulties, always
arduous and usually dangerous. The voluntary effort of these
practitioner health officers has been the mainstay of rural sani-
tary work for years, and too much honor cannot be given to them
for their unselfish devotion to the cause of preventive medicine
at a time when they alone realized its needs and possibilities.
It is, however, no reflection on such men or their work to
inquire if the method is after all the best one under modern
conditions, and if in the development of popular education and
appreciation of sanitary work, their sacrifice is necessary or
proper. We must recognize, first, that preventive work and pri-
vate practice are opposed, economically, one to the other, and
that in no other profession is a man expected to work constantly
for the obliteration of his own sources of income. Then, too,
the faithful and efficient performance of one's duty as a health
officer often arouses the most bitter antagonisms, and creates per-
manent enmities in the communitv. If the health officer be a
private practitioner, this may frequently result greatly to his
professional and financial disadvantage. The private practice of
medicine is not so remunerative that the average man can venture
to arouse such opposition without endangering his OAvn bread and
butter. In addition, ethical considerations often prevent the
efficient performance of duties involving relations with the
patients of a fellow practitioner.
We must, too, keep in mind the fact that the enormous ex-
pansion of medical knowledge, seemingly endless as it is, requires
every effort on the part of the private practitioner to keep abreast
of the times, and that he has but little time to keep up with
the equally rapid and extensive advance of its sister, sanitary
science.
EoRAL Hyqiexe: Freemas 863
In addition, every one wlio has worked with assistanta, for only
a part of whose time one contracts, realizes the great difficulty
in securing efficiency as compared with the assistant whose whole
time and energy are at your disposal.
These facta have long been recognized in muDicipal sanitary
work, and in every progressive health office to-day you will find
the majority of workers to be trained men, out of private practice
for all time, and devoting their whole energy to the work. The
same rule should apply to the country. The rural health officer
to-day should be, in my opinion, a physician, well acquainted
with the territory committed to his charge, independent of local
political influences, trained in the special work be. is called upon
to do, and giving his whole time to the work. Such a man need
not be a graduate of a school of sanitary engineering, he need not
even be a bacteriologist. Personally I should prefer him to be a
good, sensible practitioner, whose interest in the subject has
kept him abreast of the times and who is given a few
weeks or months of special training in the field, in the prac-
tical details of the work. But he must, in any case, devote his -
whole time and his whole energy to health work alone. The
amount of territory such a man can cover is much larger than is
usually realized, and the salaries for part time work in two or
three counties will often suffice for the employment of such a
man, with a vast gain in efficiency.
Vital Statistics
Xest in importance to the personality of the health officer in
influencing the efficiency of rural work, comes the matter of vital
statistics. Ko man, no matter how able and efficient, can prop-
erly supervise the health of any district, however small, without
accurate vital statistics for that district. You are fortunate
enough in New York to possess such a system, well established,
complete and reliable. The absence of such
constitutes a handicap to the work of on
which cannot be overcome until the system
full operation. I believe that in general
vital statistics constitutes the most serious
progress in the .Southern States to-day.
864 conferex('e of s-vnitauy officers
Legal Enactments
Third in order among onr needs is that of better legal re-
quirements. In common with every other branch of govern-
mental endeavor, Public Health has suffered much in the past
from an excess of law. Unenforced laws bring all law into con-
tempt, and yet the statute books of practically every State are
cluttered up with laws which we could not enforce if we would,
and we would not enforce if we could. For effective rural work
we need few laws, but we need these to be plain, easily compre-
hensible and capable of immediate enforcement. In most cases
the statutes need only empower the State Health authority to
make regulations, thus making the law flexible enough to cover
the changing needs of the times, and subject to immediate test in
the courts. Such regulations should however be as few and as
simple as it is possible to make them, and every effort should be
made to enforce each one to the letter.
Results Possible fkom Effective Work
If we secure efficient health organizations for our country dis-
tricts along the lines I have been bold enough to suggest what
results may we expect? Can we hope to reduce the excessive
mortality from preventable disease to which we have referred i
For an answer we need only look at the cities with their declining
rates from all preventable diseases and their even more signifi-
cant decline in the general death rate. We must then realize that
the same efforts in the country, under more natural habits of life
than are found in the crowded and artificial life of our cities, can
but yield even greater results.
From our experience in Virginia, T am quite sure that the in-
stallation of proper means for the disposal of night soil, and the
education of the country people as to the dangers of contact in-
fection, will result in lowering the typhoid death rate in rural
districts to one fourth of its present proportions. Such a cam-
paign has be^n conducted in Virginia for the last two years and
though limited in its extent, and far from complete in its details,
it has resulted in lowering the number of reported cases of ty-
phoid fever thirty-five per cent. Education regarding con-
sumption, with tlie establishment of a country home for the in-
Jvi i:al IIv(.ii:.m:: Fkki.man S(>5
tractable open cases aiid the improvemeut of the ventilation of
country homes, especially the sleeping rooms, should cut the death
rate in rural districts far faster than we are able to do in the
cities. In diphtheria, the use of early laboratory diagnosis, re-
lease cultures, effectual isolation, and above all, intelligent epi-
demiological work, offer hoj>c of prompt and substantial reduc-
tion in the attack rate. In every branch of preventive medicine
the country invites careful and conscientious work.
The country health officer, whether he be a practicing physician
or an expert with a diploma in public health, has opportunities
unequalled in any other field for both research and practical pre-
ventive work. The field is just opening, and those in early will
reap the greatest rewards, not only in money and reputation but
in that far more valuable thing, the consciousness of real and ef-
fective service to the increase of human happiness and the lessen-
ing of human woe.
Commissioner Howe — The hour is early, and we purposely left a lot of
time so as to have a heart-to-heart and hand-to-nand talk on " Rural
Hygiene." Some of the speakers were selected to open this discussion, but
we would like to see all of you avail yourselves of an opportunity to dis-
cuss the questions presented, and we will use all the time that is available
for general consideration of this topic wliich comes home to each one of us.
The speakers marked down to open tlie discussion are Dr. Charles F. Butler,
Dr. B. F. Chase, and Dr. G. Scott Towne. Is either present? (No response.)
Db. Kkeb, C ape Vincent — 1 did not undertake to enter into any discussion,
but tne question arose in my mind that if the State Department is furnish-
ing these receptacles, aa they are in this State, how can a man get receptacles
enough for a whole school or a community without the State Department
being somewhat committed to the plan?
Db. Aixex W. Frkkman — If 1 may answer that directly: There is a little
intimate history connected with that. 'Ihe countv was rather close to Rich-
mond, and we are a little lazy in pcttinp to the office down there. The
janitor usually opens up about 8 o'clock in the morning, and was in the
office when this d ctor run in and said that he wanted 100 diphtheria tubes.
The janitor tried to communicate with Dr. Williams, but he could not get
hira on the phcme, and as tJie fellow was very insistent, the janitor gave
him the tubes, and we could not catch up with him again until the cultures
came back.
Dr. Maoiix, State Department of Health of the State of New York — The
reader of the paper seemed to me to insinuate or imply tnat it was such a
simple matter to develop an investigator of typhoid epidemic, that the student
of common sense, layman or grocery clerk, could become a very valuable
investigator in an epidemic, rather than some qualified person. That touches
me on a sensitive point. I tliink the door should be closed to anyone with-
out medical training. ->iy experience, together with that of the Chairman I
am addressing, I am certain has convinced us that it is an exceedingly diffi-
cult matter to undertake to do tnia work in a conscientious way and arrive
at a scientific conclusion without men trained in medicine. And in a great
many epidemics of typhoid fever in the country, it would be exceedingly
28
^(\i\ (\».\m;i:k\< K (»!• Sa.mial'v ()ifi<"KUs
eriticisable in a health department, 1 should think, that would put such a
delicate matter in the hands of an untrained person, that is, a person without
medical education.
Db. Van Hoesen — Mr. Chairman, I would say that wc have in our county,
and in all of the dairy counties, a very good point which helps to educate
the people, and enables us to quarantine typhoid much easier than elsewhere.
We are a dairy community, as I said before, and the health authorities of
the city of New York do not allow any milk to be shipped from dairies or
from anyone employed in dairies from a place that has typhoid fever, nor
can it be handled by any member of his family. Inasmuch as the authorities
of the city of New York will not consider receiving such milk, it is easy for
us to convince the people in our communities that typhoid is a contagious dis-
ease that needs instant attention. The people are not allowed to come into
contact with the patients, nor to go about the premises any more than is
absolutely necessary. This has proved the best doctor that we could have,
and I am convinced that if the sections from which the milk supply of large
towns and cities comes could be made to view it in the same light, that
typhoid is considered dangerous under those conditions, why I think it would
soon stamp it out.
Db. Bullaju) — I want to say something on the lines of this discussion
as originally laid out and presented by the paper to which we have listened
with so much interest.
It is very pleasant for a large number of us to meet here together and to
all of us who come here it is a matter of personal benefit. But as suggested
by the reader of the original paper, we go home and the demands of our
own practice prevent many of us in the country from giving that time to
the matter that is necessary or desirable, so that our communities could get
the benefit. In a way these conferences have been a splendid thing; but I
think these large conferences are evolutionary and transitory; I think that
the time is coming in the near future when there will be fewer health officers
in the rural districts. There are many towns with only four or five thousand
population in which there are two or three villages, each sending a repre-
sentative here, and they return home and each municipality is bearing the
burden of expense of sending a health officer or member of the board of
health here. The populations of the towns and the villages are perhaps
almost identical, and while I enjoy being a health officer, I realize that in the
near future it is inevitable that we have got to abandon the territorial
divisions in which we now work. The health officers in the sparsely settled
districts should be men who receive enough more than their present pay so
that they can give it more time and attention, and have jurisdiction over
more inclusive territory. We must recof?nize what is coming in the future,
and prepare for the inevitable, prepare to make the change with less pain
and resistance on acount of these men who will have to retire in favor of
these who show special fitness for the work. I think that is one of the best
points that has been brought out. I am going to take that back home.
I have received some splendid ideas here, and here is an important one:
Not only are the country newspapers and the people being educated by the
press, but the moving picture is also being used extensively. It is a great
educator through what they see at these different entertainments; but I do
not get enough out of it unless I am very specially interested. Therefore,
in the more sparsely settled districts there must be fewer health officers,
larger salaries and more work for them to do.
CoMMissioxER Howe — Are there any other remarks on this discussion?
Db. 1 have been for a long time thoroughly imbued with the
idea that the health officer has got to be a health officer and not at the same
time a private practitioner of medicine, and in the matter of education I
would pass this as a suggestion:
For several years I have been attending these Health Officers' Conferences,
and enjoy them very much, and when I return to my home I have a public
meeting and get the public out and give them in a brief manner the points
that we get here at these conventions; and I use that as a means of educa-
tion for the public in the community. And I must say it has been a means
of education in my district.
Db. After having water from a spring or well which has been
condemned because of containing typhoid infection, shall we allow the family
or anyone else to use the water from that well or spring until it has been
re-examined and declared to be free from infection?
Dr. Bwtton — One of our brothers here mentioned- about barns and houses
in connection Mith typhoid fever epidemics. I belong in the southern tier
of counties of this State, and we are connected and interested in the milk
supply of New York citj^. The board of health of the city of New York is
strong and positive in its rules and regulations as to the condition of the
dairy from which milk is taken, and the barns must be ventilated in such
and such a way, so much light admitted for so many cubic feet of interior,
and they must be whitewashed. But this New York health department
doesn't go far enough with those people so as to make them keep clean in
their houses. I saw a place thirty-six hours ago where you could throw
your coat against the side of the house and it would hang there.
Now, we must bring pressure to bear upon people who have houses of this
character. They must be clean in their homes as well as in their bams.
I do not think any health officer on earth can prevent typhoid under those
conditions.
Dr. Youno — I want to call the attention of this convention to the matter
of cesspools. That nuisance exists in every village. We have them, and in
our village we have a peculiar geology to deal with. How shall we pet rid
of that most insanitary thing, the cesspool? I have tried to find some
method of making a half-sanitary cesspool at least; but it seems to me tlie
3tate of New York should employ a sanitary engineer to devise a cesspool
which can be used in our rural districts and small villages, where we do not
have perfect drainage or sewerage. It is the insanitary condition of our
cesspools, as we have them in our villages, that makes the trouble.
Commissioner Howe — I will ask Mr. Horton, our chief engineer in the
Department, to talk on that subject later. Are there any further remarks?
Dr. IjAKE — I was greatly interested in this paper, and there are some
points, it seems to me, gentlemen, that should leave a deep impression upon
us. To-day throughout the country' the cities are pretty thoroughly pro-
tected in every way, as regards the public health, and yet the rural districts
or territory on which this paper treats is, in my opinion, the largest source
for the continued spreading for infectious disease, and every health officer
of every locality is largely responsible for this.
I am not saying this in the way of throwing blame upon those officials,
but I think we are not insistent enough to the people, and in relation to
carrying out the things whicli should be carried out for the proteoticm of the
public. It should be education, and yet what are we doing in the rural
districts in the way of education? It may be said with the utmost truth
that apathy exists everywhere, and yet I think enthusiastic health officers
will imbue their boards of supervisors with the opinion that what he wants
done should be done if ne will go about it right. I do not think it is neces-
sary that he should cover a large territory. These conferences are informal,
and health officers in every town and locality come to them, and all we want
is for that fellow representing each particular town to get his people out
and inform them about these things we discuss and consider here.
Then there is the examination as to the condition in the schoolhouses out-
side of large towns. See to the conditions of ill ventilation. Many of the
children in these pchools have diseases and are in fit condition to infect
others. Have those children examined.
^gain, let us look into the milk supply of those places — how much of it
Sr.S ('o.m"ki:e.\< K m Samial'v Ori'u kks
has been examined? How iinniv stablfs have l>ccn looked over bv tbe in-
spector or the health officer of the rural districts? What do you know as
to the character of the milk coming in from every rural district? That is
all in the province of the health otlicer, and ho should make his board aee
that he is equipped to carry tliat out. Ihe result would be far reaching.
Me. Bradtox, Homer — I rise to ask for stnnc help: We are now under-
going an epidemic in Homer, eighteen cases having been reported since the
first of September, the population l>eing 2,oO(>, or less, and our private water
supply has not been examinetl in some oases. In my investigation in this
case, I thought it was largely due to colon Inicilli carried by flies; I think
that is what is making our trouble. But I believe that colon bacilli producc^i
some of our caso:^, and if they are not pure typhoid they become so.
Dr. Seiden, Catskill — Don't some of this trouble come from a lack of re-
porting on the part of physicians? Once in a while in going around I get a
typhoid germ and 1 go to a physician and have, a talk with him, and the next
time he has such a case he will report the case, and then I go and examine the
premises and do what I can toward teiu'lnng tliose people what is necessary.
Last spring the Department made an exanu?)ation of a number of boarding-
houses tliruugliout the ('at.skill region, f think all of the houses had
twenty-five or niore lioarders' aecomujodations. The people from the Depart-
ment made recommendati(ms in one case which were not carried out. 8ince
the close of their season on Labor Day, twelve cases of typhoid fever have
occurred among the people who patronized that boarding-house, one of whom
was the proprietor himself, and i think prol>abIy it will do him good. Ihe
case was reported ; I went to the place and looked it over. The only wonder
to me was that intelligent peo]>le, who go out to the country for rest and
recreation from the large cities, slioiild go to such a place. But they do,
and when they have trouble they blame it on the health department.
Within a very short time tliere had been a number of cases of scarlet
fever there too. 1 say a number — probably it was five or six — in the
lower end of our town, which, as you know, is largely given over to the
foreign element, and contains a class of people that it is dilhcult to manage
because of tlie difiiculty of making them understand what you want them to
do. Ihere are Poles tliere that do not understand each other, they are from
difTerent sections of their common countrv. Q hey have some fourteen or fif-
teen dill'erent forms of expression, an<l some of them say that they cannot
understand even their own talk. I do not know about that. But a good
deal is chargeable to the conditions under which these people live.
1 have had less trouble with the foreigners as a class than with a certain
class of Americans as to contagious diseases. An American shrugs his
shoulders and says he is as good as anyboily else. " Why don't you make
the^e people clean up?" Why don't you do this and why don't you do
that? Within a week I was called into quarantine a house where there were
two cases of scarlet fever. I went to the village and talked to the people.
They understood the situation perfectly, and they did all they could to pro«
tect the neighbors. When we came to investigate the origin of that trouble,
we found that a young woman of this household had worked out in another
part of tlie town. While there — she was tliere about two weeks — she had
a sort of rash. Some fifteen or twenty people were in the boarding-house,
and people came from the city with children, and the children all got sore
throats. They did not call a physician, because these people who brought
it there knew* exactly what it w^as, and they knew also if they called a phy-
sician something would be done to interfere with their freedom. This young
woman finally recovered after leaving there, and one day at home she took
out a skirt and shook it out in the house, and within a week three children,
all there were in the house, came down with scarlet fever. It is pretty diffi-
cult thing to guard against infection against any of these diseases if you do
not know where to locate it.
1 have started my campaign of education by talking with the truant
officer. He came in on Monday and he told me of the condition where these
liuKAL Hygikne: Fkeemax SOO
men worked, and fourteen or fifteen families are keeping their children out
of school, absolutely refusing to send them there as everybody had scarlet
fever in that neighborhood, as they put it. The truant ollicer said, *' What
are you going to do about it? " 1 said, *' You let it lie quiet for a week,
and then we will go down together and see what happened." He was a
sensible sort of a fellow and he did that. We went dovm and did the best
we could. He will go back there and explain the situation to these people,
and they will understand what is to be done in the future. Tliat is the be-
ginning. Of course it must be followed up closely.
Dr. Everts — I am located in a district where the milk supply is brought
into Buffalo, and they send their inspectors out there throughout the country
too, and they condemned two of the dairies in the country, one on account
of dirt and one on account of insanitary conditions, and the farmer im-
mediately loads his milk into a wagon and carries it over to a creamery.
It geems to me that when milk is unfit to be sent to the city to be drank
as milk and used in that way, there sliould be some way to prevent it going
to a creamery to be made up into butter
Dk. Everbht — Someone referred to the diffuuilties regarding dis.semina-
ticm. I want to mention one or two matters which have occurred in my
practice as a liealtli ofllcer rather than as a physician. During the past
summer we have sulTercd from one or two epidemics. I had twenty-eight
quarantines and eiglity-two cases of contagious disease. During the epidemic
of scarlet fever which appeared earlier in the season everything was placed
under rigid quarantine, and I have tried to make it a practice that when I
had to quarantine any place that no disease should escay)e from those prem-
ises. The exceptions are very rare, but in a neighborhood where the scarlet
fever was prevailing I was notified by an attending physician that there
were four cases of scarlet fever that had develoiHjd in four children on the
same day. I found on examination that it was true; and I inquired where
it was that they contracted it. They said they had not been anywhere. They
had been right there and they were so afraiil they would get the scarlet fever
that they had not allowed anybody to come there. It is rather strange where
that came from. I found upon inquiry that a family had moved away and
moved everything except the cat, and the cat came tJiere with a kitten, and
the children liking the cat made a playfellow of it, and as soon as it got there
they were all delighted with the cat, and they were caressing it and the cat
had kittens, and they all got scarlet fever, kittens, children and cat.
The Chaibman — We will now call on Dr. Freeman to close the discussion.
Dr. Allen W. Freeman — T have little to add except to make myself
clearer on a few points. As to the student investigators, I probably have
not made mvself as clear as T had intended. I had not intended to convev
the impression that we would take students who were just beginninj;, or
clerks. Our students have all been medical students who have completed at
least their second year, and as far as their availability for public health
is concerned they are entirely as useful as if they liad attended clinics for
years. Of course, being students, they are cheaper than physicians, and
they are more enthusiastic and energetic than the practitioners we have used
for the same purpose. As to their efticiency, we have re])orts on the preva-
lence of typhoid fever in two counties of Viryjinia. which until recently were
free from typhoid and in which a sputum investigator has investigated
every single one reported. And 1 must say they constitute a good piece of
epidemiological work.
Now after the bacteria. I think it is a pretty dangerous doctrine for a
health officer to contend that typh<»i<l is not c;uis'»(l by a germ in feces. There
are some things we ao not know alM)nt nn'ilirine, but we do know that
typhoid spread is spread from discharges from sick y)ersons, and if we leave
that position we mi.st dr<»]) all typhoi<l ])revcnti\c work and stop it to-morrow.
As to closing and condenininijr a well spring tliere is no general statement
that can be made upon that. We concluded as a result of most careful work
870 CONFEREISCE OF SaJSITAKY^ OFFICERS
that comparatively few springs have become infected, and very few wells.
We find that fiies and filth and fingers are the great spreaders of typhoid
fever, and if we can get those things cleared up we do not have trouble
with typhoid. The dairy communities will not improve thei^ water supply.
There is no way to improve except by protecting the well-cup and removing
privies. Typhoid is cut down with cleanliness. I have in my hand here
what I regard as a most important contribution to sanitary science. It ia
a design of a sanitary privy designed by the officers of the Marine Hospital
Service at Washington; it is published in the last, or the next to the laist.
Public Health Reports. We are testing this out in Virginia, and it seems
to me that all the conditions of a sanitary privy are complied with in this.
It consists especially of a water-tight barrel that is sunk in. the ground about
one-half of its height, and the barrel is half fiill of water and on top of the
water there is some heavy oil poured. From that barrel a pipe may run to
another barrel, which is also water tight, and the barrel has special divisions.
The feces and urine go directly into the barrel and a small amount of mate-
rial particles go over into the second barrel, but that equals in volume only
the actual volume of the feces, less evaporation, which is a very small amount.
In the laboratory they had one of these in a room, and they had not ten
gallons of material to dispose of in a considerable time, although it was
used by a large number of people.
Br. What laboratory is that?
Br. Freeman — The Hygienic Laboratory. This is a cut of a device which
may be of interest to some of you (passing around printed illustration).
Br. -t How about septic tanks?
Dr. Freeman — I never saw a cesspool I could approve of, but the septic
tank is such a broad subject. This is not a septic tauK.
As to the matter of colon infection or typhoid or intermediate cases of
typhoid, we are convinced in Virginia that whether it is colon, or whatever
may be the intermediate organism, the material that is dangerous and which
fjivea ns typhoid and hookworm diseases is human excrement, and if we look
after that the exact nature of the organism does not make much difference.
We are trying to dispose of that excrement in a satisfactory manner.
I am sure I am very much obliged for this full discussion of this very brief
paper.
The Chairman — Br. Freeman, I want to say that no further assurance
should be necessary on the part of your hearers of their appreciation of your
paper than the discussion and the attention which they have given to it.
Now you have been hearing for several years the views of the next speaker
— he is the voice in type, as it were, of the Department. There is, perhaps,
no one man in the whole Bepartment who has wielded so constant an influence
over you as Br. Cole, the efficient editor of " Tlie Bulletin."
Br. Hilus Cole — Gentlemen, I have a bad reputation in the Bepartment.
Tliey tell me I have a faculty of finding jobs for others, but none for myself.
I have to get up these conference programs, and they tell me T always find
a place for this man and that man, but I always leave myself off the program.
I have a few announcements to make at this point:
First, this afternoon is left as an open afternoon. Ihree different oppor-
tunities are ofl*ered you for the employment of your time. Those of you
wlio care to, cnn sec something of the meat inspection work of the city of
HnfTalo. Dr. Heath who has charge of that work for the city of Buffalo
will take tho=e who wish to follow up this feature; he will take charge of
them and take them around this afternoon.
At the close of the meeting last night Dr. Fronczak showed some pictures
of the work which ia being done by his department in the city of Buffalo.
Those pictures will be repeate*! here this afternoon at four o'clock, and again
tomorrow niglit at eight.
The Medical Olticers of Health have a special meeting this afternoon at
five o'clock at the Hotel Iroquois.
There will be a tuberculosis clinic held in this hall at two o'clock this after-
noon by Dr. Pryor, and anybody caring to come he will be glad to see present.
We are a little late — but we will hurry as much as we can.
First of all, with regard to the Bulletin, we are very anxious that it
should have as wide a circulation as possible. Unfortunately our purse does
not permit us to send it to everybody to whom we would like to send it, so
that we feel the first thing to do is to send it to those who would like to
receive it. We believe every physician should have it, but we do not want
to send it to a physician unless he wants to read it. If you have any physi-
cians or laymen interested in public health matters, and particularly members
of your Board of Health, we should be pleased to see that they get a copy
of it monthly; and in order that they may get it, if you will write to the
Department and give us such names, we will put their names upon the
mailing list.
The division over which I have the privilege to preside must arrange con-
ference programs. It is hard for us sometimes to decide on the topics that
you would like to have discussed, and when the conference period comes
around I wish you would b^ar that in mind and send in any suggestions
you have to make. Just send the word to us at Albany, and say that you
would like to hear discussion on such and such a topic.
Recently a special edition of the Bulletin was mailed to every physician
in the State, and if you know of any physician who did not receive it let
us know and we will mail it to him. That issue gives an outline of the work
of the Department, vital statistics, registration of births and deaths, and
other things which it is important to get physicians to know in order that
they may act in harmony with you in the work of the Health Department.
We are working in Albany on a series of public lectures, the idea being
that we can frame up the text of a lecture and supply lantern slides, so that
if any of you want to talk to your own people on subjects of sanitation we
shall be glad to offer some assistance. We may not be able to send a lec-
turer in person, but we will help you with lantern slides and the text of a
talk on the slides. When this is further advanced, notice of it will be g^ven
in the Bulletin.
Please do not forget that we have a library iii Albany with books on sani-
tation, and we are glad to lend them to the health officers of the State.
You may be interested in knowing that we have recently started a weekly
news letter service, sending to the press a w^eekly letter dealing with sanita-
tion and the work of the State Department of Health. Any of you having
access to your local papers, if you would like to have any assistance from the
State Department of Health in helping you out with statistics or anything
of that character please remember that we are at your service for this class
of work.
872 (\)xfki:k\( E of Sanitary Ofkk'Kks
POLLUTION OF STREAMS
By Theodore Horton, C.E.
Chief Engineer, State Department of Health
I believe that if any of you gentlemen should attempt to give
a ten-rainute talk on the ^* practice of medicine," you would ap-
preciate my position in attempting to discuss the subject of stream
pollution in this short interval. In fact I propose to let you do
the discussing, for if I can succeed in giving a mere outline of
the subject in this short time I will feel that I have accomplished
my object.
Foregoing further introductory remarks then I will proceed
with the fimdamental proposition that there is not a town or vil-
lage in the State that has not flowing through it for a greater
or less period of the year a stream of some measurable size. I
believe that I may state with equal safety that every one of these
streams receives in some way or another pollution of some char-
acter; be it large or small; be it dangerous or not. This pollu-
tion may for example come from sewer systems or industrial
establishments; from cesspools or vaults; overhanging privies;
garbage and nuimire piles and what not. Some of it may pro-
duce nuisances and some may be dangerous to health, and it there-
fore becomes necessary for us to differentiate rather sharply be-
tween these various classes or sources of pollution in order that
we may understand and judge correctly their relative importance
or significance.
1. Perhaps the simplest classificaticm is that between direct and
indirect pollution.
By direct pollution I mean the sewage and wastes that enter
the stream directly without any intervening space or barrier
which might result in a partial or complete purification. This
would include sewerage systems and house drains and wastes
from factories, overhanging cesspools and miscellaneous wastes
discharged directly into it. It is evident that this pollution is
the most serious and is in fact the cause of some of our worst
nuisances and dangers to health. Further it is the class of pollu-
PoLLUTiox OF Strkams: JIortox 87^
tion specifically enjoined by the Public Ilealtli Law and which
the health officer has the greatest difticnity in dealing with.
By indirect pollution I mean the .s(^wa*2:e and wastes tliat are
not discharged directly into the stream but reach it after flowing
over or through the spil, or through sewage disposal works where
opportunity is afforded for it to be partially purified. This
would include sewage from cesspools and vaxdts w^hich are situ-
ated some distance from the stream; effluents from sewage dis-
posal works ; drainage from barns and hog pens ; and the washings
from fertilized fields. Although this pollution is not usually as
objectionable or as dangerous as direct pollution on account of
the partial purification tliat takes place, it tnay, nevertheless, be
objectionable and dangerous, espcciolUj when the stream is used
for water supply purposes.
2. Again, avo may classify pollution as that which is organic
and that which is inorganic, i. e., pollution that contains any of
the parts, substance, materials or products of animal or plant
life, an-d that which does not
The organic pollution is perhaps more important, for it is this
matter which often contains the deadly germs of disease and
under certain conditions makes sewage objectionable or offensive.
This organic matter is characteristic of most but not all classes
of pollution, but especially of domestic sewage and of certain
manufacturing wastes such as paper and pulp mills, tanneries and
creameries, etc.
Now this organic matter is as you . know decomposable and
putrescible. Some of it is quite stable and decomposes very
slowly, while some of it is very unstable and decomposes very
rapidly. This decomposition, of course, takes place by aid of
certain bacteria. When there is plenty of oxygen present the
aerobic bacteria perform the work and the organic matter becomes
oxidized or nitrified without the production of gases. When,
however, there is not sufficient oxygen present or after it is all
used up by aerobic bacteria, then another set of bacteria, the
anaerobic, do the work, and this decomposition which takes place
in the absence of oxygen is attended with evolution of gases which
give rise to odors and nuisances. In other words, so long as
oxygen is available in ihe water for the bacterial process to be
874 CoXFKHKXrE OF SamTARY OfFH ERf^
carried on then there will be no nuisance; but the very
moment this oxygen becomes exhausted, then gases aro given off
and odors arise, and a nuisance may bo created.
The inorganic pollution, or what may be considered mineral
matter, may be of manifold character and from different sources,
but is usuaDy characteristic of c^^rtain factory wastes or refuse,
more especially chemical works. It may be, for instance, poison-
ous acids which may kill fish life or even human life. Again it
may have characteristic odors, such as of certain chemical com-
pounds or wastes from certain factories, and produce a nuisance
in this way. Finally, it may be largely inert matter in suspense
which may cause deposits and unsightliness in a stream. This
class of pollution does not, however, decompose and does not give
rise to offensive organic odors such as that which arises from
organic pollution.
3. Finally, pollution may be classified as tliat which is patho-
genic and nonpathogenic. These are assumed terms and are
meant to define or differentiate between pollution which is of
human origin and that which is not. This classification is,
perhaps, the most important for upon it depends the public
health.
Pathogenic pollution may be considered that pollution which
contains the excreta and washings, or any of waste products from
the human body and, of course, may contain germs of disease.
This pollution is associated with the contents and discharges from
sewers, drains, cesspools, vaults, etc., and, if it reaches a stream
used for water supply, it may spread infectious disease imless the
pollution is removed by filtration, ifany of our streams and most
of our rivers receive this class of pollution and so long as it is
not used for water supply there is no great danger. The fact to
remember, however, is that a very small amount of it discharged
into a stream may seriously contaminate it and give rise to
epidemics of infectious diseases.
The nonpathogenic pollution, or that which does not contain
wastes or washings from human beings, is, of course, not danger-
ous from a sanitary standpoint. This kind of pollution is char-
acteristic of factory wastes, when these wastes are not mixed with
human waste?;. It is very important to remember, in regard to it,
PoLLiTTiox OF Stkeams: lIoKTOX 875
that, although these wastes may often bo the cause of some of our
worst nuisances, they do not in themselves give rise to infectious
diseases and are not in themselves a menace to life.
I have laid considerable stress, therefore, upon a classification
of pollution, for I feel that it is essential and necessary to know
the character, importance and significance of etich in its relation
to the production of nuisances or to the danger to public health.
The Chaibman — Does anyone wish to ask any questions of Mr. Horton?
(No response.)
Dr. Buixard — Somebody here a short time ago asked the question as to
what they were going to do in towns where they have cesspools, and as
reply we have been handed a description of the sanitary pri\"y, and we have
been informed that this matter should not be carried into public streams.
Xow the sanitary privy works nicely out in the country, but it does not
fill the bill in certain villages where they have a water supply, perhaps, and
would like to have the sanitary conveniences in the house, and have no means
of disposing of the sewage save in that way, or under ground. I believe this
is a very vital point, and people putting in tanks in the house and water
supply, they want to know what to do with the material after it leaves the
house. I think sewage disposal plants can be constructed in nine out of
ten cases.
Db. CDonnell — I am very much interested in this question of cesspools.
I am located in a rural district in a town of 1,500 inhabitants, and the ques-
tion arises in my mind: How are we going to dispose of our own human
fecal discharges, and the water we bathe in, and the water our clothes are
washed in?
Modern houses are connected with a sewer, and they go down about ten
feet for gravel, and they give us no trouble later. We want to know, if the
engineer will tell us, if we are contaminated by our own discharges, how is
the best way to dispose of them? We are not aspiring to a sewage system
in our place as yet — we have a water sr.pply that is about 2o0 feet elevation
and we do not feel that our discharges arc going into the water that we
are drinking; still, I would like the sanitary engineer to explain what danger
we are running of infecting ourselves from our own sewage discharges and
how should the people build such houses in the future.
Mb. Whitney — I am vitally interested in that question, and I would like
to ask Mr. Horton, if he will not answer that question fully in the Monthly
Bulletin.
The Chairman — We will now move on to the last number of the morning
— Dr. Magill, whose work is evidenced frequently l)efore the health officers
of the State.
8T«> (\)NFKnKx< K OF Samtaicy Offickus
THE STATE LABORATORIES
By W. S. Magill, ^1.1).
Director of Laboratories, State Dopartmfnt of Health
Mr. Chairman and Gentlemen: I will give a statement as to the
laboratory work, what we want you to do, and what we want to
do for you.
We have three laboratories connected with the State Depart-
ment of Health. There is the antitoxin laboratory at Albany, and
the State Hygienic Laboratory, and a branch of the latter labora-
tory at Ithaca. I can dispose of Ithaca by saying that it is used
for sanitary water examinations for a particular field or division of
the State, and is not different in its work than if it were located at
Albany.
All correspondence concerning examinations of water at Ithaca
should be addressed to Albany ; it is merely located at Ithaca as a
matter of convenience, and it is not an administrative office.
The antitoxin laboratory at Albany prepares the tetanus and
diphtheria antitoxins. The tetanus antitoxin is issued to every
health officer of the State, and every effort is made by the Depart-
ment of Health to have such officer keep both antitoxins on hand,
and to prevent the development of tetanus. It has happened far
too often that health officers are telephoning or writing to the De-
partment for tetanus antitoxin for emergency purposes, and they
quite forget that they are expected to have this tetanus antitoxin
on hand. It is the duty of the health officer to have it on hand, and
have it used in every case of open wound of that kind. How can
you urge the use of tetanus antitoxin if you haven't it on hand ?
That is the way we control the record of efficiency on our work.
When we find that towns have not made use of the tetanus anti-
toxin for two years, we have not much confidence in the officer
there.
The antitoxin is prepared by injecting toxin into a horse, and
then it is drawn out in the blood of the horse. This is tested by
United States tests as to its power. We put up two prophylactic
dases (1,500 units each) in a vial, and also in larger vial — 10,000
"units to be used as a curative dose.
The State Laboijatokipis : Magill 877
The diphtheria antitoxin is far more extensively used in
this State, and is supplied in bottles containing 1,500 units in
some; and others 5,000, and where a lot of i)eople have to be im-
munized sometimes in bottles of 10,000 units. For this immuniz-
ing purpose, it is in bottles, the physician distributing the dose, to
the amount in his judgment it should be and using his own
syringe.
For therapeutic uses it is distributed in a syringe package, the
syringe containing about 3,000 unit doses. When used the package
should be returned to the laboratory as we have a plunger which
can not be dra^vn out so that the syringe can be used again.
During this year, 5,000 syringes failed to be returned to our
laboratory, and that cannot be because of breakage, as we seldom
have a break among them. I think someone is negligent, because
in each one of those packages is a small slip, yi How for tetanus and
blue for diphtheria. It is scarcely to be realized that with the
medical profession of this State, when each physician taking this
antitoxin furnished by the State, subscribes his nauio and pledges
his honor to return them, that the laboratory is scarcely receiving
«
10 per cent, of those reports.
I have undertaken to write to every man who has sent incom-
plete reports, and I can see a notable progress during this year.
It is, however, only in 10 per cent, of roi)orts scut in. I find
that we must resort to writing to every man who has signed a re-
ceipt, for that package, and ask where the report is. That should
not be necessarv. There is honor and efficiencv, and there must
be discipline in the medical profession. When you have promised
to report the results of the use, we expect the realization of that
promise generally, and not once in ten times.
The question often comes up as to whom diphtheria antitoxin
shall be supplied by the health officer, and we say that the health
officer should have our fresh supplies always at hand. By the tests
of our laboratory, the antitoxin remains satisfactory for use for
about one year, if kept in a cool place. If you have a doubt as to
the efficiency of your antitoxin, as to its being good, send it back to
us, and we will supply you with fresh antitoxin. Now, you should
have it always on hand — unfortunately you do not all have it; ••
600 town^ of this State made no u^^p of the antitoxin laatywrj
878 CONFEKEXCE OF SaMTAUY OkKKKKS
is, 600 last year out of 950 towns — that is a very high percentage,
of misses.
You have the antitoxin on hand, and the first thing to remember
is that this has proved itself the most important life-saver in diph-
theria ; that its use prevents the possibility of anybody contracting
the disease, if they are injected with a prophylactic dose in time.
Further, that if the tetanus antitoxin is used in any suspicious
wound, it prevents absolutoly the apj)carance of tetanus in that
wound; and 1 liavo ])lfasuro in reiH)rtini( that of the last IS case-;
of lockjaw tetanus, after convulsions appeared, and treated witli
antitoxin, we had eight recoveries.
Xow, the therapeutic effect of diphtheria antitoxin depends on
its immmediate use. Our statistics show that where diphtheria
antitoxin is used in the first 2-1 hours, there is only a trifle over 3
per cent, of fatality; in 48 hours, it jumps to 5^ per cent; another
day to 9, another day to l.*) and 25. Now, then, the physician
that has it in his power to supply antitoxin and to save one hour, if
he does not do that, is morally responsible for a fatality that occnrs.
Bear that in mind.
The object of this department, as announced by the Commis-
sioner of Health, is to help those who cannot help themselves.
The patient must have antitoxin. If the physician attending that
case and the drug store there, haven't it on hand, it may be a
millionaire's son, still it is your duty to help that man as he can-
not help himself.
Now, then, where people can secure their antitoxin and have
the means to pay for it, then they should. The State service is
not to be used and abusal as a charity. But because a man can
pay, if he cannot obtain it, is no reason why he should not be fur-
nished it by the State officer. Where it can be used to advantage,
it must be used, but it is never to be abused.
This is the antitoxin service at the present time, and that is
determined by the limitations of our antitoxin laboratory. We
have been preparing and striving to the best of our ability to fur-
nish this year vaccine for rabies. We are overburdened, however,
with work and need money, and that has progressed so slowly that
it is not ready at this time. I am waiting now to have three weeks
of perfect quiet in the laboratory, an order to start my series.
Then we will have the rabies vaccine for distribution.
The State Labok-vtokieb: Magill 879
We have, further, the State Hygienic Laboratory, the functions
of which are: The sanitary examination of water — diagnosis of
infectious diseases, and special pathological' work. We uudertake the
sanitary laboratory examination of all public water supplies. We
have about 240 of them in the State. We do that as frequently as
possible. That means money and a plant whereby we can reach and
take these samples ; and that is the routine work of the laboratory.
We examined — I do not remember the figures — but last month
something over 300 analyses in the month, so you can see to what
extent we are busy, and in our opinion a public supply should be
examined by the State Laboratory at least once a month. Now,
bear that in mind and see if we examine the 240 sources of water
supply of this Stale, that we would be at the maximum of our
capacity, and could do very little other than water examination.
We have by law the examination of water supplies to all State
institutions, and we undertake — although it is not required by
law — new supplies proposed for communities; we undertake to
prepare for them a proper statement by which they can go before
the Water Supply Commission. That thing in itself would carry
us over our capacity for water analysis.
That brings up a little item which I have put here at the sug-
gestion of the chairman — the question of well water. I do not
think there is anything that occurs in the laboratory and the health
officer's work which is so much involved as the question of the
examination of a well. We quite understand that the rural health
officer is quite alone in the communily, and that be may forget
that there are far more important problems in the water examina-
tion than John Jones' well. We have 9,000,000 of population in
this State, and if wc undertake the examination of the wells in the
Stale that are merely suspected, why you will see the difficulty we
will have in trying to do anything else.
My experience in water analyses for a great many years, in
many communities, brings
that the laboratory analysis
must remember, if yon hav
yoiir garden, or from your
that kind that occur in tho
tion which our laboratory :
Bnt still that does not mean
8M> ( N)Nfi:kk.\( k of S\mtai:y ()ri'i(i:i:s
from cattle, that dots uot mean even a dangerous souree of typhoid
fever to the consimier. Now, suppose you have a typhoid fever in
a family, and you want that well examined. Kemember that pol-
lution was two or three weeks earlier than the api>earauce of the
sickness, and that the damage was done that much before you were
notified of it; before you learned of the injurious character of the
water it had very likely disappeared long ago, and testing the well
now you may find it to be good water.
Or suppo&c Ave will take that water and send it on and have it
examined, and the report that would come back would be that
fecal organisms were ])resent in it. That does not prove that the
well was your source of typhoid pollution; and if we condemn that
well, you as well as the Department are liable to be considered
arbitrary. It is i)roper that if you have a well that is getting
baniyard and garden drniiingc. or that is not properly covered, that
vou should correct that. Then, when vou have a well where the
local conditions are sati^l'actorv, then is the time for the laboratory
conditions to come in and see if anything is happening under-
groimd. We cannot undertake all the wells in the State that should
be examined, and we cannot say we are doing you any great good
by examining such a well.
*-'] Furthermore, you heard this morning from the first speaker that
it is the exception that typhoid fever is carried from a well; that
fo'phoid is carried by this alliteration — Hies, filth and fingers.
I'he water examination of such well cannot be undertaken by this
Department, that is, analysis of well water as a possible source of
typhoid fever, until every other source of infection has been elim-
inated. When you have done that, then it might be well to look
into the water.
We issue a little ii:vQcu circular called '* Water Analysis." The
conditions are in the manual or circular, and they were i*epeated
in a special number of the Btlletix of last August, and we have
made every effort to make clear to all what we can do and what
you should do when you want our service.
There is scarcely a day that we do not have three, five or six
applications for containers for water, in which they do not conform
to the rules. They do not tell us what they want or why they
want it.
TllK StATK L.VBOKATOIJIES: Ma(;ill SSI
Xow. \vc have liealtli uliicers who tclc^raphj *' Send three con-
taiuers for water examination,'' and we do not want to be arbi-
trary, and we ask why the man telegraphed. Sometimes lie an-
swers and sometimes he does not. Sometimes he sends down a
sample of the water in containers of his own. Now, I ask that
you will earefnlly read the literature of the I)<;partuient and the
conditions under Avhieh the laboratorv must Ixj used for water
examination. If tho^v conditions are arbitrary or irrational, \ve
would welcome any suggestions; but unlei^s wc can better them, we
ask you to please comply with what wc have set forth.
The State Department also makes other examinations, but the
bulk of these ai^e as to the presence of diphtheria germs, and the
examination of blood serum for widal reaction, and, as far as we
can, the examination of stools. Every health ofHcer is requested
to keep supply of our culture outfits, as we call them.
That is a little glass tube, in which is the projier blood serum, and
another little glass tul)e with :i swab for taking spei*inien^ from the
throat. They are both in a tin tube, and that is put in another
outside tin tube. There is a slip for filling out, with the blanks for
information, and that we supply to every health officer. It is neces-
sary for him to keep those fresh, as the blood serum will dry out,
and as soon as it is dry and wrinkled — not a smooth, white snr-
face — 'it is no longer fit for nse. In that case it should be ex-
changed. We supply a sputum ontfit (container) ; that is a glass
bottle, thoroughly corked, with directions in a tin box, with a
secure top, and that is, like the other, packed in the outside tin
box with a screw top. That is for the sputuui, providing for its
transportation by mail to the lalwratory.
Then we have the widal outfit for diagnosis of typhoid, a small
glass tube with a needle for puncturing the ear. That has a single
wood box. The double boxes for diphtheria and sputum specimens
are fixed by the ix>stal regulations of the country, and we therefore
have complied with them and cannot do anything else.
Now, it is forbidden to send such materials as those which these
ordinarily contain through the mails except in such an outfit as
we provide to mail them. If such material is sent in any other
tlian fbnt wny llie ]»cr-nn i- liable to a fine np to $200. Now, tiieai,
\vr iwv insiv|, 111 ui>oii llu' licjdtli <»tli(Mr-. using our outfit.
882 CoxFERE^xE OF Samtary Officers
are prescribed by the United States postal regulations, and we are
protecting the health officer from fine. It is a penal offense, and
yet, in spite of that, there is not a day goes by that we do not see
some one who has sent a diphtheria specimen improperly packed,
which is sometimes smashed by the postal clerks stamping it. Such
a health officer should be retired from the profession or put in jail.
Our widal outfit is a capillary glass tube and a needle to puncture
the ear and get a drop of the blood, which is then drawn into the
tube and sent to us, after sealing the ends. There is nothing in-
fectious in that, but we must have the name of the patient and
details supplied on the accompanying blank. You must heat the
end of the glass tube to seal it. Some of these glass tubes have
been made so hot that the blood inside was charred. Such heating
of the cells results invariably in destruction of the specific reaction
properties of the serum by that degree of heat You would then
get a negative result where it might have been positive, and the
fault is through the overheating. Just heat the little end enough
to seal it.
Now, in requesting reports of these examinations for diagnostic
work, cross off " Mail " if " Telegraph " is wanted. The health
officers sometimes cross off both ; and it seems to me simple enough,
for here are two words on our blanks, " Mail " and " Telegraph."
Leave the one act which you want us to do in full plain print, and
cross out the other one. Cross out the one you do not want us to
do with your report.
It may be of interest to you to know that our laboratory func-
tions night and day, holidays and Sundays. Its work is going on
night and day, so there is no delay in any part of work at the
laboratory. The special work on the diagnosis is examination of
some intestinal worms and tubercle bacilli in milks, etc. Our
water inspector seeks these specimens, and in that way we are
gathering statistics as to the extent to which milk is infected. We
will accumulate a bulk of that data in time.
A day or two ago I attended a meeting of municipal engineers
in Rochester, and the cry of every person of experience and influ-
ence in that learned body was the necessity of education of peopfe
as to their needs and the proper application of municipal improve-
ments. Yesterday I attended a meeting of the State Board of
The State Laboeatoeies : Magill SS3
Charities and also a meeting of the Lunacy Commission, where
every one spoke of education. This morning the first paper here
and everything else that happened here speaks of the necessity for
education. You health officers are educating your communities.
Last fall the Conmiissioner of Health called to your mind the estab-
lishment of courses for health officers; and in Albany we would
say that we are giving four-day courses in bacteriology, and sani-
tary bacteriol(^y and chemistry of water and milk, and we are
giving every quarter — the next one will be on the 7th of December
and last for four days — a special course in conjunction with the
Division of Engineering on the purification of water and sewage.
I think our bacteriological courses are well known to you, and
they are going on every week. Every health officer is welcome any
week that he can come. It is not necessary for him to announce
his arrival ; he can come any time. If he comes on a Monday, the
four first days of the week will be on the bacteriological course,
and the last four days of the week on milk and water. And every
three months, as I said before, it will be a four days' course in con-
junction with the Engineering Division on the purification of
water and sewage. This is a splendid course. There will be a
laboratory demonstration of the principles involved, the lec-
tures in fl general way handling the topics of water purification
and sewage purification by the Engineering Division, and then
there will be an investigation and practical demonstration of typi-
cal plants, sand filtration plant in Albany, mechanical filtration
plant at Rensselaer; then there will be an examination of sewage
purification of one tyi)o at Eallston Sj)?!, and a further one at
Saratoga.
Xow, if the health officer shall take this course, ho will have
explained to him the fundamental principles underlying the purifi-
cation of water and sewage, so that by that course, and seeing these
different plants in actual operation, he is in a position to act as an
expert adviser for his local community. I hope many of you will
come to that course, as you can there see what you need to learn
for the betterment of vour communities.
You will remember also that last year it was announced that a
special effort would be made to bring about the establishment of
county laboratories, and I think it is the duty of every ImAIi
S84 Co^FERExcE OF Samtaky OmCEBS
officer to make a wide propaganda for the establishment of eusdi a
laboratory in his particular county.
This year we have brought out about six, but there are sixty-one
counties in our State. We must make more rapid progress than
that; otherwise it will take us ten years to get them established.
I will not take up your time to say why we want the county labora-
tory, but I wish to engage each one of you in this effort to get a
county laboratory. I will point out one thing; you are siwsxe that
the law requires that any person that will present a specimen of
sputum to his health officer is entitled to its bacteriological examina-
tion to determine an infection of tuberculosis. Now, remember,
the statistics of the tuberculosis agitators. We should have to make
at least four examinations of each case, and you can see that we
should have something like from eight million to twenty million
examinations of sputum in the coui*se of a year. Siich a thing is
out of the question to expect from a State laboratory, and yet it is
proper and fitting work for a county laboratory.
rf
The Laboratory as ax Aid to Diagnosis: Amyot S8r>
FRIDAY, NOVEMBER i8, lo A. M.
Fifth Session
Presiding: Dr. W. S. Magux.
The Ch airman — In opening this session on " Communicable Diseases/' it
gives me great pleasure to introduce a colleague to you, gentlemen — Dr.
John A. Amyot, Director of the Laboratories of the Provincial Board of
Health, Toronto, Canada.
THE LABOEATORY AS AN AID TO DIAGNOSIS
By John A. Amyot, M.D.
Director of Laboratories, Provincial Board of Health, Toronto, Canada
Me, Chairman, Ladies and Gentlemen — I have come here
to-day, not to defend the laboratory, it needs none; I have come to
recall to you the many things it can do for you in your public
health work. I am not going to tell you about new things, only to
remind you of the many ways in which it can be useful to you —
the laboratory that this great State has provided for this work and
which is available for you all.
It has facilities for routine diagnostic work, for the making and
testing of sera and for research work. By routine work is meant
the work that is done day by day in the procuring of exact data
for the commoner communicable diseases, to control the time of
isolation in these and to search out their origin. This is available
to all the health officers of the State and to practitioners of
medicine.
There is not time to point out all the things the laboratory can
do for you ; suffice it to take up a few of the most prominent.
Diphtheria
This is a germ disease, not very well appreciated. Much yet is
to be learned with reference to it, but sufficient is known to be of
great value to you. The laboratory has supplied this.
Provision is made for the sending of swabs to the State Labora-
tory for two purposes, diagnosis and release from isolation. This
ewab neceegarily ought to be properly taken. It should be taken
S86 C\»:feren<e of Samtauy Officers
irom the lesion, no matter where the lesion is. There is where the
organisms are in greatest numbers and at their best. Don't just
put the swab into the mouth, but find the lesion and rub it on thai.
It is quite possible for you to directly make the examination of a
swab so taken at your own home. It only requires a little practice
for you to become familiar with its character and staining quali-
ties. In properly taken swabs you could make a positive diagnosis
in 90 per cent, of your cases at the first examination. In doubtful
cases, repeated swabs might have to be taken. In this way you
could avoid a certain amount of delay.
Usually, for one reason or another, the health officer finds it bet-
ter to send them to the State Laboratory. There the bacteriologist,
if he were sure the swab had been properly taken, could make a
direct examination, and where it is requested does so, and reports
to you without any further delay. But in routine it happens so
frequently that they are not properly taken, so that the organisms
are apt to be few in number. It becomes necessary for him tlien
to have them multiply so that he can get a sufficient number of
them to be sure of their character. He cultivates them on a suit-
able medium for from fifteen to eighteen hours. They develop
certain very diagnostic characteristics during this growth. How-
ever, there is the objection, delay, but it is best to be sure. He
reports the presence or absence of the bacilli of diphtheria. He
does not say the case is diphtheria or not diphtheria, simply that
the organisms are there or not in this particular swab.
The physician, when he has seen and studied carefully a few
cases of diphtheria, can make a diagnosis of diphtheria in a large
percentage of cases. There are case^ in which be would have very
little doubt. Some clinicians on this account come to the conclusion
that they can diagnose nearly all cases of diphtheria, and that diph-
theria is diagnosable on clinical data. They will say the membrane
points it out, but false membrane is found in other diseases besides
diphtheria. Streptococci, pneumococci and other organisms besides
diphtheria bacilli will give rise to membrane formation. We have
diphtheria often without membrane, in some cases only a slight
exudate, in others only inflammation. Where exact observation is
made it is found that a clinician from bedside data alone will only
diagnose correctly about 70 per cent, of his cases ; in other words,
The Laboratory as ax Aid to Diagnosis: Amyot 887
ho is out on 30 per cent, of his cases. Send those doubtful ones,
if you are to choose, to the laboratory, better eend all if you can.
It has also been found that in those oases where the practitioner
concludes it is not diphtheria that he is again out in as many as
40 per cent. He calls it sore throat or tonsilitis, and so on. Forty
per cent, of these will on laboratory examination show diphtheria,
bacilli. The presence of the diphtheria bacillus does not necessarily
mean that the patient is suffering from diphtheria. He may be
suffering from inflammation in the throat due to any of the other
organisms I have mentioned. The clinician must combine the
laboratory's report with his clinical data to make a correct
diagnosis.
But for you health officers the finding of the diphtheria bacilli
in the smear from the patient is a very important thing. Given the
presence of the organism and clinical signs, you have to deal with
a subject dangerous to the public health. The organisms are at
their best.
In cases where there are no clinical symptoms the organisms may
be much attenuated, usually are, but still are often enough as viru-
lent as in clinical cases. Until it can be shown to you that the par-
ticular organism in question is not virulent, your duty to the public
is evident. Even if they are not now virulent, they may, with
change of environment, become so. At least, this has not been
satisfactorily disproved as yet.
Keeping in mind that accidents may happen to the swab in
transit to the laboratory, if you receive a report of absence of the
diphtheria bacillus and you stiU find clinical signs, make sure;
send other swabs until you are sure. Don't let tonsilitis cases go
about without being sure; 40 per cent, of them are diphtheria.
Individuals having diphtheria bacilli in their throats should be
isolated until they are shown to be free from them. Diphtheria
bacilli often persist for days, weeks or even months after all clinical
signs have disappeared. These are always dangerous cases. They
become carriers and may spread the disease very widely.
In many localities a time isolation is made without reference to
presence or absence of organisms. After four weeks 20 per cent,
of the cases still show organisms in the throat The absence of
clinical symptoms is unsafe as a guide to release from isolation,
SSS CoNKKKFXt K nF S\MT\I:Y OpFirKKS
more so than the time limit, especially in these antitoxin days when
the symptoms disappear so early. The average time of disappear-
ance is twenty-five days, but even then 20 per cent, or more of
cases still show organisms. This the lalK)ratory has pointed out
and it is still the one to finally settle when the organisms have dis-
appeared in any given case. You have a fine tool in the laboratory,
you health officers. One negative swab is not sufficient though to
liberate on. As high as 20 per cent^ escape detection, as swabs are
generally taken, on the one examination. This would give us a
false security.
When two consecutive negative results with at least twenty-four
hours intervening are obtained the percentage of escapes drops
dowTi to 1 or at most 2 per cent In many infectious hospitals it
is customary to seek five coiiseeutive negative results before allow-
ing the patient to go. In many cities the infectious hospital is
under the supervision of the health officer. Don't let the con-
valescent go until you are sure the organisms have vanished. It is
not a pleasant thing for a health officer to release a patient from a
hospital and then find three or four other cases crop up in houses
to which the patient went. The swab method is your weapon and
the surest method you have. It is a method of precision. You
cannot depend upon clinical symptoms for the release of a patient
who has had diphtheria.
The laboratory can help you out in another condition. Diph-
theria seems sometimes to be endemic in schools, children's homes
and other institutions. Outbreaks frequently repeat themselves
and are very difficult to control. You isolate your clinical cases.
Others keep breaking out You have carriers to deal with. Take
swabs. You can pick them out. Keep them apart until they be-
come free. In one hospital I investigated for this trouble the data
pointed to the nurses as the possible source of repeated outbreaks.
We took swabs. Found two showing typical diphtheria bacilli.
One of the two only had had sore throat, the other was a carrier.
We had them removed. There have been no fresh cases since. In
another institution nearly one-half of the inmates showed definite
or suspicious organisms. Diphtheria had been breaking out there
on all kinds of occasions. We separated the infected from the non-
infected. It took months, and now every newcomer is held imtil
TiiK Lai;oi:at()UY as an Aid to Diagnosis: Amyot SS9
two consecutive negative cultures show absence of diphtheria
bacilli before he is put with the rest. These nonclinical cases,
through drinking cups, spoons and direct contact, keep such organ-
isms passing from one to the other. It isn't to the plumbing, etc.,
that you must direct your attention, but to infection carriers. Irri-
table looking fissures at the nares or comers of the mouth should
make us suspicious. Swabs will show if organisms are present.
Tuberculosis
The examination of the discharge from suspected lesions of the
disease will show us if it is tuberculosis or not, always, of course,
keeping in mind does this belong to the patient. If the patient has
a discharging lesion he is dangerous to the public. Give the labora-
tory a fair chance, though. Send material from the lesion, wher-
ever it is, not just nose secretion or stomach contents, but expectora-
tion; if it is a pulmonary case, material from the lesion. There
will be a percentage missed even then. Take repeated samples and
again, always from the lesion.
When you know your patient is discharging tubercle bacilli you
know he is a source of infection, and that he will l>e until all dis-
charge ceases, and often that will take a long time, but you know
what you have to deal with.
Those coming in contact with this patient, dressing the wounds
or looking after him, run the greatest risk. Any one using a cup
after such a patient runs extivme risk. Thoso who come in and
breathe up the dust of the room do not run the same degree of risk
as those who are next to the patient. They do not take up organ-
isms as do those who take articles from the hands of the patient,
wash his linen, etc. The laboratory point? ont these sources of
infection to you and indicates exactly where your work is to be
done.
There are diseases which simulate tuberculosis so exactly that
clinically they cannot be distinguished. Lot nie cite a case which
will bring this homo. A patient with all the clinical signs of tuber-
culosis was sent to a sanatorium, though no bacilli were found in
his expectoration, and this happ^^ns in real cases. He had expe<v
toration and at the sanatorium it was frequently examined, but the
bacilli of tuberculosis were never found, but certain organisms
vSOO ('oNKKRKXCK <>F SaMTAUY OkFIC'KKS
which resembled the diphtheria bacilli, and these persisted. The
patient was given diphtheria antitoxin with only slight improve-
ment. Diphtheria bacilli have two kinds of toxin, the intra-ceUu-
lar and the extra-cellular. The antitoxin neutralizes the extra-
cellular as it finds it in the fluids of the body. The other acts
locally, and in this particular case was the one chiefly in action,
setting up local pulmonary inflammatory reaction ; so the case was
attacked from this side. A vaccine was made from the organisms
isolated from his expectoration and given to him. He recovered
completely after two short periods of treatment
Only the laboratory could have showTi that this case was different
from others.
There is still field for investigation along this line. During the
last two years at the Toronto General Hospital Prof. MacKenzie
has shown on autopsy that some six cases that had clinically been
thought to be acute diffuse pulmonary tuberculosis were actually
cases of blastomycosis, when only the closest observations by labora-
tory methods could have demonstrated the true cause, a pmthogenic
yeast. The results obtained in the few years that laboratory
methods have l>een used compare well with the results obtained in
the previous two thousand years of clinical methods.
Typhoid Fevkb
The regular routine in these cases is to make the Widal test with
the blood of the suspect. The laboratory reports the presence or
absence of this reaction, not that the ea^e is typhoid or not typhoid.
Typhoid cases do not show the reaction throughout the course of
the disease. It is found on some days only or late in the case or
not at all. When a positive reaction is found it is typhoid in 95
per cent, of the oases. When negative it tells you nothing, unless
repeatedly so. Don't say it is not typhoid because you get a nega-
tive Widal report.
The examination of the blood for the organism would be the
more exact method of finding whether your patient is suffering
f ix>m t\*phoid fever. It is usually diiRcult to get a sufficient quan-
tity of the blood to the laboratory in good condition (without con-
tamination). Then, again, in typhoid it is only in the early stages
The Lajiouatouy as an xVid to Diacjxosis: Amyot 891
of the disease that you can get any good percentage of presence of
bacilli. During the first ten days you may get them in from 90
to Do per cent, of the cases. Later on you miss them. They have
become localized. For use away from hospitals' this method is
hardly satisfactory for general application. The future may de-
velop means of carrying blood culture methods into general iLse as
the Widal is now done.
Where the laboratory can do something else for you in the direc-
tion of diagnosis in typhoid is in the examination of the excreta for
the bacillus. This is especially useful for the health officer. For
the clinician it is not so useful, for cases not suffering from typhoid
at all may carry the organisms in their intestines or other organs.
These carriers are a nuisance to the public. The laboratory only
can determine the carrier. You can, by collecting evidence, get
suspicious of an individual, but only the laboratory can tell you if
he is actually harboring the bacilli of typhoid fever.
Ophthalmia Neonatorum
The examination of the discharge will give you positive evidence.
For the patient's sake it is the clinician who should do the examin-
ing at the bedside, and thus save time. These eyes may perforate
in twenty-four hours. The information is useful to the health
officer in that he can protect those about.
Specific Cerebrospinal Meningitis
Meningitis may be duo to various organisms. The specific type
is due to the diplococcus. Don't send specimens of blood for the
search. The organism is located in the meningeal spaces. This is
the fluid to send for examination. Have it taken aseptically. It
is the old story again, from the point of lesion. The laboratory
cannot always tell you, but it can in the majority of cases, whether
it is present or not.
It is possible under conditions to make examinations of secre-
tions from the upper nasal cavities and get results which will give
you a hint but not positive knowledge. The positive evidence is to
be gotten from the ccrooro^pinal fluid.
80:3 (^)nkkkkn(:k ok Samtaky Officers
Kabies
Nearly every one bitten gets a gun and shoots the dog — don't —
tie or lock him up. When a rabid dog bites it is because he is
delirious and is due to die within a very few days. His symptoms
will become definite. Then you have positive evidence, and within
three or four days at most, usually earlier. If the dog is still well
after ten days and is taking his food well, then there is not one
chance in thousands that he is rabid. I know it is not always pos-
sible to tie up a rabid dog, but in most cases it is quite possible.
Always do it when you can. Your patient is not going to lose
materially by the delay.
Of course, if you get word that the dog is shot, then do the next
best thing, send the head to the laboratory. If it is simply a case
of where animals have been bitten, get track of all these animals
for future reference. The laboratory will make inoculations into
animals from the brain substance of the head you sent in. It is the
most certain method, but it takes a long time, usually sixteen or
seventeen days. It may be three hundred, as happened out in
Minnesota.
Where human beings have been bitten this delay is too long.
More rapid methods, though less certain, must be resorted to, and
the search for the Negri body is the one now generally resorted to.
We do not know whether these are the causes of the disease or only
the result, but we know tliat they are present in the nerve cells of
the brain of the infected animals and only present in this disease.
These bodies are present in the nerve cells and it is these that
have to be examined. If the brain has undergone any advanced
putrefaction the examination would be useless, the cells are disin-
tegrated. A diagnosis of any value can only be made if the bodies
are found in the cells. So pack the head in such a way and as early
as possible so tbat it will not undergo putrefaction in transit, so
that it will not run out on the car floor and have the dogs that pass
by later lick the fluid up. You must protect the public. If the
bodies are reported present treat the case as one that might develop
rabies. Your laboratory will supply you the vaccine to treat him
with and give you all the necessary instruction or treat him for you.
Tjik Laiiuuatoky as ax A[|» Ti) J)ia<;n()sis: Amyot ^U')
Malakia
Much of our old malaria was typhoid. But when you suspect
malaria the laboratory can help you out. Do not send blood in a
bottle. The examination cannot be made satisfactorily from this.
]Mdke a smear preparation of the blood as you would if yon were
going to have a differential white blood cell coimt made. Don't
apply any chemicals. Let it merely dry in the air. It is necessary
that the red corpuscles be in good condition, for it is in them that
the organisms are located.
Glanders
Send material from the lesion on sterile swabs, which your
laboratory will supply to you on application. Don't send the blood.
The Mallein test is the best one to use.
Anthrax
Send the blood or a piece of the spleen or, again, a piece of the
lesion, but don't put any chemicals on them. Cultures have to be
made from them.
So far the laboratory can do nothing positive for you in measles,
scarlet fever, chicken-pox or infantile paralysis. You will have
to depend on clinical data and history.
Water Analyses
These are made for sanitary purposes. They are biological and
chemical. I want to discuss only a few points in this connection.
The colon bacillv^, — The presence of this organism in a drink-
water does not say it is the cause of typhoid fever, simply that
material of intestinal origin has got into the water. The laboratory
cannot tell you whether it is from man or animal. The history
and the local circumstances only can tell you thi^. If it is from *
man, then see if there are any possible typhoid cases about or car-
riers of this organism. It is next to impossible to find the typhoid
organism in drinking water. So far the colon bacillus is the best
indicator of fecal contamination of water we have. ^Nearly every
well has thean present. Nearly every well is contaminated, and
it is not surprising. How often have you seen a properly covered
well, one that would not let contaminated water get into it.
mm; ( *<).\ Fi:i:KNt k <H' S\M'r\K'v ()1'Ki<ki:.s
receiving the l)ein»rit that is deriviMl from the laboratory in their immediate
vicinity. You have heard the speaker state and tell you how nece&sary it in
for you to get your specimen early to the laboratory to get early returns
or benefit. The health officer should take the initiative. You must lead.
Unless you do so you cannot expect anyone else to take your place in this
particular field.
Now, to get right home, we have a laboratory in our county which has been
in existence for four years. Here I liave the fourth annual report of the
board of supervisors of our county. What have they done for the citizens
of our own county? We have put tliom in the position where they can help
themselves i6 get rid of contagious and infectious diseases, and we know that
results have been accomplished far in excess of any expense paid out by the
citizens of the county. The citizens are the beneficiaries, and there is no
asset so great to any community as good health.
All in the world you have to do is to prove to your board of supervisors
that it will be an asset to your county, and you will have no trouble getting
the laboratory. Of course it may he said that a great deal of this work
we do is done by the State gratis. That is perfectly true, but follow that up
and you will find that you have done four- fifths more work if you have a
laboratory at hand than by sending it to Albany or elsewhere.
WTiat do we do at our laboratory? We examine for the bacilli of diph-
theria, and the importance of that you have heard from the previous speaker.
The next thing is for tuberculosis. If you have many specimens to be ex-
amined, they cannot be examined satisfactorily if you have to send them
away. Y^ou know it is difficult to pay the postage. If you have the labora-
tory at hand you will have the work done and you will have the disease
staved.
We have the Widal test for typhoid. We examine also for diplococcus and
streptococcus, etc.
In oplithalmia neonatorum, how long does it take you to collect a specimen
from the patient and to get returns? If you have your laboratory at hand
you can get your results in a very few hours.
We examine also urine. This is an excretion examined by most physicians.
I believe if you have a laboratory such as we have you would nave many
specimens of urine examined, and you would find in that way many cases
of doubtful diagnosis and constitutional troubles would be shown with their
data that you want determined but cannot obtain otherwise.
We also examine human milk. Tlie human milk is for the ascertainment of
the fats. etc. We make bacteriological examination of the water, of our
water supplies and the wells supposed to be infected. We also make ex-
amination of feces, and you know tlie importance of examining feces in many
diseases. Then the blood counts; and we also have tests for malaria.
In this tabulated report for our county, which is a small county of 52,000
inhabitants, we have a laboratory that does the work of our own countv and
also the work of another county, the county of Yates, which immediately
adjoins us. Under a contract with the other lx)ard of supervisors we make
the examinations for tliem. We have found that our bacteriologists can do
it, and it is a source of a revenue to us and a saving of expense to them.
Our total number of examinations last year was 921. That is more by
104 than we had made in any preceding year.
Everything that pertains to the public health is examined free for our
own county — sputum, diphtheria, water suspected of contamination, all of
those are free to our people, and it leaves the physician and health officer
to advise where there is any suspicion of this trouble, and to send in speci-
mens; and we get them in that way.
In the case of Yates county, we chargre them a nominal fee for all work
done in that county. We employ a bacteriologist at a salary of $1,500 a year.
Gentlemen, if you will got your health officers in your county together,
with the physicians, get them interested too. you will have no trouble in get-
ting your appropriation if you get them all to work as a unit.
Our laboratory is a little building 12 by 20, and it cost $1,000 and the
equipment cost aibout $500. We are self-sustaining. We, of course, pay the
The Labokatoey as ah Aid to Diagnosib: Amyot 897
bActeriologiBfe Baluy frmu the tatmtj. The supeTvisors of every connty
can pay a ulaiy for k bacteriologist. When we started we eame up against
thia: That one of the board of EUpernaon iupeeting our plant laid there ma
no way of paying for the bacteriokigiat, eo we created a new official, called
a bacteriokigiat, and be is paid as any other offleial of the oounty.
The Chaibuan — For further diBCueeion, we hare Dr. W. W. Waite, of
Syracuse, bacteriologiat of the city there. Is Dr. Waite preeenbT (No re-
apouBe. )
Would Dr. Hennington, bacteriologiet of the oounty of Monroe, contribute
something to the dlseuesioaT
Dk. Hbnntnstoh, Rochester — In reply to your Invitation to apeak, Hr.
Chairman, I reepcnd as a representative of one of these smaller local labora-
tories that have been described by Dr. Hallenbedc, namely, the Honroe
County Bacteriological Laboratory. There are now five or six ench labora-
tories maintained by the counties of our State.
The paper before us by Dr. Amyot has been Tery instructive and valuable,
and I can add only one feature, and that is, to narrate a recent ezperimce
with a diphtheria bacillus carrier. Our laboratory has been examining the
new admissimis to a targe boys' institntimi, which last winter had a diph-
theria epidemic. We wished to help to prerent a recurrence of that. Among
them I found a deflnile carrier, toree weeks fteo, in the case of a boy In
apparently good health. Comments surely are not necessary after that.
The Chaiemah — In closing the discuasion on the first paper, I wish to
exprees my personal appreciation and that of the Department and of the
audience to Dr. Amyot for the very clear and plain and explanatory paper
on the use of the' laboratory. I wi^ you would keep in mind his statements
regarding the examination of well water and jniOc. It is hard to have our
health officers understand our limitations, but if you will remember this
very careful czpreaaion of the limitations you will have no trouble.
I will ask Dr. Amyot if he has anything further to say in closing the
discusalon.
Db. I want to ask: for information, speaking of the conseeatlve
nwab cultures, when the first is negative, how soon should these oomecutive
swab cultures be taken and sentT
TsB Chaikiian~I will undertake to answer tJiat, as it is a matter of pro-
cedure of this State; I ahall call attention to the fact that the action of
the Commissioner of Health with the unanimous recommendation of the
medical ofGcers of this State has brought about the adoption of a rule, that
no case shall be liberated from diphtheria quarantine without two bacterio-
logical examinations that shall be found negative. That is to say, when
the case is to your clinical mind recovered you would take a swab culture
and send it to the laboratory and get two negative cultures before the
quarantine is raised. You can get your answer on the second day, and after
getting the second one, which may Ik taken on the second day, the quaran-
tine can be raised if you have two negative ones, and the regulations have
been complied with. Until you get two negative cultures on successive days,
signed l^ the laboratory, you should not raise the quarantine.
898 Conference of Sanitaby Officers
The Chaibhan — So far as the infectiouB diseases are concerned, labora-
tory examination makes no distinction; everyone has the right. It is only
when you have tumors and the examination of nephritis secretions, some-
thing which cannot be called for the general good, it is an individual ease.
The public health is dealing with infectious materials; that seems to be a
good line of separation.
Db. Is cancer eliminated from the infectious diseases?
Db. Ahyot — For the time being, yes.
The Chairman — I think you can meet this question if you will remember
that the State laboratory is to do the work gratuitously, if it protects the
public from disease. If it is a question of solving a problem of interest to
the patient alone, it is a private matter.
I desire again to call attention to the course afforded by the State Depart-
ment at Albany in bacteriology, these matters touched upon by Dr. Amyot —
which course is given every week in Albany, from Monday until Thurs-
day — a four days* course. Every health officer is welcome there for the
entire course of any week or any portion thereof. If you will let me know
of your arrival beforehand, we can give you probably better attention.
The last four days of the week are devoted to a course in sanitary water
examination, or the chemical and bacteriological examination of water and
milk. That begins on Wednesday and runs the last four days of the week.
In addition there is arranged, every once a quarter, the first course to be-
gin December 7, a course of four days in water and sewage purification.
This is by the co-operation of the engineering and the laboratory divisions of
t)ie Department of Health. It begins with a talk on the fundamental prin-
ciples involved. There are lectures by the sanitary engineers, and demonstra-
tions and visits to typical plants. In this case there is a visit to a slow-sand
filtration type at Albany; to a mechanical filtration type across the river at
Rensselaer, and to a type of sewage purification at Ballston Spa, and another
at Saratoga. So we give you a complete demonstration of the plants used
for these different purposes. We think we can ^ve you that in four days,
so that every health oflftcer taking the course will understand the needs of
his community, and can be called in as an expert adviser. Every health
officer is invited to take that course, and what you learn there will help yon
solve the problems related to those subjects in your communities.
Proceeding to the next paper, I have the pleasure of introducing to you
Dr. E. C. Levy, the health officer of Richmond, Va.
Education vs. Compulsion: Levy 899
EDUCATIO]^ vs. COMPULSION IN SECUEING
EEPOKTS OF CONTAGIUS DISEASES
By E. C. Levy, M.D.
Chief Health Officer, Richmond, Va.
In the development of local health departments there have been
thrnst upon them many matters which are by no means distinctly
health problems, but which by common consent have to be attended
to by health departments everywhere. There is perhaps no health
oflScer in the country who would not, if the matter were entirely in
his own hands, get rid of many of these matters and employ the
funds thus saved for inaugurating or enlarging work which would
undoubtedly do far more for the cause of public health.
Unquestionably the most legitimate field of public health work
is in connection with the control of contagion? diseases. In order
to secure such control a fundamental necessity is the securing,
from the physicians of the community, complete reports of every
case of contagious disease. Important as this is it may still safely
be said that very few of our local boards of health in the United
States are at the present time securing anything like complete re-
ports. This is sufficiently evidenced by the ratio between reported
cases and deaths. When, for example, we see the annual report
of a health officer in which the number of cases of typhoid fever is
only two or three times, or even five or six times, as great as the
number of deaths, we may feel confident that only from one-fifth
to one-half of all cases of this disease have been reported.
Perhaps no city in the country was worse off in this respect than
Bichmond five years ago. Upon entering office four and a half
years ago, the writer began at once to investigate the cause of this
delinquency and seek the remedy. Ordinances of the city of Rich-
mond fully covering the case, and imposing a fine of $10 a day
for each day's failure to report were on the statute books, but so
far as could be learned no physician had ever been fined.
Although having ample legal recourse in dealing with physicians
who failed to report their cases the writer did not believe that this
furnished the real solution of the problem. It seemed to him that
900 Conference of Sanitary Officers
great as was the import of this matter yet the cordial support and
co-operation of the two hundred doctors of Bichmond were even
more important, and a plan was sought whereby results could be
secured by other than court proceedings.
In order to accomplish this it was first necessary to ascertain
where the difficulty lay. It seemed to the writer that two causes
were chiefly operative: (first) the fact that the practising phy-
sicians were not fully acquainted with their duty in this connection,
and especially that they did not know just what contagious diseases
they were required to report: and (second) that a physician witii
a case of reportable dise&se either found that he did not have the
necessary blank for reporting, or else that he had placed his supply
of blanks where he could not lay his hand on them.
Acting along these lines, the first move was to send a circular
letter to each physician, acquainting him with the ordinances and
asking his cooperation. This was followed up as soon as possible
by sending to every physician the outfit box here exhibited. This
box is rather ornamental in appearance and no physician objects
to giving it a prominent place on his desk. In this box, as sent to
the physicians, there is a full supply of all forms needed by him in
complying with our ordinances, including a requisition card by
which he may secure an additional supply of any forms before he
has used the last one. On the inside cover of this box are printed
extracts from the various ordinances in this connection^
It is not easy for any physician to lose this outfit, which fur-
nishes him immediately a full list of reportable diseases, and the
necessary forms on which to report them. The cost of these outfit
boxes (which was 12-% cents each) is saved over and over again
by the fact that all postal cards, stamped envelopes, etc., which
they contain are safeguarded against loss, while formerly it was
nothing unusual for a physician to get fifteen or twenly postal
card blanks of various kinds, use one or two of them and not be
able to remember where he put the rest, thus necessitating a new
supply.
The box itself covered two of the hypothetical causes of delin-
quency and made it easy for each physician to report his cases
if he wanted to. The next thing seemed to be getting all physi-
cians in the proper spirit for reporting their cases of contagious
Eddoatior vs. Compulsion: Levy 901
diseasee, and this proved aa eaey as the oihet two matters. Prac-
tically the entire problem in this coimection was solved bj bB.viiig
the physiciaiia understand the importance of their reports. Ob>
viouely they could not feel that their reports were important unless
something happened in every case when a report was received.
The writer believes it to be utterly unfair to busy practitioners to
ask that they take time — however litU© — to send in reports when
they have every reason to believe that notihing is done with them
after they are received.
Katurally no health department would regard this as the only,
or even the chief, reason why active work in connection with con-
tagious diseases should be done. Yet letting the physicians know
what is being done makes them not only willing but anxious to
eo-operate.
If the health officer regards (.he securing of complete returns of
contagious diseases as really a matter of very great importance, he
will naturally hold this view only if he uses these reports as the
basis of active work.
What then should a health officer do with these reports i One
of the first things, of course, is to send a list of contagious diseases
each day to the superintendent of pablic schools, for uses too
obvious to meotion. Next, every case of contagious disease (ex-
cept perhaps chicken pox, mumps, whooping cough, and measles in
o£E years) should be immediately visited by a medical inspector who
gets full data of eveiy kind in connection with each case. These
data are used in the office for many purposes. Frota therp. the
origin of many cases can be at once made apparent, and measures
taken to prevent further spread of the disease.
Chronolc^ical charts of each disease are kept in order that a
comparison may be made with previous years, and also because
chronology is frequently one of the main points to be ccmsidered in
determining the cause of any outbreak. Spot maps are kept thor-
ough]
diseai
Th
sponc
maps
thec<
902 CONFEBBNCB OF SANITARY OFFICERS
a map on which the location of the cases are shown for the current
7ear. For the latter map rubber stamps are used instead of tacks.
On such a map hollow circles represent recovery of current cases
and solid circles represent fatal cases.
One of the most useful devices employed in our Richmond office
is a blackboard showing at all times the number of cases on hand at
the beginning of each day of the current month, the nuanber of cases
reported on that day, and the number of recoveries reported. From
these the number of cases on hand at the beginning of the next day
is calculated and posted. This board has not only space for the
current month, day by day, but also has apace for a monthly sum-
mary of oases on hand, reported, and recovered, for each of the
preceding twelve months. On the lower part of this blackboard are
tacked clippings from the annual reports of preceding years. The
health officer thus has always before him a summary of cases on
hand, and reported, and can at once make a comparison wit9i the
corresponding period of other years. This gives him the means of
replying to inquiries from outside, but most of all it enables him
to compare results with results of previous years.
Besides what has been mentioned above all diseases are plotted
on cross section paper to show the curves by months and by years.
A large percentage of the physicians of Bichmond are in the
health office one or more times each year, and it is always made a
point to show them something of this work. Every physician who
has once seen this is duly impressed with the importance which
his own reports have in the general scheme, and he leaves with a
strong desire to help the cause.
A large percentage of our physicians, moreover, are now learning
that they may themselves use our tabulated information as a great
aid in diagnosis. In doubtful cases the physicians may save con-
siderable time by knowing whether or not a given disease is espec-
ially prevalent in the city at that time, or especially prevalent in
the neighborhood of his case, or in the school attended by his
patient. This again makes each physician desirous of contributing
his part to a scheme which he himself finds most valuable.
The results in Richmond of working along the above lines have
been all that could be desired. It is exceedingly exceptional for
us to learn of any case of reportable disease in our city, -having
Education vs. Compulsion: Levy 903
a physician in attendance, which is not already on our records.
This is well shown by the fact that last year we had 377 cases of
typhoid fever the outcome of which was known at the end of the
year. This included cases on hand at the beginning of the year
and terminated eases reported during the year. During the year
we had 28 deaths from typhoid fever, giving a case fatality of 7.4
per cent, for the year, or 13^/4 cases to each death. These figures
must be convincing as to the comipleteness with which typhoid
fever cases are reported to the Richmond Health Department
These figures are in strong contrast with those of the year before
the reorganization of the Richmond Health Department. In that
year (1905) there were 40 deaths from typhoid fever out of only
164 reported cases, giving a case fatality of 24.4 per cent., or one
death in every 4 1-10 reported cases.
The writer believes that work of this kind which has proved
80 successful in Richmond furnishes the real key to securing com-
plete returns of contagious diseases, and at the same time retaining
the friendship and support of the medical profession. Without
these latter not only must any health department fail to do its best
work but the life of the health officer will also be made miserable.
Of course aggravated or repeated failures on the part of physicians
to comply with the laws must be reported to court, but in Richmond
there have been but three such cases in the past four years.
Every attempt to secure results through the courts invariably
leaves hard feelings, and on the whole the results are inferior to
those secured by co-operation and education, while this latter course
also maintains friendly relations with the entire medical profes-
sion, whose solid support is so frequently required by every health
officer when dealing with complicated questions which he has to
handle.
Bb. Hills Cole — Those newly in the field can teach many of us who are old
in the field. I know it was an inspiration to me when I attended a meeting
in Richmond to hear Dr. Levy frive a talk on this same line, and it was for
that reason I was instrumental in having him scheduled on our program.
He has given us a very valuable thing here in this box, and inasmuch as
quantity always regulates price, I should be pleased to arrange for getting
quotations on a large quantity of these boxes if there is any chance of the
health officers using the same. I do not mean that the State Department of
Health would like to commit itself to the point of furnishing these free of
eharge to the local health officers; but if you decide you can use these profit-
ably in your communities, it is possible that by arranging to have these boxes
made in quantity, it is possble that you can get them at much reduced rates.
Is Dr. Willard present. Dr. Willard, of Watertown? (No response).
904 Conference of Sanitary Offiobbs
Ia there anybody present who cares to ask Dr. Levy any questiooa, or to
take part in a general discussion?
Db. Watebs — Wouldn't it be a good idea to allow the health officers of
the State to report to the Health Commissioner at Albany, say by the firafe
of December, the number of boxes w^ich they could use if the Health Depart-
ment would take that number into consideration, and see what figuree they
could get on them?
Db. Buixabo — I think t^^e box idea is a good things I waa speaking
last evening as to what was needed to assist the health officer in his work.
Proper facilities for doing the buaineas is right, next an index system and
a modern business system cannot get along without these. Now, that box
idea is splendid, and I think many of the local boards would be glad to
furnish the health officer with sofficieBt funds for the local phyaiciaju to
get them.
I think it would be a good thing for the Btate Board, or some one, to
furnish them, they to be purchased by the local health officers, to fumiah aa
many as will be exclusively for the use of the health officer himself, and
containing all of the various blanks to be uaed by local boards of health.
Local boards of health have their work and their reporting inefficient because
of lack of proper stationery and> the forms upon which to make them out,
and properly transact their business.
One other idea that occurs to me in this direction of reporting com-
municable diseases is: the people of the State of New York are all getting
sharp; they are. getting quite well informed in many wa^s in regard to
many of the health laws. They know, for instance, that births and deaths
have to be reported, and they are also getting so that they understand that
the Health Department approves of or requires treatment of the eyes of
newly born infants. If a doctor does not do that now, they ask him why
he don't; and it is not so difficult, and I think there is a very small per-
centage of births and deaths not reported now in the State. But there is
no law that requires another person, excepting the physician, to report
oommunicable diseases, with the exception of tuberculosis. Therefore a great
many people who have measles, whooping oough and even tonsilitis, are
sometimes seen with these troubles, who do not even employ a physician for
fear of quarantine which is possible if the case is reported. As much as
we feel sometimes that we have all the laws we need now, still I feel we have
got to have such legislati(Hi as will make it obligatory on householders to
report cases of communicable disease.
Db. The last speaker made one good suggestion in relation to
records. It may be I am blessed with a liberal board, for they have
never refused any reasonable request of mine. iSeveral years ago I told them
I should have some place for filing the records of the Department, and they
authorized me to purchase a filing cabinet at an expense of thirty-five dollars
which has a glass front, and it holds all my correspondence with the State
D' partment of Health, and all the necessary blanks and books relating to
sanitary matters and the monthly bulletin as well. I think instead of ask'
ing the State Department for these things, I think if the health officers would
have a little more backbone and ask their own boards of supervisors they
could get the necessary equipment.
The Chaibman — Dr. Levy will close the discussion.
Db. Lett — I have already taken sufficient time, Mr. Chairman and gentle-
The Chaibman — We will now hear from our very efficient Deputy Com-
missioner of Health of the State of New York, Dr. William A. Howe.
QvARAHfTIKE, ISOLATION AND DlSIlSTBOTION : HoWB 906
QUARAITTINE, ISOLATION AND DISINFECTION
By Wiixiam A. Howe, M.D.
Deputy State Commisftioner of Health
Before presenting the brief paper which I have prepared for
your consideration this morning, I hope you wiU pardon my di-
gression long enough to permit me to express to you the profound
pleasure and gratification which I find in being more dosely asso-
ciated with such a powerful body of men and women as the health
ofiicers of this great State, men and women who are so freely and
unselfishly devoting their time, their energy and their skill to one
of the grandest works of mankind - — the suppression of disease.
To a line of work in which the greatest accomplishments are pos-
sible, made so only by personal sacrifices and untiring devotion to
this noble cause of humanity. At the same time I want to assure
you that my one ambition will be to f oUow steadfastly in the path
of our distinguished Commissioner of Health, whose sympathies
have always been so closely in harmony with the health officer, and
who has always been so solicitous of his welfare. I want you to
know that such influences as it may be my privilege to exert, either
officially or personally, will be in but one direction, and with but
one purpose, namely to lend a helping hand to every effort having
for its purpose the protection of the health of the people of our
Empire State. In doing so I only voice the earnest desire of our
Commissioner, in urging the active co-operation of every health
officer, every physician, every dentist and every health worker of
the State, in one common crusade against the prevalence of com-
municable diseases. To deal with this important question, the
suppression of communicable diseases, in a manner commensurate
with its gravity, and to hold a restraining hand over contagion and
infection, is indeed the most far-reaching problem of present day
sanitation. In it we find the greatest possibilities of future accom-
plishments in saving human life, the most blessed privilege of man
to man. While it is not to be expected that we will inmiediately
realize the idealism of total suppression of these diseases, it does
seem as if a very material reduction in their frequency and fatality
906 Conference of Sanitary Officers
could and should be accomplished. To do this, however, certmin
things are absolutely necessary. In the first place, we cannot
rightfully hope to suppress communicable diseases until we can
succeed in getting them universally reported to the health au-
thorities. This pertains to every contagious and infectious diseaaep
the report of which is required by the State Department of Health.
The diseases to be reported hiave, under the law, been designated
by the State Commissioner of Health, as follows :
Anterior poliomyelitis, anthrax, bubonic plague, cancer, cerebio-
spinal meningitis, cholera, diphtheria, hydrophobia, leprosy,
measles, ophthalmia neonatorum, pellegra, pneumonia, scarlet
fever, smallpox, tetanus, tuberculosis, typhoid fever, typhus fever,
whooping cough and yellow fever.
It should be the moral duty of every person interested in the
suppression of these diseases, whether he be physician or layman,
health officer, attending physician, or parent, to exert his or her
influence to secure the prompt report to the health authorities
of every such case coming under his or her observation. When
this is done, and when proper reciprocal relationship of mutual
helpfulness prevails between the attending physician, the parents
and the health officer, then may we hope to get these cases uni-
versally reported, and having done so, surround them with the
necessary quarantine, isolation, and disinfection so absolutely in-
dispensable for their control or suppression. It is plainly incum-
bent upon us as health officers and health officials to employ every
possible means at our command to accomplish this purpose, a
realization of which is the first great step mandatory for the sup-
pression of those diseases which are to-day the greatest menace
to public health. And just in proportion as we may be able to
increase or perfect the efficiency of notification of communicable
diseases, so may we hope to advantageously employ the further
remedial agencies of quarantine, isolation and disinfection so in-
dispensable for their control.
To you, my hearers, more than any other people, it must be
axiomatic that the successful management of any transmissible
disease is dependent, first on its prompt report, second its proper
quarantine, third its efficient isolation and lastly, its thorough
disinfection.
Quarantine, Isolation and Disinfection: Howe 907
You will agree with me, I am sure, that were we able to secure
the prompt report of every infectious and contagious disease oc-
curring in our midst, and could establish and maintain thereon
a suitable quarantine under strict isolation and thorough disinfec-
tion, we would soon be able to control the spread of these pre-
ventable diseases, and save thousands, yes, millions, of precious
lives.
In the matter of quarantine the Commissioner has under con-
sideration the advisability of adopting rather a radical modifica-
tion of the present plan in vogue throughout the State. It is
my purpose to briefly outline this plan to you, after which I trust
you will avail yourselves of the opportunity to freely discuss it
both pro and con. Instead of having one general class of quar-
antinable diseases as at present, in which the term quarantine
means practically the same in every instance, it has been sug-
gested that we might, with advantage, have one class of diseases
for an absolute quarantine, another class for a modified quaran-
tine and a third class for an observation quarantine. Then we
should have an official quarantine card and an uniform system,
which could and would be used in every municipality throughout
the Stat^. So far as that is concerned, a similar card and an
uniform system might well be used in many States. Personally
I can see no reason why diphtheria or any other communicable
disease should not be quarantined in the same manner in Massa-
chusetts as in Pennsylvania or in Ohio as in New York, and I
can plainly see several good reasons why such an interstate sys-
tem would be decidedly advantageous in the work of general sani-
tation throughout the country. The adoption and general employ-
ment of such a set of quarantine cards and an uniform system
would, in my opinion, not only tend to materially enhance the
efficiency of our present methods, but materially strengthen the
hand of the local health officer, and relieve him of many of his
present troubles, with which you are all so familiar.
In the first class of absolute quarantine should be placed small-
pox, scarlet fever, diphtheria, bubonic plague, cholera, typhus anJ
yellow fever, a type of diseases in which the greatest care and the
most stringent prophylactic measures are absolutely imperative,
With this extreme degree of quarantine, no person, unless pwE^
908 Conference of Sanitart Officers
mitted by the health authorities, should be allowed to go in or
out of the building in which the disease prevails. This ruling
should of course not exclude the attending physician, the health
ofl^r, the civic officer or the attendant on the sick, whose freedom
of movements, however, should be under strict compliance with
every precautionary measure. In addition to this prohibition of
entrance and exit, an official quarantine card should be posted in
a conspicuoTis place on the building, giving name of the disease
within, the degree of quarantine, and the penalty imposed for
failure to observe the same. This card, as suggested above, should
have the official signature of the State Commissioner of Health
and when placed in position, should be dated and signed by the
local health officer. Further than this, the municipality enforcing
such a quarantine should consider itself responsible for the main-
tenance of the family so detained, furnishing such necessary food
or other supplies, even nurses, when circumstances require it. No
article coming in contact with the sick or in any manner exposed
to possible infection should be permitted to be taken from the
building, until the same has been treated in such manner as may
be prescribed by the local health officer to insure absolute safety
to those without. This quarantine, as you will observe, is exactly
what its name implies, an absolute one, and if religiously em-
ployed in the above-mentioned diseases, would, as you can well
appreciate, accomplish much toward their extermination.
The second or modified quarantine, like that of the preceding,
requires the enforcement of the same precautionary measures, but
grants more privileges to members of the family of entrance and
exit to and from the building. These privileges, however, must
be subject to certain well-defined limitations, as prescribed by the
health authorities, any violation of which should be ample justifi-
cation for the substitution of the absolute quarantine. Here, as
before, the official card must be posted, the patient and attendant
carefully isolated and all articles leaving the sick room undergo
satisfactory disinfection. In case the wage-earner or other mem-
ber of such a household remain entirely away from the sick room,
the attendant or other sources of possible infection, he may be per-
mitted to go to and from his work, but in doing so the utmost care
must be exercised, especially with those people whose vocation
brings them in close contact with others who might be highly sus-
Quarantine, Isolation and Disinfection: Howe 909
oeptible to the disease under quarantine. GoneraUy epeaking,
children are most susceptible to all communicable diseases, and it
18 their safety which you should guard most vigilantly, not only in
matters of modified quarantine, but even more so with that of the
absolute form. In the class of modified quarantine should belong
such diseases as anterior poliomyelitis, cerebrospinal meningitis,
measles and whooping cough.
With the third or observation quarantine, the health officer
should be expected and required to maintain such vigilance of the
sanitary management of the case as may^ in his judgment, be nec-
essary to safeguard the health of the well. He should never be un-
mindful of the fact that his sphere is purely that of the sanitarian,
the promoter of health, and not that of the diagnostician or the
physician. In his real capacity he can be of invaluable assistance
to the attending physician and of inestimable protection to the
family and the community. The diseases which might well be
placed under this degree of quarantine are tuberculosis, typhoid
and malarial fever, cancer, ophthalmia neonatorum, pneumonia,
hydrophobia, tetanus and pellagra, an intelligent observation of
which would, as you know, accomplish most brilliant results. In
this class of quarantine I would not at present deem it advisaUe
to attempt to placard the house, being content to have such diseases
fully reported to the Health Officer, that he might exercise a vig-
ilant observation over their sanitary management.
It matters not what the disease may be, or the degree of quar-
antine to be maintained, you, as health officers, must always be
conscious of the fact that the burden of responsibility rests on your
shoulders. This need not necessarily mean that you should bear
the full burden of such duties. * On the contrary, it is far prefer-
able that you should share such responsibilities with the attending
physician. In every instance let him imderstand that you look to
him for assistance and that he may expect the same favor at your
hands. Impress him with the idea that such success as you may
attain in the case belongs equally as much to him as to you. Make
him feel that you are in the case only in an official capacity, and
that for the protection of the health of the people. Let him feel
privileged to make your position plain to the family, that they
may fully appreciate your combined skill and energy are being
utilized for their care and protection. With such mutual co-opera-
910 Conference of Sanitary Officers
tion between health officer, attending physician and family, the
highest possible efficiency should be accomplished, not only in
matters of quarantine, but in general sanitation, and as health offi-
cers that should be your constant endeavor.
ISOLATION
Isolation bears somewhat the same relation to quarantine that
the latter does to notification, in that one is essential to the other
and both are absolutely necessary for the success of either. While
notification is a prerequisite to quarantine, isolation is indispens-
able to quarantine. These three terms are bound inseparably to-
gether, being integral parts of the same chain of preventive meas-
ures, which are indispensable for the suppression of communicable
diseases. To weaken one weakens the others and endangers the
success of the whole plan of prophylactic management With iso-
lation as with quarantine it should be a matter of degree. Not
the same stringent measures are necessary for all communicable
diseases, and as with quarantine, even far better results will often
be accomplished by enforcing just such a degree of isolation as
may be required to insure perfect safety to others, and only such.
A needless confinement usually tends to engender resistance and
disobedience on the part of the patient and family, and they should
be made to fully understand that they are being given all the free-
dom of liberty which the disease will permit in safety to their
friends and the unaffected ones.
The degree of success with which you meet in maintaining the
proper isolation of the patient, will depend largely on the extent to
which you can gain his co-operation and that of the family. This
is particularly so among the mild diseases, in which both patient
and family are far too often unappreciative of the actual dangers
surrounding the case. With all communicable diseases the family
must be made to fully appreciate the gravity of the situation.
They must be made to realize not only their own danger, but the
calamity which they might bring to others, were they to disregard
the explicit mandates of sanitary isolation. Their position to
themselves and to the public should be made one of education.
They should be taught its full significance and made to understand
what their strict compliance thereto means, not only to their
Quarantine, Isolation and Disinfection: Howe 911
family but to their friends and to th© whole community. Much
of this educational work is plainly within the province of the
health oflScer and no one better than he is able to carry it on as it
should be done, and on him the responsibility naturally falls.
disinfection
In some respects proper disinfection is even of greater necessity
and value in the suppression of communicable diseases than any
of the preceding measures. It matters not how early such an in-
fectious disease may be reported to the health authorities or how
perfect its quarantine and isolation may be, it still remains a
menace to public health until its ejected poison is thoroughly dis-
infected or destroyed. You can no more rightfully expect to sup-
press communicable diseases without effectual disinfection, than
to establish a quarantine without notification. It is indeed abso-
lutely impossible and impracticable. You can never feel justified
in promising protection to an aflBicted family or to a community,
until you are convinced of the efficiency and thoroughness of the
disinfection which has been employed during and after the preva-
lence of the infectious disease. It really lies at the very foundation
of the whole system of prophylactic measures applicable to the
suppression of preventable diseases, and should receive the per-
sonal consideration of the health officer in its application thereto.
Many of you are, no doubt, familiar from personal experience,
with serious consequences which have arisen from ineffective or
careless disinfection during or after infectious diseases. How
many of you have seen tuberculosis contracted in a house in which
a previous patient had either resided or died ? How many have
seen an outbreak of typhoid fever arise from the hazardous prac-
tice of permitting typhoid ejecta to be deposited upon some water-
shed or accessible to some public water supply, or within the reach
of the germ-carrying fly? How many have seen precious lives
sacrificed to the infection of diphtheria by utter disregard to the
well-known pemiciousness of the Klebs-Loefler bacillus? How
many have had sad experience with the well-known tenacity of the
tmdiscovered germ of scarlet fever ? And yet all of these sad re-
sults can and should be largely prevented.
I believe it is within the possible accomplishment of each of you
as health officers to inaugurate and enforce such a drastic system
912 CoirFEKTwcE OF Sanitaky Otfigsss
of disinfection daring and Jifter the prevateoce of inf eotioua di»-
oftses in jour midet^ as to practicaUj preclude the poBsibiUty of
their further apread. But to do this you must take the matt^ into
jour own hands, and eith^* eee that the disinfection is properly
done, or do it yourself.
I fully appreciate the difficolties which confront you in attempt-
ing to give to this matter the time and attention which its import-
ance rightly demands, and yet I know far too well, and so do you,
that this line of work, as at present done througihout the State, is
one that is most sadly n^lected, and of t^i most imperfectly done.
I am mindful of the fact that this unfortunate condition pcevailsy
not by any fault of yours, but largdy because moat of the munieir
palitiee of the State either pay their health c^Seers practically
nothing for Iheir services, or refuse to provide ways and means
by which the right kind of disinfection could be accomplished.
Eveiy town, village and city vnUiin this great State should not
only pay its health officer a salary commensurate with the extent
of the services which he renders, but place in his hands every
means with which to attain the highest possible degree of efficiency
in the detailed administration of his responsible office. It is in-
deed a sad reflection on the conscience of our people, that so little
concern is often manifested in saving human life. It yet remains
to be explained why both State and federal appropriations are
more liberal for the care and safety of animak, than for the health
of their people. In spite of this deplorable condition, however, the
combined energies of the medical profession and health (^Scers
can save thousands of lives being lost in this State each year from
diseases that are known to be preventable.
Is it not within the power of our 1,400 efficient heslth officers
•and of the 13,474 intelligent physicians of this State, which is so
proud of her empire supremacy, to unite in such a war of ext^v
mination on communicable diseases that this appalling death rate
may fall to an insignificant number before our combined energies ?
I firmly believe such is possible and that by the energetic employ-
ment of the four cardinal principles of notification, quarantine,
isolation and disinfection, we shall at some future day find our-
selves masters of the situation.
Ths Ckajmuajt — I am sony I cannot allaw any diseiuaion at this time
out of justice to the gentlemen who have come here. I wiU now call on
Dr. Hin, of Minnesota, to give ns a talk on typhoid fever.
Thk Control of Typhoid Fitfsk: Hill
913
THE CONTROL OF TYPHOID FEVER
By H. W. Hill, M.D.
Director cf the BptdeMiological IHvisiMU Miancsota State Board of Health
The control of typhoid fever depends merely on finding the
courses of the stream of human discharges which flow c<mtinually
into the mouths of the people and then stop that flow. This is the
•whole secret of the matter. To find the particular stream which
is infected in any given case, you must investigate every case of
•typhoid fever in full as it occurs — not three months later ; not
just before they take him out and bury him, nor when he has a high
fever; but when he comes in first, and is comparativdy sane <md
can tell you about himself and where he has been and what he has
done, etc. Sometimes you can get it from the family and par^
ticularly from the mother who usually remembers tilings of that
kind. Having tiha/t data, you have your basic data, that ie^ the
data which you cannot do without, and which will permit you to
•proceed further.
Another stage of the investigation is to determine where the
possible sources of infection for the particular flow of discharges
are or have been. It may be from the sewage of the community^
it may be from a carrier, a convalescent or some one just coming
down with the disease, and so on.
You must search for a possible infector for the infectees you
have, and you must trace the carriage of infection from one to
the other. Of course, we know the customary routes are water,
miilk supply, food, flies, fingers ; and you inquire and figure out for
each particular outbreak, what the route of the infective material
was.
The circulation of normal discharges is a most important thing.
Each health officer should know in his own community the prin-
cipal avenues which the discharges of has own particular public
are taking under normal conditions, from their bowel and bladder
orifices to their mouflis. A moment's consideration will show that
snch transfers are continuously occurring. An outbreak of typhoid
from milk infection does not mean that flie particular man who
914 Conference of Sanitary Officers
infected that milk put his discharges into that milk only on that
occasion ; it simply means that h^ has been putting them in right
along but they had no obvious effect to call attention to them until
they became infected with typhoid bacilli and so produced a speci-
fic disease.
When in Wisconsin a student who was stacking dishes in an
apartment house, produced forty-three cases of typhoid out of the
ninety people who were boarding there, it did not merely indicate
that that student who was handling the dishes, had put his dis-
charges on those dishes for that one time only. He had unques-
tionably been doing it right along. Typhoid Mary is not the first
or only cook who put her discharges into food. They are doing it
all the time ; but fortunately the discharges of ordinary cooks are
often normal, and do not do much harm ; it is only when you intro-
duce into them an abnormal factor — the bacteria of typhoid and
dysentery, that the diseases develop and attention is called to them.
The distinction between public and private health to my mind
is: The public official should protect public utilities, such as
water, milk, food in food stores and in restaurants, hotels, etc.,
wherever the public go, from contamination with human dis-
charges. Public utilities include the schools and public institu-
tions of every variety in the State — libraries and hospitals, etc ;
every place and everything and every person who handles any-
thing which the public uses ; that is what I consider to be within
the Department of Public Health. Private health belongs largely
to the mother. It is for the mother to see that circulation of dis-
charges in the home does not occur. We must have education in
the schools, and practically all mothers with children must be
trained from the earliest moment to know how to guard against
these discharges.
The actual emergency steps to control a typhoid epidemic are
to my mind very simple. If the water is infected, disinfect it —
boil it or better still, use hypochlorite. If the food is infected,
stop the source of infected food supply; if the milk is infected,
boil the milk, or, best and simplest of all, and involving least loss,
put the particular dairy from which the infection comes into
the hands of some other set of people. Milk is practically in-
fected in most instances by some one of those who are handling it
The Control of Typhoid Fever: Hill 915
If you put it in the hands of someone else for the time being, of
course, that infection stops. If food is infected, stop the infected
food supply. Abolish the fly, if it is responsible. We have had a
very widespread outbreak of dysentery and typhoid from flies in
Minneeota this year. In the last fifteen months I have seen thirty-
six outbreaks of typhoid fever, and a majority of those were dur-
ing the summer, and due to flies. In every outbreak of summer
typhoid, where outdoor closets are used, a question of great im-
portance is to screen the windows, abolish the breeding places of
flies, and use plenty of sticky fly paper inside the house. When
you cannot abolish the flies, you can abolish or disinfect with
lime the material they carry from the closet, and those precautions
will stop the fly epidemic. These are immediate emergency steps
to take. Then having cut out temporarily the main source of in-
fection, and prevented further spread, sit down at leisure and ar-
range permanent measures to prevent recurrence. In all out-
breaks, direct contact from the patient to those about him is to be
considered. You must look to the nurse, who is usually the mother,
for from her the infection is passed to herself and to the rest of the
family on her fingers. You may try to instruct the mother what to
do but there is no absolute cure except to take the mother away,
and put the case in charge of a trained nurse, who sometimes
proceeds to infect herself and others just the same; then the only
thing to do is to take the case to the hospital. I think the English
practice of moving typhoid cases to a hospital at the outset is the
proper procedure. From 25 to 27 per cent* of our typhoid cases
are contracted directly from the case in the bed, the discharges
being touched by those handling them and caring for them. When
typhoid is introduced into a community often it spreads by the im-
mediate neighbors coming into direct contact with it — visiting,
helping to nurse, etc. The direct spread of typhoid fever by direct
contact is an extremely realistic matter in the rural districts, and I
know of no way to stop it except to take the case away from the
house, so that the discharges of the sick will no longer be available
for distribution to the mouths of the rest of the family and the
neighbors.
The progress of typhoid is instantly stayed "when flies, food
and fingers refuse it their aid. Food of course must be interpreted
to include water and milk."
916 CONPEKENCK OF SaNITART OfFICKES
I want to speak of several common fallacies regarding typhoid
fever. One of the most exasperating things is that to the public
mind and too often to the health officer and the physician, as well,
typhoid fever means polluted water. Too often they think the
first thing to do is to seiise upon some well water and send it to the
State Board of Health to have it analyzed. We had an instance
where in a town of about 2,000 people, 350 cases of typhoid ex-
isted. But the first thing and the only thing reported to us was
that the health officer was sending in a vinegar jug of water, re-
questing " Please analyze this water." We asked to know why the
water should be analyzed and this elicited a reply stating that the
town was full of typhoid. We did not analyze — we had not time
to wait for that — we sent a man at once to find out the facts and
what to do about them. I want to point out one fallacy which per-
haps give rise to this widespread belief that water is almost always
a tremendous factor in every typhoid fever outbreak. When water
does become infected you are likely to have a large number of
cases from it; that is obvious. But the number of times that water
becomes infected, as compared with the number of times that milk
and flies and fingers cause the disease, is very small. The total
cases produced by each of these sources is not an indication of the
relative prevalence of each particular source of infection. I hesi-
tate to give any estimates but I should say that jKMsibly not one-
tenth of the total instances of infection of typhoid fever — not
cases, but instances — are instances of infection by water, i. e.,
one instance of infection of the water supply of a great city may
give rise to 500 to 5,000 cases. One instance of milk infection
may give rise to only fifty cases. One instance of finger infection
may give rise to only five cases. But there are daily occurring
perhaps 100 instances of finger infection to each one of water infec-
tion and so on.
Another fallacy is that the analyst can tell all about the epidemic
and its control by analyzing the water. There seems to be some
sort of fetish worship or voodooism to the public mind, in making
an analysis.
The public imagine that if someone in a far-off laboratory who
never heard of their community before only analyzes the water
their troubles are at an end. They see no sequence, they ask no
The Control of Typhoid Fevee: Hill 917
questions — they blindly demand an analysis and rest content
One would, think an analysis was a kind of charm.
Another fallacy rather of the health oflScer than of the public
consists in considering the date of report of a typhoid case as of
6ome importance. I have seen tabulations and deductions made
from them based upon the date of the report. I have seen summer
typhoid regarded as autumn because they did not think of when
it was infected, but when it was reported, which is usually about
three or four weeks after infection. Typhoid reports are usually
made at least a month after the infection occurred. That is a
fallacy so obvious that I am ashamed to refer to it, yet I know
it is often disregarded and this is done in serious articles — even
in annual reports.
Again, we find physicians who think that the severity of the
case has some meaning with regard to the epidemic, I have had
physicians say, ^' Yes, I have had so many cases and this one
died, and this one bad hemorrhages, etc., etc." I say, "What
about the mUd oases? Did you report such and such a case?"
They say, " No, that was so slight I did not report it."
Usually a physician will not talk patiently with the investi-
gator about the epidemiological features of his cases — he wants
to tell all about the pulse, the temperature^ the diet, etc. If we
covild get physicians to realize that they should report all cases
even when mild, we have done well.
Constant confusion is found in the mind of the public and also
the physician and the health officer between the primary cases of
typhoid fever, which alone indicate the source of the general out-
break, and the secondary cases, which come from the prinwiry,
and have no bearing on the primary source which started the
epidemic. Almost always some of the cases in every outbreak are
really imported cases. The investigator, after getting all the cases
on his records, should carefully elinunate imported cases and sec-
ondary cases before feeling that the real field of investigation for
the primary source is laid bare. One of these instances of con-
fusion of imported cases with native cases occurs in Mr. Whipple's
book on typhoid fever where Duluth, Minn., is quoted as having
a high typhoid death rate and the deduction is made that it must
therefore have a bad water supply. Yet almost every death from
typhoid in Duluth is due to imported cases from the Iron Bange.
918 Conference of Sanitary Officers
Another fallacy is that cases reported indicate cases occurring.
Every health officer knows this is not correct It is usually safe,
except in Ridiinond, Va., to double the number reported, in order
to find the number of cases which really exist. Dr. Levy, Health
Officer of Kichmond, is exceptional in securing the theoretical
returns which he should get. Few cities can boast such complete
returns.
Another fallacy is this — that the extent of the infection of
persons is limited to the extent of the development of cases. As
a matter of fact, ten cases doe^ not mean ten infected, but it
means about one hundred infected. We had an instance where a
population of 10,000 possessed an artesian water of the finest kind
for water supply, and yet so arranged that when the river rose
the sewage backed up into the water supply. Now of the popu-
lation of 10,000 we know that 6,000 drank it while the sewage
was in it because that number were sick with acute diarrhea. Yet
only 500 cases of typhoid developed. There were as a matter of
fact, 6,000 people infected but only 8 per cent, came down with
typhoid. Remember then that your cases do not represent the
extent of the infection, and probably do not represent more than
five to ten per cent, of the total infection.
Another fallacy is that ice is a factor in typhoid fever infection.
Speaking of that subject in New York yesterday I told them my
belief that natural ice is practically never a factor in the sense
that water is, i. e., through carrying the typhoid bacilli in the
ice from the source where it is derived. I think ice may occa-
sionally be a factor in that it is taken as an excuse to wash hands
in the drinking water when people fill the tank with ice, using
bare hands to carry the ice, and if they have typhoid bacilli on
their hands, they may put it in the water.
Dr. Levy of Richmond has informed me of a case in his ex-
perience where a man dropped ice into the drinking water with
his hands and as usual the man had bowel and bladder discharges
on his hands ; unfortunately his bladder and bowel discharges con-
tained typhoid bacilli also and they went in with the ice into
the water. The man happened to be in the early stages of ty-
phoid fever at the time.
Thob Contbol of Typhoid Fevbb: Hill 919
There is just one other point I want to bring up here: it is
usual to quote for the eastern States a typhoid fatality of ten
to fifteen per cent. Our fatality — not the death rate,, but the
number of deaths in proportion to cases in Minnesota, is about
4 per cent, as far as we can find out. I would like to have an
explanation as to this enormous difference of rate between the
fatality here and in Minnesota. The fatality which Dr. Levy
quotes is a little over seven per cent, for Richmond, and it is
just the fatality we had in Mankato — and did not represent our
average fatality. It was an outbreak.
&20 CONFERKNCB OF SanITAICY OtFIOKBS
FRIDAY, NOVEMBER 18, 2 P. M.
Sixth Session
Presiding — Dr. H11X8 Cole.
The Chaibman — The seBsion will please ocnne to order. It is now quarter
jMLSt two o'clock and it has been suggeated that we teJce the nest two papers
first, and then have discussion upon those portions of the morning program
which were unfinished, as well aa upon the two papers which we wiH nov
read, so we shall be sure to get the papers before us, anyway, and then allow
ample time for the discussion. Would that meet with the approval of those
present, or would discussion of the morning papers be preferred?
Voices — Read the papers.
The Chaibman — That is well. We will take up the papers. I have
looked forward to the day when I could hear a paper on the neict subject
read before a meeting of this character. I think it is one of the questions
we must take up in the immediate future. I do not believe the Empire State
can move behind any other State in the Union in this matter, and there
arc States in the Union which are discussing it and actually handling the
topic and the matters related thereto which are to be discussed in the first
paper of this afternoon. Some of the best work in this line has been done
by the little State of Rhode Island and we have an opportunity this after-
noon of hearing Dr. Swarts, Secretary of the State Board of Health, and his
views upon certain " Unattacked Communicable Diseases ** — I take pleasure
in presenting Dr. Swarts.
Db. Gabdneb T. Swabts — Mr. Chairman and sanitary officers, as I was
informed by the management of this convention, I am to be allowed fifteen
minutes to present my subject. Fearing I would take two and one-half
hours if I got interested in the subject, I have arranged to give my address
in condensed form, so you will pardon me for reading it.
UNATTACKED COMMUNICABLE DISEASES
By Gabdneb T. Swabts
Secretary R. I. State Board of Health, Providence, R. I.
I wish to express to you my appreciation of the honor conferred
upon me in asking the little State of Rhode Island to come to
this Empire State, with its large head lines, to speak to you upon
a subject as vital to the interests of every State and Nation as
it is to our small State. Now we hear a great deal, in these latter
strenuous days, of conservation; and while we are paying dose
attention to the struggle between the conservator of forests and
lands, and his superior officer, we must not forget the importance
of conservation of human life for which boards of health and
UnATTACKBD COIOCUBIOABLI DISEASES : SWABTS 921
their representatives have been appointed; and in the active every
day work of jour latx>r8 in the endeavor to furnish suitable water
supplies and to give advioe as to the suppression of nuisanees,
it must not be forgotten that our most successful work in the
preservation of life comes from our knowledge of the means of
production and spread of that class of diseases which we call
communicable.
We know that scxne of these diseases are communicated by an
organism whose life history we can understand ; others we know
exist only aftar exposuie to a previous casa In such cases as
diphthma, s^rlet fever, smallpox and typhoid fever, by our close
attention to the manner in which they are spread, by meana of
isolation, quarantine and by preventing the passing of the secre-
tions and excretions from an affected case to a well one, we are
able to check them in a measure.
Smallpox has been brought to a standstill, diphtheria does not
spread when under control, and plague, cholera and yellow fever
have been banished in certain localities, yet two of the most com-
municable and preventable diseases have received no attention
from health authorities. Knowing the cause of these diseases
and being familiar with the means of their spread, no systemat-
ized effort has been made to check them as has been done with
other diseases which are less perfectly understood.
These two diseases, syphilis and gonorrhea, have existed from
earliest history and are causing a vast amount of sickness, misery
and death and yet we do not find them classified anaong those
diseases which are even reported to the health authorities, and
why? Because, being diseases which are commonly communi-
cated by means of illicit contact^ they are placed imder the ban
of shame and silence.
Knowledge of these diseases only comes to those who must first
be afflicted, usually as the result of enforced ignorance of the
existence of them and from submission to natural animal passion
which is not properly tmderstood, owing to the demands of an
established false prudism. Health authorities are ever ready to
warn the wayfarer as to the dangers of smallpox, the police are
required to ponish the offenders who succumb to the passion for
drink, the clergyman is ever ready to help those who are down
922 Conference of Sanitary Officers
and out and the instructors in our schools are ever anxious to
hold up the dangers arising from the use of alcohol, but who gives
a moment's thought as to what course should be taken for those
liable to be exposed to gonorrhea which represent 60 per cent,
of the adult male population, and to syphilis with its victims to
an extent of ten to fifteen per cent, of the population of our
large cities, each one of these having become infected and a menace
to his neighbor? Dr. Prince A. Morrow estimates that there oc-
cur three to four million cases of syphilis annually in this coun-
try. What is being done to prevent the occurrence of three to
four million more next year except the treatment that each case
may possibly have from his physician after he has in his turn
already infected others?
If this data is correct, and it is given to us by observers whose
standing is vouched for, is it not high time that the appointed
conservators of health and life, the health departments, should
take immediate steps to utilize every practical means for control-
ling the spread of these diseases ? Shall we wait as we have done
in the control of tuberculosis, for social betterment associations
to take up the task of improving the health of the people? Al-
ready twelve societies scattered throughout the United States have
joined hands in a common crusade. This very day in the city of
Buffalo another society for the prophylaxis and control of venereal
diseases is being organized ; and what are you doing about it here in
this convention ? What is your State Board doing to advise you
as to your duties in the matter ?
It will be contended that it is an impracticable problem, but
have we been permitted to properly study ways and means? If
the subject is broached by the layman, a physician, a clergyman
or an individual health officer, he is at once condemned as one
who is meddling with pitch and who is seeking notoriety, or has
some morbid interest at stake. But health boards can properly take
up the problem, as it is in the routine of their legitimate and
appointed work. But how can they best accomplish it ?
First, by a crusade of education at the proper time and place,
and with attention to those who are to be instructed. This means
a different manner of approach to the subject according to age,
sex and social position. While the adult will give interested at-
TJn ATTACKED COMMUNICABLE DISEASES : SwARTS 923
tention to the subject, they are usually persons who have little
need of instruction; some who are not likely to be brought into
danger and others because they have passed through the fire and
we can teach them nothing. Education, as with all other matters,
commences with the child when the mind is receptive for what is
clean, honest and true. The knowledge of sex hygiene is the
foundation for a future imderstanding of influences and desires
which follow in the development of the animal and this should
be properly understood by the pupU without having it appear
that he is learning something which is looked upon by his elders
as a mysterious, forbidden subject. Already the instructions iu
the kindergarten grade, in the subject of biology, are uncon-
sciously acting as the foundation of further study on sex hygiene.
The young child learns the interesting story of the maimer of
development of the seed in the ground, the exchange of pollen in
the flower, the gradual development of the butterfly; from that
to frogs, hens, and eggs, roosters, domestic animals, man and the
perpetuation of the species of all living things is but a short step.
Unfortunately in the present curriculum and in the text-book
the child loses the sequence. By the time he reaches the age of
seven his book on hygiene will inform him of the location and
function of his lungs and stomach, but in regard to other import-
ant organs he is left to learn from his mischievous companions,
in secret and with disastrous results, because you and I are not
men enough to protest. Not for one moment would it be con-
sidered admissible that these subjects should be projected at the
present time into the studies of pupils from five to seventeen, or
the period of adolescence. The mischief which we have permitted
to generate would only be increased. It should not be possible
for such information to be a novelty.
As the matter stands now we must Wait until the boy has grown,
until he becomes a student, and as a student he will hear and
see, perhaps in his fourth year of medical instruction, the serious
results of these diseasea But this is too late; seven years before
he has learned by bitter experience in one short month, much
more than any professor can teach him. During the freshman
year is the most critical time in the student life. The first year
in college is the easiest for work; the time when he rushes into
924 CONFKBENCE OF SanITAHY OfFIOSBS
exciting entertainment; perhaps drinks his first glass of beer and
is led into contact with prostitution and consequent gonorrhea
and syphilis. This awakening period, however, is when the most
that can be done is a warning or enlightenment on the liability
of the contraction of these diseases ; how they are spread and their
serious consequences. Owing to neglect of previous instruction
along these linos only a few, perhaps, will be deterred from sow-
ing their oats.
Some conscientious instructors endeavor to give a frank,
brotherly talk to their students in the first lecture that they present
to them. A philanthropist has made it possible, through the New
York society, to issue to each freshman student in all colleges in
this country, a small pamphlet which presents this subject in a
practical manner which must appeal to the fair-minded boy. As
to the working boy who leaves his preparatory school he truly
enters life with a handicap. No interested adviser to w^m him ;
having just reached manhood, suddenly becoming possessed of even
a small amount of money as the result of his own labors, he may
readily be tempted into channels by his uneducated fellow work-
men, thinking that he can thus better assert his manliness. Why
should they not also have the assistance of health authorities and
philanthropists ?
We should naturally assume that the parent was the proper per-
son to instruct his child against all the dangers of life, but how
many are there in this audience who would feel competent to
present this subject in a proper manner to his own boys, even if
he had the temerity to do so? Where are the mothers who do
their duty to their daughters in this respect? As the education
of the parent has been neglected, who will teach the parent how he
may approach his own flesh and blood with this important topic ?
There are few physicians who are willing to assist, still fewer
those who are capable of approaching the subject with tact, but
there is an awakening for information on all practical subjects
by those societies known ae women's clubs and especially mothers'
clubs, churchmen's clubs, and labor unions of the better class, who
are ready and eager to receive information which will assist them
in their betterment and for the protection of their children who
are to become husbands cmd wives.
UnATTACKBD CoMMUiaCSABLB DISEASES : SWABTS 925
One might assume that the normal school teacher who is about
to be given the responsibility of the care of the youthful mind and
character should know what sort of anim^als she was about to con-
trol and at least be prepared to be shocked by immoral proclivities
from her charges which may crop out at any time, but an attempt
made in the State Normal iSchool of Ehode Island, to give instruc-
tion, was met with censure from some of the parents of those
would-be-teadhers of youth.
Ab an illustration of how wide-spread is the desire for sugges-
tions as to how this subject may be taught it may be mentioned
that following a conference upon this subject in Providence^ B. I.,
a statement was made in " The Purity Advocate " that the State
Board of Headth of Bhode Island had offered to send circulars on
sex hygiene to suitable persons, free, upon application. This re-
sulted in requests from ^ parts of the Union, England, Hawaii,
South Africa and even New York State. Little Bhode Island un-
fortunately was not prepared to supply other than its own popula-
tion although it might have been glad to have helped other states
which ought to have been capable of caring for their own needs.
Other states than Bhode Island are distributing thousands of leaf-
lets and paanphlets of instruction, notably Indiana, California,
Ohio, Vermont and Massachusetts. A series of pamphlets are is-
sued by the twelve societies previously mentioned, but probably
the best set of these are the ones issued by the American Society of
Moral Prophylaxis of New York.*
These pamphlets are prepared under the direction of Dr. Prince
A. Morrow who perhaps has given more attention to this crusade
and toward the advancement of this subject than any other person
in this vicinity. They appeal to the different ages and give specific
methods as to how the parent or teacher may handle the question
with intelligence and without sensation.
As with the tuberculosis crusade the exhibition method of
graphically appealing to the mind has been successfully employed
by the State Board of Health of California. State boards of health
•The series include, No. 1, "The Yoiinp Man's Problem;" No. 2, "For
Teachers;*' No. 3, ** The Relation of Social Diseases with Marriage and Their
Prophylaxis;" No. 4, "The Boy Problem;" No. 6, "Kow My Uncle, the
Doctor, Instructed Me in Matters of Sex ; " No. 6, " Health ana Hygiene of
Sex '' — No. 9 East 42d street, New York city.
926 Conference of Sanitary Officers
ahould be in a position to supply literature, exhibits, lantern elides
and selected lectures to local boards of health and should encour-
age local formation of leagues for the suppression of the '^ Black
Plague," or as the California board prefers " The Eed Plague."
The State of Indiana goes further and endeavors to protect its
people by laws prohibiting marriage by those who are afflicted with
tuberculosis, insanity or syphilis or gonorrhoea. Compliance witi
this law will of course be avoided, but it at least calls the attention
of the contracting parties to the fact that some danger exists to
call for the enactment of such stringent regulations.
But the Puritanical moralist will tell us that a man should
suffer for his sins, making him responsible for instincts given
him by nature and concerning the control of which it is forbidden
that he should be enlightened. If we do assume that immoral as-
sociation must receive punishment, how are we to clear our con-
science of the responsibility of allowing the innocent to suffer?
The Committee on Moral Prophylaxis in New York reported
that from statistics collected in that city and Baltimore, 10 per
cent, of the men who marry, infect their wives. The New York
commission found that 30 per cent, of all venereal diseases occur-
ring in their private practice in the city, in women, are communi-
cated to them by their husbands. This is not a tale from the lower
classes or from those lacking knowledge of other important mat-
ters. "Seventy per cent, of all women who come to the New York
Hospitals for treatment of venereal diseases are reputable married
women who have been infected by their husbands."
Fear has been expressed that the presentation of these figures to
the public gaze would place the marriage contract in the danger
zone for nearly all and that marriage would cease. It need not be
feared that the works of nature will cease from fear of danger, but
it seems eminently proper that protectors of health and life should
at least place warning signs at dangerous crossings and permit
tfiose who will heed to ''iStop, Look and Listen,'' as they might in
the presence of tuberculosis and insanity.
But what of the 30 per cent, of the women who present them-
selves at the hospitals and who are not married ? If it is deemed
necessary that they shall suffer, who will assume the responsfibility
of the evils coming to their offspring? Sixty to eighty per cent
Unattaokbd Communicable Diseases: Swakts 927
of the children of syphilitics die before or shortly after birth. Are
we to be a party to infanticide even if some of them might later
have proved to be undesirables ?
As health officers you have been instructed to take cognizance
of several communicable diseases, to ascertain their location and
to place restrictions upon the spread of these diseases. Thus in
New York city there are reported annually 12,500 cases of measles,
11,000 cases of diphtheria and about 9,000 of tuberculosis; in
round numbers, 41,500 cases of infectious diseases. During that
same period there are treated 243,000 cases of venereal diseases,
namely, six times as many as from all other communicable dis-
eases, and for which no eflFort is made to control the spread of
syphilis and gonorrhoea even in a small way. No report of these
cases is made, no quarantine, and not even instruction by the health
departments as to their communicability.
It is understood that, naturally, not all the deaths occurring
from these diseases are recorded as such, the physician being de-
sirous of protecting his patient from publicity. That health
boards may know of the prevalence of these diseases in their own
locality and where instruction could be utilized to the best advan-
tage, it is necessary that a report be made to the boai^ds of these two
communicable diseases of as many cases as possible to one common
bureau. While legal requirements would be evaded largely in the
beginning, yet as with tuberculosis, the physician would gradually
see his way clear to assist rather than to obstruct the eflForts. At
the present time there is an eflFort in this line being made in Cali-
fornia and Vermont and the Paige bill in the State of New York
is towards the same end. A study of the prevalence of this dis-
ease can satisfactorily be made in the navy for the shore leave of
the naval man is under surveillance and the presence of sickness
is disclosed by the patient or discovered by the surgeon on duty
for none are allowed to go ashore from many of the ships before
they are inspected and found free from venereal disease. In the
United States army there were treated during the year 1908, some
11,113 cases of venereal disease in a total of 78,441 men; one
out of every seven.
In the navy the number incapacitated, if applied solely to the
force afloat, " would render inactive for over a month three bat-
928 Conference of Sanitaey Offioebs
tleshipB with a compl^nent of 1^000 ofiSoeis and men each," as
stated in the report of Sui^eon-General Rixey for 1908. Atten-
tion is called to the fact that " the soorce of snpply of our first en-
listment recruits are picked men and are recruited mostly from
the rural districts and are in point of virtue above the average
grades of society/^
It is not the duty of the health officer or the enthusiast in this
propaganda to assume control of the moral side of this question
ezoept so far as an education in the cause and effect of communi-
cability may reach. It would nullify the e£Fect of the work in-
tended to attempt to assume police powers and methods and it is
questionable how much control can be obtained over this form of
vice by force. Ke^ementation by segregation and registration
have all been tried and have proved failures. Clandestinism and
increase of the diseases have resulted under such controL
Licensing of the prostitute is objectionable on account of its
being an official sanction of support of a social evil. Inspection
gives a false assurance of security, for the most expert physician
cannot guarantee the absolute absence of the presence of the gon-
oooccms in every case. A license to-day is void to-morrow because
the male prostateur, as he is called by Morrow, is not examined
and when inspection of men is even suggested l2iere is immediate
opposition although they are the ones who must necessarily be the
means of spread from one infected female to the other.
Before closings permit me to allude to one sanitary phase of ihe
subject. As has been shown in the figures presented, it is often
the innocent who are the sufferers from the wrongs of others.
They are, however, capable of instruction, capable of learning if
knowledge is placed before them and they may protect themselves ;
but who is to speak for the innocent babe who is brought into
the world by no volition of its own, but who in being bom is in-
fected with gonorrhoeal infection of the eyes, and, from the lack
of attention of the midwife, nurse or attending physician, or from
ignorance of the mother, is made partially or totally blind, yet
with die physical power to go on through a full period of life grop-
ing with hands for the pleasurable sensations of the sight of
which they have been deprived? Twenty-five per cent, of the
children in our blind asyliuns are blind as the result of ophtihalniia
Un ATTACKED COMMUNICABLE DISEASES : SwARTS 929
neonatorum, a gonorrheal infection of the eyes. If we have no
sympathy with the innocent adult victims, if we have no charity
for the immoral profligate, may we not be permitted to offer some
assurance of safety to the unborn even if we are obliged to soil our
hands, in checking the spread of this one disease in such ways as
may lie within our power i
Gentlemen, you have been appointed by the people to protect
the health and lives of the men, the wives and the children of
your respective localities; are you willing and prepared to execute
that duty ?
Last evening we listened with a good deal of enthusiasm to a
number of stories while Ave were in a happy frame of mind; now
let me add a story whioh I heard some tiTtie ago, apropos of
whether children should be iuptructe*] in ^he^o matters —
A physician interested in rhr-.e mailers in a.Xew England
state had occasion to treat a boy for gonorrhoea or rather a couple
of boys who were attending school in his neighborhood. He
learned from one of the bovs that he had becm inducted into ono
of the secret societies of the sciiool ; that one of the ooints of initia-
tion was that he should be '^ made a man ;" and therefore a prosti-
tute was brought into tlio club house and each one of these candi-
dates were permitted to become infected with gonorrhoea. If it is
necessary that boys should go into secret societies and be inducted
into them by such methods of initiation^ is it not your duty and
my duty to instruct the w.^n undertalun.':^ the induction into these
societies of the existence nf these di?oat('<, and to warn them to
take care ?
The Ckairmax — Within tlie 7)apt month or two you have received from
tlie State Department of Health at Alhany certain blanks calling for reports
upon cases of epidemic anterior poliomyelitis. We all know that we do not
know very much about the epidemiologry of that disease at present. Wo
are working, to a certain extent, in the dark. The United States govern-
ment is doing its share in contributing to existiTii' knowledge on the subject,
and its most prominent investigator, I think, is with ub this afternoon lo
tell us of some of his findings in this epidemic diseat«e. I take pleasure in
palling to the platform to address you Dr. W. IT. Frost, United States Public
Health and ^farine Hospital Service, Washington, D. C.
30
930 Conference of Sanitary Officers
EPIDEMIC ANTEKIOR POLIOMYELITIS
By Dr. W. H. Frost
United States Public Health and Marine Hospital Service
Epidemic poliomyelitis, which has for many years been recog-
nized at intervals, in circumscribed localities, as a serious problem
for the guardians of the public health, has, in the present year,
become in the United States one of our national public health
problems. It has become so chiefly by reason of its enormously
increased prevalence — an increase both in the total number of
persons aflFected and in the area of epidemic prevalence.
Lovett, in a compilation prepared for the Massachusetts State
Board of Health, gives the number of cases of poliomyelitis re-
ported in the literature of the world as occurring in epidemics by
five-year periods from 1880-1909 as follows:
6-year period Cases
1880-1884 23
1885-1889 93
1890-1894 151
1895-1899 345
1900-1904 349
1905-1909 8,054
After making all due allowance for the increase due to greater
accuracy of diagnosis, it is still clearly evident that there has been
an actual, progressive and rapid increase in the occurrence of
epidemics of this disease. And, what is of more vital importance
to us, of the 8,000 cases reported from 1905-1909 approximately
5,500 have occurred in the United States, practically all within
the three vears 1907-1908-1909. The cases in 1907 were con-
fined quite definitely to New York city and its vicinity. Epi-
demics were reported in 1908 from several states ; in 1909 from at
least four, and in 1910 from at least seventeen states.
The surgeon-general of the Public Health and Marine Hospital
Service is endeavoring to collect from the health officials of all the
Kpldemlcs
Averts •
numbe
of caaes
2
11.5
7
13
4
38
23
15
9
39
25
322
Epidemic Anterior Poliomyelitis : Frost 931
states reports of the prevalence of the disease in 1910, These
reports, known to be fragmentary as yet, indicate approximately
2,500 cases reported from twenty-three states; and additional re-
ports, unofficially received, make it quite certain that 3,000 is a
minimum estimate of the cases occurring in the United States
during 1910.
These figures, to be sure, are not alarming when compared with
the statistics of other infectious diseases; but there are, in the
prevalence of epidemic poliomyelitis, certain features which add
to the seriousness of the problem. First, its rapidly progressive
increase, indicating, so far as predictions are justifiable, that the
situation for the ensuing year will be more serious than at present.
Again, while the mortality of the disease, averaging perhaps ten
of fifteen per cent., is not greater than that of other more wide-
spread infections, the mortality in this case represents but a small
part of the suffering and economic loss entailed. A very large
percentage of those who escape with their lives are left with a
permanent disability of greater or less degree, which often results
in a lifetime of dependence on the part of the victim and of dis-
tress on the part of his family. Epidemics of other diseases come,
go and are forgotten ; but epidemics of poliomyelitis leave in their
wake cripples who will remain as objects of sympathy, often as
objects of charity, to the next generation. Another most serious
feature of epidemic poliomyelitis is the mystery which still sur-
rounds its origin and means of dissemination, resulting in a lack
of confidence in preventive measures and a magnification in the
popular mind of the terrors of the disease.
It is not, however, the seriousness of epidemic poliomyelitis, but
•ts preventability w^hich fastens upon the health officer his respon-
sibility in the matter; the seriousness of the disease only increases
the gravity of this responsibility. So long as a disease is known to
be irremediable the health officer may stand by and commiserate;
if there is reason to suspect that it is preventable, it is his duty
to investigate ; if it is known to be preventable, he must prevent
To define the status of the health officer in regard to epidemic
poliomyelitis, it will be necessary first to give a brief summary of
facts bearing on its preventability.
Laboratory studies, a large and valuable part of which have
9'12 Conference of Sanitary Officeks
been contributed by Flexner and Lewis from the Rockefeller Insti-
tute, have demonstrated that the disease is transmissible from
human beings to monkeys, and from monkey to monkey; animals
other than the monkey have been found insusceptible, except by a
few observers who report successful inoculations of rabbits.
It has been demonstrated that the specific causative organism is
of minute size, being able to pass through a Berkefeld filter; that
it is easily killed by heat, and by comparatively weak disinfect-
ants; that it is very resistant to cold and to drying. In the bodies
of infected animals the virus (germ) of the disease has been
demonstrated not only in the spinal cord and brain, but in the
nasal mucous .membrane, the salivary glands, mesenteric glands,
and, after subcutaneous inoculation, at the site of inoculation and
in the lymph glands receiving the drainage from that area. The
cerebrospinal fluid and blood have been found infectious in the
early stages of infection.
The most uniformly successful method of inoculating monkeys
is by injection of the virus into the central nervous system, but
successful inoculations have been made into the peripheral nerves,
intravenously, intraperitoneally, and subcutaneously ; also, which
is of great importance, by introducing the virus into the stomach
or intestines, by rubbing it into the scarified mucous membrane of
the nose, and, as reported by one observer, by bathing the un-
injured nasal mucosa with an emulsion of the virus.
Immunity after an attack of the disease is manifested in mon-
kevs bv insusceptibility to re-inoculation. In the blood of both
persons and monkeys after recovery from tlie disease, specific anti-
bodies have been demonstrated, capable of neutralizing in vitro
certain amounts of the virus. The efforts to produce an antitoxin
of therapeutic value have so far been unsuccessful, as have also
the efforts to devise a safe means of protective inoculation or
vaccination.
Reviewing briefly the results of laboratory experiments, it is
shown that epidemic poliomyelitis is an acute infection due to a
specific micro-organism. The demonstration that the secretions of
the nose and mouth are infectious even in monkeys inoculated
intra-cranially, and the successful inoculation of monkeys through
the respiratory and digestive tracts, form a convincing chain of
evidence that the disease is transmissible by direct contagion.
Epidemic Anteeiob Poliomyelitis : Frost 933
Epidemiological studies have, to some extent, confirmed the in-
ference drawn from experimental work, that epidemic poliomye-
litis is transferred from person to person )>j direct contact, and
have further indicated the probability of conveyance of the dis-
ease by healthy persons. Widely divergent inferences have, how-
ever, been drawn from the study of epidemics in different localities.
Wickman stands as the pioneer in the epidemiology of polio-
myelitis, having convinced himself, by extensive field studies in
Sweden, that the disease is spread by direct contact. Other ob-
servers, reporting epidemics, have emphatically stated that there
was no evidence of contagion. Such divergences of opinion may
be partly explained by differences in the thoroughness of investi-
gation and in the personal equation of the observers. It must be
evident, however, to any one studying the reports, that epidemics
of poliomyelitis vary greatly in their degree of infectivity and in
their apparent relation to contact.
Clinical studies have taught that the disease is protean in its
manifestations, often diverging widely from the classical descrip-
tions generally given in text books. This fact is important from
an epidemiological standpoint, as it raises, at the very outset, an
obstacle alike to investigation and prevention, namely, the diflS-
culty of recognizing the disease. Of extreme importance in this
connection is the occurrence of abortive forms of poliomyelitis —
cases in which there is no paralysis. The absolute diagnosis of
such eases has, in the past, often been impossible. There is, how-
ever, reason to hope that diagnostic methods worked out within
the last year will aid greatly in their future recognition.
As regards the preventability of poliomyelitis then, the disease
is certainly due to a specific micro-organism which can be quite
readily destroyed bv the usual methods of disinfection. It is,
therefore, preventable provided that we can locate the organism ac-
curately and api>ly the germicides thoroughly. The first problem
is to locate the organism in that part of its cycle where it can be
most readily destroyed. Our present knowledge indicates that
man is the essential host, the breeding place of the organism, and
that prevention should consist in the destmction of the organism
as it is excreted from the body of the patient. The efficiency of
such preventive measures remains, however, to be demonstrated.
934 Conference of Sanitary Officers
While it is, therefore, the duty of every health officer for the pres-
ent to put into effect the preventive measures already indicated,
it is highly important that he should at the same time make dili-
gent investigation to ascertain whatever deficiencies there may be
in such methods and to point out the means of supplementing or
supplanting them.
Invaluable as laboratory studies have been and will continue to
be in formulating knowledge of epidemic diseases, such investiga-
tions, often of necessity carried out at a distance from the field,
never have given, and perhaps never will give a complete knowl-
edge of the conditions governing the spread of epidemic diseases.
First-hand knowledge of attendant conditions, derived from ob-
servations in the fields have always been necessary to give a prac-
tical solution to the problem of the control of any epidemic dis-
ease ; and this is especially true in regard to epidemic poliomyelitis,
which seems in so many respects to disr^ard the laws which are
supposed to govern epidemics of contagious diseases.
It is of the utmost importance to ascertain the exact prevalence
of the disease. To accomplish this it is absolutely essential that
the disease be made reportable in all states. The transmissibility
of epidemic poliomyelitis has already been sufficiently indicated to
justify such a requirement on the ground of protection to the com-
munity, and as a means of obtaining accurate statistics the meas-
ure is absolutely essential. Laws to this effect have already been
made in a number of states, and it is to be hoped that in the com-
ing year all other states will follow their example.
So far the disease has been made reportable chiefly, if not solely,
in states where its prevalence has already alarmed the people. Let
us hope that other states will not postpone their legislation until
such circumstances make it imperative, but will at once enact laws
to keep them forewarned and forearmed.
The importance of obtaining reports of all cases of anterior
poliomyelitis may be illustrated by a few examples:
1. Our knowledge of its prevalence is at present derived largely
from unofficial reports of epidemics. These reports embrace for
the most part only outbreaks of sufficient magnitude to have at-
tracted special attention and study, failing very often to take ac-
count of scattered, so-called sporadic cases. The result is a failure
Epidemic Anteeiob Poliomyelitis: Frost 935
to give an accurate idea of the actual prevalence of the disease
and, what is perhaps of greater importance, a failure to grasp the
connection between seemingly isolated cases and epidemic foci. A
case which appears absolutely isolated to the attending physician or
even to the local health authorities may be seen by the State health
officer — who has before him reports of all cases in the State —
to have a definite relation to some epidemic focus.
2. By reports of all cases, the isolated as well as the epidemic,
valuable inferences may be drawn as to the influence of many large
factors, such as density of population, routes of travel, climatic
conditions, drainage, the prevalence of insects, the prevalence of
paralysis of animals; all of these being points concerning which
the most careful intensive study of epidemic foci alone is apt to
give erroneous impressions.
3. Prompt and accurate morbidity reports are obviously neces-
sary as a preliminary to intensive study of cases. An edict mak-
ing poliomyelitis reportable in Sweden laid the foundation for the
epidemiological study of poliomyelitis, making possible the exten-
sive studies of Wickman.
Reports from a large area of country cannot be expected to be
accurate in detail. Such reports must necessarily be obtained
from hundreds of different observers each introducing an unknown
co-efficient of error in his own personal bias. To reduce this error,
such extensive reports should be made as simple as possible, em-
bracing only bare facts, in reporting which the chances of error
due to faulty observation, carelessness in expression or unwar-
ranted inference are reduced to a minimum. Much will be lacking
in these reports, much that is of importance in interpreting the
laws of epidemic poliomyelitis ; but they will at least have the ad-
vantage of being broad and, what is better, of being accurate.
To supplement the extensive knowledge gained by collective re-
ports, it is necessary to have other observations not less accurate
but more detailed. These observations must be made by indi-
vidual intensive studies, in which thoroughness and accuracy must
be the first aim, extensiveness of observation secondary. Accuracy
in such studies may best be obtained by the employment of spe-
cially trained, experienced obsen^ers; uniformity by having the
men engaged in such work keep in close touch with each other;
936 CONFEBENCE OF SaNITABY OFFICERS
extensiveness by having a large number of observers, each of them
devoting as much as possible of his time to the work. In some in-
stances the local health officer can best make these studies, es-
pecially in small localized outbreaks, having as he does the ad-
vantage of local knowledge. In most cases, however, it is better to
have the studies undertaken by the State, especially studies of epi-
demics so large as to require more time than the local health offi-
cer can devote, and studies of cases so widely scattered as to be in-
accessible to one having local duties to perform. The local health
officer can, however, even when he is not the principal in the study,
be an invaluable ally, being already possessed of a knowledge of
local conditions which a stranger in the community would have
difficulty in acquiring without his aid.
Our knowledge of the epidemiology of poliomyelitis is based on
the result of comparatively few field studies. Wickman has con-
tributed a careful extensive study of over 1,000 cases occurring in
Sweden in 1305-1906, a study which is still unsurpassed in com-
bined extent and thoroughness. The Collective Investigation Com-
mittee of the N^ew York Neurological Society made a careful study
of the epidemic of about 2,500 cases occurring in and around New
York in 1907. The Massachusetts State Board of Health has
been actively engaged since 1907 in the study of the disease in that
State. Their report for 1909, giving the distribution of cases in
the State for three years and the results of the intensive study of
150 cases, is as valuable a contribution as has ever been made to
the subject, and serves admirably to illustrate the advantages of
combining intensive studies with collective reports. Minnesota
has made some excellent studies on similar lines, the results of
which have not yet been published in full. Some interesting con-
tributions have also been made from Nebraska and scattered re-
ports of smaller outbreaks from various places. During the
present year the collective and intensive studies have been con-
tinued in Massachusetts and Minnesota, and similar studies imder-
taken in Iowa. A number of other States, including Virginia,
Pennsylvania, Connecticut and Kansas, and doubtless still others
of which I have no knowledge, have undertaken at least collective
studies of the disease ; while in the District of Columbia a collec-
tive study has been undertaken by an organization of the medical
profession.
Epidemic Anterior Poliomyelitis: Frost 937
The information gathered from the studies in 1910 will be very
valuable, but still not sufficient Reports are wanted from every
State to give a clear idea of the situation and how to control it.
To take up now in detail the objects, methods and difficulties of
an intensive study of epidemic poliomyelitis:
The official morbidity reports miist first be verified as to ac-
curacy of date and diagnosis. Almost invariably, too, these re-
ports will have to be supplemented by the addition of abortive and
suspected cases. It is not even to be expected as yet that official
reports will include all the abortive cases of poliomyelitis occurring
in a community, although tlie wide discussion of the subject now
taking place, calling attention to the existence of such cases, will
undoubtedly result soon in their more general recognition.
Wickman, in reporting his exhaustive studies of epidemic
poliomyelitis in Sweden in 1905-1906, first pointed out clearly the
occurrence of abortive forms of the infection, and emphnsizod
strongly their frequency and epidemiological importance, llo dis-
tinguished several types of abortive cases.
1. With symptoms of general infection.
2. With symptoms indicative of meningitis.
3. With hyperesthesia and pain.
4. With gastro-intestinal disturl aneos.
Cases showing symptoms referable to the central nervous sysf* m,
such as meningitis, hyperesthesia, di?tu'')>anc<,\< of reflexe.-, or
transitory paresis, are sufficiently distinctive to make a clinical
diagnosis possible. Other cases, however, can be (Iia<rn0'=?ed only by
inference, from their relation to typical cases of poliomyelitis, and
are almost certain to be overlooked unless this relation is known.
The practicing physician is usually unaware of the relation of his
caso-^ to cases occurring in the practice of other physicians.
Prompt reporting of all cases to the local health officer will
therefore not only help the health officer, but will equally help the
practitioner who, hv keeping in touch with the health officer and
being informed of the relation between cases, may often get a lead
on an otherwise impossible diagnosis.
Caverly states that during the epidemic of poliomyelitis observed
by him, the prevailing diseases of children were accompanied by
unusual nervous symptoms; and similar obsen^ations have boill
938 Conference of Sanitary Officers
made in other epidemics. It would be of great value to obtain,
in each focus of epidemic poliomyelitis, careful information con-
cerning diseases of children diagnosed as influenza, neuritis,
muscular rheumatism, " summer complaint,'^ etc. Such informa-
tion can be obtained only by enlisting the hearty co-operation of
practicing physicians.
Very frequently, also, abortive cases of poliomyelitis are so slight
as not to have been brought to the attention of any physician. The
matter, then, of tracing out abortive cases is always one of difficulty,
and there is good reason to believe that, except in very limited
epidemic foci, such cases have never been traced with satisfactory
thoroughness. A house to house canvass of the town seems the
only way to accomplish this end satisfactorily.
After tracing up possible abortive oases of poliomyelitis there
remains the even greater difficulty of deciding which of these cases
may be safely considered as due to this infection. There is the
danger on the one hand of too great conservatism and on the other
hand of too great enthusiasm for a convenient diagnosis. On the
whole I think it may be safely asserted that the error has generally
been on the side of conservatism. In order that the epidemiologist
may be able to decide which cases he shall include under the
diagnosis of poliomyelitis it is necessary that he should, if possible,
be provided with a field laboratory sufficient to enable him to
make examinations of blood and cerebrospinal fluid. Examina-
tions of this kind promise to be very helpful to the epidemiologist
in the future. Especially in regard to abortive cases it is highly
important that the field study be undertaken during the progress
of the epidemic or very shortly thereafter, as such mild cases of
illness will often have been forgotten alike by physician and family
within a few weeks after their occurrence.
It may not be out of place here to call attention to the frequency
of abortive as compared with paralytic cases in several different
localities.
Of the 1025 cases studied by Wickman in Sweden during 1905,
1906, 157 or a little over 15 per cent are classed as of the abortive
type. The author states, however, that this does not, in his
opinion, represent the true proportion of such cases. In three
circumscribed epidemic foci, offering favorable opportunities for
Epidemic Anterior Poliomyelitis: Frost 939
tracing all cases, Wickman found 68 paralytic cases and 62 of the
abortive type, approximately 48 per cent, of the total. Taking
into consideration only those houses in each of which there oc-
curred more than onenjase, Wickman states that of 404 cases oc-
curring in 156 houses, 211 or 62 per cent were of the abortive
type.
In Massachusetts, in the intensive study of 150 paralytic cases
occurring in 142 houses, 49 possible abortive cases were found to
have occurred in the same houses, which is 26.6 per cent, of the
total.
In a field study in Iowa during the past summer, I investigated
67 houses in which there had been 74 paralytic cases and 44
possible abortive cases, making a total of 118 cases, of which 37
per cent, were possible abortive types. Taking into consideration
cases occurring in the same vicinity but not in the same houses
with paralytic cases, I collected 83 cases which I suspected to be
abortive types of poliomyelitis, as compared with 74 frank cases.
Anderson, in a summary of 86 cases occurring in Polk county,
Nevada, in the summer of 1909, states that 40 per cent, of the
cases showed no paralysis.
Muller gives an account of an epidemic, evidently poliomyelitis,
occurrijig in the Island of Nauru, in Oceanica in January, 1910.
Within two weeks, 700 of the 2,500 inhabitants of the island were
attacked by an acute general infection affecting the nervous sys-
tem, but of these 700, only about 50 showed paralysis after three
months.
The occurrence of abortive cases of poliomyelitis is by this time
well established, and while conservatism in diagnosis is to be
commended, we can no longer make definite and lasting paralysis
the criterion for inclusion of oases under the diagnosis of poliomye-
litis. Abortive cases may be considered as probably more import-
ant than paralytic cases in the epidemiology of this disease, and no
intensive study can now claim to be complete without taking such
cases into consideration. These cases, in fact, are deserving of
special study both by the clinician and the epidemiologist.
The plotting of cases upon a map is a helpful and even necessary
procedure. The map should be as nearly as possible accurate,
and should be on a generous scale. The cases should be plotted on
940 Conference of Sanitary Officers
this map with care as to location and with an easily comprehended
graphic representation of the date as well as the location of each
casa Such a map, showing at a glance the grouping of cases with
regard to previous cases, as well, as in relaUon to elevation, drain-
age, sewage disposal, dirty streets, etc., often shows more at a
glance than could be learned from the study of many tabulations.
The map, however, is often misleading unless interpreted in the
light of further observations. Epidemiological observations to be
reliable must be made by personal canvass of cases. Allowance
must be made for a certain amount of error in the information ob-
tained from even the most careful personal canvass. It is the
realization of this unavoidable error, which leads those who have
tried to get accurate information by this means to distrust the
accuracy of compilations made from the scattering observation of
many different observers.
In the canvass of cases of poliomyelitis it is necessary to go into
the symptomatology of each case with more care than is usually re-
quired in the epidemiological study of other infectious diseases.
This is necessary because, as already stated, in many cases the
diagnosis is doubtful, and clinical study is necessary to give to
these cases their proper epidemiological significance. It is de-
sirable also to utilize such an opportunity to collect statistical data
as to the symptomatology and utimate effects of epidemic
poliomyelitis.
In trying to determine the source of infection in each case,
while no possible factor should be overlooked, special attention
should be paid to detennining contact with previous cases, para-
lytic or abortive. Even when there has been direct contact with
a previous case in the acute stage of the disea.se, it is not always
easy to determine this. Contact with unrecognized abortive cases
is still more difficult to determine especially in the case of chil-
dren, whose playmates are often unknown to parents. In reckon-
ing the chances for contact, accoimt must be taken of neighbors,
chance playmates, visitors and schoolmates; also, attendance at
schools, Sunday schools and church, public places of business or
amusement, railway travel, etc. Add to this the chances of indi-
rect contact through other members of the family, visitors, ser-
vants, tradesmen, etc., and the possible avenues of contact become
Epidemic Anterior Poliomyelitis: Frost 941
surprisingly numerous and complex, even for a child kept strictly
at home in a small family, comparatively isolated. Complicate
all this with confusion of dates, failure to remember visits and
visitors, and all the other vagaries of the memory, and it is readily
seen that even the most careful investigator must needs be very
cautions about asserting that there was no chance of contact infec-
tion in any given case.
Considering then the diflBculties of tracing contact between cases,
the tracing of contact is of more epidemiological value than the
failure to trace it. This is especially true as regards many of the
epidemics which have been reported after verj superficial observa-
tion.
On the other hand, in interpreting the finding that a certain
percentage of cases have been in contact with previous cases, it
is necessary to take into consideration numerous factors, such as
the probable number of persons exposed to infection and the pro-
portion of these that develop the disease. For instance, in a small
community where there had been say, one case per hundred in-
habitants, it would mean very little to find that 20 or 30 per cent,
of the patients had been in contact with previous cases. This per-
centage of traceable contacts would mean a great deal more, how-
ever, in a larger community where there had been perhaps only one
case to each 10,000 inhabitants.
In the effort to trace out conta»^r between cases one must not lose
sirrht of the numerous other possible factors in the spread of the
disease, paying most attention to those factors which seem most
pi''»bably important, but not forgetting to gather information con-
cerning even the seemingly least important. Factors which must
be considered are food and water supply, insects, paralysis of
flomestic animals, relation to water courses, dust, sewage disposal,
general hygienic conditions, previous health, etc
Tt is impossible, in this space, to discuss the relation of all these
factors to the spread of poliomyelitis. Moreover, their iiniwrt-
ance is, as yet, largely undetermined. Food and water supplies
have quite generally been eliminated as probable sources of general
i?ifection; although Wickman cites one group of cases apparently
infected by their common milk supply.
Previous health appears to have no appreciable i
942 Conference of Sanitary Officers
termining infection. The influence of insanitary ccmditiona of
life is particularly difficult to determine, as it is usually impossible
to make more than a rough estimate of the proportion of people in
any community who live under what may be called insanitary
conditions.
It would seem that, in general, the disease id more prevalent
among those classes of people that live in rather crowded, insani-
isCry surroundings; but the incidence of cases among the lower
social strata is not sufficiently disproportionate to justify attach-
ing any great importance to general hygienic conditions as a factor
in infection.
The probability of insect transmission of the disease is strongly
suggested by several epidemiological facts already established.
One of the most striking of these facts is the seasonal incidence of
epidemics. In this latitude epidemics occur almost without excep-
tion in the warm season, from May to November — the season
when insects are most prevalent and most active. It is of in-
terest to note in this connection that the epidemics reported from
the southern hemisphere have occurred between January and
April, a period corresponding seasonally to our late summer and
fall months. Another fact which suggests insect transmission is
the geographic distribution of epidemics. Generally speaking,
epidemic poliomyelitis is a summer disease of cold countries. In
Europe, Norway and Sweden, Holland, Germany and Austria have
suffered most ; in this country, the states which have suffered most
are those included in the northeast quadrant.
A further indication of the probability of insect transmission is
the distribution of the disease in relation to density of population.
Apparently, density of population bears no constant relation to the
prevalence of epidemic poliomyelitis. Wickman noted this in
Sweden in 1905, and statistics for the United States, so far as
they are available, confirm this observation. Indeed, it has been
noted both in Sweden and in the United States that epidemics of
poliomyelitis are most severe in small towns and rural communi-
ties, the larger cities as a rule suffering less in proportion to popu-
lation.
Since the first considerable epidemic in this country occurred in
and around New York city in the summer of 1907, and epidemics
Epidemic Anterior Poliomyelitis : Frost 943
all over the country have been more common since that time, it 3s
naturally suggested that the disease has spread from New York.
Yet, if such is the case, the spread has been remarkably slow,
considering the constant communication between New York and
other parts of the country; and still more remarkably irregular
in its progress. In 1907 the region of greatest prevalence was in
and around New York city, extending to Massachusetts. In 1908
there were . epidemics in Massachusetts, Minnesota, Wisconsin,
Michigan, and at least two small outbreaks in Iowa. In 1909 the
epidemics reached their height in Massachusetts, Minnesota and
Nebraska. In 1910 the disease has been less prevalent in Massa-
chusetts and Nebraska ; but has been epidemic in Iowa, Pennsyl-
vania, District of Columbia, Virginia, Connecticut, and other
widely separated states. If the disease has been disseminated from
New York along routes of travel, it is hard to understand why it
has progressed so irregularly, skipping wide areas of thickly set-
tled country ; and why it has spread so slowly, becoming epidemic
in the District of Columbia, for example, three years subsequent
to the epidemic in New York.
These facts are strongly suggestive of the existence of some as
yet unrecognized biologic factor, possibly an insect, whose pres-
ence in a community is necessary or at least favorable to the spread
of epidemic poliomyelitis.
Considering, on the other hand, the evidence against insect
transmission, the most striking is that presented by laboratory ex-
periments already cited, viz., the low degree of infectiousness of
the blood; the apparent dissemination of the virus through the
body by the lymph stream rather than the blood; the demonstrated
infectiousness of the nasal and buccal secretions, the possibility of
infecting animals through the normal mucosa of the respiratory
and digestive tracts. Epidemiological studies have failed to give
evidence of the prevalence of unusual insects or of common in-
sects in unusual numbers in epidemic foci ; they have failed to give
any evidence of an extrinsic period of incubation ; they have failed
to show that infection is confined to places rather than persons
and have indeed shown the probability of healthy persons acting
as carriers of infection. Any insect to merit consideration as an
obligatory factor in the transmission of poliomyelitis must be of al-
944 Conference of Sanitary Officers
most worldwide distribution and perennial prevalence, for polio-
myelitis tas occurred in all latitudes from Australia to Canada;
and, while epidemics have been confined almost exclusively to the
warm months, cases have been reported in the United States in
every month of the year. On the whole, the evidence at present
available is against the theory of any insect being a necessary or
important factor in the spread of the disease; but on this, as on
other points, undoubtedly more evidence is needed — another indi-
cation of the necessity of field studies.
As regards the relation of paralytic diseases of animals to epi-
demic poliomyelitis, it has been noted in connection with a num-
ber of epidemics that domestic animals, especially chickens, dogs,
horses, hogs, cattle and sheep, were found in the same community
to be suffering from paralytic diseases clinically similar to the
disease prevailing among human beings. The earliest observation
of this kind of which I am aware was recorded by Caverly in his
report of an epidemic occurring around Rutland, Vt., in 1894,
when he noted paralysis of chickens and dogs. One of these
chickens, examined by Dana of Xew York, showed lesions of the
lumbar cord resembling the lesions of acute anterior poliomyelitii,
this being the only instance of which I am aware in which such le-
sions have been found. On the other hand, I have knowledge of a
considerable number of paralyzed fowls and other animals having
been examined in which no lesions of the central nervous system
could be found, and know of several unsuccessful attempts to trans-
mit the paralysis by inoculation to other animals of the same
species. While the pathology of the paralytic disease of animals
has certainlv not been sufficientlv studied, the bulk of the evidence
available is against the assumption of any close relation between
such affections and epidemic poliomyelitis. Xumerous attempts
have been made to inoculate various animals other than the monkey
with human poliomyelitis, but the results have been uniformly
negative with the exception of some inoculations of rabbits, al-
ready referred to. The evidence in regard to these rabbits can-
not be ignored, yet it is not quite convincive, and lacks confirma-
tion.
The reports of paralysis among domestic animals in localities
where poliomyelitis is prevalent have certainly been quite striking.
Epidemic Anterior Poliomyelitis : Brost 945
Paralysis among domestic animals is, however, quite common and
it may be that the numerous reports of it from such localities are
due more to increased interest in the matter than to any unusual
prevalence of such diseases among animals. The most careful in-
vestigation of this point by the Massachusetts State Board of
Health showed that the distribution of paralysis among animals
did not correspond to the distribution of human poliomyelitis.
The occurrence of epidemic poliomyelitis in the hot, dry, dusty
season has given riic. to the surmise that dust may be in some way
a factor in the spread of the disease. This surmise has been
strengthened by the grouping of cases along dusty thoroughfares,
observed in several localities ; and by the cessation of several epi-
demics shortly after the dust has been abated by rainfall or
sprinkling of streets.
Other observations in support of the causative relation of dust
to epidemic poliomyelitis are, the greater incidence of the dis-
ease among children at the age when they are likely to crawl and
play in the dust, and the greater incidence among males, who are
out of doors in the dust, than among females, who are more inti-
mately exposed to infection through contact with sick persons. It
has been suggested in view of the occurrence in horses of a dis-
ease resembling poliomyelitis that the infective agent in dust is
horse manure. The excessive prevalence of dust has not, however,
been found constantly to coincide with the prevalence of polio-
myelitis. It is true that the disease is more prevalent in the late
summer and fall months; it is also true that dust is generally more
prevalent at this season, but the coincidence is not sufficient to es-
tablish the relation of cause and effect.
Epidemic poliomyelitis must, in the light of present knowledge,
be regarded as probably transmissible by direct contact. Its
spread, to be sure, does not exactly follow the routes and the laws
which we should exi)ect in the case of a disease transmitted by di-
rect contagion ; but it is to be remembered that infection of the
human body with any micro-organism is a fairly complex bitv
logical phenomenon into which there may enter many factors other
than the mere bringing together of the body and the germ.
We must consider, first, that the infecting organism is not an
unchanging, fixed quantity, not a definite thing like a stable chem-
946 QpNFEBENCE OF SaNITARY OFFICERS
ical compound, but a far more complex and probably very variable
factor — a living organism, reacting to all kinds of external con-
ditions. Realizing the complexity of conditions in the environment
of the organism, together with our inability even to analyze these
conditions, much less to appreciate their effect upon an ultra-
microscopic body, we should be prepared to find the organism de-
\dating at times from the course which, with our very limited
knowledge, w^e should lay down for it.
Taking up, on the other hand, the factor of susceptibility to
the infection of poliomyelitis, we may assume this factor also to
be extremely variable. There are. some facts which indicate that
only a certain proportion, usually a small proportion of persons
exposed to the disease are readily susceptible to infection. In
general it has been found that only one, or at most, a few of a
family have the disease. Assuming that the disease is contagious,
the other members have certainly been exposed to infection, and
their failure to develop the disease would seem to be due to a lack
of susceptibility. Even assuming that the disease is not contagious
and that infection is contracted from some other source in the
environment, it is certainly probable that in general the members
of one family, especially the small, children, are likely to be ex-
posed to the same environmental conditions. Whether we regard
the disease as contagious or not, the rarity of multiple cases in a
family seems best explained by individual variations in suscepti-
bility. The occurrence of abortive cases is also an indication in
the same direction.
The conditions constituting susceptibility are of course unknown
except in a broad, general sense. Statistics indicate that children
are more susceptible than adults; that males, especially in later
life, are more susceptible than females ; the white races more than
the negro. The increased incidence of the disease in the summer
months among children, suggests the possible operation of causes
similar to those which make diarrheal diseases especially preva-
lent among children in hot weather.
It has been the object of this paper not to explain the spread of
epidemic poliomyelitis, but rather to point out the difficulties in
the way of explaining it ; to attempt an interpretation of known
facts chiefly to show the deficiencies in the facts. If the facta
Epidemic Anterior Poliomyelitis : Frost 947
already ascertained seem contradictory, it b because they are in-
complete. What is needed to harmonize the apparent contradic-
tion is more facts. Laboratory workers have contributed a gener-
ous share of knowledge concerning this disease, clinicians all over
the country are studying it; and every health officer should em-
brace the opportunity to contribute his share of the facts which
shall explain the spread of epidemic poliomyelitis. Thiere is little
chance of making a brilliant discovery in this work. If such a
discovery remains to be made it will be made by one or at most
a very few of the many workers engaged. There is a certainty,
however, that every accurate observation, every common sense fact
added to the subject, will play its part in solving a problem that
has already become very serious and shows no indication of becom-
ing less so.
While a discussion of the prophylaxis of epidemic poliomyelitis
is not strictly germane to this paper, a few words on the subject
may perhaps not be altogether out of place.
After a careful consideration of the facts of epidemic polio-
myelitis as known at present, it seems to me that health authori-
ties are morally bound to put into eflFect to the best of their ability
certain pretty definitely indicated measures for the prevention of
the spread of epidemic poliomyelitis — measures similar to those
adopted for the control of other diseases accepted as directly con-
tagious. Without attempting to go into detail, these measures may
be given as
1. Isolation of the patient, with isolation of the contacts so
far as practicable — certainly to the extent of excluding members
of the patient's family, from school for at least three weeks.
2. Disinfection of the secretions of the nose and mouth and of
the stools and urine. Disinfection of all articles which might have
been contaminated by the patient.
3. Fumigation of premises after recovery.
In framing our expectation of results from these measures we
must consider several circumstances:
1. The disease is already disseminated over a wide area. Ex-
perience with other widespread contagious diseases such as scarlet
fever, for the control of which we have to depend solely on isola-
tion and disinfection, has demonstrated that we can hardly expect
948 Conference of Sanitary Officers
to eradicate such a disease by present methods, but that much may
be done in the way of limitiug its spread.
2. Epidemic poliomyelitis presents unusual difficulties in the
recognition of even tyr)ica] cases in their early stage, and of
abortive cases in all stages.
3. It will be difficult to ostimato the effect of })revei!iive meas-
ures, since* the disease often faiJs to spread in communities where
conditions seem most favorable for an epidemic.
The hope is certainly justified, hv)wever, that energetic pre-
ventive measures will result, if not in an actual immediate reduc-
tion in the total number of cases as compared with previous years,
at least in a reduction of the number that would have occurred
without such measures.
The Chairman — Now, frentlenien, wc will discuss these scries of papers
on communicable diseases, and first of all I will call upon Dr. Tutbill, of
Penn Yan. (No response.)
Is Dr. Frank S. Ovorton. of Patciioguc, here?
Dr. Frank S. OvnnoN — Mr. ( lirJrman, in the closing hours of this Con-
ference we sliould '^^o.i impressions of the proper balance of judgment in regard
to what wc have lioard.
Now, wc Imvc lioard i viMy long, very varied, very interesting, and very
practical program. Jt haR been in two parts, I might say. First, the
scientific instruction, acndoniic inytruction, which we all need so woefully;
and, second, is to tell us pnictica'ly what to do in cases.
Now, as we go back to our districts, to other doctors and our patients,
we want to know the practical things to do and details of how they should
be done. There is whero wc Jiave not had as much instruction as we should
have, and through lack of timo. Now. of all the papers which have l)een
read, tlie most practical for U3 to take home for immediate use was Dr.
Howe's paper of tliis mov.iri;:. which we did not hear in full, as out of
deference to the visitin;: docrors he contented him. elf witli stating that his
paper would l)e publis^iod in the proceedings.
TluMo are one or Iv.o things about quarantine and isolation that I would
have liked to have had pro-ciit«nl strongly. One of tnem is what we, as
health ofhcers, shall do in «iuaranilning and disinfecting? That seems to
be o'.;r main subject.
I !ten we have had an interesting paper on rej^orting diseases. At home at
this time I am stn:;:gling with an epiilemic of mild scarlet fever. Where
does tliis scarlet fever come from? It is gonernlly from unsnHpccted cases
that doctors do not see and tliat parents do not suKpcct the dit>eaae ha« its
origin. I am asked, 'Where are these cases coining from?" If I say, "I
do not know," they think I am derelict in my duty, and if I say, **They come
from cases we do not know about," they say, " Why don't you knovv- something
abo'it it?"
Now, to ferret out these cases is who^-e we should learn something. In
diphtheria and scarlet fever, which have been with us since the days of our
grandfathi'rs. we slnjuld know. There are coses of cold, unBU8|)ected cases
of scarlet fever, diphtheria, or pneumonia where we can accompli sh a great
deal.
Now, the second point is on the qutraniining: and of all things which come
home to us people as we '^o our way, this plan of having three stages or
varieties of quarantine, which Dr. Howe spoke of, seems Tery important.
Epidemic Anteriob Poliomyelitis : Frost 949
On Long Island we liad talked that over to a certain extent, and I am glad
that has been brought to our attention; and I hope that will be put into
effect, and that the State will give us cards signed by the State Board of
Health, and not leave the burden of quarantine on our shoulders.
Now, as to disinfection: When are you going to fumigate, is the question.
If you do not fumigate, they thinlc the health officer is derelict in his duty.
Now, when you come to listen to statements of prominent health officers
here of large cities, and they say that fumigation is not of much account
and not worth doing, when we know that the health officer of the port of New
York publicly writes and preaches the futility of fumigation, and then when
the State Board of Health sends out pamphlets and tells us to fumigate,
where are we at? I think that is an old subject which is ever new, and we
should know what to do.
I hope the State Board of Health will tell us.
The Chairman — I think that is an extremely valuable point; but I am
sure you will excuse me from saying anything about it, as I am not par-
ticularly responsible for that department of the work of the State Department
of Health.
Now, is there any discussion of Dr. Tlill's paper? We have yet to hear,
in this connection, from Dr. Joseph Roby, assistant commissioner of health
of the city of Rochester.
Dr. Joseph Roby, Assistant Commissioner of Health, Rochester — I have
to apologize, Mr. Chairman and gentlemen, for my voice, as I have a bad cold
and do not speak well anj-way. Apparently it is a difference of opinion that
makes horseracing, as Mark Twain said, and I will .say the same here, as I
disagree with some of the statements made about typhoid this morning. Dr.
Hill said he thought as a rule it was four weeks before we became cognizant
of the fact that typhoid was existing. I think it may be four weeks, but
often and usually it is leas than four weeks. I believe the period of incuba-
tion in the milk epidemic is abi>ut two weeks, and of water it is much less
than two weeks. 1 think it can be cut down to one week. I think many of
our men make a diagnosis in from three to four days; so that brings it down
to much less than four weeks.
The next point was that he said ten per cent, of the instances of typhoid
was due to water. 1 think that would Iiave to be modified to suit localitv.
If it is meant that in Rochester, for example, that out of 100 cases of typhoid
fever, that 06 of them are due to water, one of tliem to flies, and one to milk,
and one to contact, and one to oysters, I would agree, if you bunched the
wliole hundred and callerl it five, that would be about right, that out of five,
one would l)c due to water. But in Niagara Falls and Buffalo, where there
is constant aHVction by bad water, yt)u will find very much more than 10
per cojit. is due to water.
For the last two years we have tried to trace the origin of typhoid in
Roclio^ter. Of course it would be better if we could trace all of them, but
I think the most conmion means of affection in different localities should be
traced, and we should really do that in all parts of the State — every health
officer should try to trace every single case he can find time for.
Tlie common means of infection have been supposed to be water, milk,
more or less direct contact with previous cases, flies, shellfish and raw vege-
table*5. The Washington report laid more stress on contact and milk. 1
do not believe, in Rochester, milk has played much of a part, and it is here
where the importance of tracing all cases in each particular locality comes
in. In Washington it may be of importance to pasteurize all the milk. In
Rochester it would not be so necessary, for heating the milk and sterilizing all
the bottles and utensils is the only way to prevent an epidemic. All that
I need to say is if you have a dairy which is deriving milk from one or five
or six farms, and any bad typhoid carrier comes along on any particular
morning when they are short of a man, and they hire that man and he goes
on and mixes up possibly 5,000 or 6,000 quarts of milk, I think by that you
would get widespread milk epidemic in that case, and I do not think any-
thing but pasteurization could prevent it. If you do not think that is Eabw
950 Conference of Sanitary Officers
to happen, then the pasteurization falls. I have heard in some cases that
they prevented milk epidemic. To my mind nothing could be more aberurd,
as the damage was done two or three weeks before they got on to the job.
In Rochester, little of the typhoid has been due to milk, shellfish, etc
Most of it has been from a wife taking care of her husband and children in
the family. We have all been accustomed to charging up a certain number
of cases to typhoid infection. Although the task seems colossal, I think
there should be a clearing-house, so that when Rochester reports a case,
there should be an examination to see whether the case was affected in
Buffalo or whether it is chargeable back to Rochester.
There are only a few points that I should like to make in this discussion.
For two years now I have been trying to trace the origin of cases of typhoid
in Rochester. Of course, these results could be much surer were they con-
trolled by laboratory tests of all reported and suspicious cases. But even as
it is, I think this tracing of clinical cases should be done in order to deter-
mine the most common means .of infection of the different localities. Per-
haps the commoner means have been supposed to be water, milk, more or
less direct contact with a previous case, nies, shellfish and raw vegetables.
I believe that there will be no absolute control of typhoid until all sewage
is practically sterile before being poured into lake or stream, and that every
drop of water is safeguarded by efficient filtration or carefully patroling the
watersheds.
I believe that all cities where there are two supplies, one for domestic
purpose and one for fire purpose, should see to it that the two supplies
cannot possibly be mixed.
The Chaibman — We will now call on Dr. Groler to say a few words.
Db. G. W. Goleb, Rochester — Mr, Chairman and Fellow Trouhle-Makers :
Last night there was a meeting in the city of Rochester of the Conference
of Charities and Corrections of the State of New York, and at that meeting
Dr. William M. Pultney read a paper " For the Prevention and Control <3
the Social Evil." In that he said tnat boards of health ignore the problem;
that boards of health fear the problem, as by attacking it, they may jeopar-
dize themselves with the public.
As I listened to the papers this afternoon and the discussion which fol-
lowed, I was reminded of a story. A man whose acquaintance I am privi-
leged to enjoy, and who is a master of some fourteen or fifteen languages,
has in his large private library a replica of the Moabite stone, and he has a
child of whom he is fond and he has taught that child the Hebrew inscription
upon the Moabite stone. One morning while she was walking about the
university grounds the little girl met the university president. The presi-
dent said U> the little girl, " Good morning, Dagma, I suppose your father
teaches you Hebrew?" The little girl replied, "Yes; I used to read the
Moabite stone, but now I go to kindergarten."
A well-known philologist said to me there was no word in any language
which meant for man what the word " virgin " means for woman. I do
not know whether that is so or not. I have not taken the pains to verify
the statement, but if that is so, haven't we then with our old attitude toward
the social evil to get — what Helen Putnam spoke of the other night in
Baltimore — to get a new mental attitude toward the social evil and to
have a new code of morals that should be the same code for men as that
we now make for women?
It has been said by Dr. Swarts in his paper — and I agree with what he
has so wisely, and it seems to me, so well said — that we should begin,
especially we medical and health men, should begin to teach the parents
and children something of the eex question.
Well, where will you besjin? Are you going to begin in the public schools?
Probably not. If I understood Ih*. Swarts, we must begin in the high
school, but onlv twelve per cent, of the children who go into the public
schools get to the high schools; what shall we do with the other eighty-eight
per cent.?
Epidemic Anterior Poliomyelitis: Frost 951
Shall we begin in the colleges? If we begin in the colleges, less than five
per cent, of those who go into the high school get into colleges — so we are
practically neglecting about ninety per cent, of our children.
Haven't we got to begin to teach the child something of this question of
sex at the very earliest period of its life, at five or six years of age, ap-
proximately? Haven't we got to begin to teach our patients, and to teach
the men who are teaching their patients, that at an early age when a
child begins to ask the question " Where did I come from? " Where do
babies come from" — ^** How did I come into the world" — isn't that the time
to satisfy the awakening desire for knowledge on the part of the child?
It seems to me that it can be done, and very readily. I can assume that
a mother might say to a child when that question came from the little
child — not to tell her the " doctor's satchel " or " the stork," but to tell
that child the truth. When that child is undressed, before she puts it to
bed, she might take it on her lap and folding it to her breast tell her of
the womb in her body and of the egg in that womb, and of the attention
given to that egg and the growth of the being in that egg, until finally
there comes out from the body of the mother, where she has cherished
it and treasured it, the child of her heart, and that that child is then bom in
pain into this world. That is the story I told my own child. That is the
story told to me by a young and good matron many years ago in the seat of
a railroad train. She had told the story to her children in that way, and it
seems to me the story might be told to other children in a similar manner.
At any rate if the story is not told early enough, if it comes later, then
it must be taught to the mdividual; to the boy, or to the girl, or the young
man or young woman, by some chance acquaintance. And when, at the
proper age and time, it is told, that time may be almost anywhere; and
when we tell them we must depict the dangers of venereal diseases, and
we should tell the boys particularly that it is their duty to be chaste, not
because the sin will be visited directly upon them, but because it may be
visited upon those whom they hold nearest and dearest.
The Chaismait — In the discussion of the next paper, Dr. Irving Snow,
of BufiTalo, will say a few words.
Db. Ibving M. Snow, Buffalo — In contrast with the social evil this subject
of the field investigation of anterior poliomyelitis is new. It is the most
interesting disease we have to study. It is generally a spinal meningitis,
and we have learned from Dr. Thatcher that the disease has now become
a scourge. It has started all throughout the country, and it is certainly
very prevalent in Western New York. A committee was appointed by the
Academy of Medicine and it made an investigation into the subject. The
disease was reported as prevalent in Buffalo and throughout New York
State — the western part of New York State. Here we have a map of Buf-
falo: The black pins indicate death and the other pins indicate a case, so
that we know how the disease prevails in 1910. The disease commenced in
June — two cases in June — and in August we commenced to get them in
very fast. In August, September and October, we got a total of fifty-five.
We find there are a number of aborted and paralytic cases that get well.
On the other hand, two-thirds are permanently paralyzed and eight per cent,
die; and if in the State of New York there are 300 or 400 crippled children
as a result of this disease it is serious.
Every authority of the last two years who has written on the subject
states it is communicable. In one case it affected a cousin who was in a
room with another two weeks; and as it is communicable it is certainly
preventable. It prevails in epidemics, and then you have some sporadic
oases. That is a peripheral case coming from a central focus, usually. But
you might find that there is a large center, such as Buffalo, New York or
the Adirondacks. That is one of the points set forth by Whitman.
The abortive case is like influenza, but if the patient lies with its head
back, with stiffness and rigidity for three or four days, you have a case of
neuritis, and such terminate in paralysis of the extremity and they should
be reported and quarantined.
952 Conference of Sanitary Officers
Regarding the reporting of cases, I think it should be done by every health
officer and 1 think the physician should take care of his own case and quar-
antine it. He should report the cases and then the State could send out an
examiner.
In regard to New York State, there was an epidemic in Lake Placid,
another in VVellsville, and the disease has given us fifty-five reported cases
in Buffalo. There is an epidemic in Hamilton county and throughout Ontario,
and also in the western part of New York State. There are business rela-
tions between these points and many thousands of our people go into Canada
during the summer, so we are exposed to great danger of infecting them and
they of infecting us. So it is a matter for some central authority to control
and communicate with the different States. I think the liealtb officers of
the adjoining towns should carefully watch its progress in the affected ter-
ritory.
Regarding a study of the case, I think the first thing is you should send
a qualified investigator to examine reported cases.
Dr. Cole — The last speaker made a point deserving of a word of re-
buttal. It was said that the State shoulcl not send out blanks but investi-
gators. If the State Department could do that, it would be glad to do so;
but the State Department has to depend upon certain fixed appropriations,
and there is a limit to what we can do from the State Department of Health,
and that limit is fixed by the dollar, the almighty dolhir. Jf we have the
money to pay for the investigator, it is all well enoiiufh ; but if we have not,
then the investigation must stop where it began. That is why we have to
rely upon the long suffering physician.
Dr. Snow — There should be an appropriation of $15,000 or $20,000
specially devoted to this purpose.
TiiE Chairman — We shall be delighted to ask for it.
The Chairman — I see Dr. LeSeur. We should like to have Dr. LeSeur
make a few remarks on this subject.
'Dr. J. W. LeSeur. Batavia — Mr. Chairman and Memhers of the Conven-
tion: The hour is late and I have a few serious charges to prefer against
the Chairman of this meeting. I do so with a feeling of great responsibility,
and still with a feeling that I fail to do my duty to mynelf and my asso-
ciates if I fail to do this; and as this is the only time and the only place,
and the proper place, that I will liave opportunity to do it I shall do it now,
after making a few remarks before beginning.
The subject is "The Chairman." I charge the Chairman, first, with all
seriousness an<l sobriety, with having prepared the best program for the
State Sanitary Otlicers' meeting that has been prepared. 1 ask you, gentle-
men, is the Cliairman guilty or not guilty? (Cries of "guilty.")
Dr. Lj':ShL"R (continuing) — I charge him with not only having prepared
this program, but on the further ground that it has maintained interest
from start to finish, and it has made everv member of this convention feel
that it was worth while to attend this convention. Gentlemen, is the Chair-
man guilty or not guilty? (Cries of guilty.")
Dr. LeSeur — He stands "guilty," and such punishment as your wisdom
shall devise shall be meted out to him in the near future.
I regret that discussion of Dr. Swarts' paper could not follow the delivery
of the paper. T regard it as a masterly presentation of a very grave and
important subject, and before I forgot it I want to add another to the charges
against the Chairman of this meeting, as well as those against the Health
( ommispioner. He has provided for us from the sister States some of the
ablest, clearest-thinking, most efficient sanitarians that New York State has
ever welcomed to her scientific discussions. Is he guilty or not guilty?
(Cries of "guilty.") And in this number I include the secretary of the
State Board of Health of Rhode Island, our little sister State, whom we
have learned to respect for her efl^ciency and energy in the work of general
sanitation. We have learned from our study of bacteriology that it is not
Epidemic Anterior Poliomyelitis: Fbost 953
necessarily the largest body that is the most efficient for either good or harm,
and it holds good of States that it does not require a large area in order to
produce some efficient men.
The discussion of the topic in hand is one that is approached with hesita-
tion by all of us; and present company excepted, I am led to recall a quota-
tion from a large book which recites a statement from a physician of
prominence: "Men love darkness rather than light because their deeds are
evil;'' and the discussion of this problem of venereal disease and its rela-
tion to the general public health is one that, dodge as we may and evade as
we will, comes to us with ever increasing force.
The essayist referred to the fact that the son suffered for the sins of the
father. That is in line with "The sins of the father are visited upon the
children, unto the third and fourth generation;" and nowhere is it more
true than in this particular sin. It is particularly true that while all sins
may be forgiven, that that applies only to the moral world, for in the
physical world the man that sins, suffers. And while it is possible to pre-
vent suffering entailing upon the children, I believe the remedy should be
used. But mankind is mostly converted in the spring, backsliding in the
summer, sinning in the winter and back again to be converted in the spring.
We have, all of us. periods when we resolve to be good, and we decide that
the right, proper and dignified thing to do is to be virtuous and true. And
then we have periods when we forget all about it, and literally and strictly
" we go to the devil.'*
That is not true of a sanitary convention, but it is true of the general
public outside; and that is what makes the general subject so difficult to
deal with and so hard of remedy. The difficulty lies in the general propo-
sition, which is the keynote of this convention. Within this small rounded
head here to my left, there have lain dormant plans for the development of
the best sanitary forces in this Empire State. And fundamentally in the
thought of this distinguished teacher has lain the fact which has been em-
phasized over and over again to-day, namely, "/Education." We must be
taught, and in this particular subject, in this particular vice, as in others;
education of the children as they grow up to maturity must lie at the root
of any considerable improvement in this condition. It is well enough, of
course, to trim trees after they have grown up — and they do get trimmed
beautifully sometimes — men and women alike, by the surgeon, and the
doctor and then the undertaker, but that does not give you a shapely, sym-
metrical tree. As the twig is bent the tree is inclined, and until you learn
the importance of disseminating the right kind of knowledge on this import-
ant subject, until you meet and plan for the sexual life with the same clear-
ness and definitencss of purpose that you meet an anatomical or physical
fact and give the children to understand that the wages of sin are death
and tfiat the way of the transgressor is hard; until those facts are wrought
into the fiber of the children, ana until they learn to hate a mean thing and
to despise an ignoble one, until that day ai rives you have not settled the
question. Godspeed the day when that may be realized in the Empire State.
Dr. Swakts — In connection with this subject, I desire to call attention
to the preventive package which has been prepared for use in cases of
ophthalmia neonatorum. New York and Rhode Island have had a bit of
rivalry in this subject, and we of Rhode Island had our package for pre-
vention of ophthalmia neonatorum sixty days ahead of the time when New
York State had its prepared. The solution is placed in every store and dis-
pensary where the diphtheria tubes may be obtained. We have also a series
of little pamphlets, numbered 1, 2 and 3; one for boys, another for young
women, and another for men, and when any of these go to physicians to be
treated for ailments of that kind they hand them this literature. Not much
good can be done by telling them what they should have done after they had
contracted certain of those diseases; but if you placed in the hands of a
young man this little pamphlet you might possibly save the expansion of
any disease he has contracted to the other members of his family. It is a
little thing, but it is practical.
954 Conference of Sanitary Officers
Db. Maoill — There has been a question raised in the discussion, and I
would like to offer some :jUggedtions. A gentleman here asked what was to
be done to quarantine or discover these mild cases of scarlet fever and
diphtheria. Our own experience is this: In a State institution we found
a continually occurring number of cases of diphtheria, and they were not able
to render a permanent bill of health for diphtheria or have not been for a
number of months. It invariably happens that when the institution is in
such a condition there is no prevention until you undertake a methodical
examination of the throat of every person in that institution. We have
shown that can be done. We have an orphan asylum just outside of Albany
which ran this kind of thing for several months. Finally they appealed to
us and we took hold, and in the course of a properly selected quarantine and
strict enforcement thereof we succeeded in cleaning up the institution. There
were no more diphtheritic germs found in that institution. That was cleaned
up last November, and there has been no case since and there was no freedom
from it before.
As a matter of expense, the superintendent of that institution told me the
entire expense of carrying out our operations did not amount to the cost of
caring for the sick in that institution during a period of three months. You
will say that these mild cases of diphtheria cannot be controlled outside as
they can in institutions, but there are cases where you can catch them, as was
done in this school. Tliese are infantile affections, and if you thoroughly
inspect every child going into the school, and every person going in there to
work you will find it is perfectly practicable to find these mild cases, and
when you have once found them, separate them and you are safe. That is
what makes you safe, and it only requires an effort and a little energy.
There is another question: A gentleman here from Loncf Island has asked
when you have some noted authority in the State who tells you that disin-
fection is of no use and the State Department of Health suggests it, recom-
mends it, what shall the health officer do? A similar question came up
before. Answering that I would say that I believe in discipline and obedi-
ence. If your State Department of Health is your authority, you will take
your course of action from it rather than from some extraneous source. If
distinguished scientific authorities who do not believe in disinfection are at
loggerheads with one of the recommendations of the State Department, I am
perfectly certain, and I think we all are, that your Commissioner of Health
is seeking the best thing for the health of the people of the State of New
York and he will not stick to an old thing, if he has anything better. Until
he has something better he will stick to the present method. I shall do so,
at any rate, because I am told to do so by the Commissioner.
Db. J. W. Kino — As regards the investigation of institutions and the
general public, I would like to inquire, have we a legal right, a conferred
riglit to go into a school and subject each and every attendant at that school
to a swab culture, and the same question about whether we have a right to
go into the homes where such children reside?
I have those things to contend with. I am taking charge of an epidemic
of diphtheria now. I know the strain that the health officer works under.
I have had the pleasure of being sued for $5,000, and a verdict was brought
in of "not guilty; ** but, have we that right?
The Chairman — Is there any health officer from the floor who will answer
that question? If not. Dr. Hill will answer it.
Db. Hill — He certainly has in Minnesota, and it is his duty to do so.
He has a right of entry and search anywhere in his jurisdiction.
The Chairman — I think that is a rule which holds throughout the
United States. You are protecting the public and the individual's rights
must be a little circumscribed when the benefit of the public at large is at
stake.
Some of the statements made by Dr. Hill had exception taken to them,
and I think it is only fair to give the floor to Dr. Hill in order that he
may say something in rebuttal.
Dr. Hnx — I did not hear the objections. What were they?
Epidemic Anterior Poliomyelitis: Frost 955
Db. Roby — It is very difficult to get into a discussion here.
Perhaps the distinction Dr. Hill made may be true of Minnesota, and the
statements made about typhoid favor it. The doctor said, for instance, that
ten per cent, was due to water. I said if there were one hundred cases in
Rochester and ninety-six were due to water, to group those all under one kind
of infection, and one for those due to milk, and one for those to flies, one to
oysters, and one to direct contact, then you might say that twenty per cent,
were due to water. But that would give a very erroneous impression of the
number of cases due to water, if ninety-six per cent, were due to water and
four per cent, were due to other means of infection.
Again, you said the period was four weeks before typhoid became known.
I think in milk epidemics, and also in some water epidemics, that the peribd
of contamination has been less than ten days and it is possible to make a
diagnosis, and many skilled men make them in three or four days.
Db. Hill — As far as Dr. Roby's statement goes as to tne definition be-
tween cases and instances he is correct. In Mankato we had one instance
of infection resulting in five hundred cases. In the last summer we have
had twenty instances of fly infection. Say that all the cases in these twenty
outbreaks amounted to only five hundred; tliere are twenty instances of fly
infection for one of water infection.
The Cuairman — Dr. Swarts, have you anything further to say?
Db. Swarts — No, sir.
The Chairman — Dr. Frost?
Dr. P*bost — Nothing, except to get one thing on record: In a meeting
of the investigation of anterior poliomyelitis — you must remember that this
investigation is only preliminary to controlling it — we only want to prevent
it, and while we still know something about it, we must investigate a good
deal more before we can know much about the problem or put in operation
preventive measures. The preventive measures we know are briefly: isola-
tion of patients, exclusion of insects, disinfection of all discharges from the
patient and fumigation of the premises.
As to the efficiency of these methods we cannot say. They "have been put
in operation in a few places, but not on a sufliciently large scale for us to
know their efficiency. Isolation and quarantine alone in such cases have
never eradicated such diseases. Take scarlet fever: we believe it is worth
while to quarantine, although we cannot eradicate; while we may not eradi-
cate it by quarantine, we hope to reduce the number of cases.
Dr. Hill — I would like to ask Dr. Frost why he omits the precaution of
watering the streets? We had a large proportion of the cases on unwatered
streets in Winona. They began watering the streets on the fifth of August,
and on the twelfth of August the last case appeared. Winona never had
another case, although the surrounding country was full of poliomyelitis.
That is simply a repetition of the results which were obtained by watering
at Euclaire and New Richmond.
Dr. Roby, Rochester — I would like to say a word. As deputy health
officer under Dr. Goler, of course, I cannot believe in disinfection, but as a
member of the State Department of Health, I must believe in it; but if
you carefully disinfect, it can certainly do no harm. It may be right enough
to say that burning formaldehyde in one room of a house where there has
been scarlet fever and where the child has unrestricted run of the entire
house, to say that that will not be efl[icacious. It could not be expected to be.
The Chairman — The State Department of Health is very proud of our
traveling tuberculosis exhibit. This exhibit was shown in Washington, and
the authorities of the National Tuberculosis Congress granted a medal to
the State of New York. Whatever excellence has attended this exhibition
has been largely due to the painstaking work done on it by Mr. Fetherolf,
and I take great pleasure in calling on Mr. Fetherolf to present his paper
"The Tuberculosis Campaign as Conducted by the State Department of
Health."
956 Conference of Sanitary Officers
THE TUBERCULOSIS CAMPAIGN
By Mr. Charles W. Fetherolf
New York State Department of Health
Our civilization is not yet sufficiently removed from the age of
the stone axe and the bronze spear to permit lis to forget that our
primitive ancestors owed their very existence to the ability to have
and to hold food.
For centuries before modern inventive genius produced the gang
plow, and reaper and binder, locomotive and steamship, humans
had more than passing acquaintance with the gaunt spectre of
starvation. The slaying of wild animals; the ability to domesti-
cate animals ; the capacity to grow, harvest and store, meant life.
For hundreds of years the prevention of death from disease had
small consideration compared to the prevention of death from
starvation.
The famines of India, Russia and Ireland in recent years create
but a faint picture of the extent and horror of a famine such as
existed, for* instance, in Egypt during biblical times when speedy
succor from more favored quarters could not be given because
transportation facilities had not been developed.
Perhaps it is this primitive fear of want, transmitted down
through the ages, that fastened upon us the spirit of industrialism
and commercialism — a love of gain that nurtures selfishness and
lust for property — holding to such a degree that examples of men
risking and losing their life to gain, maintain or regain physical
property, are common.
So to-day we find our Ifation, our State, counties and cities
keenly bent on the preservation of property. An examination of
governmental expenditures will reveal that for every one dollar
spent directly to preserve human life we are spending hundreds
for the prevention of disease in cattle and plants; the conservation
of forests; the digging of canals; the construction of good roads
and the maintenance of fire and police protection.
But we are on the threshold of a new era — the era of the Man.
Thanks to Loewenhock, Cohn, Lister, Pasteur, Koch, Jenner and
Tl'berculosis Campaign: Fetherolf 957
others, an amazing field of possibilities for the conservation of
human life has spread out before us. We are turning from the
grosser to the finer things of life. We are coming to an apprecia-
tion of the fact that " Health is the first wealth/'
In this evolution the combat of tuberculosis will be recorded by
historians as the first great milestone in popular sanitary prog-
ress. It is the first instance in the history of the world when the
people of all nations, in all quarters of the globe, have rallied
to a universal standard and united in international bonds for
the purpose of ridding the earth of a disease enemy.
Other conflicts will be waged for public health, but this great
crusade against tuberculosis will have paved the way, and it seems
providential that the mode of warfare that must be adopted against
tuberculos-is should also be warfare against all that tends to foster
a low stratum of societv.
The victories over smallpox, bubonic plague and yellow fever
have been the victories of the medical profession, and the public
had small part in the winning of them. But in the fight against
the tubercle bacillus a larger force must enlist. We must have the
physicians ; we must have public oflScials, clergymen, business men,
teachers, farmers, mechanics, laborers, housewives and children.
We must have all of them, and the great weapon of all must be
knowledge.
The struggle against tuberculosis must be a struggle against the
sweat-shop, crowded tenements, long working hours, small wages
and against evervthing that tends to reduce one whit the sum
total of human happiness. Therefore, the fight against tubercu-
losis means progress, for progress is truly measured by the in-
crease of human happiness.
The discovery of the tubercle bacillus by Koch in 1882, hav-
ing demonstrated the communicability and preventability of the
most prevalent .and greatest death-producing disease, does it not
seem strange that almost nothing was done for twenty-five years to
take advantage of the knowledge ? There was dense apathy on the
part of the people because in their ignorance they continued to
look on the consumptive as the product of heredity and a person
who had urgent need to put temporal affairs in order and pay
close attention to the spiritual.
958 CONFEREXCE OF SaXITAKY OFFICERS
The campaign against tuberculosis is a campaign for popular
education that must reach all. Official action is urgent, but it
awaits its master — the public.
Methods vary in various countries and states, in carrying on the
fight. Some states, notably Pennsylvania, have adopted the pol-
icy of making institutional eflfort a state effort. The Keystone
State in one year appropriated several million dollars for the in-
auguration of a chain of state hospitals, sanatoria and dispensaries
— the latter to be located by counties.
In New York State the policy adopted places the burden of in-
stitutional effort on the community, and the Legislature in annual
bursts of generosity has appropriated the princely sums of from
$7,500 to $10,000 to educate the people of the communities as to
their responsibilities in this matter.
Progress during the three years these imposing appropriations
have been made, has been greatly accelerated by considerable
financial aid from the Russell Sage Foundation, capably admin-
istered through the State Charities Aid Association. This Asso-
ciation has worked hand in hand with the State Department of
Health in carrying on the State campaign, which does not embrace
the confines of the city of New York.
We have found in this work of educating the people that they
are a great deal like a certain Swede, in that they require a severe
"jolt" to make them sit up and take notice that there is such a
disease as tuberculosis. The Swede that I am referring to had
been haled before a corner's jury to tell about a railroad fatality.
He was told to tell in his own way just how his friend came to
his de^th. He said:
" Val, Olie and me bane valking on the tracks and when I hear
a whistle I yust step off de track. Purty soon a train go by.
Wal, I go back and walk on the tracks, but when I speak to Oley,
Oley don't answer. I look around but Oley not in sight. By^m
by I come to Oley's hat laying by the tracks. Pretty soon I come
to wan of Oley's arms by the tracks, and then I come by wan of
Oley's legs, and by'm by I see Oley's head laying by the tracks,
and then by yimminy, I yust make up my mind dat something
must have happened to Oley."
So in the campaign against tuberculosis, we are trying to make
Tuberculosis Campaign: Fetheeolf 959
the people realize that for centuries something has been happening
to them.
The municipal campaign is a strenuous affair. Months before
the prospective campaign begins representatives of the Stete De-
partment of Health and the State Charities Aid Association visit
the city and confer vnth about a score of the leading citizens for
the purpose of securing a fomial request that the city be given a
campaign. The local board of health is asked to appropriate
about $200 to defray the cost of purely local publicity. About
two weeks before the campaign IjogJns a staff representing the
two agencies goes to tlie city and puts through a program of adver-
tising designed to make the tuberculosis campaign the sole sub-
ject of public intere.^t.
The fraternal and benevolent societies are circularized; the
clergymen are interviewed arji asktvd to deliver a sermon on tuber-
culosis on the Sunday pnx^oding the opening of the campaign.
In some cases they dispense with the regular evening service and
hold a joint union meeting on tuberculosis at which Catholic,
Protestant and Hebrew clergymen deliver addresses. Every
worker in factory or shop receives a card in the pay envelope
calling attention to the meeting. The store windows contain cards
advertising meetings and the exceptional privilege of placing
posters in the street oar windows Is secured. Columns of press
notices are furnished the newspapers and huge banners em-
blazoned with the international emblem of the fight against tuber-
culosis — the double Red Cross — span the principal streets ; the
motion picture shows display slides advertising the exhibition, a
week before the campaign begins.
A program of meetings is arranged. There are meetings for
school children to be held at the exhibition during school hours and
the children are marched there by their teachers. There are
usually meetings for the laibor organizations; for the fraternal
and benevolent societies; for the women's clubs, and in case of a
large foreign speaking population, meetings are held in the mother
tongue; meetings with addresses and lectures in French, German,
Italian, Polish, Sweedish and Albanian languages have been held.
In a city where there is a United States Army Post an entire re^-
ment of infantry was marched to the exhibit, accompanied by the
regimental band.
960 Conference of Sanitary Officers
For the purpose of displaying the large traveling tuberculosis
exhibition of the State Department of Health and seating the
people who attend the meetings, the largest and most central hall
available is secured. This is usually the State Armory with its
immense drill hall. The exhibition being disposed about the
walls of the hall, seats are placed on. the floor; the stereopticon
lantern is provided, and campaign actually begins.
At each meeting there is a presiding officer, prominent business
man, clergyman or lawyer to give an address and a prominent
local doctor to give a lecture with a stereopticon lantern. These
lectures are accompanied by slides comprising the standard lecture
of the Department on Tuberculosis and the doctor is provided
some days in advance with a booklet in which the slides are
pictured in a logical order accompanied by suitable text.
At each meeting the people are urged to keep in mind the big
mass meeting with which the campaign will culminate and the
preparations that are made for this meeting are, to say the least,
bizarre and unconventional.
Prominent speakers have been secured from out of town; the
daily newspapers give whole pages of display advertising for the
meeting; the telephone companies on the day of the meeting call
up all subscribers and remind them of the meeting. The people
are told to listen at 7:30 o'clock in the evening, for at that time
the final invitation to attend the meeting is given by the blowing
of all the whistles of factories and locomotives and the ringing of
the church bells for three minutes.
And then, forth comes the city band or a mass band, and for
half an hour before the meeting opens parades the principal
streets in the presence of a big transparency with the words
"Come with us to the tu'berculosis meeting'' — and they do
come to the meeting, which is usually held in the biggest theatre in
the city. Generally the seating capacity is packed to the limit,
and hundreds crowd the aisles and available floor space.
Enthusiasm has been aroused to the highest pitch, and then be-
fore the effect of the campaign begins to subside there is organized
a permanent local committee to continue the good work so auspi-
ciously started. This committee is affiliated with the tuberculosis
committee of the State Charities Aid Association. This Asao-
TcBERcuLOSis CAMPAIGN: Fetherolf 961
ciation, in turn, is the New York State Branch of the National
Association for the Study. and Prevention of Tuberculosis, which,
in turn, has international afEliations.
With this local committee organized and in good running order
the real struggle begins — the struggle to secure local preventive
measures, including a coimty tuberculosis hospital, a county
laboratory, a municipal dispensary, a tuberculosis visiting nurse,
a thorough compliance with the law relating to registration of
cases and disinfection after removal or death, and medical in-
spection of school children.
Oftentimes the influence of one city, even though it is the prin-
cipal place in the county, is not equal to the task of securing action
from the Board of Supervisors. There are outlying villages, ham-
lets, and rural districts whose representation in the Board of
Supervisors is slow to perceive the necessity of county action.
In order to create in this lar^re constituency a demand for a
county institution, the State campaign has been made to embrace
in its propaganda a series of campaigns in the villages and hamlets
of those sixteen counties in which there seems to be the best
prospects of securing favorable action.
Six small exhibits in charge of paid demonstrators will visit
nearly two hundred places, and an important duty of these de-
monstrators is to secure petitions from as many citizens as possible
asking the Board of Supervisors to provide a county tuberculosis
hospital. In nearly every county in this list the exhibits will be
installed in the rooms in which the supenisors meet, and the
supervisors are prevailed upon to make the subject of tuberculosis
a special order for a certain day.
Now as to results.
It is still too early to expect any marked reduction in the
mortality of tul>erculosis as sliovvn by statistics, although I have
no doubt there has in reality been a pronounced decrease. I think
that for a numl)er of years the actual decrease of deatlis from
tuberculosis will not show in statistics because the physicians will
report deaths from tuberculosis more truthfully.
Three years ago there was not a county tul>erculo8is hospital
in the State: to-day snch hospitals are in actual operation in four
counties and four others have authorize<l their construction.
31
962 CONl^ERENCE OF SANITARY OFFICERS
Three years ago there was scarcely a city in the State, ex-
cepting the metropolis, that had a tuberculosis hospital dispensary
or a tuberculosis visiting nurse. To-day there are five cities
having a nurse, free dispensary and hospital. Twelve have two
of the above named agencies, and eight have at least one of the
preventive measures in force.
Three years ago there were not more than two local committees
for the prevention of tuberculosis; to-day there are seventy-Aree
such committeee scattered about the State.
During the three years the State campaign has been in opera-
tion, progressive laws have been enacted in behalf of the effort
to stamp out tuberculosis, and all indications point to a glorious
fulfillment of the prophecy, "No uncared for tuberculosis in
New York in 1916.''
Ths Chairman — If there is nothing else to come before the Conference,
A motion to adjourn is in order.
(Motion made, stated, seconded and carried.)
Conference adjourned sine die.
Delegates in Attendance
963
HEALTH OFFICERS AND DELEGATES IN ATTEND-
ANCE AT CONFERENCE
ALBANY COUNTY
Dr. J. R. Davidson, South Bethlehem.
C. W. Fetherolf, Albany.
Thomas E. Finegan, Albany.
Theodore Horton, Albany.
Dr. Wm. A. Howe, Albany.
Dr. F. H. Hurst, Guilderland Center.
Dr. Chas. P. McCabe, Greenville.
Dr. W. a Magill, Albany.
Dr. Albert Mott, Cohoes.
Alec H. Seymour, Albany.
ALLEGANY COUNTY
Dr. A. T. Bacon, Canaseraga.
Dr. C. R. Bowen, AUnond.
Dr. Geo. E. Burdick, Alfred.
Dr. W. 0. Congdon, Cuba.
Dr. H. E. Cooley, Angelica.
Dr. Jasper W. Coller, Wellsville.
Dr. Geo. Hackett, Ceres.
Dr. W. J. Hardy, Belmont.
Dr. Charles F. Hoffman, Bolivar.
Dr. F. E. Howard, Friendship.
Dr. H. L. Hulett, AUentown.
Dr. C. W. 0*Donnell, Andover.
Dr. F. L. Redmond, Filhmore.
Dr. Geo. W. Roos, Wellsville.
Dr. Edith W. Stewart, Hume.
Dr. Wm. S. Todd, Belfast.
BROOME COUNTY
Dr. Dan S. Burr, Binghamton.
Dr. F. McLean, Chenango Forks.
Dr. W. H. Wilson, Lestershire.
CATTARAUGUS COUNTY
Dr. E. L. Fish, Ashford.
Dr. 8. Z. Fisher, Randolph.
Dr. William Follett, Sandusky.
Dr. W. F. Gardner, Conewango.
Dr. H. W. Hammond, Ischua.
Dr. John C. Hoeffler, Salamanca.
Dr. Charles Kelley, Franklinville.
Dr. Frederick Krehbiel, Delevan.
Dr. A. D. Lake, Gowanda.
Dr. S. B. McClure, Allegany.
Dr. W. E. MacDuffie, Clean.
Dr. E. M. Shaffner, Salamanca.
Dr. Geo. R, Turk, Little Valley.
CAYUGA COUNTY
Dr. N. B. Ford, Owasco.
Dr. R. R. McCuUy, Union Springs.
Dr. Francis W. St. John, Weedsport.
Dr. W. A. Strohmenger, Moravia.
Dr. 8. N. Thomas, Moravia.
Dr. J. H. Witbeck, Cayuga.
CHAUTAUQUA COUNTY
Dr. A. J. Bennett, Jamestown.
Dr. A. E. Dean, Brocton.
Dr. G. E. Ellis, Dunkirk.
Dr. Guy Granger, Sherman.
Dr. L. C. Green, Panama.
Dr. Vernon M. Griswold, Fredonia.
F. P. Hall, Jamestown.
Dr. Wm. A. Putnam, Forestville.
Dr. D. 8. MacNee, Ripley.
Dr. John J. Mahoney, Jamestown.
Dr. Edgar Rood, Westfield.
Dr. 0. C. Shaw, Cassadaga.
Dr. Walter Stuart, Westfield.
Dr. A. D. Young, Mayville.
CHEMUNG COUNTY
Dr. F. B. Parke, Elmira.
Dr. A. M. Loope, Wellsburg.
CHENANGO COUNTY
Dr. Paul B. Brooks, Norwich.
Dr. A. R. Morse, Oxford.
Dr. James B. Noyes, New Berlin.
CLINTON COUNTY
Dr. Gilbert Dare, Schuyler Falls.
Dr. F. M. Swift, Plattsburg.
964
Conference of Sanitary Officeks
COLUMBIA COUNTY
William E. Carney, Philmont.
Dr. Franklin D. Clum, Cbeviot.
Ambrose Lasher, Germantown.
Dr. Louis Van Hoesen, Hudson.
CORTLAND COUNTY
Dr. George D. Bradford, Homer.
Dr. F. H. Forshee, McGrawville.
Dr. H. F. Van Hoesen, Truxton.
DELAWARE COUNTY
Dr. C. S. Allaben, Margaretville.
Dr. F. E. Bait, East Meredith.
Dr. Robert Brittain, Downsville.
Dr. Gilbert T. Scott, Davenport.
DUTCHESS COUNTY
Dr. John N. Boyce, Stanfordville.
Dr. C. L. Fletcher, Dover Plains.
Dr. Edward J. Hall, Mooers Mills.
Dr. Frederick J. Mann, Poughkeepsie.
Dr. John S. Wilson, Poughkeepsie.
ERIE COUNTY
Dr. W. H. Baker, Williamsville.
P. M. Blake, Buffalo.
Dr. C. E. Bowman, Alden.
Wm. B. Brenner, Buffalo.
Joseph H. Carley, Buffalo.
Dr. Edward Clark, Buffalo.
Dr. John T. Claris, Buffalo.
J. J. Coughlin, Buffalo.
Dr. E. A. Dean, Lackawanna.
Dr. Homer E. Dyke, Buffalo.
Dr. Francis E. Fronczak, Buffalo.
Dr. Arthur R. Gibson, Buffalo.
Ceo. H. Gorman, Buffalo.
Mr. John D. Goshleski, Buffalo.
Dr. Franklin C. Gram, Buffalo.
Mr. William J. Hanley, Buffalo.
Dr. F. A. Helwig, Akron.
Dr. T. H. Johnston, Farnham.
Dr. W. B. Jolls, Orchard Park.
F. H. Klecke, Buffalo.
Dr. Henry C. Lapp, Clarence.
Dr. Garra K. Lester, Blasdell.
Dr. J. G. Levy, Buffalo.
Dr. L. B. Longee, Marilla.
Dr. P. A. McCrea, West Falls.
Dr. J. D. MacPherson, Akron.
Dr. William B. May, Buffalo.
Dr. Burt J. Maycock, Buffalo.
Dr. Charles S. Meahl, Buffalo.
Jos. C. CGorman, Buffalo.
Frank Recke, Jr., Buff9,lo.
Dr. Ralph Robinson, Lackawanna.
Dr. Alfred Regan, Buffalo.
Walter L. Ruth, Buffalo.
Dr. Arthur C. Schaefer, Buffalo.
Dr. M. B. Shaw, Eden.
Mr. Frank B. Smering, Buffalo.
Dr. Irving M. Snow, Buffalo.
Dr. F. H. Stanbro, Springville.
Col. F. G. Ward, Buffalo
Dr. Walden M. Ward, North Collins.
William H. White, Buffalo.
Dr. F. B. Willard, Buffalo.
Dr. J. D. Wooster, Whales Center.
R. S. Woodburn, Buffalo.
ESSEX COUNTY
Dr. F. M. Noble, Bloomingdale.
FRANKLIN COUNTY
Dr. W. H. Harwood, Chasm Falls,
Malone.
Dr. A. L. Rust, Brushton.
Dr. W. A. Wardner, St. Regis FalU.
Dr. C. F. Wicker, Saranac Lake.
FULTON COUNTY
Dr. John Edwards, Glo vers vi lie.
J. Frank Titcomb, Gloversville.
GENESEE COUNTY
Dr. R. M. Andrews, Bergen.
Dr. John W. Baker, Batavia.
Dr. Henry E. Ganiard, LeRoy.
Dr. Charles D. Graney, LeRoy.
Dr. E. E. Hummel, Darien Center.
Dr. J. W. LeSeur, Batavia.
Dr. M. P. Messinger, Oakfield.
Dr. E. C. Richardson, E. Pembroke.
Dr. Elliott C. Smith, Corfu.
Dr. Ward B. Whitcomb^ Batavia.
GREENE COUNTY
Dr. George Haner, Tannersville.
Dr. Robert Seldon. C'atskill.
Delegates in Attendance
965
Dr. William A. Wassen, Greenville.
Dr. Charles E. VVillard, Catskill.
HAMILTON COUNTY
Dr. John P. Brannen^ Long Lake.
Amos Hough, Long Lake.
Walter D. Jennings, Long Lake.
Dr. Fred Stevenson, Indian Lake.
HERKIMER COUNTY
Dr. Charles H. Glidden, Little Falls.
Dr. F. J. Harter, Herkimer.
Dr. Cyrus Kay, Herkimer.
JEFFERSON COUNTY
Dr. C. F. Adams, Carthage.
Dr. Francis W. Bruce, Carthage.
Dr. J. D. Cole, Alexandria Bay.
Dr. Eugene M. Crabb, Cape Vincent.
Dr. John T. Fowkes, LaFargeville.
Dr. H. J. Frame, Clayton.
Dr. J. E. Jones, Evans Mills.
Dr. A. L. Morgan, Dexter.
Dr. E. A. Simonds, Carthage.
Dr. Frank M. Vebber, Clayton
Dr. E. S. Willard, Watertown
LEWIS COUNTY
Dr. F. E. Jones, Beaver Falls.
Dr. H. A. Pawling, I^wvillc.
Dr. I. H. von Zierolshofen, Croghan.
LIVINGSTON COUNTY
Dr. J. H. Burke. Dansville.
Dr. C. J. Carrick, Nunda.
Dr. H. B. Marvin, Lima.
Dr. R. A. Page, Geneseo.
Dr. Arthur P. Reed, Geneseo.
>L\D1S0N COUNTY
Dr. R. H. Ash, Canastota.
Dr. R. L. Crockett, Oneida.
Dr. H. S. Gardiner, Hamilton.
Dr. J. W. Knapp, Canastota.
Dr. Geo. F. Mills, Oneida.
Dr. A. R. Thomas, West Eaton.
Dr. Geo. W. Willcox, Hamilton.
MONROE COITNTY
Or. J. M. Allen, East Rochester.
Dr. W. W. Belcher, Rochester.
Dr. P. D. Carpenter, Pittsford.
Dr. John L. Hazen, Brock port.
Dr. 8. G. Hermance, Clarkson.
Dr. Chas. W. Hennington, Rochester.
Dr. M. E. Leary, Rochester.
Dr. Horace J. Mann, Brockport.
Dr. D. G. Mason, Henrietta.
Dr. J. Pease, Hamlin.
Dr. Joseph Roby, Kochester.
Dr. William Stanton, Webster.
Dr. E. H. Vail, Churchville.
MONTGOMERY COUNTY
M. Jennings, Amsterdam.
Dr. James S. Walton, Amsterdam.
Dr. C. C. Vedder, St. Johnsville.
Dr. William Zoller, Fort Plain.
NASSAU COUNTY
Dr. J. A. Hutchinson, E. Rock away.
Dr. H. G. Wahlig, Sea Cliff.
NEW YORK
Prof. Charles Baskerville, New York
Dr. Hills Cole, New York.
Dr. John B. lluber. New York.
Dr. John B. Garrison, New York.
Dr. E. H. Porter, New York.
C. Christian Sofleiss, New York.
NIAGARA COUNTY
Dr. F. W. Bentley, N. Tonawanda.
Dr. Frank T. Carmer, Newfane.
C. F. Crofur, Lockport.
Dr. J. E. Helwig, Martinsville.
Dr. John C. Plain, Ransom vi lie.
Dr. F. A. Watters, Lockport.
Dr. Edwin Shoemaker, Newfane.
Dr. H. A. Wilmot, Middleport.
ONEIDA COl^TY
Dr. Arthur P. Clark, New Hartford.
Dr. G. W. Fisher, Utica.
Dr. G. C. Lyons, Camden. •
Dr. G. W. Miles, Oneida.
Dr. Wm. D. Peckham, Utica.
Dr. Otto Pfaff, Oneida.
Dr. G. J. Pollard, Oriskany Falls.
Dr. W. C. Rosen, Boonville.
966
Conference of Sanitary Officers
ONONDAGA COUNTY
Dr. W. D. Alsever. Syracuse.
Dr. J. W. Brower, Mottville.
Dr. Frank R. Coe, Warner.
Dr. S. Ellis Crane, Onondaga Valley.
Dr. €. H. Graves, Delphi Falls.
Dr. A. B. Rood, Manlius.
Dr. B. W. SherWood, Syracuse.
Dr. D. M. Totman, Syracuse.
Dr. R. A. Whitney, Liverpool.
Dr. J. R. Young, Liverpool.
ONTARIO COUNTY
Dr. L. P. Conley, Clifton Springs.
Dr. O. J. Hallenbeck, Canandaigua.
Dr. B. T. McDowell, South Bristol.
Hon. Chas F. Milliken, Canadaigua.
Dr. F. H. Newland, Clifton Springs.
Dr. W. A. White, Phelps.
ORANGE COUNTY
Dr. Palmer R. Bowdish, Cornwall.
Dr. F. E. Gessner, Port Jervis.
Dr. J. C. Hanmer, Middletown.
Dr. W. H. Snyder, Newburgh.
Dr. Ira C. Whitehead, Walden.
ORLEANS COUNTY
Dr. John Dagan, Albion.
Dr. David E. Fraser, Lyndonville.
Dr. Frank H. Latin, Albion.
Dr. Leon G. Ogden, Albion.
Dr. Geo. F. Regan, Medina.
Dr. George Strasenburgh, Kendall.
Dr. John H. Taylor, Holley.
OSWEGO COUNTY
Dr. W. G. Babcock, Cleveland,
Dr. E. W. Crispell, Williamston.
Dr. E. J. Cusack, Fulton.
Dr. E. J. Drury, Phoenix.
Dr. F. E. MacCallum, Pulaski.
Dr. C. W. Radway, Mexico.
Dr. Robt. Simpson, Fulton.
OTSEGO COUNTY
Dr. H. V. Frink, Richfield Springs.
PUTNAM COUNTY
Dr. J. C. Slawson, Mahopac.
RENSSELAER COUNTY
Dr. £. E. Finch, East Greenbush.
Dr. Geo. R. Little, Schaghticoke.
ROCKLAND COUNTY
Dr. L. B. Couch, Nyack.
Dr. Ralph DeBaun, Congers.
ST. LAWRENCE COUNTY
Dr. James W. Aitchison, Madrid.
Dr. H. T. Carter, Piercefield.
Dr. F. E. Graves, Morristown.
Dr. D. M. Taylor, Edwards.
Dr. Frank F. Williams, Canton.
SARATOGA COUNTY
Dr. T. E. Bullard, Schuylerville.
Dr. M. M. Dolan, South Glens Falls.
Dr« D, C. Moriarta, Saratoga Springs.
Dr. J. P. 0*Keefe, Schuylerville.
Dr. Charles S. Prest, Waterford.
Dr. Frank J. Sherman, Ballston Spa.
Dr. J. Seward White, S. Glens Falls.
Dr. Wm. Van Doren, Mechanicville.
SCHENECTADY COUNTY
Dr. Charles F. Clowe, Schenectady.
Hon. Charles C. Duryee, Schenectady.
Dr. C. W. Ensign, Rotterdam Jet.
Dr. William L. Wilson, Scotia.
SCHOHARIE COUNTY
Dr. Chas. K. Frazier, Cobleskill.
SCHUYLER COUNTY
Dr. S. B. Allen, Burdett.
SENECA COUNTY
Dr. W. W. Carleton, Waterloo.
Dr. D. F. Everts, Romulus.
Dr. A. J. Frantz, Seneca Falls.
Dr. A. Letellier, Seneca Falls.
Dr. W. M. Stacey, Waterloo.
Dr. F. W. Severn, Interlaken.
STEUBEN COUNTY
Dr. P. L. Alden, Hammondsport.
Dr. S. H. Bennett, Gteenwood.
Dr. H. S. Gillette, Savona.
Dr. Chas. 0. Green, Homell.
Delboatbs in Attendance
967
Dr. D. P. Mathewflon, Bath.
Dr. J. B. Murritt, Prattsburg.
Dr. Geo. M. Peabody, Wajland.
Dr. G. L. Preston, Canisteo.
Dr. W. W. Smith, Avoca.
Dr. F. L. Spaulding, Cohocton.
Dr. F. S. Swain, Coming.
Dr. James F. Trant, PrattAorg.
SUFFOLK COUNTY
Dr. Wm. A. Baker, Islip.
Dr. Wm. B. Gibson, Huntington.
Dr. Hugh Halsey, Southampton.
Dr. Frank Ovefton, Patchogue.
Dr. Guy H. Turrell, Smithtown.
SULLIVAN COUNTY
Dr. G. H. Lathrop, Livingston Manor.
Dr. Frank I. Smith, Barryville.
TIOGA COUNTY
Dr. VV. L. Ayer, Owego.
Dr. G. S. Carpenter, Waverly.
Dr. C. W. Chidester, Newark Valley.
Dr. M. B. Dean, Candor.
Dr. R. D. Eastman, Berkshire.
Dr. R. H. Fisher, Spencer.
TOMPKINS COUNTY
Dr. J. F. W. Allen, Ithaca.
Dr. H. H. Crum, Ithaca.
Dr. Wilbur G. Fish, Ludlowville.
Dr. C. H. Gallagher, Slaterville
Springs.
ULSTER COUNTY
Dr. J. W. Bowman, Wallkill.
WARREN COUNTY
Dr. G. H. Aldrich, Stony Creek.
Dr. Floyd Palmer, Glens Falls.
WASHINGTON COUNTY
Dr. R. A. Heenan, Hudson Falls.
Dr. Robt. H. Lee, South Hartford.
Dr. D. C. McKenzie, Granville.
Dr. 6. M. Stillman, Argyle.
Dr. A. M. Yoimg, Salem.
WAYNE COUNTY
Dr. J. S. Brandt, Ontario.
Dr. W. J. Hennessy, Palmyra.
Dr. G. A. Jones, Wolcott.
Dr. Robert Morris, Lincoln.
Dr. F. L. Willson, Sodus Point
Dr. Geo. D. Winchell, Rose.
Dr. A. A. Young, Newark.
WESTCHESTER COUNTY
Dr. W. J. Carpenter, Katonah.
Dr. E. H. Codding, New Rochelle.
Dr. W. S. Coons, Yonkers.
Dr. G. P. M. Curry, Mt. Kisco.
Dr. John L. Hughes, Mt. Vernon.
Robert Haviland, Chappaqua.
Dr. P. H. Mason, Peekskill.
Dr. H. F. Patch, Chappaqua.
Dr. Leon E. Peeler, Harrison.
Dr. Edwin G. Ramsdell, White Plains
WYOMING COUNTY
Dr. Lemar M. Andrews, Warsaw.
Dr. E. B. Belknap, Wyoming.
Dr. J. R. Brownell, Perry.
Dr. W. 0. Burbank, Pavilion.
Dr. W. J. French, Pike.
Dr. W. B. Gifford, Attica.
Dr. P. S. Goodwin, Perry.
Dr. W. N. Martin, Cowlesville.
Dr. L. E. Stage, Bliss.
Dr. Z. G. Truesdell, Warsaw.
YATES COUNTY
Dr. William H. Hawlev. Dundee.
968
Conference of Sanitary Officers
KEQISTERED VISITORS IX ATTEXDAXCE AT
COXFEREXCE
ALBANY COUNTY
Mrs. J. R. Davison, S. Bethlehem.
BROOME COUNTY
Mr. A. W. Beilby, Lestershire.
Mrs. F. McLean, Chenango Forks.
CATTARAUGUS COUNTY
Mr. W. 0. Curtiss, Olean.
Dr. Geo. F. Reusch, Franklin ville.
ERIE COUNTY
Dr. John H. Grant, Buffalo.
Mr. Daniel H. Squire, Buffalo.
Dr. L. M. Wuugh, Buffalo.
GREENE COUNTY
Mr. Charles Voss, Tannersville.
MONROE COUNTY
Mrs. A. B. Hermance, Clarkson.
Anabel Hermance, Clarkson.
NASSAU COUNTY
Capt. J. S. Boyce, Lynbrook.
NEW YORK COUNTY
Mr. M. N. Baker, New Y'ork.
Mrs. Charles Baskerville, New York.
Capt. G. W. Smith, New York.
ONEIDA COUNTY
Dr. Martin Cavana, Sylvan Beach.
RENSSELAER COUNTY
Mrs. E. E. Finch, East Greenbush.
SARATOGA COUNTY.
Mrs. J. Seward White, S. Glens Falls.
STEUBEN COUNTY
Mr. M. E. Shannon, Bath.
WARREN COUNTY
Mrs. Floyd Palmer, Glens Falls.
WASHINGTON COUNTY
Mr. J. E. Ryan, Hudson Falls.
Dr. John A. Amyot, Toronto, Canada.
Dr. Wm. G. Ebersole, Cleveland, O.
Dr. Allen W. Freeman, Richmond, Va.
Dr. W. H. liVost, Washington, D. C.
Dr. P. M. Hall, Minneapolis, Minn.
Dr. H. W. Hill, Minneapolis, Minn.
Dr. Chas. A. Hodgetts, Ottawa, Can.
Dr. E. C. Levy, Richmond, Va.
Dr. Gardner T. Swarts, Providence,
R. L
Mr. Frank D. Van Da Linda, Boston,
Mass.
INDEX
PAGE
American Public Health Aaeociation, report of department representative
on meeting of 207
Analytical results of examination of samples from public water supplies. 280
Anmal experimentation, value of 361
Antitoxin Laboratory, report of director 273
Births, registration of 73
See (Uso Vital statistics.
Cancer, deaths from 189
Cancer Laboratory, report of director 349
application of new principles to treatment of human beings 361
cancer hospital 362
cancer in fishes 36 1
goiter and cancer in man 357
International Cancer Congress 367
parasitic theory of cancer 359
scheme for exhibition on cancer diseases 364
value of animal experimentation 361
Commissioner of Health, report of 1-62
Communicable diseases, report of director of division 239
cancer 256
cases reported 243
cerebrospinal miningi tis 25 1
diphtheria 243
distribution of morbidity by counties 241
epidemic poliomyelitis 252
influenza 254
measles 247
ophthalmia neonatorum 253
pneumonia ^ 255
scarlet fever 245
smallpox 251
tuberculosis 257
Registration of living cases 1907-1910 257
typhoid fever 248
whooping cough . . . .^ ^53
Conference of Sanitary Officers, proceedings of 701
For contents, see page 703
Deaths, see Vital f^tatistics.
Diarrhea, deaths from 207
Diphtheria, deatlis from 204
Kngineering division, report of director 369
P\>r separate index, see page 371.
Erie canal, pollution by vegetable washing 324
Financial statement ^^
Fishes, cancer in 35 1
Goiter and cancer in man 357
(Jowanda Hospital, investigation of complaint relative to clothing dam-
aged by disinfection materials 327
Hygienic Laboratory, repwrt of director 279
analytical results of examination of samples from public water
supplier 280
comparati\ie tabulated report of work 345
diagiiostic work for 1910 316
(knvanda Hospital, investigation of complaiat relative to clothing
damaged by disinfection materials 327
[969]
970 Index
Hygienic Laboratory — Continued: paok
pollutdon of Erie Canal by vegetable washing 324
Rouses Point, typhoid at 329
Sara/toga Springs, invwtigation of mineral waiters of 317
Yonkers water supply 337
Infant mortality 177
Intemationial Cancer Congress 357
Marriages, by counties 1907-1910 76
Measles, deaths from 205
Morbidity, distribution by counties 241
Parasitic theory of cancer 359
Pneumonia, deaths from 207
Rouses Point, typhoid at 329
Saratoga mineral waters, investigation of 317
Scarlet fever, dearths from 206
Seasonal fatality from diflferent causes of death Ill
Tuberculosis campaign, report on 263
mortality from, 1885^-1910 179
by sanitary districts 179
in cities 181
in Greater New York and rest of State 185
Typhoid fever, deaths from 190
city mortality • 191
Violence, deaths from ■ 206
Vital statistics, report of director of division 71
births, registration of 73
city registration 78
death rate and per cent, of deaths at different age periods 110
from difierent causes 110
from principal causes in counties 112
deaths by causes 1885-1910 175
in State Institutions 78
detailed statement of causes of death 118
infant mortality 177
marriages in New York State by counties 1907-1910 : 76
mortality, by months 116
by sanitry districts 154
from principal causes in cities 114
from principal zymotic diseases by counties 156
of Greater New York and Buffalo 105
population and relative area of sanitary districts 178
registration by counties 80
registration of births, deaths and marriages by counties 77
of deaths since 1885 72
of marriages 76
seasonal fatality from chief causes of death Ill
special report on vital statistics by Walter F. Willcox, consulting
statistician 209-37
summary of mortality for year 1910 101
total mortality for year 126
urban and rural death rates from different causes 103
Willcox, Walter F., special report on vital statistics 20^37
Yonkers water supply 337
^i
LANE MEDICAL LIBRARY
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