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SEWER    GAS    AND    HEALTH. 


DEDICATED 

TO 

SIR    THOMAS     WRIGHT, 

TO  WHOSE  FORETHOUGHT,  WISE  COUNSEL,  AND  PERSEVERANCE 
THE  TOWN  OF  LEICESTER  IS  INDEBTED  FOR  MANY  SANITARY 
AND  OTHER  IMPROVEMENTS,  AND  WHO  HAS  FOR  A  GREAT 
NUMBER  OF  YEARS  GIVEN  FREELY  OF  HIS  VALUABLE  TIME 
FOR     THE     BENEFIT     OF     HIS     FELLOW-CITIZENS. 

AS     A     MARK     OF     HIS     VERY     HIGH     ESTEEM    AND     REGARD. 

THE    AUTHOR. 


SEWER   GAS 


INFLUENCE    UPON    HEALTH 


TI^E-A-TISE 


BY 


H.^^'^FKED    ROECHLING.    C.E., 


ASSOCIATE    MEMBER   OF   THE    INSTITUTION   OF   CIVIL   ENGINEERS  ; 

MEMBER    OF   THE   SANITARY    INSTITUTE; 

FELLOW  OF   THE   ROYAL   STATISTICAL  SOCIETY  ; 

FELLOW   OF   THE    IMPERIAL    INSTITUTE  ; 

MEMBER  OF  THE   SOCIETY  OF  ARTS  ; 

MEMBER   OF  THE   ROYAL  AGRICULTURAL  SOCIETY  J  .      ,     . 

MEMBER  OF   THE   AMERICAN  ACADEMY  OF    POLITICAL  AND  aOCML  kl^NCF  j 

ETC.,    ETC.  /    ^,*'*''^       4  '    ''N   *^         '// 

l<^'\     '     r      ,      ]r^ 

London : 
Biggs  and  Co.,  139-140,  Salisbury  Court,  Fleet  Street,  E.C. 


\To^t^  •5'! 


Although  a  great  deal  has  been  written  at  one  time  or  another  about 
the  influence  sewer  gas  exerts  upon  health,  yet,  in  the  author's 
opinion,  the  published  information  has  dealt  invariably  only  with  one 
or  two  aspects  of  this  question,  and  not  with  the  whole,  and  the 
student  of  sanitary  science  was  left  to  grope  his  way  in  the  dark,  as 
it  were,  and  without  guide  through  this  apparent  chaos,  emerging 
therefrom  probably  after  having  formed  a  very  one-sided  opinion. 

This  state  of  things  the  author  has  endeavoured  to  remedy  in  the 
treatise  before  the  reader,  and  although  he  is  fully  aware  that  great 
gaps  still  exist  in  our  knowledge  concerning  the  subject,  he  hopes  he 
has  succeeded  in  shedding  some  light  upon  it,  and  upon  the  way  that 
will  lead  to  its  ultimate  elucidation. 

Questions  affecting  Nature  and  the  processes  by  which  she  works 
her  marvellous  changes  should,  in  the  author's  opinion,  not  be  looked 
upon  from  one  standpoint  only,  but  ought  to  be  viewed  in  their 
entirety  and  with  their  surroundings,  otherwise  one  is  apt  to 
exaggerate  the  importance  of  one  or  more  symptoms  and  leave 
others — equally  important,  or  perhaps  more  so-^altogether  unobserved. 
It  is  therefore  to  the  harmonious  working  together  of  a  number  of 
specialists  — such  as  the  chemist,  the  medical  man,  the  bacteriologist, 
botanist,  and  engineer — that  the  author  looks  for  the  true  answer 
concerning  a  number  of  questions  affecting  the  health  of  individuals 
and  communities. 

In  the  search  for  material  wealth  this  age  has  at  times  apparently 
forgotten  scientific  research,  which  did  not  promise  some  immediate 
material  return ;  but  there  are  hopeful  indications  that  such  temporary 
neglect  is  passing  away,  and  that  in  future  the  scientific  side  of  many 
practical  sanitary  questions  will  receive  due  consideration.  It  is  then 
to  be  hoped  that  full  light  will  be  thrown  upon  many  subjects  at  the 
present  still  shrouded  in  mystery. 

Since  writing  the  treatise  the  author's  attention  has  been  drawn  to 
two  explosions  which  have  occurred  in  the  "septic  tank"  at  Exeter. 
In  the  first,  the  City  Surveyor  of  Belfast  narrowly  escaped  ;  and  in  the 
second,  the  City  Surveyor  of  York  is  said  to  have  received  severe  burns, 
and  such  a  shock  to  his  nervous  system,  that  he  has  been  obliged  to  keep 
to  his  bed  at  an  Exeter  hotel  for  some  days. 

As  the  "septic  tank"  is,  like  its  predecessor  in  title,  "the  old  cess- 
pool," a  place  for  the  manufacture  of  rank  sewer  gas  on  a  large  scale, 
containing  considerable  quantities  of  hydrocarbons,  such  as  marsh  gas, 
one  cannot  be  surprised  to  hear  of  explosions,  but  it  is  sincerely  to  be 
hoped  that  the  practical  demonstrations  of  the  dangerous  character 
of  the  gases  forming  in  the  septic  tank  will  not  be  lost  sight  of,  and 
that  the  lessons  thereby  learnt  will  be  utilised  in  future  to  prevent  loss 
of  life. 

To  all  those  who  have  been  kind  enough  to  supply  him  with  informa- 
tion and  particulars,  the  author  wishes  to  express  at  this  place  his  best 
thanks.  He  hopes  he  may  continue  to  receive  information  on  the 
influence  of  sewer  gas  upon  health  from  those  interested  in  the  subject, 
with  a  view  to  making  a  second  edition  more  complete  than  the  first. 

If  in  the  opinion  of  some  he  has  not  dealt  fully  enough  with  the 
subject  in  places,  the  author  hopes  this  may  be  excused  ;  but  the  leisure 
at  his  command  for  this  work  was  limited,  and  only  obtainable  at 
intervals  that  were  often  very  far  between. 

H.    AlFBED   RoECHIilNQ. 

Leicester, 

January,  1898. 


^e)4-y^ 


SYNOPSIS   OF   CONTENTS. 


PAGE. 

Dedication    „ iii. 

Preface vii. 

PART  I. 

General  Considerations. 

Pages  1  to  29. 

CHAPTEK  I.— Introductory  Remarks 1  to  3 

Importance  of  Subject — Additions  to  our  Knowledge  during 
the  last  Five  Years— No  Comprehensive  Treatise  on  the 
Influence  of  Sewer  Gas  on  Health  up  to  now  in  existence  in 
any  modern  language. 

CHAPTER  II.— History  OF  Sewer-Gas  Controversy    4  to  13 

History  of  Controversy  in  England — Murchison's  Theory — 
Budd's  Theory  and  Present  Views — Diseases  attributed  to 
Sewer  Gas — Phases  through  which  Scientific  Questions  pass 
in  Foreign  Countries  must  be  studied  with  a  view  to  a  com- 
plete understanding— History  of  Sewer-Gas  Controversy  in 
Germany — Views  expressed  there — Opinions  held  in  America, 
France,  and  Italy. 

CHAPTER  III.— Definition  of  Terms  Used 14  to  15 

Explanation  of  the  terms  Putrid  Gases,  Sewer  Air,  Sewer  Gas, 
Cesspit  Air — Cesspit  Gas— Privy  Gas— Decomposition  and 
Putrefaction. 

CHAPTER   IV.— The   Present  State    of   our  Knowledge  of 

THE  Changes  F;ecal  Matters  Undergo  after  Evacuation...  16  to  19 

Our  Knowledge  of  these  Changes  still  very  limited  — 
Aerobes,  Anaerobes  and  Facultative  Anaerobes — Decom- 
position —  Putrefaction —  Nitrification  -  Micro-Organisms 
found  in  Human  Excreta — Aim  of  all  True  Sanitation. 

CHAPTER   V. — The   Conservancy   and   the  Water  -  Carriage 

System   20  to  25 

Conservancy  Methods  and  their  Disadvantages — Pails  and 
Typhoid  Fever — Water- Carriage  System  and  its  Advantages 
when  properly  carried  out. 

CHAPTER  VI. — Notes  on  the  Etiology  and  Epidemiology  of 

Typhoid  Fever    26  to  29 

Former  Views  as  to  the  Causation  of  Typhoid  Fever — Present 
Views— The  Typhoid  Bacillus  (bacillus  typhi)  of  Eberth 
and  Gaffky — Microbes  of  Infectious  Diseases  appear  to  be 
Specific  Germs  which  spring  from  their  like,  and  only  create 
their  like— Behaviour  of  Typhoid  Bacillus  under  Different 
Conditions. 


X  SYNOPSIS  OF  CONTENTS. 

PART  II. 

Observed  Cases  of  Injury  to  Health  from  Sewer  Gas. 

Pages  80  to  43.  page. 

CHAPTER    I— Casks  in  which  Outbreaks  of  Typhoid   Fever 

HAVE    BEEN    TRACED    TO   SeWER    Ga8    30  tO  31 

Buchanan's  Classical  Investigations— Other  Investigations  in 
England  and  Germany. 

CHAPTER  II. — Notes  on  the  Coincidence  between  Typhoid 
Fever  and  Faulty  Drains  as  Demonstrated  by  the  Smoke 
AND  other  Tests 32to33 

Experience  at  Leicester,  Bristol,  Hornsey,  and  Leeds. 

CHAPTER  III.— BiBMiNGHAM  Sbweb-Gas  Cask 34 

CHAPTER  IV.— Mephitic  Poisoning  through  Sewer  Gas 35  to  37 

Mild  Form  of  Poisoning — Severe  Form — Various  Cases  Men- 
tioned. 

CHAPTER  v.— Health  OF  Sewermen 38  to  39 

Scanty  Information  —  No  Proper  Records  Kept  —  Munich 
Experience — Asphyxia — Sore  Throats— Rheumatic  Affec- 
tions— Typhoid  Fever. 

CHAPTER  VL— Septic  Poisoning  through  Sewer  Gas 40  to  42 

Sutton  Coldfield  Case — Contamination  of  Soup  by  Sewage — 
Meat- Poisoning  at  Coventry. 

CHAPTER  VII.— Explosions  in  Sewers  and  Cesspits 43 

Coal  Gas — Presence  of  Hydro-Carbons  such  as  Marsh  Gas. 


PART  III. 

Contents  of  Sewer  Air. 

Pages  44  to  58. 

CHAPTER  I. — Poisonous  Gases  Contained  in  Sewer  Air 44  to  48 

Carbonic  Acid— Ammonia— Sulphuretted  Hydrogen —Hydro- 
Carbons— Volatile  Fatty  Acids — Examinations  of  Air  in 
Old  and  Modern  Sewers— East  Ham  Sewer  Fatality,  1st 
July,  1896. 

CHAPTER  II.— Micro- Organisms  in  Sewer  Air 49  to  58 

Methods  of  Air  Examination  still  imperfect — Examinations 
of  Air  in  the  Sewers  of  Paris,  Berlin,  Sydney,  Dundee, 
Bristol,  and  London — Sewer  Air  under  Ordinary  Conditions- 
Bursting  of  Bubbles— Splashing— Slimy  Skin  of  Sewers — 
Results  obtained  by  Different  Observers  Practically  Agree — 
It  is  possible  but  not  very  probable  that  Sewer  Gas  carries 
the  Typhoid  Germ — Difficulty  of  Detecting  the  Bacillus 
Typhi  in  Sewer  Air  and  Sewage  very  great. 


SYNOPSIS   OF  CONTENTS.  XI. 

PART  IV. 

Experiments  on  Animals  with  Sewer  Air, 

Pages  59  to  69.  page. 

CHAPTER     I. — EXPEKIMENTAL     RESEARCHES     INTO     THE     GaUSAL 

Relations  between  Sewer  Air  and  Typhoid  Fever   59  to  G9 

Typhoid  Fever  and  the  Lower  Animals— Inoculating  Animals 
with  Large  Doses  of  Bacillus  Typhi— Protective  Forces 
of  the  System — Dr.  T.  H.  Barker's  Experiments  with 
Three  Dogs  and  One  Mouse — Dr.  G.  Alessi's  Experiments 
with  408  Animals  in  Rome — Contentions  against  Dr.  Alessi's 
Experiments  and  Conclusions. 


PART  V. 

Conclusions  as  to  the  Influence  of  Sewer  Gas  upon  Health. 
Pages  70  to  73. 

CHAPTER  I.— Influence  of  Sewer  Gas  upon  Health 70  to  73 

Conclusions  from  the  previous  Observations — Action  of  Sewer 
Gas  apparently  two-fold  —  Direct  or  Mephitic  Action  — 
Indirect  or  Predisposing  Action — Foetid  Smells  on  Sewage 
Farms  Harmless — Immunity  of  Sewermen. 


PART  VI. 

Allied  Subjects. 

Pages  74  to  86. 

CHAPTER  I. — Difference  between  Waterworks  and  Sewerage 

Works  in  their  Influence  upon  the  Public  Health 74  to  79 

Buchanan's  Classical  Investigations  in  1866 — Improvement  in 
Death-rates  consequent  on  and  subsequent  to  a  Systematic 
Water  Supply  and  Sewerage  is  now  a  Sanitary  Axiom  — 
Sewerage  Works  contribute  to  this  Improvement  in  a  more 
marked  degree  than  Waterworks. 

CHAPTER  II. — The  Dilution  of  Sewer  Gas  and  its  Escape  in 

the  Centre  of  Roads  and  Streets 80  to  83 

It  is  better  to  allow  Sewer  Gas  to  escape  in  our  Streets  and 
Public  Places  than  to  force  it  into  the  Interior  of  our 
Houses — Leicester  Experience. 

CHAPTER  III.— Concluding  Remarks 84  to  86 

Effect  of  Sewer-Gas  Theory  upon  Advances  in  House  and 
General  Sanitation  —  Building-up  and  Maintenance  of 
Protective  Forces  of  the  Human  System. 


XIL  SYNOPSIS  OF  CONTENTS. 

APPENDIX  I.  PAGE. 

Index  to  the  Literature  upon  the  Subject  of  Sewer  Gas 
AND  ITS  Influence  upon  Health  (including  Allied 
Subjects)  in  the  English,  German,  French,  and  Other 
Languages— 180  Books,  Papers,  etc.,  Enumerated    87  to  99 


APPENDIX  II. 

Three  Tables  giving  the  Composition  of  Sewer  Air  or  Sewer 
Gas,  the  Gases  Dissolved  in  Kaw  Sewaue,  and  the  Mephitio 
Vapours  Found  in  Disused  and  Unventilated  Cellar 
Dwellings 100  to  101 


APPENDIX  III. 

Pages  102  to  118. 
Micro- Organisms  in  Sewer  Air,  Experimental  Results. 

1.  M  icro-Orgauisms  in  the  Air  of  the  Paris  Sewers  102 

2.  Micro-Organisms  in  the  Air  of  the  Berlin  Sewers     103 

3.  Uffelmann's  Observations  103 

4.  Micro-Organisms  in  the  Air  of  the  Sydney  Sewers  103 

5.  Carnelley  and  Haldane's  Observations     104 

6.  Laws  and  Andrewes'  Experiments  in  the  London  Sewers 105 


APPENDIX  IV. 

Pages  119  to  130. 

Experimental  Researches  into  the  Causal  Relations  of  Sewer  Gas  and 
Typhoid  Fever. 

1.  Experiment  by  Dr.  T.  H.  Barker 119 

2.  Researches  by  Dr.  G.  Alessi  in  Rome  120 


APPENDIX  V. 

Pages  131  to  133. 
Explosions  in  Sewers  and  Cesspits. 

1.  Explosion  in  one  of  the  London  Sewers  131 

2.  Explosion  in  a  Cesspit  at  Mayence  131 

3.  Explosion  in  a  New  Sewer  at  Burton-on-Trent 132 


SYNOPSIS  OF  CONTENTS.  xiii. 

APPENDIX   VI. 

Pages  134  to  137. 

Health  of  Sewermen.  page. 

1.  General  Remarks  134 

2.  Opinion  of  the  late  Dr.  E.  A.  Parkes  1,84 

3.  Cases  reported  by  Gaultier  de  Claubry 135 

4.  Observations  of  Hankel   135 

5.  Sewermen  at  Munich 136 

6.  Sewermen  at  Wiesbaden 136 

7.  Health  of  London  Sewermen ..  136 


APPENDIX  VII. 

Pages  138  to  148. 
Some  Authentic  Oases  op  Mephitic  Poisoning  through  Sewer  Gas. 

1.  Poisoning  Case  at  Clapham 138 

2.  Deaths  of  Four  Men  in  a  Sewer  in  the  City  of  London 138 

3.  Case  reported  by  Gaultier  de  Claubry    138 

4.  Case  reported  by  Halle 139 

5.  Chevalier,   Blumenstock,   and    Thierling    mention    Similar 

Cases  of  Mephitic  Poisoning 139 

6.  Case  reported  by  Caspar    139 

7.  See  also  Item  4,  "Health  of  Sewermen"  (page  135) 139 

8.  Accident  in  the  Paris  Sewers 139 

9.  Case  reported  by  Finkelnburg     139 

10.  Fatality  in  a  New  Sewer  at  Bast  Ham,  near  London 140 

11.  Observations  by  Dr.  Hankel 143 

A.  The  Mild  Form 143 

B.  The  Fairly  Severe  Form 144 

C.  The  Severe  Form  144 

D.  The  Qhronic  Form 144 

12.  Case  reported  by  Hankel  145 

13.  Death  in  London  Sewers 146 

14.  Death  of  Three  Men  in  a  Sewer  at  Widnes 146 

15.  Death  of  Five   Men   from    Sulphuretted  Hydrogen   at  the 

Tynemouth  Gasworks   147 

16.  Death  of  One  Man  in  a  Sewer  at  Harpurhey ,  near  Manchester. .  147 


APPENDIX  VIII. 

Pages  149  to  155. 
Cases  of  Septic  Poisoning  through  Sewer  Gas. 

1.  Case  of  Poisoning  at  Sutton  Coldfield    149 

2.  Cases  reported  by  Dr.  Fenton 165 


XIV.  SYNOPSIS  OF  CONTENTS. 

APPENDIX  IX. 

Pages  15«)  to  1G4. 

Casks  whrrk   Outbreaks   of  Typhoid    Fkver  nAVE  brkn  Traced  to 
Sewer  Gas. 

PAGE. 

1.  Buchanan's  Historical  Cases 156 

2.  Cases  reported  by  Dr.  Blaxall 15H 

3.  Case  reported  by  Dr.  Airey 158 

4.  Great  Number  of  other  Cases 158 

5.  Enteric   Fever    at   the   FoundlinLj   Hospital,    1891,   reported 

by  Dr.  J.  F.  J.  Sykes  159 

6.  Outbreak  of  Typhoid  Fever  at  a  Fever  Hospital  at  Leeds...  160 

7.  Case  reported  by  H.  Alfred  Roechling     163 

8.  Cases  reported  on  the  Continent    164 


APPENDIX  IXa. 

Pages  165  to  185. 

Other  Effects  of  Sewer  and  Cesspit  Gas  not  previously 
referred    to. 

1.  Case  of  Blood-Poisoning  at  Birmingham  through  Sewer  Gas...  165 

2.  Case  of  Diphtheria  attributed  to  Cesspit  Gas 185 


APPENDIX  X. 

Pages  186  to  194. 

Influence  of  Sanitary  Works  upon  the  Mortality  from  Typhoid 

Fever. 

1.  Investigations  by  the  late  Sir  George  Buchanan  186 

2.  Cases  quoted  by  Soyka 187 

3.  Investigations  by  Baron  188 

4.  Typhoid  Fever  at  Berlin 189 

5.  Other  Cases 194 


APPENDIX  XI. 

Pages  195  to  198. 

NoTE.s  ON  the  Coincidence  between  Typhoid  Fever  and  Faulty  Drains 
AS  Demonstrated  by  the  Smoke  and  Other  Tests. 

1.  Experience  at  Leicester  195 

2.  Experience  at  Bristol 1 95 

3.  Experience  at  Hornsey    196 

4.  Experience  at  Leeds 196 

5.  General  Remarks  on  Smoke-Testing  Drains  198 


SYNOPSIS  OF  CONTENTS.  XV. 

APPENDIX  XII. 

Pages  199  to  209. 

Notes  on  the  Typhoid  Mobtality  and  the  Ventilation  op  the  Sewers  in 

Leicester. 

Detailed  Index  of  Names  and  Subjects. 
Pages  211  to  224. 


INFLUENCE    OF   SEWER    GAS    UPON 
HEALTH. 


PART    I. 

General  Considerations. 

CHAPTEE    I. 
Introductoby  Eemarks. 

The  subject  chosen  by  the  author  for  his  treatise  has 
been  very  hotly  discussed  for  years  past,  both  in 
scientific  assemblies  and  in  the  public  Press,  and  many 
and  various  are  the  opinions  which  have  been  expressed 
upon  it  in  this  country  as  well  as  abroad.  In  fact, 
perhaps  it  is  not  too  much  to  say  that  the  subject 
has  been  clothed  in  many  forms,  some  of  them  of  an 
almost  mysterious  construction,  and  that  it  has  created 
a  great  deal  of  confusion  in  the  public  mind. 

To  those  who  are  more  intimately  acquainted  with 
the  matter,  this  can,  perhaps,  not  be  surprising,  as  the^ 
cause  of  it  is  undoubtedly  to  be  found  in  our  imperfect 
knowledge  up  to  the  present  time  of  sewer  gas  and  its 
influence  upon  health.  Both  those  who  strongly  main- 
tained the  pathogenic  character  of  sewer  gas  and  those 
who  as  strongly  opposed  it  were  unable  to  support  their 
belief  with  scientific  proof,  for  want  of  sufficient  know- 
ledge of  these  matters.  But  within  the  last  four  years 
further  light  has  been  thrown  upon  this  abstruse  subject, 
and  the  author  thought  that  it  might  not  be  out  of 
place  to  critically  review  it  in  the  light  of  our  increased 
knowledge,   with   a  view,  if  possible,   of  clearing  up  the 

1 


2  SEWER   GAS    AND    HEALTH. 

question,  and  lifting  the  veil  somewhat  behind  which 
it  has  been  hidden  up  to  now. 

Our  century  is  fast  sinking  into  its  grave,  and  it 
must  be  our  aim  to  do  what  lies  in  our  power  to 
disentangle  questions  of  great  public  importance,  and 
hand  them  over  to  the  next  century  in  a  clear  shape, 
so  that  they  may  be  easily  understood  by  all. 

Apart  from  these  considerations,  it  has  appeared  to 
the  author  that  a  rather  one-sided  interpretation  has 
been  given  in  this  country  to  the  very  able  reports  of 
Messrs.  Laws  and  Andrewes  for  the  London  County 
Council,  which  have  been  published  within  the  last  four 
years.  But,  as  will  be  shown  later  on,  these  reports 
must  be  accepted  with  certain  reservations,  the  chief 
amongst  them  being  that  they  do  not  cover  the  whole 
subject  of  sewer  gas  and  its  influence  upon  health ; 
that,  on  the  contrary,  they  only  deal,  as  it  were,  with 
one  phase  of  it  —  viz.,  the  microbes.  If,  therefore, 
these  limitations  are  lost  sight  of,  there  is  the  danger 
that  the  conclusions  drawn  from  these  researches  are 
one-sided  also,  if  not  altogether  wrong. 

With  a  view  to  avoid  such  a  mistake  being  made, 
the  author  intends,  amongst  others,  to  draw  attention 
in  the  treatise  to  the  very  painstaking  investigations 
made  about  four  years  ago  by  Dr.  G.  Alessi,  in 
Italy,  into  the  question  of  putrid  gases  as  predisposing 
causes  of  typhoid  infection.  As  he  considered  these 
researches  of  the  greatest  importance,  he  had  them 
translated  ;  and  the  Sanitary  Institute,  sharing  his  views, 
was  good  enough  to  publish  this  translation  in  its 
volume  for  1895.  These  investigations  supplement  those 
of  Messrs.  Laws  and  Andrewes,  and  ought  to  be  carefully 
studied  with  them  in  order  to  get  a  complete  insight 
into  the  whole  question. 


SEWER    GAS    AND    HEALTH.  3 

There  is  yet  another  reason  why  the  author  ventures 
to  think  that  the  bringing  forward  of  the  question  in 
^he  form  of  a  short  treatise  may  not  be  inopportune. 

When  suggesting  on  the  Continent  various  alterations 
in  the  house-drainage  arrangements,  he  had  to  run  the 
gauntlet  of  a  fairly  hot  opposition  in  reference  to  the 
injurious  character  of  sewer  gas,  and  when  trying  to 
refresh  his  memory  by  reference  to  the  published  infor- 
mation, he  found  the  greatest  difficulty  in  doing  so,  as 
it  is  scattered  about  in  many  places  and  not  easily  avail- 
:able.  He  thought,  therefore,  it  might  be  a  considerable 
advantage  to  put  the  subject  into  such  a  shape  as  would 
;  afford  an  easy  reference  even  by  those  members  of  his 
profession  with  whom  to  live  means  work  and  to  work 
life.  With  a  view  to  attaining  this  end,  he  has  attached 
to  the  review  several  appendices,  in  which  he  has  given 
some  of  the  information  contained  in  a  great  many 
•  different  sources  and  reported  in  different  languages. 

The  public  mind  lends  itself  as  easily  to  an  unlimited 
rsense  of  security  as  to  a  gross  and  unreasoning  panic, 
but  in  the  judgment  of  the  author  either  of  these  should 
be  avoided,  and  those  who  make  and  control  public 
opinion  in  hygienic  matters  should  not  err  in  the  direction 
■  of  either  extreme,  as  sooner  or  later  a  collapse  or  a 
reaction  is  sure  to  set  in,  which  will  sweep  everything 
clean  before  it,  and  tend  to  make  the  pendulum  swing 
to  the  other  extreme  of  its  amplitude.  But  by  such  a 
-course  nothing  is  gained,  and  the  words  of  Ovidius 
.('* Medio  tutissimus  ibis")  seem  to  indicate  to  the  author 
.the  right  course  to  be  adopted  in  this  question. 


4  SEWER   GAS   AND   HEALTH. 

CHAPTEK    II. 

History  of  the  Sewer-Gas  Controversy. 

Before  entering  upon  the  subject  in  detail,  it  might 
be  convenient  to  give  a  general  outline  of  the  history  of 
this  question,  which  has  caused  many  a  severe  conflict 
of  opinion. 

The  opinion  that  filth  and  disease  go  hand  in  hand 
is  practically  as  old  as  the  hills,  and  might  be 
said  to  underlie  the  Mosaic  Law.  From  it,  no  doubt, 
in  times  long  gone  by  sprang  the  conviction  that  the 
emanations  rising  from  filth,  especially  from  decomposing 
organic  waste  matters,  were  capable  of  producing  certain 
diseases,  but  it  was  not  till  about  the  middle  of  the 
present  century  that  this  doctrine  was  applied  to  the 
putrid  exhalations  proceeding  from  our  sewers,  cesspits, 
privies,  etc. 

It  had  been  noticed  by  various  observers  that  typhoid 
fever  frequently  broke  out  in  houses,  the  air  of  which 
had  been  rendered  impure  through  the  emanations  from 
sewers  and  cesspools,  and  this  gave  rise  to  the  theory 
that  this  disease  was  the  result  of  a  putrid  process,  and 
caused  directly  by  these  emanations.  In  this  theory, 
which  was  called  the  "  pythogenic  theory,"  it  was 
endeavoured  to  establish  the  self-produced,  or  spontaneous 
generation,  of  typhoid  fever,  and  amongst  its  chief  sup- 
porters were  men  such  as  Murchison  (see  A-45,  Appendix 
I.)  and  Kiecke. 

It  was  not  long,  however,  before  men  like  Budd  (see 
A-17,  Appendix  I.),  and  others,  assailed  it.  Whilst 
admitting  the  facts  observed  by  Murchison,  Budd  main- 
tained that  the  disease  was  not  spontaneously  generated ,„ 


SEWER    GAS    AND    HEALTH.  5 

l)ut  that  putrid  substances  were  only  capable  of  producing 
iyphoid  fever  in  the  presence  of  a  specific  contagion. 

Each  school  of  thought  endeavoured  to  support  its  own 
theory  by  advancing  facts  observed,  and  the  controversy 
raged  at  one  time  somewhat  fiercely,  without,  however, 
apparently  clearing  the  air.  As  time  went  on,  the  list  of 
diseases  observed  to  have  been  caused  by  emanations 
from  cesspits  or  sewers  increased,  and  at  the  present 
time  nearly  all  the  zymotic  diseases,  and  several  others 
besides,  are  attributed  to  this  cause,  such  as  typhoid  or 
enteric  fever,  diarrhoea,  dysentery,  diphtheria,  scarlet  fever, 
^erysipelas,  cholera,  malaria,  yellow  fever,  puerperal  fever, 
hospital  gangrene,  inflammation  of  the  lungs,  gastro- 
'Cnteritis,  etc.  Without  expressing  any  opinion  at  this 
point,  it  cannot  be  denied  that  this  is  a  very  formidable 
list,  and  at  any  rate  goes  to  show  how  widespread  the 
mischief  from  sewer  air,  etc.,  is  supposed  to  be. 

In  our  day,  when  the  daily  Press  takes  a  deep  interest 
in  the  doings  and  sayings  of  scientific  men,  it  cannot  be 
surprising  that  it  endeavoured  to  place  before  the  general 
public  the  opinions  entertained  amongst  professional  men 
in  reference  to  sewer  gas — hence  the  great  interest  taken 
generally  in  this  question.  This  interest  has  not  always 
been  a  well-defined  one,  and  as  the  connection  between 
sewer  gas  and  disease  was  somewhat  shrouded  in  mystery, 
it  cannot  be  surprising  to  find  that  the  general  public 
has  come  to  look  upon  any  smell  proceeding  from  cesspits 
or  sewers  as  dangerous  to  health  and  poisonous.  No 
doubt  this  conviction  in  the  public  mind  of  the  dangerous 
•character  of  sewer  gas  has  at  times  given  rise  to 
exaggerated  fears,  but  at  any  rate  it  has  had  the  good 
-effect,  by  bringing  pressure  to  bear  upon  our  sanitary 
^authorities,  of  vastly  improving  the  hygienic  conditions 
;and  surroundings  of  our  houses  and  towns.     In  fact,  it 


b  SEWER   GAS   AND   HEALTH. 

has  been  stated — and  in  the  author's  opinion  very 
properly — that  this  conviction  has  attributed  more  to- 
the  advance  in  the  sanitation  of  our  houses  and  towns 
than  any  other  theory  or  cause. 

But  the  history  of  the  sewer -gas  controversy  would 
not  be  complete  without  a  short  reference  to  the  stages- 
through  which  it  has  passed  in  foreign  countries.. 
Fortunately,  the  laws  of  Nature  do  not  follow  arbitrary 
political  lines,  but  are  the  same,  with  but  slight  local 
modifications,  throughout  the  globe  ;  hence,  he  who  wants- 
to  understand  the  importance  of  any  question  connected 
with  them  must  be  able  to  follow  its  various  phases  in 
the  various  countries  of  the  civilised  world.  This,  no- 
doubt,  entails  a  great  amount  of  labour,  as  it  frequently 
happens  that  simultaneously  investigations  into  the  same 
subject  are  carried  on  in  three  or  four  countries,  whicb 
are  afterwards  reported  in  the  various  scientific, 
periodicals. 

Notably  has  this  been  the  case  of  late  with  the  newly- 
founded  science  of  bacteriology,  where  observers  seem  to- 
have  sprung  up  like  mushrooms  in  nearly  every  part 
.of  the  civilised  world,  and  practically  showered  their 
frequently  most  contradictory  observations  upon  the 
scientific  public  to  such  an  extent  that  it  was  almost, 
impossible  to  keep  pace  with  them.  In  the  general 
interest  and  in  the  interest  of  this  science  itself,  it  is- 
sincerely  to  be  hoped  that  this  pace  will  considerably 
slacken  in  future,  and  that  every  observer  will  only 
publish  his  results  after  the  most  careful  scrutiny. 

In  Germany,  the  sewer-gas  theory  was  utilised  by  those 
who  were  opposed  to  the  water-carriage  system  for  faecal 
matters  as  an  argument  against  it.  According  to  them,, 
a  system  from  which  these  dangerous  emanations  arose 
could  not  but  be  a  standing  danger  to  the  public  health — 


SEWER    GAS   AND    HEALTH.  7 

hence  it  ought  not  to  be  carried  out ;  and  in  its  place  was 
recommended  one  form  or  other  of  the  conservancy 
system.  In  their  zeal  against  the  water-carriage  system, 
these  advocates  of  the  conservancy  system  forgot  entirely 
that  putrid  gases  are  perhaps  more  easily  formed  in 
cesspits,  tubs,  privies,  etc.,  which,  owing  to  their  con- 
centrated nature,  are  more  injurious  to  health  than 
those  formed  in  sewers,  and  that  in  this  country,  to 
which  frequent  reference  was  made,  the  conviction  that 
the  putrid  gases  rising  from  sewers  were  dangerous  did 
not  lead  to  the  abolition  of  the  water-carriage  system 
at  all,  but  to  its  perfection  by  causing  sanitary  engineers 
to  be  doubly  careful  in  excluding  these  gases  from  our 
houses. 

This  controversy  was  hotly  fought  out  in  many  towns, 
but  perhaps  in  none  more  so  than  in  Munich,  where, 
on  the  advice  of  Prof.  Pettenkofer,  the  late  Joseph 
Gordon  had  been  asked  to  prepare  a  combined  drainage 
scheme.  It  would  lead  much  too  far  to  go  into  details, 
as  whole  volumes  have  been  filled  with  this  controversy; 
it  must  suffice  to  say  that  the  advocates  of  the  water- 
carriage  system  made  light  of  the  sewer -gas  theory, 
and  endeavoured  to  show  that  sewer  gas  had  not  the 
influence  assigned  to  it  in  this  country.  Such  a  course 
was,  perhaps,  but  very  natural,  as  the  causal  relations 
between  sewer  gas  and  typhoid  fever,  for  instance,  could 
not  be  proved ;  and  the  conviction  had  grown  amongst 
professional  men  and  others  that  the  water-carriage 
principle  was  greatly  to  be  preferred  to  the  conservancy 
methods. 

The  German  Association  of  Public  Health  convened 
in  September,  1881  (see  B-55,  Appendix  I.),  with  a 
view  to  settling  this  question,  a  congress  at  Vienna,  at 
which  the  late  Prof.  Soyka  read  a  paper  on  the  influence 


8  SEWER   GAS   AND   HEALTH. 

of  sewer  gas  upon  health,  and  submitted  the  following 
resolutions  to  the  meeting,  which  it  would  appear, 
however,  were  not  accepted  by  the  same : 

1.  The  positive  proof  of  the  connection  between  sewer 

gas  and  the  spread  of  epidemic  disease  has  not 
been  established. 

2.  The    investigations    made  up   to  the   present   time 

admit,  on  the  contrary,  in  the  majority  of  cases, 
the  conclusion  that  the  spreading  of  epidemic 
diseases  takes  place  quite  independently  of  sewer 
gas,  and  that  towns  have  better  mortality  figures 
after  the  carrying  out  of  sewerage  works  than 
they  had  before.  The  same  difference  has  been 
observed  between  the  sewered  and  non-sewered 
parts  of  one  and  the  same  town. 

Soyka  tried  to  prove  these  resolutions  with  the  aid 
of  experimental  facts  and  epidemiological  data  taken 
from  a  number  of  typhoid  fever  outbreaks,  including 
the  Croydon  outbreak  in  1875. 

In  1882  Prof.  Eenk  published  a  pamphlet  (see  B-46, 
Appendix  I.)  in  which  he  sums  up  his  remarks  on  the 
hygienic  importance  of  sewer  gas  as  follows  : 

"We  summarise  our  opinion  on  the  importance  of 
sewer  gas  by  stating  that  we  look  upon  it  as 
one  of  the  factors  which  cause  the  pollution  of 
air  in  our  houses,  and  hold  it  responsible  for 
the  effects  of  this  pollution. 

**  We  cannot,  however,  admit  that  it  exerts  a  special 
influence  upon  the  distribution  of  infectious 
diseases,  or  that  it  predisposes  the  constitution 
for  them,  but  consider  that  its  injurious  influence 
upon  health  consists  in  the  nauseating  effect 
which  it  produces  in  the  whole  nervous  sj^stem. 


SEWER    GAS    AND    HEALTH.  9 

^'Although  we  make  these  reservations,  we  consider 
the  keeping  of  sewer  gas  out  of  our  houses  an 
important  task.     .     .     ." 

According  to  Soyka  and  Eenk,  then,  sewer  gas  has 
no  epidemiological  importance;  and,  further,  according 
to  the  latter  observer,  the  influence  of  sewer  gas  upon 
health  must  be  considered  from  the  point  of  general 
hygiene. 

For  at  a  certain  concentration  the  gases  contained  in 
sewers  form  a  most  poisonous  combination,  and  numerous 
fits  observed  amongst  sewer-men  lead  one  to  suppose 
that  it  is  a  question  of  the  noxious  influence  produced 
by  ammonia  and  sulphuretted  hydrogen.  The  prolonged 
action  of  these  gases  gives  rise  to  a  chronic  poisoning, 
which  is  accompanied  by  disturbances  of  the  organs  of 
digestion  and  nutrition,  and  in  the  end  leads  to  attenua- 
tion, and  physical  and  intellectual  weakness.  When 
the  air  is  very  impure  and  saturated  with  ammoniacal 
vapours,  it  obstructs  breathing,  and  violently  irritates 
the  mucous  membrane  of  the  eyes  and  nostrils. 

If  these  conclusions  of  Kenk  were  correct,  it  would 
follow  that  the  longer  these  gases  are  breathed  the  more 
would  the  constitution  become  undermined,  until  in  the 
end  collapse  would  take  ^place.  However,  against  this 
hypothesis  the  observations  of  facts  and  daily  experience 
bear  witness  ;  these  teach  us  that  sewer-men,  tanners, 
manufacturers  of  glue,  labourers  in  manure  works,  and 
other  workmen,  who  are  forced  to  live  for  the  greater 
part  of  the  day  in  foul  air,  end  by  not  feeling  its  noxious 
influence  at  all.  Instead  of  getting  weaker  and  weaker, 
these  workmen  seem  to  become  gradually  immune  to 
the  influence  of  putrid  gases ;  and  to  this  extent,  at 
:any  rate,  Kenk's  theory  cannot  be  correct. 

As  is  frequently  the  case,  those  who  shared  the  views 


10  SEWER   GAS    AND    HEALTH. 

of  Soyka  and  Kenk  went  a  great  deal  farther  than  their 
authors,  and  freely  stated  that  sewer  gas  is  perfectly^ 
harmless.  In  this  opinion  they  were  supported  by  the 
bacteriological  results  obtained  so  far,  which  seem  to 
be  against  the  probability  that  sewer  air  carries  the 
germs  of  infectious  diseases  such  as  typhoid  fever. 

In  September,  1894,  the  author  was  invited  to  read  a 
paper  before  the  German  Association  of  Public  Health 
at  Magdeburg,  on  the  **  water  supply  and  drainage  of 
houses,"  in  which  he  very  shortly  referred  to  the  dangerous 
character  of  sewer  gas.  This  gave  rise  to  a  discussion,, 
and  the  impetus  given  to  this  question  by  the  author's 
paper  led  the  council  of  the  association  to  set  the  subject 
down  again  for  discussion  at  the  next  yearly  meeting  at 
Stuttgart,  in  September,  1895.  The  title  of  the  subject 
was  somewhat  altered  to  "  Injurious  Character  of  Sewer 
Gas,  and  how  to  keep  it  out  of  our  Houses";  and  two 
gentlemen  (Dr.  Kirchner,  professor  of  hygiene  at  Hanover, 
and  Mr.  Lindley,  late  borough  surveyor  of  Frankfort-on- 
the-Maine)  expounded  then*  theories,  which  were  some- 
what similar  to  those  of  Soyka  and  Eenk. 

The  author  opened  the  discussion,  which  extended  over- 
several  hours ;  but  in  the  end  the  resolutions  proposed  ta 
the  meeting  by  Messrs.  Kirchner  and  Lindley,  and  which 
were  as  follows,  were  not  accepted  by  the  same : 

1.  The  theory  that   sewer  gas   causes    such  epidemic 

diseases  as  typhoid,  cholera,  and  diphtheria,  is 
not  in  keeping  with  our  present  knowledge  of 
pathogenic  germs. 

2.  However,   the  putrid  gases,   which    are    formed  in 

street  sewers  and  house  drains,  are  dangerous  to- 
health,     not     so     much     directly    as     indirectly, 
especially    during    long    exposure,   as    they  cause 
nausea    and  tend;  to  lower    the    general  vitality,. 


SEWER   GAS   AND    HEALTH.  11 

and  with  this  reduce  the  power  of  resistance  of 
the  body  against  disease. 

3.  The  formation  of  these   gases  and  their  accumula- 

tion in  the  sewers  can  be  reduced  to  a  minimum 
through  proper  arrangements,  such  as  regular 
flushing,  cleansing,  and  sufficient  ventilation. 

4.  Therefore,  neither  foul  water  nor  air   ought  to  be 

allowed  to  stagnate  in  the  public  or  private  sewers, 
nor  should  suspended  matters  be  allowed  to  collect 
in  them. 

5.  In   order  to   avoid  the  entrance   of  noxious  gases- 

from  the  sewers  and  drains  into  the  air  of  the 
subsoil  and  of  our  houses,  it  is  necessary  that  all 
drains  and  pipes  in,  under,  and  by  the  side  of 
our  houses  should  be  perfectly  air  and  water  tighty 
and  that  all  water-closets,  sinks,  etc.,  should  be 
provided  with  proper  traps  which  are  protected 
against  anti-syphonage  and  evaporation. 

6.  House  drains  can  only  remain  permanently  efficient 

if  the  whole  arrangement  is  simple  and  can  easily 
be  inspected. 

7.  For  these  reasons  the   direct   connection   of  house- 

drains  and  street  sewers  is  preferable  to  the  dis- 
connecting system,  because  the  latter  makes  the 
flushing  and  ventilation  very  difficult,  necessitates 
very  complicated  ventilating  arrangements,  and 
causes  the  accumulation  of  decomposing  matters 
in  the  immediate  vicinity  of  our  houses. 
It   will  be  observed   from   these   resolutions   that   the 

meeting  was  asked  to  pronounce  against  disconnecting 

traps  in  house  drains. 
Looking  back  upon  the  result    of    these    two    years'" 

discussions,  the  author  is  of  opinion  that  the  conviction 

is  gaining  more  and  more  ground  on  the  Continent  that 


12  SEWER  GAS   AND   HEALTH. 

the  gas  formed  in  the  sewers  must  be  excluded  from  our 
houses  on  account  of  its  injurious  influence  upon  health. 
In  America  similar  views  to  those  held  in  this  country 
have  always  prevailed,  and  though  at  times  opinions 
have  been  expressed  that  there  is  no  connection  between 
sewer  gas  and  infectious  disease,  they  have  not  been 
generally  accepted. 

The  author  is  not  very  intimately  acquainted  with 
the  views  generally  held  in  France  concerning  putrid 
gases,  but  he  may  point  out  in  this  place  that  after 
very  careful  consideration,  extending  over  a  number  of 
years,  the  city  of  Paris  has  decided  to  abandon  the 
conservancy  methods  so  far  in  vogue,  and  to  make  a 
change  to  the  water-carriage  principle,  and  that  further, 
by  the  new  by-laws  which  came  in  force  on  the  8th 
day  of  August,  1894,  the  disconnecting  trap  has  been 
made  compulsory  for  all  houses.  Article  15  of  these 
.by-laws  is  as  follows : 

"Each  drain,  before  it  passes  out  of  the  house,  is  to 

be    provided    with    a    disconnecting    syphon,    the 

seal  of  which  shall  not  be  less  than  2*75in.,  so 

as  to  ensure  a  permanent  and    air-tight  barrier 

between  the  house  drainage  and  the  street  sewer. 

•**  Each   disconnecting  syphon  is  to  be  provided  above 

the   bend  with   an   inspection  pipe   with   air-tight 

cover. 

**  The  models  of  these  syphons  and  apparatus  are  to 

be  submitted  to  the  authorities  for  their  approval." 

It  may  be   inferred  from  this   by-law  that  sewer  gas 

is,  in  Paris,  considered  injurious  to  health. 

Concerning  Italy,  the  author  has  already  mentioned 
that  Dr.  Alessi  has  made  some  very  interesting  researches 
(see  A-4  and  D-2,  Appendix  I.)  into  the  causal  relation 
hetween  sewer    gas    and    typhoid    fever.      After  a  very 


SEWER   GAS    AND    HEALTH  13 

painstaking  enquiry,  this  observer  has  arrived  at  the 
conclusion  that  these  gases  predispose  the  constitution 
for  the  reception  of  this  disease;  but  as  full  particulars 
of  these  investigations  will  be  given  later  on,  nothing, 
further  need  be  said  at  this  point. 


i4  SEWER   GAS   AND   HEALTH. 

CHAPTEK   III. 
Definition  of  Terms  Used. 

It  might  not  be  out  of  place  to  explain  here  shortly 
the  meaning  of  the  terms  used  in  this  treatise.  Such 
s.  course  might  prevent  misunderstandings. 

The  general  term  of  "  Putrid  Gases "  includes  all 
gases  arising  during  the  process  of  putrefaction  of 
■organic  matters ;  it  therefore  includes  all  the  gases 
forming  in  sewers,  cesspits,  vaults,  privies,  privy 
middens,  ashpits,  etc. — in  fact,  it  is  the  collective 
description  of  all  gases  and  combination  of  gases 
forming  in  the  decomposition  of  the  matters  of  the 
animal  and  vegetable  kingdom  which  have  served  for 
the  food  and  sustenance  of  man. 

The  terms  "Sewer  Air"  and  '*  Sewer  Gas"  are  taken 
in  this  paper  as  identical  expressions,  and  denote  the 
air  and  the  gas  in  sewers  or  drains.  Various  writers, 
and  especially  some  of  those  who  have  endeavoured  to 
prove  the  harmless  nature  of  sewer  gas,  have  made 
distinctions  between  these  terms,  using  the  term  "  sewer 
air"  for  the  air  when  it  is  devoid  of  smell,  and  the 
term  "  sewer  gas "  for  the  air  when  it  is  charged  with 
noxious  smells.  Such  a  distinction  is,  however,  in  the 
author's  opinion  somewhat  arbitrary,  as  the  difference 
between  the  two,  if  it  exists  at  all,  is  at  the  best  one 
•of  degree  only.  Of  course,  there  is  a  great  deal  of 
difference  in  this  sense  between  sewer  air  and  sewer 
gas  as  far  as  our  nasal  organs  are  concerned,  but 
whether  the  same  difference  exists  as  far  as  our  health 
is  concerned  is,  to  say  the  least,  by  no  means  certain, 


SEWER    GAS    AND    HEALTH.  15 

the  weight  of  the  evidence  collected  so  far  being 
apparently  against  any  difference. 

The  terms  ''Cesspit  Air,"  "Cesspit  Gas,"  "Privy 
^Gas,"  etc.,  will  not  be  much  referred  to  in  this  treatise, 
but  where  they  occur  they  will  be  used  as  identical 
expressions  denoting  the  air  in  cesspits,  privies,  etc., 
which  is  always  more  or  less  charged  with  gaseous 
<;ompounds. 

The  term  "Decomposition"  shall  be  generally  used 
only  in  reference  to  the  process  of  complete  oxydation 
or  mineralisation — that  is,  that  process  in  which  the 
organic  matter  in  the  presence  of  an  ample  supply  of 
oxygen  is  converted  into  such  products  as  water,  carbonic 
acid,  nitrous  and  nitric  acids,  without  the  creation  of 
foul  smells. 

The  term  "  Putrefaction  "  shall  generally  be  applied 
only  to  the  process  of  incomplete  oxydation — that  is, 
that  process  in  which,  in  the  absence  of  oxygen,  the 
albuminoid  bodies  are  first  peptonised,  and  then  split 
up  into  a  great  number  of  chemical  substances,  notably 
fatty  acids,  trimethylamine,  ammonia,  ammonium  sul- 
phide, sulphuretted  hydrogen,  indol,  scatol,  etc.,  and 
under  certain  conditions  also  into  poisonous  alkaloids 
(ptomaines).  This  process  mostly  gives  rise  to  very 
foul  smells  which  poison  the  atmosphere. 

A  rough-and-ready  distinction  between  decomposition 
and  putrefaction  is,  therefore,  the  absence  or  presence 
■of  foul  smells,  although,  strictly  speaking,  it  is  not  quite 
^correct. 


16  SEWER   GAS    AND    HEALTH. 

CHAPTEK    IV. 

The  Present  State  of  our  Knowledge  of  the  Changes 
FiECAL  Matters  Undergo  After  Evacuation. 

Before  considering  the  causal  relations  between  sewer 
gas  and  health,  it  might  be  opportune  to  describe 
shortly  the  changes  faecal  matters  undergo  after  leaving 
the  body. 

It  is  to  be  greatly  regretted  that  our  knowledge  of 
these  changes  is  still  very  limited;  we  know  that  they 
ultimately  become  mineralised  through  bacterial  activity, 
but  we  know  very  little  as  to  the  progress  and  the  various 
stages  of  this  change,  as  to  the  kind  of  bacteria 
at  work,  and  their  life  products.  This  oxydation  or 
mineralisation  proceeds  quicker  and  at  a  more  active 
rate  in  the  pores  of  the  soil  than  in  water,  owing, 
most  probably,  to  the  more  abundant  supply  of  air, 
especially  in  very  porous  subsoil;  and,  in  fact,  all  the 
investigations  made  so  far  seem  to  prove  that  the 
amount  of  oxygen  available  during  decomposition  is 
the  most  important  factor  in  this  process. 

In  the  processes  of  decomposition  and  putrefaction  of 
organic  matters  three  different  kinds  of  bacteria  may  be 
distinguished,  which  are  subject  again  to  further  sub- 
division— viz. : 

1.  The  aerobes,  or  those  bacteria  which,  as  their  name 

expresses,  can  only  exist  and  work  in  the  presence 
of  oxygen. 

2.  The  facultative  anaerobes,  or  those  bacteria  which 

exist  and  work  in  the  presence  of  oxygen,  but  da 
not  altogether  cease  work  in  the  absence  of  this- 
gas;   and 


L 


SEWER    GAS    AND    HEALTH.  17 

3.  The  anaerobes,  or  those  bacteria  which,  as  their 
name  expresses,  can  only  exist  and  work  in  the 
absence  of  oxygen. 

It  will  be  seen  from  this  enumeration  that  the  facul- 
tative anaerobes  form  the  connective  link  between  the 
aerobes  and  the  anaerobes ;  and  it  might  be  said  that 
the  former  are  the  bacteria  of  decomposition,  the  latter 
those  of  putrefaction. 

Concerning  the  products  of  activity  of  these  different, 
forms,  it  is  now  generally  supposed  that  those  formed 
by  the  aerobes  are  more  or  less  harmless,  being  products 
of  complete  oxydation,  whereas  those  formed  by  the^ 
anaerobes  frequently  contain  ammonia,  sulphuretted 
hydrogen,  and  strong  poisons  of  an  alkaloidal  nature^ 
being  products  of  incomplete  oxydation. 

Probably  the  following  is  a  picture  of  the  process  of 
decomposition,  followed  eventually  by  putrefaction :  At 
first  the  aerobes,  assisted  to  some  extent  by  the 
facultative  anaerobes,  carry  on  the  work  satisfactorily 
until  the  oxygen  of  the  medium  becomes  more  and 
more  consumed,  when  such  products  as  carbonic  acid, 
water,  nitrous  and  nitric  acids,  are  formed.  In  this 
way,  the  amount  of  oxygen  available  is  still  further 
reduced,  and,  if  not  supplied  afresh,  the  aerobes  must 
cease  their  work.  At  this  stage  decomposition  proper 
ends  and  putrefaction  sets  in,  fr-equently  accompanied  by 
very  foul  and  injurious  smells  when  the  decaying  matters 
are  invaded  by  the  hordes  of  anaerobes,  which  commence 
at  once  their  dangerous  activity,  and  continue  it  until 
they  finally  perish  in  the  ever-increasing  quantities  of 
carbonic  acid,  or  in  other  substances  of  their  own  making.^ 
Then  this  process  may  be  said  to  have  come  to  an  end. 

^For  particulars  of  the  products  of  incomplete  oxydation  see  th© 
remarks  made  in  the  definition  of  the  processes  of  putrefaction. 

2 


18  SEWER    GAS    AND    HEALTH. 

Such,  then,  is  in  very  general  outline  a  probable 
picture  of  the  processes  which  take  place  when  the 
waste  matters  of  the  animal  and  vegetable  kingdom  are 
reduced  and  split  up  through  bacterial  activity.  But 
before  it  will  be  possible  to  give  a  complete  and  accurate 
description,  much  more  will  have  to  be  ascertained, 
and  a  great  many  gaps  in  our  knowledge  will  require 
to  be  filled  up.  Although  this  is  the  case,  it  ought, 
on  the  other  hand,  to  be  acknowledged  with  pride  that 
within  the  last  few  years  much  has  been  done  to  make 
■us  better  acquainted  with  the  processes  of  decomposition 
and  putrefaction ;  and  the  knowledge  gained,  that  in  the 
same  bacteria  play  a  very  important  part,  has  to  some 
extent  lifted  the  veil  which  covered  so  long  this  phase 
of  the  cycle  which  Nature  in  her  marvellous  wisdom 
has  ordained  for  the  benefit  of  mankind. 

In  passing,  it  might  be  remarked  that  it  has  lately 
been  established  that  the  process  of  nitrification  in  the 
soil  is  the  work  of  two  separate  microbes,  of  which  the 
first  converts  ammonia  into  nitrous  acid,  whilst  the 
second  transforms  the  nitrous  acid  into  nitric  acid. 

So  far,  no  mention  has  been  made  of  the  swarms  of 
bacteria  which  are  found  in  the  dejecta  even  in  a  fresh 
condition,  their  number  in  the  case  of  a  grown-up  male 
having  been  calculated  at  34,000  millions. 

Some  of  these,  and  perhaps  by  far  the  greater  portion, 
do  not  seem  inimical  to  life,  but  there  are  also  others 
which  appear  of  a  doubtful  nature,  and  finally  those 
to  which  a  pathogenic  character  has  been  attributed. 
Amongst  the  latter  may  be  mentioned  Koch's  comma 
bacillus  (the  bacillus  of  Asiatic  cholera)  and  the  bacillus 
of  typhoid  fever,  which  are  always  found  in  the  stools 
of  those  suffering  from  these  diseases.  What  becomes 
of  these  in  the  process  of    decomposition    has  not  yet 


SEWER    GAS    AND    HEALTH.  19 

iDeen  fully  elucidated,  but  it  is  frequently  held  that,  by 
the  law  of  the  survival  of  the  fittest,  the  pathogenic 
germs,  being  of  a  more  delicate  nature,  succumb  after  a 
while  in  the  struggle  for  existence  with  the  swarms  of 
other  microbes.  How  long  these  pathogenic  germs  retain 
their  power  for  mischief  is  not  clearly  established,  and 
the  most  contradictory  statements  have  been  made  in 
this  respect,  but  the  observations  seem  to  point  in  this 
■  direction,  that  for  about  a  week  or  ten  days,  when 
in  sewage,  they  may  exert  their  baneful  influences.^ 

Even  if  the  products  formed  by  the  aerobes  should 
eventually  be  proved  to  be  perfectly  harmless,  it  will  be 
clear  from  the  foregoing  remarks  that  it  must  be  the 
aim  of  all  true  sanitation  to  remove  these  waste  products 
.as  quickly  and  as  completely  from  our  surroundings  as 
possible,  so  that  even  in  the  absence  of  pathogenic 
germs  putrefaction  may  not  take  place  in  the  vicinity  of 
our  dwellings,  with  all  its  attendant  evils  in  the  form 
of  dangerous  gases,  ptomaines,  etc.  Experience  has  over 
;.and  over  again  proved  the  wisdom  of  such  a  course. 


See  also  tne  remarks  in  Chapter  VI. 


20  SEWER    GAS    AND    HEALTH. 

CHAPTER  V. 
The  Conservancy  and  the  Water- Carriage  System. 

In  these  days,  when  the  sanitary  advantages — not  to* 
mention  the  pecuniary  and  administrative  advantages — of 
the  water-carriage  system  over  any  other  system  appear 
to  be  almost  universally  recognised,  it  might  seem  sheer 
waste  of  time  to  compare  it — even  though  it  be  but  very 
briefly — with  the  conservancy  methods  ;  but  as  voices  are 
still  heard  from  time  to  time  in  ardent  support  of  the^ 
latter,  it  may  not  be  out  of  place  to  make  here  a  few 
remarks  concerning  this  subject. 

In  the  conservancy  methods  all  faecal  matters    remain. 
in  the  house  or  on  the  premises  for  more  or  less  time, 
during  which   they  have   a   chance  to  do  mischief,  and. 
undoubtedly  putrefactive  changes  have  set   up   in   them, 
before  they  are  removed.     But  it  has  been  shown  above 
that  it  is  just   those  changes  which  we  ought  to  avoid 
taking  place  in  our  surroundings,  and  that   the   excreta 
ought  to  be  removed  from  our  houses,  as  soon  as  possible 
after  evacuation,  in  a  fresh  condition. 

Further,  it  is  frequently  found  that  the  various  forms 
of  application  of  the  conservancy  system,  especially  such 
as  cesspits,  vaults,  privies,  and  privy  middens,  were 
constructed  a  great  many  years  ago — long  before  the 
sanitary  importance  of  these  arrangements  was  fully 
understood — and  are  consequently  very  defective;  hence 
they  afford  frequently  readier  means  for  the  systematic 
pollution  of  soil,  air,  and  water  than  drains  and  sewers, . 
which  are,  comparatively  speaking,  of  more  recent  date. 

However,   it    might    be   said  that    the    forms  of    the- 
conservancy    systems    just   mentioned — cesspits,    vaults,. 


SEWER    GAS    AND    HEALTH.  21 

privies,  and  privy  middens — are  happily  dying  out,  and 
that  against  the  only  form  remaining  in  this  country — 
viz.,  the  tubs  or  pails — no  such  accusation  could  be 
sustained.  In  support  of  this,  comparisons  might  and 
have  been  made  between  the  death  rates  in  towns  with 
the  tub  and  in  those  with  the  water-carriage  system, 
and  conclusions  drawn  therefrom  that,  so  far  as  the 
public  health  is  concerned,  no  difference  exists  between 
the  two  systems.  But  in  the  author's  opinion  such 
comparisons  between  towns  and  towns  ought  only  to 
be  undertaken  with  the  greatest  care — otherwise,  owing 
to  the  many  points  of  difference  between  them,  the 
conclusions  will  be  worse  than  useless  and  only  mis- 
leading, and  it  will  generally  be  better  and  more  reliable 
to  compare  with  each  other  different  parts  of  one  and 
the  same  town  where  tubs  and  sewers  exist.  This  has 
lately  been  done,  and,  for  instance,  in  Leicester,  New- 
castle-upon-Tyne, and  Birmingham,  observations  have 
been  made  as  to  the  bearing  of  tubs  and  water-closets 
upon  the  prevalence  and  spread  of  typhoid  fever. 

For  Leicester  1  it  has  been  shown  that  the  number 
of  typhoid-infected  houses  is  greater  in  those  districts 
where  the  faecal  matters  are  collected  in  tubs  than  in 
the  sewered  portions  of  the  town.  Further,  during  a 
local  epidemic  in  Navigation-street  in  1894  the  number 
of  typhoid-infected  houses  with  tubs  was  five  times  as 
large  as  the  number  of  infected  houses  with  water-closets. 

Similar  experiences  are  reported  by  the  medical 
officer  for  Birmingham,  ^  who  states  that  in  1894  the 
typhoid  incidence  was  IJ  times  as  great  in  houses  with 
3)ails  as  in  houses  with  water-closets,  and  that,  as 
regards  second   cases,    one   occurred  in   every  14   houses 

1  See  "Public  Health  "  for  May,  1895,  pages  280  to  285. 
^  See  "  Public  Health  "  for  May,  1895,  pages  280  to  285. 


22  SEWER    GAS    AND    HEALTH. 

with  pails,   but   only  in   every   22    houses    with  water- 
closets. 

Dr.  H.  E.  Armstrong  mentions  that  in  1894  enteric 
fever  was  twice  as  prevalent  in  Newcastle-upon-Tyne^  in. 
households  on  the  pail-closet  system  as  in  households 
on  the  water-closet  system. 

The  author  does  not  know  whether  similar  facts  have 
been  observed  in  other  towns,  but  at  any  rate  it  will 
not  be  disputed  that  these  figures  cannot  be  quoted  in. 
recommendation  of  the  last  remaining  form  of  the  = 
conservancy  system. 

Apart  from  this,  it  ought  not  to  be  forgotten  that 
nearly  all  towns  in  which  this  system  is  still  in  vogue 
are  experiencing  the  greatest  difficulties  with  the  disposal 
of  the  excreta,  and  that  these  difficulties  have  become 
so  accentuated  in  the  last  few  years,  that  towns 
like  Glasgow,  Manchester,  Birmingham,  Nottingham,. 
Leicester,  etc.,  have  decided  to  abandon  the  pail  system 
altogether,  and  establish  the  water-carriage  principle 
pure  and  simple,  although  they  had  previously  expended 
great  sums  of  money  in  introducing  the  former. 

In  passing,  the  author  would  also  mention  here  that,, 
in  a  report  lately  issued  by  the  medical  officer  of 
health  for  Nottingham,  and  which  deals  with  78  towns,, 
the  following  passage  occurs  (see  "Eeport  on  the  Con- 
servancy and  Water- Carriage  Systems,"  by  P.  Boobyer)  r. 

"One  note  of  encouragement  to  us  at  the  present 
juncture,  running  through  almost  all  the  answers 
I  have  received,  is  the  very  general  and  growing 
discontent  with  the  so-called  conservancy  systems,, 
from  whatever  standpoint  they  are  viewed.  In. 
only  four  of  the  towns   on  my   list    (78  towns  in. 

1  See  *'  Public  Health  "  for  May,  1895,  pages  280  to  285. 


SEWER    GAS    AND    HEALTH.  23 

all) — Hull,  Eochdale,  Warrington,   and  Darwen — 

is    their     continuance    openly    advocated    in    any 

form." 

If    attention   is    now    directed    to    the    water-carriage 

system,  it  has  been  stated  that  it   does  not   completely 

remove    the    faecal    matters,    but    deposits    portions    of 

them  on  the  sides  and  bottom  of  the  sewers  and  drains, 

and  that    especially  house    drains    are    great    offenders 

in  this  respect.    In  fact,  it  was  stated  on  the  Continent  two 

years  ago  with  great  pertinacity,  as  an  argument  against 

disconnecting   traps,  that   house   drains  were,  as  a  rule, 

in   a   much   fouler   condition   than   the   public  sewers  in 

the  streets. 

The  author's  own  experience  is  opposed  to  this  state- 
ment concerning  house  drains ;  and  although  he  has 
known  foul  house  drains,  yet  in  the  majority  of  cases, 
where  they  were  of  modern  construction  and  under 
rational  and  intelligent  supervision,  he  has  frequently 
found  them  entirely  devoid  of  smell  and  deposit. 

Apart  from  the  consideration  that  the  quantity  of  faecal 
and  other  matters  passing  through  house  drains  is  con- 
siderably smaller  than  that  carried  away  in  a  main  sewer, 
it  needs  no  great  effort  to  see  that  house  drains  can  be 
kept  in  a  clean  and  sanitary  condition  with  much  less 
trouble  than  street  sewers.  There  are,  further,  plenty 
of  means  to  attain  this  end,  amongst  which  a  systematic 
ventilation,  a  good  automatic  flush  from  water-closets, 
and  a  careful  supervision,  may  be  mentioned. 

There  would,  therefore,  appear  to  be  no  reason  why 
house  drains  should  still  be  permitted  to  remain  in  a 
very  foul  condition,  and  the  author  cannot  help  thinking 
that  where  this  state  of  things — which  perhaps  might  be 
called  antiquated — still  is  the  order  of  the  day,  the 
authorities    have    been    somewhat    soundly    asleep,    and 


24  SEWER    GAS    AND    HEALTH. 

require  waking  up  a  little  in  reference  to  house- 
•drainage  requirements. 

Concerning  street  sewers,  it  cannot  be  gainsaid  that* 
•especially  in  the  early  days  of  sewering,  great  mistakes 
were  committed,  as  it  was  sometimes  thought  that 
anything  in  the  nature  of  a  hollow  underground  passage 
would  do ;  but,  thanks  to  the  untiring  and  well-directed 
efiforts  of  Sir  Kobert  Kawlinson,  such  ideas  have  long 
been  abandoned,  and  in  a  system  of  sewers  constructed 
according  to  modern  notions  but  comparatively  little 
chance  is  given  to  the  faecal  matters  to  deposit  in  the 
sewers  and  gradually  fill  them  up. 

However,  this  must  not  be  misunderstood  as  if  it  was 
impossible  for  gases  to  form  in  modern  sewers.  All  those 
intimately  acquainted  with  the  subject  know,  of  course, 
that  it  is  not  possible  to  prevent  the  formation  of  gas 
altogether,  and  that  all  that  can  be  done  is  to  reduce 
the  chances  favourable  to  these  formations  to  a  minimum. 

A  very  sad  instance  of  the  truth  of  this  happened  on 
July  1,  1895  (see  A- 25,  Appendix  I.,  and  10,  Appendix 
VII.),  at  East  Ham,  near  London.  In  this  case  five 
men  lost  their  lives  in  a  sewer  which,  as  the  surveyor 
stated  at  the  inquest,  had  not  been  at  work  for  more 
than  3^-  years,  the  sewerage  of  the  district  having  only 
recently  been  carried  out. 

Although  the  formation  of  dangerous  gases  cannot  be 
altogether  avoided  in  modern  systems  of  sewers,  there  is 
absolutely  no  need  for  the  gases  when  formed  to  enter 
our  houses,  as  we  possess  plenty  of  means  to  prevent 
this,  perhaps  the  most  effective  of  them  being  the 
keeping  of  each  house  drain  clean  and  sweet,  and  its 
disconnection  from  the  street  sewer. 

It  will  be  clear  from  all  the  foregoing  remarks  that 
the    water-carriage    principle    possesses    a   great  many 


SEWER    GAS    AND    HEALTH.  25 

advantages  over  the  conservancy  methods;  and,  further, 
it  may  safely  be  concluded  that  the  gases  formed  in 
privies,  cesspits,  etc.,  are,  owing  to  their  concentrated 
nature,  considerably  more  dangerous  than  those  formed 
in  street  sewers,  especially  if  the  latter  are  well  ventilated. 


26  SEWER    GAS    AND    HEALTH. 


CHAPTEE   VI. 

Notes  on  the  Etiology  and  Epidemiology  of  Typhoid- 
Fever. 

It  may  not  be  out  of  place  before  going  further  to 
make  a  few  remarks  at  this  point  concerning  the  causation 
of  typhoid  fever. 

Although,  as  previously  stated,  a  great  many 
diseases  have  at  one  time  or  other  been  traced  to  sewer 
gas  as  their  cause,  such  as  typhoid  or  enteric  fever, 
diarrhoea,  dysentery,  diphtheria,  scarlet  fever,  erysipelas, 
cholera,  malaria,  yellow  fever,  puerperal  fever,  hospital 
gangrene,  inflammation  of  the  lungs,  gastro  -  enteritis, 
etc.,  it  will  not  here  be  necessary  to  refer  to  any  other 
but  typhoid  or  enteric  fever,  as  the  connection  between 
sewer  gas  and  the  other  diseases  is  not  sufficiently 
elucidated. 

It  will  not  be  attempted  in  the  following  notes  to  deal 
minutely  with  the  etiology  and  epidemiology  of  typhoid 
fever,  as  such  a  course  would  be  out  of  place  in  this 
treatise,  and  would  also  lead  too  far,  this  being  a  question 
on  which  volumes  and  volumes  have  been  written.  Con- 
flicting opinions  have  been  put  forward  and  defended 
with  great  pertinacity,  and  the  fight  around  them  has 
frequently  been  very  severe.  To  those  who  were  not  in 
the  front  line  of  battle,  it  has  not  always  been  an  easy 
task  to  wade  through  a  very  voluminous  literature, 
especially  as  not  only  the  conclusions  but  also  the 
observations  leading  to  them  have  been  challenged  and 
contradicted  by  each  opposing  side.  What  is  received 
with  exultation  to-day  is  to-morrow  put  into  shade 
through  a  new  investigation;   and  although  the  severe 


SEWER    GAS    AND    HEALTH.  2T 

fight  has  this  advantage  that  it  is  conducted  on  all 
sides  with  great  skill  and  astuteness,  which  in  the  end 
is  sure  to  lead  to  the  full  truth  being  found  out,  yet  it 
seems  that  at  the  present  time  we  are  still  far  from 
that  goal. 

It  has  already  been  stated  on  a  previous  page  that 
about  the  middle  of  the  present  century  abdominal 
typhoid  was  considered  to  be  the  result  of  a  putrid 
process.  Murchison  and  others  held  that  putrefying 
substances  were  the  specific  cause  of  this  disease,  and 
that  it  could  be  generated  spontaneously  by  their  emana- 
tions, such  as  sewer  gas. 

A  little  later  the  idea  was  gradually  gaining  groundl 
that  infectious  diseases  were  caused  through  a  specific 
contagium  animatum  of  a  parasitical  nature,  and  it 
cannot  be  surprising,  therefore,  that  Murchison's  theory 
was  strongly  assailed  by  Budd,  who  maintained  that 
putrid  gases  were  capable  only  of  producing  typhoid 
fever  in  the  presence  of  a  specific  exciting  cause. 

It  was  then  suggested  that  this  specific  contagion  or 
germ  was  probably  spontaneously  generated  in  putrid 
gases,  which  were  afterwards  able  to  spread  this  disease.. 

A  host  of  other  theories  were  propounded,  but  it  would 
lead  too  far  to  mention  them  here;  suffice  it  to  say  that 
it  required  a  great  deal  of  very  skilful  labour  to  prove 
that  William  Harvey's  great  word,  "  omne  vivum  ex: 
ovo,"  was  as  true  for  the  world  of  large  animals  and 
plants  as  for  the  world  of  the  most  minute  beings. 

Although  by  no  means  universally  accepted,  it  is  now 
generally  held  that  the  typhoid- exciting  cause  is  the 
bacillus  typhosus,  a  microbe  which  was  discovered  probably 
by  Eberth,  Koch,  Meyer,  and  Gaffky. 

Another  theory  has  also  been  advanced,  according: 
to   which    the  bacillus  typhosus    is  not  the  cause,  but 


•28  SEWER   GAS    AND    HEALTH. 

ihe  product,  of  the  disease,  the  latter  having  converted 
•the  harmless  bacterium  coli  into  the  pathogenic  typhoid 
germ ;  but  it  would  appear  as  if  this  theory  was  not 
supported  by  the  results  of  bacteriological  investigations 
up  to  the  present  time,  which  seem  to  show  that  the 
microbes  of  infectious  diseases  are  specific  germs  which 
spring  from  their  like  and  only  create  their  like.  At 
:any  rate,  for  the  purposes  of  this  treatise,  it  shall  be 
assumed  that  the  exciting  cause  of  typhoid  or  enteric 
fever  is  the  typhoid  bacillus  of  E berth  and  Gaffky. 

A  great  deal  has  been  written  about  this  bacillus,  and 
ihe  most  contradictory  opinions  concerning  it  have  been 
advanced  by  different  observers,  which  is  no  doubt  due 
to  the  fact  that  the  identification  of  the  bacillus 
typhosus  is  a  matter  of  some  considerable  difficulty, 
.as  there  are  other  bacilli,  such  as  the  bacillus  coli 
communis,  a  normal  inhabitant  of  the  intestines,  which 
are  very  much  like  it,  and  which  have  often  been 
erroneously  taken  for  it.  Therefore  the  published  results 
must  be  received  with  caution.  But  allowing  for  this, 
the  following  facts  appear  to  be  somewhere  near  the 
truth. 

The  bacillus  typhosus  is  found  in  the  stools  and 
urine  of  typhoid  patients,  and  retains  its  vitality  in 
them  for  a  considerable  time— according  to  Uffelmann, 
several  months.  But  sewage  does  not  appear  to  be 
quite  such  a  favourable  medium,  as  it  would  seem  that 
this  bacillus  loses  in  it  its  power  of  mischief  after  a 
period  ranging  probably  from  one  to  two  weeks.  The 
■experiments  concerning  the  vitality  of  the  germ  in  well 
and  river  water  have  given  very  different  results,  but 
it  would  appear  that  it  may  live  in  these  media  for 
:several  months.  It  appears  to  be  less  sensitive  to  acids 
ihan  to  alkalies,  and  Liborius  has  shown  that  it  can  exist 


SEWER    GAS    AND    HEALTH.  29^ 

without  oxygen.  It  seems  to  perish  tolerably  quickly 
under  ihe  influence  of  direct  sunlight,  but  retains  its 
virulence  in  soil  for  some  considerable  time.  A  tempera- 
ture of  60°  C.  =  140°  F.  will  kill  it  within  10  minutes, 
but  it  seems  to  be  able  to  withstand  a  temperature  of 
—  10°  C.  =  14°  F.  for  a  considerable  time  even  during 
alternate  melting  and  freezing.  Dunbar  states  in  refer- 
ence to  the  tenacity  of  the  typhoid  bacillus,  that  it. 
does  not  make  great  demands  on  its  nutritive  medium; 
and  that  even  without  forming  lasting  spores,  it  manages 
to  maintain  itself  in  our  climate  outside  the  human 
body  and  to  survive  the  winter. 

Concerning  the   media  through  which  this  bacillus  is 
disseminated,  it   seems  now  established   that  it  may  be 
carried  in  the  air  in  fine  dust  particles,   in  the   water,, 
and    milk.      Other    means    of     distribution    are     linen,- 
clothes,   dirty  hands,   instruments,   etc. 

Before  proceeding  to  investigate  the  composition  of 
sewer  air  and  the  germs  contained  in  the  same,  the 
author  thinks  it  will  be  more  convenient  to  mention 
first  some  of  the  forms  in  which  sewer  gas  has  exerted 
an  injurious  influence  upon  health.  In  doing  so,, 
frequent  references  will  be  made  to  the  appendices,  in. 
which  full  particulars  of  the  various  cases  mentioned 
are  given,  as  such  a  course  will  be  more  convenient 
than  to  have  embodied  these  latter  in  the  treatise- 
itself. 


.^0  SEWER    GAS    AND    HEALTH. 


PART   II. 

Observed  Cases  of  Injury  to  Health  from  Sewer  Gas. 

CHAPTER    I. 

Cases  in  which  Outbreaks  of  Typhoid  Fever  have  been 
Traced  to  Sewer  Gas. 

(See    also   Appendix    IX.) 

In  Appendix  IX.  the  author  has  mentioned  first 
Buchanan's  historical  cases  at  Worthing  in  1865,  in 
Caius  College,  Cambridge,  in  1874,  and  at  Croydon  in 
1875,  and  has  then  given  a  number  of  other  cases,  such  as 
the  outbreak  in  1880  at  Melton  Mowbray,  in  Sherborne 
in  1882,  and  in  York  in  1884,  all  of  which  have,  after 
careful  examination,  been  held  to  have  been  caused  by 
the  emanations  from  the  sewers. 

Further  interesting  cases  are  the  outbreaks  of  enteric 
fever  at  the  Foundling  Hospital,  St.  Pancras,  in  1891, 
which  was  very  carefully  investigated  and  reported  upon 
by  the  medical  officer  of  health  for  St.  Pancras  (Dr. 
J.  F.  J.  Sykes),  and  at  the  Leeds  Fever  Hospital. 

In  Germany,  too,  several  outbreaks  of  typhoid  fever 
have  been  attributed  to  sewer  gas,  and  the  late  Dr. 
Uffelmann,  professor  of  hygiene  at  Rostock  (B-60, 
Appendix  I.),  perhaps  one  of  the  most  careful  and 
painstaking  observers  and  investigators,  maintained  that 
houses  into  which  sewer  gas  entered  periodically  were 
frequently  visited  by  diphtheria,  malaria,  and  typhoid 
fever.  At  the  meeting  of  the  German  Association 
of  Public  Health  in  1895,  the  late  Dr.  Goepel  (B-23, 
Appendix    I.)    reported     a    very    interesting    case    from 


SEWER    GAS    AND    HEALTH.  31 

Frankfort-on-the-Oder,  where  in  a  house  the  typhoid 
fever  ceased  after  the  pipe  through  which  the  sewer 
gas  entered  it  had  been  seen  to.  Dr.  Lissaur  (see  B-36, 
Appendix  I.)  also  reports  an  interesting  case  of  typhoid 
fever  from  Dantzic. 

A  great  many  other  cases  might  have  been  quoted, 
as  there  is  no  lack  of  them,  but  the  author  does  not 
consider  it  necessary  to  go  beyond  a  few  typical  instances. 
Those  who  deny  the  existence  of  a  connection  between 
sewer  gas  and  typhoid  fever  are  bound  to  assume  that 
all  the  numberless  trained  and  untrained  observers, 
who  have  pronounced  in  favour  of  this  connection,  have 
made  serious  mistakes  both  in  their  observations  and 
conclusions. 

In  some  of  the  outbreaks  mentioned  above,  those  who 
investigated  them  attributed  the  cause  to  the  inhalation 
of  sewer  gas,  whereas  in  others  it  was  thought  that  sewer 
gas  polluted  the  water  supply,  and  thus  brought  about 
the  epidemic. 

It  will  not  be  attempted  here  to  explain  the  relation 
between  sewer  gas  and  typhoid  fever,  as  there  will  be  a 
special  opportunity  for  this  later  on,  but  it  might  be 
pointed  out  that  the  sewer-gas  theory  has  been  taken 
advantage  of  to  such  an  extent  as  to  bring  it  practically 
into  miscredit.  It  has  been  attempted  to  explain  cases 
by  it  in  which  sewer  gas  seems  to  have  played  no  part 
whatever,  and  this  over-zeal  on  the  part  of  some  indiscreet 
advocates  has  been  utilised  by  the  opponents  to  hold  the 
whole  theory  up  to  public  scorn  and  ridicule.  But  be 
ihat  as  it  may,  the  fact  is  now  generally  admitted,  even 
by  those  who  look  upon  sewer  gas  as  comparatively 
harmless,  that  putrid  gases  and  typhoid  fever  are 
frequently  found  side  by  side,  and  it  is  important  to 
clearly  bear  this  in  mind  in  the  future  remarks. 


32  SEWER    GAS   AND   HEALTH. 


CHAPTEE  II. 

Notes  on  the  Coincidence  between  Typhoid  Fever  and- 
Faulty  Drains,  as  Demonstrated  by  the  Smoke  and- 
Other  Tests. 

(See  also  Appendix  XI.) 

In  support  of  the  facts  just  mentioned,  it  might  not 
be  out  of  place  to  refer  here  shortly  to  the  experience 
gained  in  several  towns  as  to  the  relation  between 
defective  drainage  and  typhoid  fever. 

Formerly  it  was  not  always  possible  to  prove  the 
entrance  of  sewer  gas  into  our  houses,  but  now,  since 
the  introduction  of  the  smoke,  hydraulic,  and  sceni 
tests,  such  a  proof  is,  comparatively  speaking,  an  easy 
matter. 

In  this  connection  the  author  would  like  to  point  out 
that  the  smoke  test  is  not  under  all  circumstances  a 
completely  reliable  test,  as  there  are  cases,  especially  of 
underground  leakage,  which  can  only  be  demonstrated 
by  the  hydraulic  test.  In  his  own  experience  the  author 
has  had  cases  where,  suspecting  defects,  he  could  not 
discover  them  with  smoke,  although  he  made  repeated 
trials,  and  where  he  only  succeeded  in  localising  them 
after  the  application  of  the  hydraulic  test.  It  would, 
therefore,  be  incorrect  to  conclude  that  in  all  cases 
where  the  smoke  test  has  shown  no  defects,  sewer  gas 
could  not  possibly  find  its  way  into  the  interior  of  the 
house,  and  in  such  a  case,  if  necessary,  recourse  should 
be  had  to  the  water  test. 

In  Appendix  XI.  the  author  has  given  the  observations 
made  at  Leicester,  Bristol,  Hornsey,  and  Leeds.   He  would 


SEWER    GAS    AND    HEALTH.  35 

have  been  glad  to  have  been  able  to  add  to  these  those 
made  in  other  towns,  but  they  were  not  in  his  possession. 

In  Leicester  the  percentage  of  all  typhoid-infected 
houses  with  defective  drainage,  as  ascertained  by  the 
smoke  test,  was  31*25  per  cent,  in  1893,  and  45*18  per 
cent,  in  1894. 

For  Bristol  reports  the  medical  officer  of  health  that 
during  the  ^Ye  years  1890  to  1894,  29*38  per  cent,  of 
548  typhoid-infected  houses  showed  drainage  defects  on. 
the  application  of  the  smoke  test. 

In  Hornsey,  there  were  nine  typhoid-infected  houses 
tested  with  smoke  between  10th  August  and  30th 
December,  1893,  all  of  which  showed  drainage  defects. 
In  1894  the  number  of  typhoid-infected  houses  with 
drainage  defects  was  19. 

Particular  mention  deserve  the  interesting  observations- 
made  by  Dr.  J.  Spottiswoode  Cameron,  the  medical  officer 
for  Leeds,  in  connection  with  the  testing  of  the  drains  of 
1,121  houses  in  which  typhoid  or  diphtheritic  disease  was^ 
supposed  to  be  present,  and  30*51  per  cent,  of  which  were 
found  to  have  faulty  drainage  arrangements.  For  full, 
particulars  see  4  of  Appendix  XI. 

The  author  is  of  opinion  that  the  statistics  just  quoted 
support  the  statement  previously  made,  that  putrid  gases 
and  typhoid  fever  are  frequently  found  in  close  proximity. 


k 


34  SEWER   GAS   AND   HEALTH. 

CHAPTER   III. 

Birmingham  Sewer-GtAS  Case. 

(See  also  Appendix  IXa.) 

A  case  of  blood-poisoning  by  sewer  gas  was  tried  in 
August,  1896,  at  Birmingham  before  Mr.  Justice  Collins, 
and  as  it  contains  many  interesting  points,  the  full 
report  of  the  trial,  together  with  two  sketches  taken 
from  the  Contract  Journal^  are  given  in  Appendix  IXa. 

The  executors  of  the  late  T.  H.  Smith  brought  an 
action  against  the  King's  Norton  Urban  District  Council 
for  damages  for  his  death,  caused,  as  they  alleged,  by 
sewer  gas,  and  the  judge  gave  judgment  for  ^02,875 
against  the  District  Council. 

A  case  of  diphtheria  attributed  to  cesspit  gas,  in  which 
damages  to  the  extent  of  £50  were  awarded  by  Mr. 
Justice  Wills,  is  also  given  in  the  appendix  above 
referred  to. 


SEWER    GAS    AND    HEALTH.  35 

CHAPTEK  IV. 

Mephitic  Poisoning  through  Sewer  Gas. 

(See  also  Appendix  VII.) 

It  is  well  known  that  gases  such  as  ammonia,  carbonic 
oxide,  carbonic  acid,  and  sulphuretted  hydrogen — which 
are  frequently  found  in  sewer  air — are  highly  poisonous, 
and  have,  in  consequence,  when  inhaled,  an  injurious 
influence  upon  health,  the  degree  of  which  seems  to 
depend  on  the  amount  so  taken  into  the  system.  If 
the  dose  is  small,  then  the  poisoning  is  of  a  mild  form  ; 
but  if  the  dose  is  large,  then  the  poisoning  is  frequently 
very  acute,  and  instantaneous  death  may  be  the  result. 

It  will  not  be  necessary  here  to  dwell  upon  the  nature 
of  this  injurious  influence ;  it  will  suffice  to  say  that 
this  influence  is  universally  admitted. 

In  the  further  remarks,  therefore,  the  mild  form  of 
poisoning  will  be  distinguished  from  the  severe  or  acute 
form. 

A.     Mild  Form  of  Mephitic  Poisonhig  through  Sewer 

Gas. 

The  effect  which  the  breathing  of  small  doses  of  sewer 
gas  has  upon  the  constitution  varies  considerably.  It  is 
generally  more  marked  in  persons  of  weak  health,  in 
persons  suffering  or  recovering  from  illness,  in  women 
and  children  than  in  men.  The  following  disorders 
have  been  attributed  to  this  cause:  languor,  loss  of 
appetite,  vomiting,  diarrhoea,  colic,  [  prostration,  head- 
ache, malaise,  insomnia,  and  feverishness.  Children  seem 
to  feel  the  effects  of  the  inhalation  of  sewer  air  most — 

3* 


36  se^^i:r  gas  and  health. 

they  lose  appetite,  become  pale  and  languid,  and  suffer 
from  diarrhoea. 

If  the  inspiration  of  sewer  gas  is  allowed  to  continue- 
for  some  time  it  may  lead  to  the  chronic  derangement- 
of  the  digestive  and  nutritive  systems,  to  ansemiay 
nervousness,  neuralgia,  etc.,  and,  by  lowering  the  vitality, 
will  reduce  the  power  of  resistance  of  the  body  to 
injurious  influences  from  outside.  In  this  way  the 
prolonged  action  of  sewer  gas  tends  to  render  the 
constitution  more  perceptible  to  the  entrance  of  patho- 
genic germs  ;  and  the  causal  relation  between  sewer 
gas  and  typhoid  fever  has  been  explained  in  this  way;, 
but  the  author  is  inclined  to  think  that  such  an 
explanation  is  only  partially  correct. 

This  action  of  sewer  gas  has  frequently  been- 
attributed  to  carbonic  oxide,  carbonic  acid,  ammonia,, 
and  sulphuretted  hydrogen ;  but  as  this  subject  will  later 
on  be  referred  to  in  detail,  it  will  not  be  necessary  to- 
say  more  at  the  present  stage. 

Further  particulars  concerning  the  mild  form  of 
mephitic  poisoning  are  given  in  Appendix  VII. -11,  where, 
according  to  Hankel,  the  mild  form,  the  fairly  severe 
form,  the  severe  form,  and  the  chronic  form  are 
distinguished. 

B.    Severe  Cases  of  Mephitic  Poisoning  through  Sewer 

Gas. 

There  are  a  great  number  of  cases  of  acute  poisoning.; 
through  sewer  gas  on  record,  but  as  they  are  scattered 
about  in  the  literature  of  several  countries,  the  author 
has  given  some  of  them  (10)  in  Appendix  VII.  for 
convenience  of  reference.  It  must,  however,  be  borne 
in  mind  that  the  cases  mentioned  do  not  by  any 
means  comprise  all  those    reported  in  the    papers,    as^- 


SEWER   GAS    AND    HEALTH,  37 

■probably  the  yearly  number  of   deaths  from  this  cause 
in  all  countries  is  Considerable. 

In  most  cases  of  acute  mephitic  poisoning  death  is 
practically  instantaneous,  the  victim  perishing  through 
asphyxia.  Some  observers  have  attributed  this  to  the 
presence  of  carbonic  acid,  others  to  that  of  sulphuretted 
hydrogen  in  sewer  air. 

A  very  severe  and  at  the  same  time  very  sad  case 
•of  mephitic  poisoning  happened  on  the  1st  July,  1895, 
at  East  Ham,  near  London,  in  which  five  sewermen 
lost  their  lives.  (Appendix  VII.)  The  widow  of  one  of 
the  men  brought  an  action  against  the  Urban  District 
Council,  and  at  the  second  trial — the  Court  of  Appeal 
having  granted  a  fresh  hearing  of  the  case,  as  Mr. 
Justice  Cave  had  non-suited  the  plaintiff  in  the  first 
trial — judgment  was  given  for  the  plaintiff,  with  ^225 
damages. 

Another  recent  case  is  that  mentioned  by  Hankel, 
where  a  plumber  perished  in  thawing  up  a  frozen  water- 
<}loset.     (Appendix  VII.-12.) 

It  is  very  disappointing  that  the  post-mortem 
•examination  in  both  cases  was  not  able  to  throw 
further  light  upon  the  cause  of  death. 


38  SEWER   GAS   AND    HEALTH. 

CHAPTEK  V. 
Health  of  Sewermen. 
(See   also   Appendix  VI.) 

In  connection  with  this  subject  it  will  be  necessarjr 
to  make  a  few  remarks  about  the  health  of  sewermen^ 
as  they  have  frequently  been  quoted  in  support  of  the^ 
harmless  character  of  sewer  air.     (See  Appendix  VI.) 

It  is  greatly  to  be  regretted  that  the  statistical 
information  concerning  the  health  of  sewermen  is 
generally  very  incomplete.  No  proper  continuous 
records  appear  to  have  been  kept  anywhere,  and,  when 
required,  facts  and  figures  have  had  to  be  collected 
probably  years  after  the  dates  to  which  they  refer, 
and  that,  too,  in  a  somewhat  haphazard  manner.  The 
results  of  such  enquiries  are  therefore  in  most  cases- 
not  based  upon  a  proper  system  of  notification,  and 
must  be  received  with  a  certain  amount  of  caution. 

Further,  the  information  generally  only  deals  with. 
the  workmen  whilst  employed  in  the  sewers,  but  gives^ 
no  clue  as  to  their  health  after  leaving  this  employ- 
ment, which,  of  course,  is  a  point  of  the  greatest 
importance  when  considering  the  influence  of  sewer  gas. 
upon  health. 

The  information  in  most  cases  also  refers  only  to- 
the  days  lost  through  sickness,  but  does  not  give  any 
idea  as  to  the  state  of  the  health  of  sewermen  before 
actually  becoming  unfit  for  work. 

In  the  case  of  the  Munich  sewermen,  for  instance, 
the  information  collected  by  Prausnitz  (see  Appendix. 
VI.-5)  goes  to  show  that  out  of  the  total  number  of  421 


SEWER    GAS    AND    HEALTH.  39 

men  so  employed,  48  per  cent,  remained  on  an  average 
only  20  months  in  the  sewers.  It  would  have  been  very 
interesting  to  ascertain  the  cause  of  this,  and  whether 
their  state  of  health  compelled  the  workmen  to  leave 
this  work. 

With  these  reservations  the  author  agrees  with  the 
generally  expressed  opinion  that  workmen  connected 
with  fairly  well  ventilated  sewers  do  not  show  any 
excess  of  sickness.  The  same  can,  however,  not  be 
said  of  those  who  have  to  work  in  ill- ventilated  sewers, 
as  they  seem,  according  to  Gaultier  de  Claubry  and 
Hankel  (Appendix  VI. -3  and  4  and  Appendix  VII. -11),  to 
suffer  in  their  health  from  the  evil  effects  of  the  gases 
they  encounter,  asphyxia  being  a  common  disease 
amongst  them. 

Complaints  of  sore  throats  and  rheumatic  affections 
seem  to  be  pretty  common  amongst  sewermen,  but  the 
opinion  of  Murchison  and  Peacock,  that  typhoid  fever 
was  not  uncommon  among  them,  does  not  seem  to  be 
supported  by  the  experience  of  other  observers. 

Further  particulars  concerning  the  health  of  sewermen 
are  given  in  Appendix  VI. 


40  SEWER   GAS   AND    HEALTH. 

CHAPTEE  VI. 

Septio  Poisoning  through  Shwer  Gas. 

(See  also  Appendix  VIII.) 

Cases  have  from  time  to  time  been  reported  in  which 
food  that  had  been  exposed  to  sewer  gas  has  caused 
illness  in  those  who  have  partaken  of  it. 

A  very  remarkable  and  interesting  case  of  this  kind 
has  quite  lately  been  reported  by  the  medical  officer 
of  health  for  Sutton  Coldfield,  near  Birmingham,  full 
particulars  of  which  are  given  in  Appendix  VIII. -1. 

In  this  instance,  soup,  which  had  been  gratuitously 
distributed,  appears  to  have  caused  a  sudden  outbreak 
of  poisoning  amongst  about  100  persons  at  the  end  of 
1894.  Dr.  Bostock  Hill  in  vain  endeavoured  to  trace 
the  poison  in  the  soup  and  its  source,  and  finally, 
after  one  patient  had  died,  he  sent  a  portion  of  it  to 
Dr.  Klein  for  bacteriological  examination,  who  summed 
up  his  report  as  follows : 

"In  conclusion,  from  the  foregoing  observations,  the 
following  conclusions  can  be  drawn  : 

"1.  The  soup  contained  microbes  which  were  derived 
from  sewage,  and  it  is  thereupon  highly  probable 
that  the  soup  had  been  polluted  with  sewage. 
Amongst  the  microbes  present  in  the  soup,  the 
bacillus  mentioned  as  a  variety  of  the  bacillus 
coli  is  possessed  of  virulent  properties  on  account 
of  its  extremely  rapid  multiplication  at  the  body 
temperature,  and  the  poisonous  substance  it  elabo- 
rates. It  is  most  probable  that  this  microbe 
caused  the  consumers  of  the  soup  the  ill  effects 


SEWER    GAS    AND    HEALTH.  41 

and  the  disease.  This  bacillus,  it  will  be 
remembered  from  the  foregoing  paragraph,  was 
present  in  the  soup  in  enormous  numbers." 
The  soup  had  been  prepared  in  an  outhouse  of  an 
hotel  in  an  iron  boiler,  which  was  under  the  same  roof 
as  a  stable,  and  only  separated  from  it  by  a  wooden 
partition  in  which  there  was  a  door.  On  the  floor  of 
the  stable  there  was  a  drain  grating,  and  at  the  end 
of  the  outhouse,  near  the  boiler,  ran  up  the  ventilating 
pipe  of  the  house  drain,  while  about  20ft.  away  and 
up  the  side  of  the  hotel  itself,  there  was  a  large  venti- 
lating shaft  connected  directly  with  the  main  road 
sewer.  This  latter  sewer  was  notoriously  a  very 
stinking  one,  and  to  obviate  the  nuisance  caused  by  it 
to  residents  and  to  those  travelling  along  the  road,  the 
crown  ventilator  at  this  point  had  been  stopped  up,  and, 
by  permission,  a  large  6in.  ventilating  shaft  erected 
against  the  wall  of  the  hotel.  Dr.  Bostock  Hill  relates 
that  offensive  gases  had  been  given  off  by  this  ventilating 
shaft,  and  the  proprietress  of  the  hotel  had  complained 
that  foul  smells  had  been  noticed  in  a  room  close  to 
where  it  was  fixed. 

The  soup  had  been  allowed  to  stand  in  the  boiler  for 
about  18  hours,  including  one  night,  and  it  is  just 
possible  that  during  this  time  or  in  the  operation  of  its 
distribution  to  the  poor  it  became  polluted  by  sewage, 
either  by  handling  it  with  dirty  fingers  or  in  some  other 
way ;  but  Dr.  Hill  is  evidently  not  of  this  opinion,  as  he 
sums  up  his  interesting  report  as  follows  : 

*'I  have  previously  remarked  that  the  night  was  a. 
cold  one,  so  that  the  sewer  gas  coming  from  the 
top  of  this  shaft  would  become  heavier  as  it 
cooled,  and  would  thus  tend  to  sink  lower  in  the 
atmosphere ;  and  my  belief  is  that  this  sewer  gas 


42  SEWER    GAS    AND    HEALTH. 

in   question   did  gain   access  to  the   outhouse  hy 
way  of   the  chimney,  and   that  in   this  way   the 
soup  was  contaminated  with  those  micro-organisms 
which  were  found   by   Dr.   Klein.      I  do  not  by 
any  means  lay  this  down  dogmatically,  but  after 
a    very    careful    consideration    of    all    the    local 
circumstances,   I  see  no  method    more    likely  of 
contamination     of     the     soup    with    the     micro- 
organisms of  sewage." 
It  is  by  no    means    an    uncommon    thing    that  the 
gases    escaping    from    the    top   of    a    ventilating    shaft 
descend    again,    and  the    author    has    frequently  made 
the  same  observation  when  testing  drains  with  smoke. 

The    medical     officer    of     health    for    Coventry    also 
reports  two  similar  cases  of  poisoning. 

Further  particulars  will  be  found  in  Appendix  VIII. 


SEWER   GAS   AND    HEALTH.  4^ 

CHAPTEK   VII. 

Explosions  in  Sewers  and  Cesspits. 

(See  also  Appendix  V.) 

Now  and  again  cases  are  reported  in  which  explosions- 
are  said  to  have  happened  in  sewers  and  cesspits,  and 
the  author  has  mentioned  three  such  cases  in  Appendix  V. 

There  is  but  little  doubt  that  in  some  of  these  coal 
gas  was  the  cause  of  the  explosion,  but  in  others  the 
presence  of  hydrocarbons,  such  as  marsh  gas,  which 
are  formed  in  the  decomposition  of  organic  matters, 
may  account  for  it. 

After  having  now  dealt  with  the  effects  sewer  gas  has 
upon  health,  it  becomes  necessary  to  examine  into  the^ 
cause  of  this. 


44  SEWER   GAS   AND   HEALTH. 


PART    III. 

Gonte7its  of  Sewer  Air, 

• 

CHAPTER   I. 

Poisonous  Gases  Contained  in  Sewer  Air. 

(See  also  Appendix  II.) 

The  quantity  of  gas  that  can  be  formed  by  a  given 
^quantity  of  faecal  liquid  has  been  variously  calculated 
by  different  observers. 

Concerning  the  air  in  cesspits,  Levy  (see  C-3a, 
Appendix  I.)  mentions  an  analysis,  which  shows  a 
reduction  of  oxygen  by  2  per  cent,  and  an  increase  of 
carbonic   acid  by  4  per  cent,   over  the  normal  state. 

Erismann  made  experiments  in  the  Hygienic  Institute 
at  Munich,  and  came  to  the  conclusion  that  1,000 
gallons  of  cesspit  contents,  consisting  of  human  dejecta 
and  urine,  were  capable  of  developing  the  following 
quantities  of  gas  in  24  hours: 

Table  I. — Poisonous  Gases  in  Cesspits. 


Carbonic  acid  ... 

315-0 

gallons, 

or  about  43,376 

Ammonia          

149  0 

, ) 

}, 

7.912 

: Sulphuretted  hydrogen 

1-2 

)i 

t> 

140 

Hydrocarbons     and     volatile 

fatty  acids 

579-0 

n 

}i 

29,124 

Total    quantity  of    poisonous 

gases 

1,044-2 

,, 

M 

80,552 

Equal 

,  say,  ll-51b. 

It  will  not  be  denied  that  these  are  very  considerable 
-quantities  of  some  highly  poisonous  substances. 

Parent  Duchatelet  found  the  air  in  a  choked-up  sewer 
in  Paris  to  contain  in  10,000  volumes  only  1,379  volumes 


SEWER    GAS    AND    HEALTH.  45» 

of  oxygen,  and  as  much  as  299  volumes  of  sulphuretted/ 
hydrogen. 

Gaultier  de  Claubry,  who  also  examined  the  Paris 
sewers,  states  that  the  minimum  amount  of  oxygen  in 
10,000  volumes  of  sewer  air  was  1,740  volumes.  On  an 
average  he  found  that  sewer  air  contained  in  10,000^ 
volumes  230  volumes  of  carbonic  acid  and  81  volumes 
of  sulphuretted  hydrogen,  whilst  the  greatest  amounts 
met  were  340  volumes  of  carbonic  acid  and  125  volumes 
of  sulphuretted  hydrogen. 

It  may  fairly  be  assumed  that  the  foregoing  analytical, 
results  were  chiefly  obtained  in  old  sewers,  which,  perhaps, 
had  not  been  constructed  according  to  proper  principles. 
At  any  rate  the  analysis  of  the  air  in  sewers  of  more 
recent  date  do  not  show  such  an  alarming  amount  of 
poisonous  gases. 

Letheby,  who  examined  the  air  in  some  of  the  London 
sewers,  states  that  it  contained  53*2  volumes  of  carbonic 
acid  in  10,000  volumes,  a  considerable  amount  of 
ammonia,  and  traces  of  marsh  gas  and  sulphuretted 
hydrogen ;  he  also  calculated  that  a  gallon  of  sewage 
containing  128*8  grains  of  organic  matter,  when  excluded 
from  air,  gave  in  "  nine  weeks  1*2  cubic  inches  of  gas 
per  hour,  consisting  of  73*833  per  cent,  of  marsh  gas,. 
15*899  per  cent,  of  carbonic  acid,  10*187  per  cent, 
of  nitrogen,  and  0*081  per  cent,  of  sulphuretted 
hydrogen." 

Eussell,  who  also  analysed  the  air  of  some  sewers  in 
Paddington,  found  it  to  contain  51  volumes  of  carbonic 
acid,  2,070  volumes  of  oxygen,  and  7,880  volumes  of 
nitrogen. 

Carnelley  and  Haldane  state  that  the  air  in  the  sewers 
at  Dundee  and  Westminster  Palace  contains  on  an 
average  only  7*5  volumes    of    carbonic   acid    in  10,000 


46  SEWER   GAS    AND    HEALTH. 

volumes,  but  in  the  Bristol  sewers  this  amount  ranged 
from  9-1  to  20*7. 

Laws,  who  in  1892  made  a  series  of  analyses  of 
London  sewer  air,  states  that  in  a  normal  state  it  con- 
tained on  an  average  in  10,000  volumes  8*95  volumes 
•of  carbonic  acid ;  in  the  case  of  the  Fulham-road  sewer, 
however,  this  amount  reached  the  abnormally  high  figure 
of  93*10  volumes. 

The  Munich  sewers  contain,  according  to  Beetz,  on 
an  average  in  10,000  volumes  of  air  31*4  volumes  of 
carbonic  acid  and  2*2  volumes  of  ammonia. 

Levy  and  Miquel,  who  now  periodically  examine  the 
air  in  the  Paris  sewers,  state  that  on  an  average  of 
their  observations  between  1891  and  1893  it  contained 
in  10,000  volumes  only  4*8  volumes  of  carboni«  acid 
and  1*2  volumes  of  ammonia. 

Further  particulars  are  given  in  Appendix  II.,  where 
also,  for  convenience  of  reference,  some  analyses  of  the 
gases  dissolved  in  raw  sewage  and  of  the  vapours  in 
disused  and  unventilated  cellar  dwellings  are  given. 

From  these  analyses  it  is  clear  that  the  air  in 
modern,  well-constructed,  and  well-ventilated  sewers  does 
not  contain  the  same  amounts  of  poisonous  gaseous 
substances  as  that  in  old  and  foul  sewers.  It  is  clear 
therefore  that  to  a  very  large  extent  the  state  of  the 
air  in  any  one  particular  sewer  depends  on  the  state 
this  sewer  is  in.  If  it  contains  no  deposits  and  is  well 
ventilated,  we  may  very  properly  assume  that  in  most 
cases  the  air  contained  in  it  will  also  be  comparatively 
free  from  gas  ;  but  if,  on  the  other  hand,  it  is  very 
foul  and  badly  ventilated,  then  most  probably  its  air 
contains  a  very  high  percentage  of  these  dangerous 
mixtures.  Hence  it  must  be  the  aim  of  all  those  who 
design  and  superintend  sewers  to  see  that  ample  provision 


SEWER   GAS    AND    HEALTH.  47 

is  made  for  the  fulfilment  of  these  two  essential  con- 
ditions :  no  deposits  and  an  ample  supply  of  fresh  air; 
for  it  will  not  be  denied  by  anyone  that  in  the  absence 
of  deposits  the  formation  of  gases  in  them  will 
not  be  great,  and  that  the  safety  against  the  nefarious 
influence  of  gaseous  mixtures  lies  in  their  ample  dilution. 
How  these  two  requirements  can  best  be  carried  out  in 
a  sewerage  system  is  outside  the  scope  of  this  treatise, 
but  the  author  is  afraid  of  late  a  tendency  has  set  in 
not  to  provide  for  the  dilution  of  the  gaseous  mixtures, 
but  only  for  their  escape  in  cases  of  need,  overlooking 
at  the  same  time  that  under  pressure  these  gases  will 
escape  at  the  point  of  least  resistance,  whether  that 
be  through  the  appointed  channels  or  through  house 
drains,  water  seal  of  traps,  etc.  The  author  has  lately 
examined  a  system  of  new  sewers  in  which  the  provi- 
sion for  ventilation  was  totally  inadequate,  hence  each 
manhole,  forming,  as  it  were,  a  dead  end  for  the 
accumulation  of  gas,  emitted  a  most  horrible  stench 
of  sulphuretted  hydrogen  on  the  cover  being  removed. 

In  considering  this  subject  it  is  necessary  to  bear 
in  mind  that  normal  atmospheric  air  contains  on  an 
average  in  10,000  volumes  only  three  volumes  of  carbonic 
acid,  2,090  volumes  of  oxygen,  and  7,910  volumes  of 
nitrogen,  and  that  in  the  case  of  sulphuretted  hydrogen, 
from  10  to  12  volumes  of  this  gas  in  10,000  have  been 
considered  a  rapidly  fatal  dose. 

The  question  of  the  organic  vapour  in  sewer  air  need 
not  be  discussed  here,  as  it  will  be  referred  to  later 
on  in  connection  with  the  experimental  researches  of 
Dr.  Alessi. 

These  few  remarks  must  suffice  to  show  that  the 
gaseous  mixtures  in  sewer  air  are  of  a  highly  poisonous 
nature,    which    will    exert    a    powerful    influence    upon 


48  SEWER    GAS    AND    HEALTH. 

health  if  they  are  allowed  to  accumulate;  and  there  can 
be  little  doubt  that  the  cases  of  mephitic  poisoning 
mentioned  in  a  previous  paragraph  (see  also  Appendices 
VI.  and  VII.)  were  due  to  this  cause.  Although  in 
modern  sewers  with  good  supervision  the  formation  of 
such  gases  as  carbonic  oxide,  carbonic  acid,  sulphuretted 
hydrogen,  ammonia,  volatile  hydro-carbons,  and  fatty 
acids  may  be  to  a  very  large  extent  avoided,  it  ought 
not  to  be  assumed  that  their  formation  is  altogether 
an  impossibility,  as  the  sad  case  at  East  Ham  on  the 
1st  July,  1895,  painfully  demonstrates ;  even  their 
entrance  under  pressure  into  our  houses  is  by  no 
means  excluded,  as  the  sad  case  reported  from  Glauchau 
by  Hankel  on  the  18th  January,  1895,  proves. 


SEWER    GAS   AND   HEALTH.  4& 

CHAPTER   II. 

Micro-Organisms  in  Sewer  Air. 

(See  also  Appendix  III.) 

The  introduction  of  methods  enabling  us  to  study 
the  micro-organic  life  in  air  is  of  comparative  recent 
date,  hence  it  follows  almost  as  a  corollary  that  they 
are  still  somewhat  crude,  and  that  our  knowledge 
concerning  these  micro-organisms  is  still  far  from  perfect. 
The  author  is  far  from  wishing  to  underrate  the  value 
of  the  present  methods  for  the  examination  of  air,  but,, 
on  the  other  hand,  as  it  is  by  no  means  an  uncommon 
thing  to  hear  opinions  expressed  in  a  way  as  if  these 
methods  were  infallible,  he  thinks  it  is  but  right  to  call 
attention  to  their  comparative  primitive  character.  In 
support  of  this  the  almost  daily  improvements  may  be 
quoted  which  tend  towards  the  exclusion  of  accidental 
errors  and  errors  inherent  to  former  methods,  and 
which  entitle  us  to  the  hope  that  ultimately  we  may 
ascertain  the  true  state  of  the  air  around  us  and  in 
our  sewers.  But  how  soon  this  goal  will  be  reached, 
or  how  near  we  are  to  it,  is  impossible  to  say ;  some- 
times it  seems   a  long  way  off  yet. 

It  is  necessary,  therefore,  in  dealing  with  the  subject 
of  the  micro-organic  life  in  sewer  air,  to  make  due 
allowance  both  for  our  imperfect  methods  of  investiga- 
tion and  our  incomplete  knowledge. 

So  far  as  known  to  the  author,  about  six  sets  of 
investigations  into  the  bacterial  flora  of  sewer  air  have 
within  recent  years  been  made  in  various  towns,  as 
is  shown  in  the  following  table : 

4 


50  SEWER   GAS    AND    HEALTH. 

Table  II. — Investigations  into  the  Micro-organic  Life  in  Sewer  Air. 


Sewers  in  which 

Year  of 
Investigations. 

No. 

Name  of  Observer. 

Investigations  were 
made. 

1 

L6vy  and  Miquel    .- 

Paris  sewers. 

Periodical  investiga- 
tions commenced  in 
1891,  and  continued 
since. 

2 

Petri 

Berlin  sewers. 

— 

3 

Uflfelmann    ... 

— 

— 

4 

Smith           

Sydney  sewers. 

1893. 

5 

Carnelley  and   Hal- 

Sewers    at   Dundee, 

1887. 

dane 

Westminster  Palace, 
and  Bristol. 

6 

Laws  and  Andrewes 

London  sewers. 

1892-1894. 

In  Appendix  III.  full  particulars  of  each  set  of  investi- 
gations are  given,  and  on  reference  to  this  place  it  will 
be  seen  that  in  the  main  points  the  various  observers 
practically  agree.  These  for  convenience  of  reference 
may  be  stated  as  follows : 

1.  The  number   of  germs   in   sewer   air  is   small  and 

less  than  in  outside  air.  Whereas  outside  air 
contains  on  an  average  15  germs  per  litre,  sewer 
air  has  not  more  than  from  two  to  nine  germs 
per  litre.  Only  in  the  case  of  the  Sydney  sewers 
was  a  considerably  higher  number  found,  ranging 
from  7  to  2,260  germs  per  litre.^ 

2.  The   micro-organisms   of    sewer    air   are  related   to 

the  micro-organisms  in  the  air  outside  the  sewers, 
but  not  to  the  micro-organisms  of  the  sewage. 

3.  The  only  pathogenic  germ  found  up  to  the  present 

in  sewer  air  is  the  staphylococcus  pyogenes  aureus, 
the    cause    of   suppuration,   which  was  identified 
by  Uffelmann    B-30,  Appendix  I.) 
The    results    of    their    investigations    having    so    far, 

1 1  litre  =  1,000  cubic  centimetres  (ccm.) ;  1  ccm.  of  sewage  contains 
frequently  5,000,000  germs,  and  at  this  rate  1  litre  of  sewage  would 
contain  5,000,000,000  germs. 


SEWER   GAS    AND    HEALTH.  51 

apparently,  demonstrated  the  absence  of  pathogenic 
germs,  with  the  exception  of  the  germ  of  suppuration, 
various  observers  endeavoured  to  find  out  experimentally 
whether  there  was  a  possibility  of  the  pathogenic  germs 
being  separated  from  the  liquid,  and  then  carried  away 
by  the  air  currents  prevailing  in  sewers. 

They  therefore  tried  to  ascertain  whether  these  germs 
could  pass  into  the  air  from  the  liquid  under  the 
following  conditions : 

a.  Under  ordinary  circumstances ; 
h.  Through  the  bursting  of  bubbles ; 

c.  Through  splashing;  and 

d.  From  the  slimy  surface  of  the  sewers  ; 

and  whether  the  germs,  after  passing  into  the  air,  could 
remain  suspended  there  for  some  time  and  be  carried 
away  by  the  current. 

Naegeli  has  shown  that  it  is  not  very  likely  that  germs 
pass  under  ordinary  circumstances  from  a  wet  surface 
into  the  air    B-39,  Appendix  I.) 

Prof.  Frankland  (A-28,  Appendix  I.)  has  shown  that 
the  bursting  of  bubbles  disseminated  particles  of  lithia 
solution,  and,  therefore,  presumably  micro-organisms. 
Carnelley  and  Haldane  made  laboratory  experiments 
which  completely  justified  Frankland's  inference;  and 
the  possibility,  therefore,  exists  that  germs  can  thus 
pass  from  the  sewage  into  the  air.  But  it  is  urged 
that  in  those  places  in  the  sewers  where,  through  the 
formation  of  gas,  bubbles  rise  to  the  surface  of  the  liquid 
and  burst,  it  is  hardly  likely,  that  pathogenic  germs, 
even  if  they  are  present,  will  retain  their  virulence  for 
any  length  of  time,  as  it  may  safely  be  assumed  that 
here  the  sewage  swarms  with  immense  numbers  of 
saprophytes,    and    that     in    the    struggle  for    existence 

with    these    the    pathogenic     germs    will    soon    perish. 

4* 


52  SEWER    GAS    AND    HEALTH. 

Hence  the  probability  that  germs  could  thus  hey 
disseminated   could  not    be    considered   great. 

Concerning  splashing,  Carnelley  and  Haldane  have 
observed  in  several  cases  in  sewers  that  it  disseminates 
germs  from  the  sewage.  These  results  were  corroborated 
by  their  laboratory  experiments,  and  they  therefore  came 
to  the  conclusion  that  large  numbers  of  germs  may  be 
thrown  into  the  air  in  this  way.  Laws  states  that  it 
has  been  shown  by  some  observers  "that  if  the  splashing 
is  sufficiently  violent  to  produce  a  very  fine  state  of 
division  of  the  sewage,  organisms  will  be  carried  some 
distance,  even  50  to  60  yards."  He  concludes  therefore 
that  splashing,  such  as  is  caused  by  a  house  drain, 
discharging  its  contents  into  a  sewer  through  an  opening 
in  its  crown,  should  not  be  permitted.  From  his  own 
experiments  it  would  follow  that  sewage,  falling  from  a 
branch  drain  into  an  egg-shaped  sewer  lift,  high  by 
9ft.  wide  from  about  the  middle  of  its  height,  produces 
practically  no  effect  upon  the  number  of  micro-organisms 
in  the  sewer  air. 

It  has  been  stated  that  the  slimy  skin,  which  is  practi- 
cally a  thin  layer  of  bacteria,  and  which  lines  the  inner 
walls  of  a  sewer,  cannot  give  off  germs,  as  it  cannot 
get  sufficiently  dry  owing  to  the  moisture  contained  in 
sewer  air,  the  latter  being  always  for  its  temperature 
sufficiently  saturated  with  aqueous  vapour.  This  seems 
to  be  supported  by  the  experiments  of  Laws  in  London 
and  Ficker  in  Breslau.  Laws  made  his  experiments  on 
an  experimental  9in.  sewer  of  80ft.  in  length,  but,  of 
course,  it  might  have  been  that  the  period  allowed  for 
his  observations  was  not  long  enough  to  form  a  skin  of 
the  same  thickness  and  consistency  as  is  formed  in 
sewers  which  have  been  at  work  for  20  years  and  more- 
At  any  rate  he  states : 


SEWER    GAS    AND    HEALTH.  53 

"^^  It   is   really   remarkable   to   find   that  no   organisms 
are  given  off  from  the  walls  of  a  sewer  which  has 
been  empty  and  open  to  the  air  at  both  ends  for 
such  a  lengthened  period  as  12  days.     The  sewage 
with  which  the  sewer  had  been  kept  full  for  several 
periods  of  24  hours  would  contain   no   less   than 
three   to  four  million   organisms   per  cubic  centi- 
metre,  and   immense   numbers   of  these   must   of 
necessity  have  been  clinging  to  the  walls   of  the 
sewer.      .      .      .      The  velocity  of  the  air  current 
used  in  the  above  experiments  was  5ft.  and  15ft. 
per    second   respectively,   the   latter  being  far  in 
excess  of  any  current  that  would  normally  obtain 
in  a  sewer." 
Ficker  remarks  that  in  his  experiments  in  the  Hygienic 
Institute  at  Breslau  a  current  of  air,  with  a  velocity  of 
several  metres  per  second,  was  not  able  to  lift  up  specific 
germs  from  half-moist  soil,  and  that  a  current    of  the 
same  strength  was  not  capable  of  carrying  away  germs 
which   had  dried  on  several   substances  and   adhered   to 
them. 

Various  experiments  have  been  made  with  a  view  to 
;ascertain  how  far  germs  can  be  carried  away  by 
:air  currents  in  pipes  and  sewers.  Hesse,  who  first 
investigated  this  point,  took  a  2in.  glass  tube  about 
one  yard  long,  the  inside  of  which  he  had  covered 
with  a  layer  of  nutritive  gelatine,  and  sucked  air 
t-hrough  it  at  a  slow  rate.  When  examining  the  tube 
afterwards  he  found  that  a  large  number  of  bacteria 
had  settled  in  its  first  fourth,  that  that  number 
was  somewhat  less  in  the  second  fourth,  that  it 
«till  further  decreased  in  the  third  fourth,  and  that 
no  bacteria  at  all  had  settled  in  the  last  fourth.  In 
these  experiments,  therefore,  the  bacteria  were  not  even 


54  SEWER   GAS   AND    HEALTH. 

carried  the  distance  of  one  yard.  But  against  any 
conclusions  drawn  from  these  investigations  might  be^ 
urged  that  the  tube  employed  was  far  too  small  tO' 
provide  for  the  proper  passage  of  germs  through  it. 
Similar  experiments  with  similar  results  were  made  by 
Carnelley  and  Haldane.  As  already  stated,  Laws  reports 
that  former  experiments  have  shown  **that  if  the  splash- 
ing (in  a  sewer)  is  sufficiently  violent  to  produce  a  very 
fine  state  of  division  of  the  sewage,  organisms  will  be 
carried  some  distance,  even  50  to  60  yards." 

Ficker  used  for  his  experiments  a  4in.  tube,  which 
he  placed  upright,  and  at  the  bottom  of  which  he 
caused  bubbles  of  a  liquid  highly  charged  with  specific 
germs  to  burst.  Then,  forcing  air  through  it  at  the- 
rate  of  0*196in.  per  second,  he  found  that  the  germs 
had  been  carried  as  high  as  23ft.  into  the  air. 

It  cannot,  however,  be  said  that  any  of  the  experi- 
ments mentioned  in  the  last  series  afforded  conclusive- 
evidence  against  the  possibility  of  germs  remaining 
suspended  in  air  for  some  time  and  being  carried  away 
by  the  currents. 

It  may  not  be  out  of  place  to  summarise  now  the- 
various  results  obtained. 

1.  It  is  held  that  all  pathogenic  germs  which  reach  the 
sewers  in  the  faeces,  urine,  sputa^  in  the  water  from 
baths  and  lavatories,  in  the  house  refuse,  in  the  rain- 
water from  streets,  etc.,  meet  with  conditions  there  that 
are  not  favourable  to  them,  and  prevent  their  propagation. 

2.  Amongst  these  unfavourable  conditions  is  perhaps 
the  struggle  for  existence  with  the  myriads  of  other 
germs  that  crowd  the  sewage,  and  ending  in  the  survival 
of  the  fittest — the  most  unfavourable  one.  Hence  the 
life  of  pathogenic  germs  in  sewage  is  of  comparatively 
short  duration,  and  the  death  being  a  gradual  one  they 


SEWER    GAS    AND    HEALTH.  55 

lose  their  virulence — i.e.,  their  power  of  mischief — some 
time  before  this  event  actually  takes  place. 

3.  It  is  further  held  that  pathogenic  germs,  like  other 
germs,  cannot  rise  from  liquids  and  moist  surfaces  under 
ordinary  circumstances,  and  that  although  they  may 
become  disseminated  in  sewer  air  through  the  bursting 
of  bubbles  and  through  splashing,  they  cannot  be 
carried  very  far  by  the  air  currents,  but,  following  the 
law  of  gravitation,  soon  fall  back  into  the  sewage. 
Hence  it  is  not  all  likely  that  pathogenic  germs  are 
carried  about  suspended  in  sewer  air. 

4.  The  experimental  results  then,  so  it  is  argued,  go 
to  explain  the  cause  of  the  comparative  absence  of  germs 
from  sewer  air,  and  confirm  the  conclusions  drawn 
from  its  examination. 

5.  Further,  it  is  argued  that  the  air  is  but  seldom 
the  carrier  of  infectious  germs. 

Therefore  concludes  Kirchner  (B-30,  Appendix  I.) 
a  passage  in  his  paper  on  the  injurious  influence  of 
sewer  gas,  "we  are  entitled  to  say  with  a  probability 
bordering  on  certainty  that  presumably  pathogenic 
germs  will  never  be  found  in  sewer  air." 

But  where  the  cause  is  absent — it  is  here  assumed 
that  there  can  be  no  typhoid  fever  without  the  typhoid 
bacillus — the  effect  will  also  be  absent,  hence  sewer  air 
or  sewer  gas  is  not  capable  of  producing  typhoid  fever. 

Against  these  conclusions,  however,  it  has  been  urged 
by  those  who  support  the  theory  that  sewer  gas  is 
capable  of  propagating  typhoid  fever,  that  it  is  by 
no  means  conclusively  established  that  the  bacillus 
typhosus  is  the  vera  causa  of  typhoid  or  enteric  fever ; 
further,  as  has  already  been  stated,  that  our  methods 
of  investigation  are  still  very  imperfect  and  admit  of 
a  great  many  errors,  and,   finally,   that  the   chances  of 


56  SEWER    GAS    AND    HEALTH. 

finding  the  typhoid  germ  in  such  a  vast  labyrinth  of 
underground  conduits  as  the  London  system  of  sewers 
is,  are  practically  nil. 

Assuming  for  the  sake  of  argument  that  the  bacillus 
typhosus  is  the  true  cause  of  typhoid  fever,  it  must 
not  be  thought  that  it  is  present  in  every  litre  of  sewer 
air,  but  being  only  an  occasional  and  periodical 
inhabitant  of  it,  it  will  be  found  only  in  isolated 
places.  It  is,  therefore,  a  mere  accident  if  the 
experimenter  happens  to  take  his  samples  of  air  in  a 
locality  where  the  typhoid  germs  are  and  just  at  the 
time  they  are  passing  his  place  of  observation  in  an 
air  current ;  the  next  moment  they  might  be  wafted 
away  and  beyond  his  reach.  Further,  in  a  large  sewer 
they  might  pass  round  his  instruments,  and  so  escape 
him.  It  is  clear  therefore  that  their  chances  of  not 
being  taken  in  isolated  samples  of  sewer  air  are 
innumerable,  and  the  chances  of  catching  them 
extremely  remote. 

These  or  similar  circumstances  may  account  for  the 
fact  that  only  one  observer  (Uffelmann)  has  up  to  the 
present  been  able  to  discover  the  pathogenic  germ  of 
suppuration  in  sewer  air. 

How  very  difficult  it  is  to  catch  the  typhoid  germ 
even  in  sewage  is  clear  from  the  report  of  Messrs. 
Laws  and  Andrewes.  Although  these  experimenters 
employed  the  greatest  care,  they  were  not  able  to  find 
this  germ  once  in  ordinary  London  sewage.  They  then 
tried  the  drain  that  takes  the  sewage  from  the  typhoid- 
fever  block  of  the  Eastern  Hospital  at  Homer  ton  at 
a  point  inside  the  hospital  grounds,  and  although  this 
sewage  must  have  contained  a  vast  number  of  typhoid 
germs  at  the  time,  they  were  only  able  to  find  two: 
colonies   of    it.      Later  on   they   tried   the    sewer  which. 


'& 


SEWER    GAS    AND    HEALTH.  57 

takes  the  drainage  of  the  hospital  at  a  point  about  a 
quarter  of  a  mile  below  this  institution,  and  did  not 
find  a  single  colony  of  the  bacillus  typhosus.  Therefore, 
in  spite  of  all  their  most  painstaking  investigations, 
Messrs.  Laws  and  Andrewes  found  only  two  colonies  of 
the  typhoid  germ  in  London  sewage. 

Further,  it  is  by  no  means  a  new  thing  to  attribute 
an  outbreak  of  cholera  or  typhoid  fever  to  water  without 
having  been  able  to  discover  the  specific  germs  of  these 
diseases  therein.  For  instance,  the  late  severe  cholera 
epidemic  at  Hamburg  in  1892  was  traced  to  the  water 
supply  although  no  cholera  germs  were  found  in  it. 
Likewise  were  two  typhoid  epidemics  at  Berlin  in  1889 
and  1893  attributed  to  the  water  without  the  bacillus 
typhosus  having  been  found  therein.  On  the  contrary, 
there  are  only  a  few  cases  on  record  where  this  specific 
germ  has  been  found  in  water  in  connection  with  an 
outbreak  of  typhoid  fever,  and  it  was  considered  a  feat 
worthy  to  be  recorded  when,  at  Berlin,  where  perhaps 
the  most  elaborate  and  painstaking  searches  have  been 
and  are  still  being  made  for  this  germ,  it  was  found 
for  the  first  time  in  the  public  water  supply  by  Loesener 
on  the  27th  February,  1894.  Therefore  those  who  look 
upon  sewer  air  as  capable  of  carrying  the  typhoid  germ 
are  in  no  worse  position  than  those  that  hold  the 
water  responsible  for  some  outbreaks  of  typhoid  fever. 

It  will  not  be  denied  that  arguments  such  as  these 
in  favour  of  the  sewer-gas  theory  cannot  in  the  present 
state  of  our  knowledge  be  fully  contradicted  by  those 
who  are  opposed  to  it,  but,  looking  at  the  whole  case 
and  making  all  due  allowances,  it  appears  to  the  author 
that  the  chances  of  typhoid  fever  being  brought  about 
through  the  conveyance  of  the  bacillus  typhosus  in 
«ewer  air  are  somewhat  remote. 


58  SEWER    GAS    AND    HEALTH. 

What  then  is  the  connection  between  sewer  air  and 
typhoid  fever  ?  This  question  the  author  will  endeavour 
to  answer  in  the  following  paragraph. 


SEWER    GAS    AND    HEALTH.  59: 


PART    IV. 

Experiments  on  Animals  with  Sewer  Air. 

CHAPTEK   I. 

BXPEEIMENTAL     KeSEARCHES     INTO     THE     CaUSAL    EeLATIONS- 

BETWEEN   Sewer    Air  and   Typhoid  Fever. 
(See  also  Appendix  IV.) 

As  it  had  frequently  been  observed  that  domestic 
animals  which  are  exposed  to  typhoid  infection  in 
almost  the  same  degree  as  human  beings  never  showed 
symptoms  of  illness  during  or  after  a  typhoid  epidemic, 
or  even  pathologic-anatomical  changes,  which  could  be 
considered  at  all  identical  with  those  found  in  typhoid 
fever,  ^the  opinion  gained  ground  that  the  lower  animals 
do  not  suffer  from  typhoid  fever  in  the  sense  in  which 
it  is  recognised  in  man.  "When,  therefore,  the  bacillus 
typhosus  was  discovered,  various  experimenters  at  once 
set  to  work  with  a  view  to  ascertain  whether  it  could 
produce  typhoid  fever  in  the  lower  animals. 

Gaffky,  who  was  perhaps  the  first  to  carefully  and 
methodically  investigate  this  matter,  was  not  fortunate 
in  settling  it,  as  all  his  numerous  experiments  on  5 
monkeys,  1  calf,  16  rabbits,  13  guinea-pigs,  7  rats, 
white  and  grey  mice,  pigeons,  and  fowls  led  in  no 
case  to  illness  or  even  to  changes  which  could 
have  been  attributed  without  doubt  to  the  infection. 
Shortly  after  him,  however,  Fraenkel  and  Simmonds 
were  able  to  report  that  they  had  succeeded  in  pro- 
ducing an  acute  fatal  disease  in  guinea-pigs,  grey  house 


•60  SEWER   GAS   AND   HEALTH. 

mice,  and  rabbits  by  injecting  large  quantities  of  the 
typhoid  bacillus  (from  1  to  2  ccm.  of  broth  culture  and 
more)  into  them.  Since  then  numerous  other  observers 
have  been  able  to  observe  the  same  results  after  inoculating 
animals  with  large  doses  of  the  bacillus  typhosus,  and 
it  can,  therefore,  no  longer  be  doubted  that  this  bacillus 
<5an  produce  very  acute  illness  and  death  in  animals 
provided  the  doses  given  are  large  enough  ;  in  many 
•cases  death  took  place  within  from  three  to  four  hours 
after  the  inoculation.  But  this  disease — and  here  all 
observers  practically  agree — is  not  of  a  specific  nature, 
and  does  not  resemble  in  its  clinical  and  anatomical 
appearances  those  observed  in  typhoid  fever  in  man ; 
moreover,  it  can  be  brought  about  by  the  injection  of 
various  other  microbes. 

In  passing,  it  may  not  be  out  of  place  to  quote  here 
what  Stern  says  in  reference  to  the  action  of  the  typhoid 
bacillus  upon  animals  : 

*'We  must  imagine  that  the  animals  experimented 
upon  can  withstand,  if  the  injected  quantities  of 
culture  are  below  a  certain  standard,  which  latter 
varies  according  to  the  virulence  of  the  bacilli, 
the  amount  of  poisonous  matter  introduced  at  the 
same  time,  and  have  still  strength  left  to  deal 
successfully  with  the  bacilli  themselves.  If,  how- 
ever, the  injected  quantities  of  culture  are  above 
this  standard,  then  the  great  amount  of  poisonous 
matter  tends  on  the  one  hand  to  reduce  the  power 
of  resistance  of  the  body  against  the  injected 
bacilli,  and  on  the  other  hand  the  greater  number 
of  the  latter  will  be  able  to  break  down  all  the 
quicker  the  protective  forces  of  the  body  which 
oppose  their  growth.  Then  follows  the  secondary 
Augmentation  of  the  bacilli,  which,  of  course,  can 


SEWER    GAS    AND    HEALTH.  611 

attribute  very  essentially,  through  the  production 
of  more  poisonous  substances  alone,  to  the  fatal 
issue." 

What  these  protective  forces  of  the  body  are,  whether 
they  are  the  leucocytes  of  Metchnikoff  or  not,  and  why 
the  acute  disease  produced  in  the  body  of  the  animals- 
through  the  injection  of  large  quantities  of  typhoid- 
bacilli  is  not  of  a  specific  nature  and  cannot  be  compared 
with  typhoid  fever  in  man,  are  questions  which  are  outside 
the  scope  of  this  treatise.  Suffice  it  to  say  that  before 
they  are  solved  our  investigations  will  have  to  be  pushed 
a  great  deal  farther,  so  as  to  obtain  full  explanations 
of  a  great  number  of  other  processes  which  at  present 
are  still  shrouded  in  mystery.  For  our  purposes,  there- 
fore, it  will  be  sufficient  to  bear  in  mind  that  under 
ordinary  circumstances  small  doses  of  the  typhoid  bacillus- 
will  not  produce  ill  effects  in  animals,  but  that  large 
doses  cause  very  acute  disease  and  rapid  death. 

After  this  slight  detour  it  will  be  necessary  to  return, 
to  our  subject  and  consider  some  of  the  investigations 
which  have  been  made  with  a  view  to  ascertain,  through, 
experiments  on  animals,  the  causal  relations  between, 
sewer  gas  and  typhoid  fever. 

Dr.  Parkes  reports  in  his  "  Manual  of  Practical 
Hygiene"  that  Dr.  H.  Barker  exposed  three  dogs  and 
one  mouse  to  the  influence  of  sewer  gas.  The  animals 
were  put  into  a  box  and  lowered  down  over  a  cesspit,, 
so  that  they  were  forced  to  breathe  the  gases  formed 
through  the  decomposition  of  organic  matters.  The 
mouse  died  on  the  fifth  day,  and  all  the  dogs  suffered 
from  vomiting,  purging,  and  a  febrile  condition,  which 
Dr.  Barker  says  "  resembled  the  milder  forms  of  continued, 
fever  common  to  the  dirty  and  ill-ventilated  homes  of 
the  lower  classes  of  the  community."     But  the   effects- 


^62 


SEWER   GAS   AND   HEALTH. 


required  some  time  and  much  gas  for  their  production. 
Dr.  Barker  attributes  the  results,  not  to  the  organic 
matter,  but  to  the  mixture  of  carbonic  acid,  hydrogen 
sulphide,  and  ammonium  sulphide,  and  specially  to  the 
latter  two. 

The  best  and  by  far  the  most  elaborate  researches 
into  this  question  have  been  made  in  Italy  in  the 
Hygienic  Institute  of  the  University  of  Eome,  by  Dr. 
Alessi  (see  A-4  and  D-2,  Appendix  I.),  full  particulars 
of  which  are  given  in  Appendix  IV.  Alessi  experimented 
in  all  on  408  animals,  as  is  shown  in  the  following 
table : 

Table  III.— Particulars  and  Numbers  of  Animals  Experimented  on  by 

Dr.  Alessi. 


Treatment  of  Animals. 

Rats. 

Guinea- 
pigs. 

Rabbits. 

Totals. 

Putrid  gases  (^Xexto^edto       :: 
Special  mixture/ Exposed  to 

of  gases        \ Not  exposed  to  ... 

Totals 

49 
41 
48 
34 

Ill 

79 

8 

6 

19 
13 

179 

133 

56 

40 

172 

204 

32 

408 

The  plan  which  he  adopted  in  conducting  his  researches 
was  the  following: 

He  exposed  49  rats,  111  guinea-pigs,  and  19  rabbits 
to  putrid  gases,  including  sewer  gas,  for  a  time,  then 
injected  into  them  small  doses  of  attenuated  typhoid 
bacilli  and  bacterium  coli,  carefully  noted  the  results 
of  this  operation,  and  after  death  made  searching  post- 
mortem examinations.  At  the  same  time  he  kept  as 
a  control  of  the  foregoing  experiments  41  rats,  79  guinea- 
pigs,  and  13  rabbits  under  ordinary  conditions  and 
injected  into  them  exactly  the  same  doses  of  typhoid 
bacilli    as    before,   so    as    to    have    all    the    conditions 


SEWER   GAS   AND    HEALTH.  63 

the  same  save  the  exposure  to  sewer  gas.  This  formed 
the  first  set  of  his  experiments. 

With  a  view  to  ascertain  now  whether  the  result  of 
his  first  set  of  observations  was  brought  about  by  the 
action  of  those  chemical  substances  which  are  commonly 
given  out  in  the  form  of  gas  from  putrid  fermentations, 
he  started  a  second  set  of  experiments.  Taking  in  all 
48  rats  and  8  guinea  pigs,  he  exposed  them  to  such 
substances  as  retilindol,*  ammonia,  sulphuretted  hydrogen, 
methyl  sulphide,  carbonic  acid,  carbonic  oxide,  and  ammo- 
nium sulphide,  and  after  a  time  injected  doses  of  typhoid 
bacilli  into  them.  As  a  control  of  the  foregoing  experi- 
ments he  injected  the  same  doses  of  typhoid  bacilli  into 
34  rats  and  6  guinea  pigs,  which  had  been  kept  under 
ordinary  circumstances.  These  two  sets  of  experiments 
enabled  him  to  arrive  at  certain  final  conclusions  which 
are  given  later  on. 

Concerning  the  doses  of  typhoid  bacilli  injected  into 
the  various  animals,  it  ought  to  be  stated  that  they 
were  very  small,  amounting  only  to  from  0*25  to 
0*50  ccm.  Other  observers,  in  order  to  bring  about 
fatal  results,  had  been  obliged  to  use  doses  as  large 
as  from  2  to  4  ccm.,  and  above  that;  therefore,  their 
doses  were  from  four  to  eight  times  larger  than 
Alessi's  maximum  dose. 

Further,  the  cultures  used  by  Alessi  were  far  from 
being  virulent.  Concerning  his  culture  A  he  says :  "  its 
virulence  might  be  considered  almost  nil,^'  and  concern- 
ing his  culture  B  he  states  that  *'  it  had  a  certain 
virulence." 

The  exposure  to  putrid  gases  was  made  in  the  follow- 
ing manner :    The  rats  were  put  into  a  box  with  a  wire 

*  Rebilindol  (Scatol)  is  a  strongjly  smelling  product  of  putrefaction  of 
albuminous  substances,  and  is,  therefore,  easily  found  in  the  intestines. 


64  SEWER   GAS   AND   HEALTH. 

bottom,  which  was  so  placed  over  an  untrapped  water- 
closet  that  it  closed  its  aperture.  The  rabbits  and 
guinea-pigs  were  likewise  placed  into  a  box  with  a  wire 
bottom,  but  the  latter  was  placed  over  a  vessel  which 
contained  excrementitious  substances. 

In  reference  to  the  bacterium  coli  commune  which 
Alessi  used  for  some  of  his  inoculations,  it  might  not 
be  out  of  place  to  state  that  it  is  now  considered  a 
harmless  inhabitant  of  the  intestines.  It  is  very  much 
like  the  typhoid  bacillus,  and  has  frequently  been  mis- 
taken for  this  pathogenic  germ  ;  some  observers  call 
it  bacillus  coli  communis.  It  is  always  found  in  faecal 
matters,  and  consequently  in  sewage,  hence  its  presence 
in  a  liquid  indicates  contamination  by  sewage. 

The  experiments  throughout  were  conducted  with  the 
greatest  care,  and  cannot  fail  to  carry  conviction  to  all 
those  who  read  them ;  certainly  Dr.  Alessi  appears  to 
have  spared  no  pains  to  arrive  at  reliable  conclusions. 

The  results  obtained  in  the  first  set  of  experiments 
are  given  in  Tables  I.,  II.,  III.,  and  IV.  of  Appendix 
IV.,  from  which  it  is  clear  that  from  75  to  100  per 
cent,  of  all  animals  inoculated  with  small  doses  of 
attenuated  typhoid  bacilli  and  bacterium  coli  after 
exposure  to  sewer  gas  perished,  whilst  practically  not 
one  of  the  animals  which  had  been  kept  under  normal 
conditions  succumbed  to  the  inoculation.  These  figures 
are  highly  significant,  and  speak  for  themselves. 

It  is  not  necessary  here  to  dwell  on  the  changes 
brought  about  by  the  inoculation  in  the  organs  and 
tissues  of  the  animals  as  revealed  in  the  post-mortem 
examinations ;  it  will  suffice  to  say  that  bacteriological 
research  was  able  to  prove  the  almost  exclusive  presence 
of  large  numbers  of  typhoid  bacilli  in  the  organs  and 
tissues  in  every  case  excepting  those  animals  of  course 


SEWER    GAS    AND    HEALTH.  65 

into  which  the  bacterium  coli  had  been  injected,  where 
this  latter  germ  alone  was  found.  In  reference  to  this 
point  Alessi  remarks  :  "  By  the  distribution  then  of  the 
typhoid  bacilli  in  the  various  tissues,  and  by  the  altera- 
tions which  they  have  caused  in  them,  I  am  justified 
in  concluding  that  they  have  caused  death  in  these 
animals  following  upon  the  predispositions  which  the 
latter  had  acquired  by  breathing  putrid  gases." 

From  these  experiments  it  is  clear  that  through  the 
exposure  to  putrid  gases,  including  sewer  gas,  the  animals 
experimented  on  lost  their  natural  immunity  to  small 
doses  of  the  typhoid  bacillus,  and  acquired  a  pre- 
disposition to  the  pathogenic  action  of  this  germ  tO' 
such  an  extent  that  they  succumbed  to  small  doses 
of  attenuated  typhoid  bacilli  in  periods  ranging  on  an 
average  from  23  hours  to  5  days  and  3  hours.  How 
very  great  the  influence  was  which  the  breathing  of 
putrid  gases  exercised  on  the  animal  organism  is  further 
demonstrated  by  the  fact  that  even  the  harmless 
bacterium  coli  was  capable  of  killing  83  per  cent,  of 
the  animals  into  the  bodies  of  which  it  had  been 
injected. 

The  period  in  which  this  predisposition  or  great 
susceptibility  to  the  pathogenic  action  of  the  bacillus 
typhosus  was  obtained  by  the  animals  varied  on  an 
average  from  3  days  to  22  days,  and  was  also  different 
for  the  different  species,  rats  showing  a  greater 
resistance  than  guinea  -  pigs,  and  guinea  -  pigs  than 
rabbits.  Alessi  remarks:  "It  appears  that  generally 
the  animals  acquire  the  predisposition  to  infection  more 
easily  during  the  first  two  weeks  than  after  that  time. 
In  fact,  90  per  cent,  of  the  animals  inoculated  in 
the  first  two  weeks  died,  and  only  76  per  cent,  of  those 
inoculated  in  the   following  weeks.     This  fact  may  in  a 

5 


66  SEWER    GAS    AND    HEALTH. 

certain  degree  explain  how  it  is  that  some  individuals 
who  habitually  breath  air  from  sewers  or  in  whatever 
way  corrupted,  end  by  becoming  habituated  to  it,  and 
are  no  longer  attacked  by  intestinal  infections." 

After  having  studied  the  predisposing  action  of 
putrid  gases  taken  in  their  entirety,  Alessi  set  to  work 
to  ascertain  whether  the  chemical  substances  which 
are  commonly  given  out  in  the  form  of  gas  from  putrid 
fermentations  can  also  exercise  separately  a  similar 
influence  on  the  animal  organism. 

The  number  of  animals  and  the  various  substances 
used  in  these  experiments  have  already  been  stated. 
It  will  only  be  necessary  to  add  here  that  both 
the  gases  and  the  animals  were  placed  inside  a 
bell  glass,  which  was  closed  in  such  a  manner  as  to 
make  change  of  air  impossible.  It  is  of  course  well 
known  that  the  substances  employed  are  of  a  highly 
poisonous  nature  to  man  and  animal,  and  produce 
very  rapid  deleterious  effects.  Alessi  therefore  only  used 
very  small  quantities,  certainly  smaller  than  the  minimum 
fatal  dose. 

The  results  of  this  second  set  of  experiments  are 
given  in  Table  V.  of  Appendiv  IV.,  from  which  it  follows 
that  out  of  a  total  number  of  56  animals  which  had 
breathed  the  various  gases  and  gaseous  mixtures  only 
three  in  all  died,  and,  as  Alessi  remarks,  these  three 
died  from  other  causes,  which  it  was  impossible  for 
him  to  define.  He  therefore  comes  to  the  conclusion 
that  neither  the  gases  taken  separately  nor  in  mixtures, 
exercise  a  predisposing  influence  over  the  animal  organism. 
**  For  which  reason,"  Alessi  continues,  "  I  may  be  allowed 
to  suppose  that  both  the  exhalations  arising  from  faecal 
matter  and  the  exhalations  arising  from  organic  matter 
in  putrefaction,    are  not   composed   of  simple   mixtures, 


SEWER    GAS    AND    HEALTH.  67 

but  are  much  more  complicated  than  might  be  believed. 
And  the  predisposing  cause  might  also  have  its  seat  in 
those  foetid  substances  of  neutral  character  which  it  is 
impossible  either  to  understand  or  determine,  whether 
from  their  small  quantity,  the  insufficiency  of  analytical 
methods,  or  from  the  imperfection  of  those  which  we 
already  have.  In  any  case,  from  my  experiments  can 
be  drawn  this  useful  lesson  that  the  above-mentioned 
gases  or  vapours  can  be  breathed  in  small  doses  without 
their  predisposing  to  typhoid  infection." 

The  final  conclusions  at  which  Alessi  arrived  are  the 
following  : 

"1.  The  inspiration   of    putrid   gases   predisposes  the 

animals    (rabbits,    guinea-pigs,    and  rats)    to   the 

pathogenic    action     of    even    attenuated     typhoid 

bacilli  and  of  bacterium  coli. 
"  2.  This  predisposition  is  due  to  the  combination  of 

gases  given  out  by  putrid  fermentations,  and  not 

to  anyone  separately;  and 
'*  3.  It  is  probable  that  this  experimental  predisposition 

is  diminished  by  prolonged  breathing  of  the  said 


It  can,  perhaps,  not  be  surprising  that  those  who  con- 
sider sewer  gas  comparatively  harmless  have  endeavoured 
to  find  fault  not  only  with  the  conclusions  derived  from 
Alessi's  experiments,  but  also  with  the  way  in  which 
they  have  been  carried  out.  According  to  them  these 
researches  cannot  be  applied  to  human  beings,  as  in  the 
first  instance  these  will  never  be  exposed  to  such  strong 
doses  of  sewer  gas  as  were  applied  by  Alessi  to  his 
animals.  Those  whose  good  or  bad  fortune  it  has  ever 
been  to  have  to  examine  the  ramifications  of  house 
drains  that  have  been  laid  more  than  20  years  ago 
will    know    from    their    own     experience    whether    this 


68  SEWER    GAS    AND    HEALTH. 

objection  is  true  or  not;  at  any  rate,  so  far  as  the- 
author  is  concerned,  he  has  met  with  cases  in  whicb 
the  escape  of  sewer  gas  was  in  every  way  as  bad  as 
in  these  experiments,  and  where  the  doses  inhaled, 
cannot  have  been  much  less.  But  even  granted  that 
in  the  generality  of  cases,  though  the  amount  of 
sewer  gas  escaping  through  faulty  places  or  untrapped 
water  -  closets,  etc.,  may  be  as  great  as  in  Alessi's 
researches,  the  exposure  to  these  gases  is  not  as  con- 
tinuous as  in  them,  this  will  only  make  a  difference  as 
to  the  time  in  which  this  predisposition  is  acquired, 
not  to  the  predisposition  itself.  At  any  rate  Alessi's 
experiments  show  very  clearly  what  a  powerful  influence 
putrid  gases,  including  sewer  gas,  can  exert  upon  the 
animal  organism  under  unfavourable  circumstances ;  and 
who  shall  say  in  so  important  a  matter  as  health  what 
the  dose  is  an  individual  may  inhale  without  detriment, 
and  for  what  length  of  time  !  Social  hygiene  has  too 
often  and  too  painfully  shown  that  some  constitutions 
are  quickly  affected  by  sewer  gas,  whereas  others  are 
more  slowly  but  none  the  less  surely  conquered  by  it. 
In  the  author's  opinion,  therefore,  this  first  objection  to 
Alessi's  experiments  springs  from  an  under-estimation. 
of  the  real  condition  of  things. 

Further,  it  has  been  urged  that  the  fatal  disease 
produced  by  Alessi  in  his  animals  does  not  correspond 
to  typhoid  fever  in  man,  and  that  therefore  it  is  wrong 
to  conclude  from  the  predisposition  to  this  disease  in 
animals  a  predisposition  to  typhoid  fever  in  man. 
through  the  breathing  of  sewer  gas.  Let  us  see 
whether  or  no  this  objection  carries  more  weight  than, 
the  former. 

The  author  has  shown  that  rodents  and  all  lower 
animals   are    immune    to    small    doses    of    the    typhoid. 


SEWER    GAS    AND    HEALTH.  69 

1)acillus.  He  has  further  shown  that  in  Alessi's  experi- 
ments the  animals  after  inhaling  putrid  gases  for  a 
greater  or  less  time  lost  this  immunity,  and  became 
so  susceptible  to  the  action  of  the  typhoid  bacillus 
and  even  the  harmless  bacterium  coli  that  small  doses 
of  attenuated  typhoid  bacilli  and  of  bacterium  coli  were 
•capable  to  set  up  rapidly  fatal  disease.  He  has  finally 
mentioned  that  in  the  organs  and  tissues  of  the  dead 
animals  only  the  bacillus  typhosus  and  in  one  experi- 
ment the  bacterium  coli  was  found,  so  that  there 
<}annot  be  a  doubt  but  that  these  germs  caused  the 
•death  of  the  animals.  This  being  so  it  matters  not  for 
the  purposes  of  this  treatise  whether  or  no  the  patho- 
genic action  of  the  typhoid  bacillus  is  the  same  in 
animals  as  in  human  beings,  the  only  point  of  import- 
a^nce  being  the  fact  that  the  breathing  of  sewer  gas 
did  render  the  animals  more  susceptible,  or  in  other 
words,  predisposed  them,  to  the  pathogenic  action  of 
"this  germ.  Therefore,  if  from  experiments  on  animals 
we  may  form  opinions  as  to  the  effects  on  human 
-beings — and  this  will  hardly  be  denied — we  are  entitled 
to  conclude  that  the  breathing  of  sewer  gas  will 
predispose  human  beings  as  well  to  the  pathogenic 
action  of  the  bacillus  typhosus.  Hence,  in  the  author's 
opinion  this  second  objection  cannot  be  maintained. 

Alessi^s  experiments  then  offer  an  explanation  of  the 
causal  connection  between  sewer  gas  and  typhoid  fever, 
a  connection  which,  though  foreseen  epidemiologically  by 
:Some  observers,  had  been  disputed  by  others,  and  which 
social  hygiene  has  practically  and  painfully  confirmed 
in  many  instances. 


SEWER   GAS    AND    HEALTH. 


PART    V. 

Conclusions  as  to  the  Influence  of  Sewer  Gas  upon  Healths 

CHAPTEE   I. 

Influence  of  Sewer  Gas  upon  Health. 
Conclusions  from  the  foregoing  Chapters. 

It  will  now  be  necessary  to  summarise  shortly  the^ 
influence  which  sewer  gas  exerts  upon  health. 

It  has  been  shown  in  the  foregoing  remarks  that, 
broadly  speaking,  sewer  gas  is  able  to  cause  instantaneous 
death  through  asphyxia,  and  to  predispose  the  constitution 
to  the  action  of  the  typhoid  bacillus.  Therefore,  although- 
such  a  classification  is  not  entirely  correct,  we  may  for 
convenience  of  reference  distinguish  between  a  direct 
and  indirect  action  of  sewer  gas  upon  health. 

Concerning  the  direct  action,  it  is  highly  probable  that 
this  is  •  brought  about  through  such  gases  as  carbonic 
oxide,  carbonic  acid,  and  sulphuretted  hydrogen  acting 
either  in  combination  or  separately,  as  they  are  known 
to  be  highly  poisonous  substances.  If  the  quantity  of 
sewer  gas  inhaled  contains  large  doses  of  these  gases,. 
then  the  severe  form  of  mephitic  poisoning  will  be  the 
result — viz.,  instantaneous  death  through  asphyxia ;  if, 
on  the  contrary,  these  gases  are  only  present  in  small 
quantities,  then  the  mild  form  of  mephitic  poisoning  will 
take  place,  which,  if  the  exposure  to  sewer  gas  is  continued 
for  some  time,  will  lead  to  derangements  in  the  digestive 
and  nutritive  organs.  This  direct  action  has,  therefore^ 
sometimes  been  called  the  mephitic  action  of  sewer  gas^ 


SEWER    GAS    AND    HEALTH.  71 

The  cause  of  the  indirect  action  of  sewer  gas  is  still 
shrouded  in  mystery,  as  we  do  not  know  the  nature 
of  the  poison  which  renders  the  constitution  susceptible 
to  the  pathogenic  action  of  the  typhoid  bacillus. 
Whether  it  be  the  combination  of  gases  given  off  by 
putrifying  organic  matters,  or  whether  it  be  a  mixture 
of  some  of  them,  or  whether  it  be  one  of  them  only 
which  has  been  called  organic  vapour,  or  whether  this 
cause  has  its  seat  in  those  fetid  substances  of  neutral 
character  which  it  is  impossible  at  the  present  time 
either  to  understand  or  determine,  we  are  powerless 
in  the  present  state  of  our  knowledge  to  ascertain. 
But,  nevertheless,  the  fact  remains  that  this  pre- 
disposition exists,  and  must  not  be  overlooked,  as  has 
been  done  by  those  who,  for  want  of  being  able  to 
specify  the  cause,  have  disputed  the  effect.  This  indirect 
action  has  by  some  been  called  the  predisposing  action. 

We  have  therefore  the  direct  or  mephitic  action  and 
the  indirect  or  predisposing  action  of  sewer  gas,  and 
though  these  definitions  are,  strictly  speaking,  not  quite 
correct,  they  admit  at  any  rate  of  an  easy  reference. 
Whether  or  no  it  will  eventually  be  found  that  they 
both  spring  from  one  and  the  same  cause  is  a  matter 
of  mere  speculation  at  the  present  time,  and  therefore 
outside  the  sphere  of  practical  consideration. 

Concerning  the  direct  infective  action  of  sewer 
gas,  the  author  has  already  pointed  out  that, 
in  his  opinion,  the  chances  of  typhoid  fever  being 
brought  about  through  the  conveyance  of  the  bacillus 
typhosus  in  sewer  air  are  somewhat  remote,  and  for 
this  reason  he  has  not  taken  any  note  of  it  in  the 
previous  remarks. 

Up  to  the  present  time  the  point  whether  the  pre- 
disposing action  of  sewer  gas   extends  to  other  zymotic 


72  SEWER   GAS   AND   HEALTH. 

diseases  as  well  has,  so  far  as  the  author  is  aware, 
not  been  investigated  experimentally,  but  if  such  a 
predisposition  should  be  proved  eventually  it  would 
afford  an  easy  explanation  for  the  connection  which  has 
been  observed  by  various  observers  to  exist  between 
sewer  gas  and  such  diseases  as  diarrhcea,  cholera, 
erysipelas,  puerperal  fever,  etc. 

It  has  frequently  been  stated  that  if  sewer  gas  was 
capable  of  exercising  a  predisposing  influence  to  typhoid 
infection,  this  influence  ought  to  make  itself  strongly 
felt  on  sewage  farms,  where  the  sewage  is  spread  over 
large  tracts  of  land,  but  as  the  latter  was  not  the  case, 
sewer  gas  could  not  possess  the  power  of  rendering  the 
system  susceptible  to  the  action  of  the  bacillus  typhosus. 
In  the  author's  opinion  such  a  conclusion  is  not  correct, 
as  the  reason  of  this  fortunate  state  of  things  is  to  be 
found  in  the  nature  of  the  predisposing  poison,  and  not 
in  its  absence  from  sewer  air.  If  this  poison  were  an 
organised  one,  or  if  sewer  air  did  carry  a  large 
number  of  typhoid  germs,  then  one  might  expect  that 
an  epidemic  in  town  would  be  followed  by  an  outbreak 
on  the  sewage  farm,  but  as  the  predisposing  poison  does 
not  appear  to  be  an  organised  one  (probably  a  chemical 
one)  it  becomes  diluted  with  air  to  such  an  extent  on 
the  farm  that  it  loses  its  powers  of  mischief.  Hence 
this  objection  cannot  be  maintained. 

In  passing,  the  author  would  like  to  remark  that  the 
•experience  of  all  well  -  conducted  sewage  farms  goes  to 
show  that  they  do  not  act  injuriously  to  the  public 
health,  and  that,  for  instance,  the  epidemic  of  typhoid 
fever  which  visited  the  city  of  Berlin  in  1889  was  not 
followed  by  an  outbreak  on  the  very  large  sewage  farms. 
Against  the  predisposing  action  of  sewer  gas  has 
further  been    advanced   that  sewermen  do  not  suffer  to 


SEWER    GAS    AND    HEALTH.  73 

:any  extent  from  typhoid  fever,  but  are  practically 
immune  to  it.  The  author  has  already  pointed  out  that 
the  statistical  material  available  for  the  consideration  of 
this  question  is  very  meagre,  and  requires  care  in  using. 
But  even  granted  that  such  is  the  case,  it  does  not 
appear  to  militate  against  the  theory  of  predisposition, 
for  Alessi's  experiments  make  it  probable  that  with  a 
prolonged  exposure  to  sewer  gas  the  predisposition 
becomes  diminished.  Hence  the  experience  with  sewer- 
men  appears  to  show  that  it  is  possible  to  become 
immune  to  the  predisposing  influence  of  sewer  gas,  but 
not  that  sewer  gas  has  no  such  predisposing  influence. 
It  is  greatly  to  be  regretted  that  this  subject  has  not 
been  more  fully  and  systematically  investigated,  as  it 
would  be  of  considerable  interest  to  ascertain  what 
are  the  conditions  and  particulars  under  which  this 
immunity  is  obtained. 

Concerning  the  cases  of  septic  poisoning  through 
sewer  gas  which  have  been  mentioned  by  the  author 
(see  also  Appendix  VIII.) ,  it  is  difficult  to  offer  any 
explanation,  as  we  know  too  little  about  them.  In  the 
case  quoted  by  Dr.  Hill  from  Sutton  Coldfield  it 
appears  that  the  poison  was  an  organised  one,  and 
it  is  possible  that  it  was  carried  in  sewer   air. 

Before  concluding  this  treatise  the  author  thinks  it 
might  not  be  out  of  place  to  draw  attention  to  one  or 
two  further  points  of  interest  which,  in  his  opinion, 
bear  intimately  on  the  connection  between  sewer  gas 
.and  health. 


74  SEWER   GAS    AND    HEALTH. 


PART  VI 

Allied  Subjects. 

CHAPTER  I. 

Difference  between  Waterworks  and  Sewerage  Works- 
IN  their  Influence  upon  the  Public  Health. 

(See  also  Appendix  X.) 

If,  as  has  been  stated,  there  is  no  connection  between 
putrid  gases  and  typhoid  fever,  then  it  would  undoubtedly 
be  correct  to  assume  that  the  carrying  out  of  sanitary 
improvements,  which  aim  at  the  prevention  of  the 
formation  of  these  gases  and  their  exclusion  from  our 
houses,  such  as  a  systematic  sewerage  of  a  town, 
combined  with  a  rational  house  drainage,  would  not 
affect  the  mortality  from  typhoid  fever.  But  that 
such  a  conclusion  is  opposed  to  the  universally  observed 
facts  will  be  known  to  all  those  who  have  given  this 
matter  some  consideration  however  small. 

Ever  since  the  memorable  and  classical  report  of  the 
late  Sir  George  Buchanan  in  1866  on  the  influence  of 
sanitary  works  upon  the  health  of  towns,  in  which  this 
original  and  skilled  investigator  for  the  first  time  drew 
public  attention  to  the  fact  that  in  a  large  number  of 
English  towns  the  typhoid  mortality  had  considerably 
decreased  since  the  carrying  out  of  water  and  sewerage 
works,  this  lowering  of  the  typhoid  rates,  coincident 
with,  and  consequent  on,  the  introduction  of  a  syste- 
matic water  supply  and  sewerage,  has  been  but 
universally    observed    not    only    in     this    country,    but 


SEWER    GAS    AND    HEALTH.  75" 

practically  in   all  other  countries,  so  that  we  have  now 
come  to  look  upon  it  almost   in   the  light  of  an  axiom. 

How  far  this  reduction  in  .  the  typhoid  rates  is  due 
to  the  execution  of  works  for  the  supply  of  good  water 
and  how  far  to  the  carrying  out  of  proper  sewerage 
works  had  been  decided  by  Buchanan  in  favour  of 
sewerage  works,  and  from  his  and  further  careful 
investigations  by  Continental  observers  it  may  safely 
be  concluded  that  sewerage  works  contribute  to  it  in  a 
more  prominent  degree  than  waterworks. 

Besides  the  researches  of  Soyka  (B-55,  Appendix  1.) 
it  may  not  be  out  of  place  to  mention  here  the 
investigations  by  P.  Baron  (B-2,  Appendix  I.)  in  1886. 
After  selecting  for  his  purposes  10  towns  which  in  his 
opinion  were  comparatively  free  from  objections,  and 
after  examining  the  statistical  material  in  reference- 
to  them.  Baron  states :  *'  We  are  therefore  not  entitled 
to  attribute  the  reduction  of  the  typhoid  mortality  in  the 
10  towns  above  enumerated  to  the  introduction  of  the 
water  supply." 

Very  striking  is  the  difference  in  this  respect  between. 
the  water  supply  and  drainage  works  in  the  case  o£ 
Berlin,  of  which  full  particulars  are  given  in  Appendix  X.. 
It  appears  that  the  waterworks  were  opened  in  1856,, 
and  the  operations  for  the  sewerage  of  the  city  com- 
menced in  1875,  or  19  years  later.  In  Table  I.  and 
Diagram  I.  of  Appendix  X.  can  be  studied  the  movement 
of  the  typhoid-fever  rates  since  1854,  and  from  these  it  is 
clear  that,  whereas  these  rates  very  gradually  declined  in 
the  first  19  years  since  the  introduction  of  a  public  water 
supply,  they  take  a  very  remarkable  leap  downwards  from 
the  year  1875,  in  which  the  sewerage  of  the  city  was- 
started.  The  same  downward  movement  since  the  year 
1875  may  be  observed  in  Diagram  II.,  which  deals  with 


76  SEWER    GAS    AND    HEALTH. 

the  general  death-rates  of  Berlin,  although,  as  was  to  be 
•expected,  it  is  not  so  marked  in  this  case. 

Therefore,  in  the  case  of  Berlin,  the  introduction  of 
a  public  water  supply  has  not  been  accompanied  by 
the  same  beneficial  results  to  the  public  health  as 
the  commencement  of  the  sewerage  works,  which  has 
been  followed  by  a  most  marked  improvement  in  the 
death-rates. 

It  is,  of  course,  not  contended  here  that  to  this  state 
of  things  only  the  sewerage  works  of  a  town  have  con- 
tributed— far  from  it,  as  undoubtedly  a  great  many  other 
factors  have  helped  to  lower  the  death-rates  ;  but  what 
is  maintained  is  this,  that  so  far  as  we  can  judge  from 
the  death-rates,  especially  from  those  of  typhoid  fever, 
sewerage  works  have  had  as  a  rule  a  more  decided 
influence  upon  their  reduction  than  waterworks. 

After  having  thus  settled  the  question  of  the  reduction 
of  the  typhoid  rates  in  favour  of  sewerage  works, 
Baron  goes  on  to  mention  several  towns,  such  as 
Berlin,  Dantzig,  and  Hamburg,  where  the  introduction  of 
Si  systematic  sewerage  has  been  followed  by  a  great 
reduction  in  the  typhoid  mortality,  and  finally  compares 
the  typhoid  rates  for  nine  years  in  46  towns  with  good 
-drainage,  with  those  in  37  towns  without  drainage. 
His  conclusions  are  as  follows  : 

1.  The  heaviest  typhoid   mortality   occurred  in   towns 

without  drainage  ; 

2.  Average    rates    occurred  more    frequently    in    non- 

sewered  than  in  sewered  towns ;  and 

3.  The  lowest  typhoid  rates  were  by  far  more  frequently 

observed  in  sewered  towns. 
Baron  then   further  sub-divides  the  towns   into  those 
with  the  highest  and  those  with  the  lowest  typhoid  rates 
Sbud  finds : 


SE\\^R   GAS    AND    HEALTH.  7T 

4.  Out  of  70  towns  with  the  highest  yearly  rates,  51, 

or  73  per  cent.,  were  not  sewered ;    and 

5.  Out  of  51  towns  with  the  lowest  yearly  rates,  36,. 

or  70  per  cent.,  were  sewered. 

Summarising  all  his  results,  Baron  concludes :  The- 
lowest  yearly  typhoid  rates  occurred  in  36,  or  78  per 
cent.,  of  the  46  sewered  towns,  and  only  in  15,  or  40  per 
cent.,  of  the  37  towns  without  sewerage. 

Hueppe  (B-27,  Appendix  I.),  who  investigated  the  same 
subject,  came  to  similar  conclusions  as  Baron. 

The  foregoing  facts  then  can  only  be  interpreted  as- 
follows :  Towns  with  a  systematic  sewerage  have  as  a. 
rule  lower  typhoid  rates  than  towns  which  are  not 
sewered  at  all ;  and,  further,  the  systematic  sewerage  of 
a  town  is  generally  accompanied  by  a  corresponding, 
reduction  of  the  typhoid  rates. 

This  being  so,  it  may  well  be  asked  in  what  manner 
does  the  carrying  out  of  drainage  works  beneficially 
influence  the  public  health  ? 

This  question,  in  the  author's  opinion,  admits  in  the- 
main  of  but  one  answer — viz.,  by  preventing  the 
systematic  pollution  of  the  air  under  our  houses- 
and  in  their  vicinity  through  decaying  organic  waste 
matters.  No  doubt  this  answer  could  be  extended 
by  including  such  factors  as  the  permanent  lowering, 
of  the  subsoil  water,  etc.,  but  for  our  purposes  such  a 
course  need  not  be  adopted. 

In  the  days  of  cesspits,  vaults,  middens,  privy  middens,, 
pails,  large  uncovered  ashpits,  etc.,  the  air  in  the  vicinity 
of  our  houses  was  methodically  polluted  through  putrid 
gases  rising  from  the  stored-up  putrefying  organic  waste 
matters;  hence  people  were  forced  to  inhale  continually 
strong  doses  of  these  gases,  and  became  more  or  less  pre- 
disposed to  the  action  of  the  typhoid  germ,  which  thenu 


5  SEWER    GAS    AND    HEALTH. 

found  the  ground  already  prepared  for  its  destructive 
work.  This  state  of  things  was,  however,  altered  with 
the  introduction  of  a  systematic  sewerage,  the  main  aim 
•of  which  is  to  carry  away  from  our  houses  as  quickly 
and  as  completely  as  possible  such  organic  waste  matters 
as  excreta  and  all  refuse  waters,  which  are  always 
more  or  less  charged  with  organic  matter,  The  systematic 
pollution  of  the  air  through  putrid  gases  being  thus 
prevented,  a  reduction  of  the  typhoid  rates  followed  as 
the  natural  consequence. 

As  an  instance  of  the  gradual  decline  in  the  typhoid 
rates  coincident  with,  and  consequent  upon,  the  carrying 
out  of  various  sanitary  improvements  aiming  at  the 
prevention  of  the  formation  of  putrid  gases  and  their 
exclusion  from  our  houses,  might  be  mentioned  the 
town  of  Munich.  From  the  particulars  given  in  item  2 
of  Appendix  X.  the  reduction  of  the  typhoid  rate  can 
be  traced  step  by  step  coincident  with  the  carrying  out 
of  various  sanitary  improvements,  with  this  result,  that, 
whereas  it  stood  at  24*20  per  10,000  inhabitants  in  the 
period  1852-59,  it  had  gone  down  to  1*75  in  the  years 
1881-1885.  It  will  not  be  disputed  that  this  is  a  very 
marked  and  large  decrease. 

These  facts  then,  which  are  derived  from  daily 
observation  and  common  experience,  go  to  show  that 
there  exists  in  nature,  as  apart  from  experimental 
results,  a  connection  between  putrid  gases  and  typhoid 
fever,  and  they  further  show  that  the  conditions  pre- 
vailing in  the  conservancy  methods  are  more  favourable 
to  this  disease  than  those  brought  about  by  the  water- 
carriage  system,  which  is  an  undoubted  improvement  in 
this  respect. 

Those  observers  therefore  who  dispute  the  connection 
between  putrid  gases,   including  sewer  gas,  and  typhoid 


SEWER   GAS    AND    HEALTH.  79 

fever,  either  overlook  the  facts  just  enumerated  altogether, 
or  endeavour  to  explain  them  away  in  a  manner  that 
cannot  inspire  great  confidence. 

But  perhaps  the  most  remarkable  statement  has  lately 
been  made  by  an  opponent  who,  after  mentioning  the 
conclusions  at  which  Baron  arrived  and  admitting  their 
correctness,  goes  on  to  say  that  if  there  was  a  connection 
between  sewer  gas  and  typhoid  fever  such  a  state  of 
things  could  not  exist,  as  then  with  the  introduction  of 
a  sewerage  scheme  typhoid  fever  would  increase  instead 
of  decrease.  It  will  hardly  be  necessary  to  deal  seriously 
with  such  a  statement,  as  it  springs  (firstly)  from  a  gross 
exaggeration  of  this  influence,  and  (secondly)  from  a  sad 
want  of  knowledge  of  the  state  of  things  previous  to  the 
introduction  of  the  water-carriage  principle  and  of  this 
principle  itself. 


80  SEWER    GAS    AND    HEALTH. 


CHAPTER   II. 


The  Dilution  of  Sewer  Gas  and  its  Escape  in  the 
Centre  of  Roads  and  Streets. 

(See  also  Appendix  XII. 

It  may  not  be  out  of  place  to  make  here  a  few  remarks 
concerning  the  dilution  of  sewer  gas,  as  the  question  of 
noxious  smells  from  manhole  covers  has  considerably 
agitated  the  public  mind  and  has  caused  sanitary  com- 
mittees in  various  towns  to  adopt  such  measures  as  the 
closing  of  the  open  street  ventilators,  the  ultimate 
sanitary  effects  of  which  are  to  say  the  least  very 
doubtful. 

Without  entering  into  details  concerning  the  ventilation 
of  the  sewers,  it  has  been  stated  that  if  we  wish  to  reduce 
the  injurious  effect  of  sewer  gas  upon  health  we  must 
take  care  that  it  is  absolutely  excluded  from  the  interior 
of  our  houses,  and  that  at  those  places  where  it  is 
allowed  to  escape  it  becomes  at  once  diluted  with  large 
volumes  of  fresh  air,  if  indeed  it  is  not  already  diluted 
within  the  sewers  themselves.  This  appears  to  be  a 
wise  rule,  and  is  certainly  based  on  general  experience 
and  universally  observed  facts;  for  sewer  gas,  like  other 
poisonous  gases,  loses  its  injurious  effect  upon  health  in 
the  ratio  of  its  dilution  with  fresh  air. 

Acting  upon  this  principle,  the  gases  forming  in  our 
sewers  were  prevented  from  passing  into  private  house 
drains  through  a  disconnecting  trap,  and  allowed  up  to 
now  to  escape  through  the  open  manhole  and  lamphole 
covers  in  the  crown  of  streets  and  roads.  However, 
owing,  no  doubt,  to  the  complaints  in  the  public  Press 
and  elsewhere  about  noxious   smells   from  these  covers, 


SEWER    GAS    AND    HEALTH.  81 

a  movement  has  lately  set  in  to  close  the  open  street 
ventilators  and  replace  them  wherever  possible  by  venti- 
lating pipes  up  the  sides  of  houses. 

So  far  as  the  author  is  aware,  no  attempt  has  yet  been 
made  to  prove  that  such  a  change  is  beneficial  to  the 
public  health,  and  as  it  is,  of  course,  of  the  greatest 
importance  to  know  whether  this  is  so  or  not,  it  may 
not  be  out  of  place  to  put  here  on  record  the  observations 
made  in  Leicester,  as  they  are  perhaps  somewhat  unique. 
For  this  purpose  the  author  has  compiled  Appendix  XII., 
where  full  particulars  concerning  these  points  are  given*. 

On  reference  to  it,  it  will  be  seen  that,  so  far  as  the 
ventilation  of  the  Leicester  public  sewers  is  concerned, 
three  periods  may  be  distinguished — viz. : 

1.  The  period  before  the  year  1881,  when  the  sewers 

were  very  foul  and  not  ventilated  ; 

2.  The   period  from  1881  to   1886,   in   which   a   great 

length  of    the  old    sewers   was    cleaned  out    and 
ventilated  by  open  covers  at  street  level ;    and 
8.  The   period   since   1886,   in   which   practically   two- 
thirds    of    the    open    covers    at   street  level  were 
closed,    about   300   ventilating   shafts  erected,  and 
the  old  main  sewers  replaced  by  larger  and  better 
constructed  ones. 
If  we  now  compare  the  typhoid  rates  in   these  three 
periods  as   shown  in  Table  I.   and  Diagrams  I.  and  11. 
we  find   that   the   average  rate    for    the    second    period 
was  practically  only  half   that  of  the  first   period,    but 
that  this  decline  was  not  continued  in  the  third  period,, 
the  average  rate  for  it  being,  on  the  contrary,  somewhat 
higher  again  than  that  of  the  second  period.     The  same 
upward  movement  in  the  third  period  can  be  observed 
in  the  diagram  showing  the  number  of   typhoid  certifi- 
cates received. 

6 


82  SEWER    GAS    AND    HEALTH. 

This  rise  in  the  typhoid  death-rates  since  1886,  the 
year  in  which  the  closing  of  the  open  street  covers  was 
commenced,  is  all  the  more  remarkable,  as  since  that 
year  the  new  main  sewers  (their  cost,  including  pumping 
station  and  sewage  farm,  amounted  up  to  31  st  March, 
1895,  to  nearly  £330,000)  and  a  large  number  of  other 
sanitary  improvements  have  been  carried  out  in  Leicester, 
not  to  mention  the  general  advance  in  the  knowledge 
and  treatment  of  infectious  diseases  ;  and  if  we  look 
for  an  explanation  of  this  remarkable  fact,  the  thought 
suggests  itself  that  probably  sewer  air  had  something 
to  do  with  it. 

In  the  first  period  undoubtedly  sewer  air  or  sewer 
gas  would  find  its  way  into  the  interior  of  the  houses; 
in  the  second  period  it  escaped  largely  through  the 
open  covers  at  street  level,  hence  the  numerous  com- 
plaints; and  in  the  third  period  it  is  possible  that  with 
the  closing  of  these  open  covers,  sewer  air  gradually 
found  its  way  back  again  into  the  interior  of  the  houses. 

In  connection  herewith  it  is  interesting  to  observe  that 
the  medical  officer  of  health,  as  has  previously  been 
stated,  reports  that  in  1893,  out  of  all  typhoid-infected 
houses,  31*25  per  cent,  had  defective  drains,  as  shown 
through  the  smoke  test,  and  that  in  1894  this  percentage 
had  increased  to  45*18.  In  passing,  it  might  be  remarked 
that  the  smoke  test  is  not  altogether  reliable  in  cases 
of  underground  leakage. 

The  author  is  of  course  perfectly  well  aware  that  a 
variety  of  causes  are  at  work  in  the  propagation  of 
infectious  disease,  and  that  the  three  periods  under 
review  are  not  very  long  ones ;  but  whatever  our  opinions 
may  be  on  this  point,  the  fact  remains  that,  in  spite  of 
a  large  expenditure  on  sanitary  works,  the  typhoid  rate 
has  not  decreased  since  the  commencement  of  the  closing 


SEWER   GAS    AND    HEALTH.  83 

of  the  open  covers  at  street  level,  but  has,  on  the 
contrary,  slightly  increased,  and  this  fact  alone  is,  he 
thinks,  of  sufficient  importance  to  be  noted  down  very 
carefully  by  all  those  who  give  these  questions  their 
.anxious  consideration. 


b 


84  SEWER    GAS    AND    HEALTH. 

CHAPTEK   III. 
Concluding  Eemarks. 

When  the  history  of  the  sanitary  progress  during  the- 
present  century,  which  is  now  fast  sinking  into  its 
grave,  comes  to  be  written,  a  very  important  place  will 
have  to  be  assigned  to  what  has  been  termed  the  sewer- 
gas  theory,  as  it  has  exerted  a  most  powerful  influence 
for  good  in  the  matter  of  house  and  general  sanitation  ;. 
indeed,  it  has  been  stated  that  the  results  which  the 
conviction  that  sewer  air  or  sewer  gas  is  dangerous  to 
health  has  brought  about  surpass  in  brightness,  excel- 
lence, and  importance  the  results  achieved  by  any 
other  sanitary  doctrine. 

If  we  enquire  into  the  causes  which  were  capable  of 
producing  such  weighty  effects,  we  shall  probably  find 
that  they  are  largely  due  to  the  very  great  interest 
the  general  public  has  taken  in  this  question,  as  is 
evidenced  by  the  controversy  to  which  it  gave  rise  in 
the  public  Press  and  elsewhere.  That  during  the  same 
the  most  divergent  opinions  should  have  been  expressed 
cannot  be  surprising. 

On  the  one  hand,  it  was  asserted  that  the  influence 
which  sewer  gas  exerts  on  health  was  practically  un- 
limited and  almost  mysterious,  and,  on  the  other  hand,, 
sewer  gas  was  said  to  be  practically  harmless.  In  the 
author's  opinion  the  truth  lies  probably  in  the  middle 
between  these  extremes,  and  whilst  considering  the 
chances  of  sewer  air  acting  directly  infective,  or  in 
other  words,  of  sewer  air,  per  se,  producing  typhoid  fever 
somewhat  remote,  he  is  clearly  of  opinion  that  apart 
from  its  direct   or  mephitic  action,   which   is  admitted- 


SEWER   GAS    AND   HEALTH.  85 

Ijj  everyone,  sewer  air  or  sewer  gas  (synonymous  terms) 
has  the  power  of  predisposing  the  constitution  to  typhoid 
(and  probably  also  to  other)  infection,  so  that  if  the 
typhoid  bacillus  is  introduced  into  the  system  in  some 
way  or  other  after  exposure  to  sewer  gas,  it  finds  there 
a  favourable  soil  for  committing  its  ravages.  How 
/large  the  dose  of  sewer  gas  must  be  before  this  pre- 
disposing influence  is  felt  depends  probably  on  a  variety 
of  circumstances,  which  in  the  present  state  of  our 
knowledge  we  have  no  means  of  ascertaining  correctly. 

If,  in  his  endeavour  to  survey  the  whole  question, 
the  author  appears  to  have  been  too  detailed  in  some 
places,  he  hopes  he  may  be  excused,  as  the  subject  is 
a  most  important  one,  and  it  was  his  wish  to  give  the 
fullest  information  possible  concerning  it. 

It  is  greatly  to  be  regretted  that  we  are  not  yet  able 
to  assign  for  every  specific  effect  a  specific  cause,  and 
there  is  good  reason  to  fear  that  it  may  yet  be  a  long 
while  before  this  ideal  state  is  reached;  but  this  must 
not  prevent  us  in  matters  of  public  and  private  health 
to  carefully  obey  those  preventive  rules  and  laws  which 
we  have  been  able  up  to  the  present  time,  even  though 
it  were  but  imperfectly,  to  discern. 

We  probably  only  stand  to-day  on  the  threshold  of  the 
knowledge  of  health  and  disease,  of  life  and  death,  and 
before  us  lies  a  vast  tract  of  unknown  land  which  has 
only  been  explored  on  its  circumference,  but  into  which 
no  solitary  traveller  has  yet  penetrated.  Therefore  it 
behoves  all  those  who  interest  themselves  with  matters 
of  public  and  private  health,  always  to  fully  bear  in  mind 
-that  health  is  the  greatest  blessing  we  enjoy,  and  that 
when  once  it  has  escaped  our  grasp  it  may  probably 
snever  return  to  it.  Hence  it  is  far  better  to  prevent  an 
illness  than  to  cure  a  disease. 


86  SEWER    GAS    AND    HEALTH. 

What  the  protective  forces  within  our  system  are,, 
whether  or  no  they  are  represented  by  the  leucocytes,, 
we  do  not  know,  but  the  aim  and  end  of  every  true 
sanitation  must  be  to  carefully  nurse,  build  up,  and 
strengthen  them  and  then  protect  them  from  injury,  so- 
that  they  stand  us  in  good  stead  in  the  hour  of  our 
greatest  need,  when  we  are  assailed  by  swarms  of  hostile 
germs,  and  gain  a  splendid  victory  in  the  life  and  death, 
struggle  that  then  ensues. 

This  then  is  the  direction  in  which  true  sanitation 
must  proceed,  and  if  the  author  has  succeeded  in  shedding 
further  light  upon  this  goal  and  the  way  that  leads  ta- 
it,  all  his  labours  will  have  been  well  repaid. 


SEWER    GAS    AND    HEALTH. — APPENDIX  I.  87 

APPENDIX    I. 

A.  English  Liteeature. 

A-L— Abbott,  A.  G.,  "The  Effects  of  the  Gaseous 
Products  of  Decomposition  upon  the  Health 
and  Resistance  to  Infection  of  Certain  Animals 
that  are  forced  to  respire  them."  Transactions 
of  American  Physicians,  1895. 

A-2. — Acland,  "  Reports  on  Fevers  in  Agricultural 
Districts." 

A.3.— Airy,  ''Enteric  Fever  at  York."     1884. 

A-4. — Alessi,  G.,  ''  On  Putrid  Gases  as  Predisposing^ 
Causes  of  Typhoid  Infection."  Translated  from 
the  Italian.  Journal  of  the  Sanitary  Institute, 
Vol.   XVI.,  1895,  page  487. 

A-5.— "Army  Medical  Report  for  1861,"  page  486. 

A-6.— Barker,  T.  H.,  "  Malaria  and  Miasmata."     1863. 

A-7. — Berkart,  J.  B.,  British  Medical  Journal,  25th 
November,  1893. 

A-8.— Billings,  J.  S.,  "  Ventilation  and  Heating."  1893, 
Page  99. 

A-9.— Blaxall,  "Enteric  Fever  at  Melton  Mowbray." 
Report  M.O.L.G.B.     1881. 

A-10.— Blaxall,  "Enteric  Fever  at  Sherborne,  1873." 
Report  M.O.P.C.  and  L.G.B.,  No.  2.     1874. 

A-11.— Blaxall,  "Enteric  Fever  at  Sherborne,  1882."^ 
Report  M.O.L.G.B.     1882. 

A-12.—Blyth,  A.  Wynter,  "  Manual  of  Public  Health.'^ 
Recent  publication. 

A-13. — Buchanan,  Sir  G.  "Epidemic  of  Enteric  Fever 
at  Worthing,  1865."      Ninth  report,  M.O.P.C. 

A-14. — Buchanan,  Sir  G.,  "  Influence  of  Sanitary  Works 
upon  Health  of  Towns."  Ninth  report,. 
M.O.P.C,  1866.     London,  1867. 

A-15. — Buchanan,  Sir  G.,  "Enteric  Fever  at  Caius- 
College,  Cambridge,  1874."  Report,  M.O.P.C. 
and  L.G.B.,  No.  2.     1874. 


88  SEWER    (JAS    AND    HEALTH. — APPENDIX   I. 

A- 16. — Buchanan,  Sir  G.,  "  Epidemic  of  Enteric  Fever 
at  Croydon  in  1875."  Appendix  to  Keport, 
M.O.P.C.  and  L.G.B.  New  Series,  No.  VII. 
1876. 

A-16A. — Burton,  Ashby  and  Coalville  Guardian^  14th 
November,  1896.  "  Explosion  in  a  New  Sewer 
at  Burton-on-Trent." 

A-17. — Budd,  ''  Observations  on  Typhoid  or  Intestinal 
Fever — the  '  Pythogenic  '  Theory."  British 
Medical  Journal,  1861. 

A-17a. — Cameron,  J.  Spottiswoode,  "  On  the  Dissemi- 
nation of  Typhoid  Fever."  Surveyor,  29th 
October,  1897. 

A-17b. — Cameron,  J.  Spottiswoode,  "  Drain  Testing : 
Some  Facts  Eevealed  by  Testing  the  Drains  of 
1,121  Houses  in  Leeds."  Journal  Sanitary 
Institute,  Vol.  XVIII.     1897. 

A-18. — Christison,  E.,  "A  Treatise  on  Poisons." 

A-19.— Clark,  F.  W.,  ''  Keport  on  the  Ventilation  and 
Flushing  of  Sewers."     June,  1894. 

A-20. — Clinton,  A.,  "  Keport  to  Chief  Inspector  of  the 
New  York  Health  Department."    Kecent  report. 

A-20a. — "  Coal-Gas  Poisoning."  Papers  by  J.  Haldane, 
J.  K.  Davison,  A.  Scott,  S.  Lockie,  J.  L.  Smith, 
and  T.  W.  Parry.  British  Medical  Journal, 
3rd  October,  1896. 

A-21.— CoUins,  J.,  ''  The  Necessity  for  Efficient  Ventila- 
tion of  Sewers."  Tra7isactions  of  the  Sanitary 
Institute  of  Great  Britain,  Vol.  VI.,  page  259. 
1884-85. 

A-21a. — Contract  Journal,  12th  August,  26th  August, 
and  7th  October,  1896.  "  Important  Case  of 
Poisoning  through  Sewer  Gas  at  Birmingham." 

A-22. — Corfield  and  Parkes,  ''  Treatment  and  Utilisation 
of  Sewage."     Kecent  publication. 

A-22a. — Corfield,  W.  H.,  ''  Disease  and  Defective  House 
Sanitation."     London,  1896.     H.  K.  Lewis. 

A-23. — Davies,  S.,  "Ventilation  of  Sewers."  Sanitary 
Engineer,  14th  September,  1894. 

A-24.— Dodd,  J.,  ''  Sewer  Gas  and  its  Effects."     1879. 


SEWER   GAS    AND    HEALTH. — APPENDIX  I.  89 

A-25, — "  East  Ham  Sewer  Fatality."  Stratford  Express, 
6th,  13th,  and  20th  July,  and  Times,  8th  August, 
1895. 

A-25A. — Fanning,  F.  W.  Burton,  "  Sewer-Air  Poisoning." 
Lancet,  24th  October,  1896. 

A-26. — Fenton,  Public  Health,  August,  1895. 

A-27. — Fergus,  G.,  "The  Sewage  Question  with  reference 
to  Traps  and  Pipes."     Glasgow,  1874. 

A-28.— Frankland,  Sir  E.,  "  The  Transport  of  Solid  and 
Liquid  Particles  in  Sewer  Gases."  Proceedings 
of  the  Eoyal  Society,  April,  1877. 

A-29. — Guy,  Journal  of  the  Statistical  Society,  1848. 

A-30.— Haldane,  J.  S.,  "The  Air  of  Buildings  and 
Sewers."  Vol.  IX.,  Transactions  of  the  Sanitary 
Institute  of  Great  Britain,  1887.  See  also 
Transactions,  Eoyal  Society,  Vol.  178  (1887)  B 
and  Proceedings  of  the  Eoyal  Society  for  12th 
June,  1887,  on  "The  Pathology  of  Coal-Gas 
Poisoning."     Laiicet,  3rd  October,  1896. 

A-30a. — Hargreaves,  J.,  "  Sewage  and  Zymotic  Poisons." 
Industries  and  Iron,  6th  March,  1896. 

A-31.— "  Health  of  Town's  Eeport,"  Vol.  I.  Old  publica- 
tion. 

A-32. — Herring,  E.,  Eeport  on  the  Eesults  of  an 
Examination  made  in  1880  of  several  Sewerage 
Works  in  Europe.  Appendix  IV.  to  Annual 
Eeport  of  the  National  Board  of  Health,  1881. 
Contains  on  page  200  an  elaborate  Index  to  the 
Literature  on  Sewerage  Works,  etc. 

A-33. — Hill,  Bostock,  "  The  Possible  Dangers  of  Certain 
Methods  of  Ventilating  Sewers."  Public 
Health,  August,  1895. 

A-34.— Hun,  H.,  Medical  News,  20th  August,  1887. 

A-35. — International  Congress  of  Hygiene  and  Demo- 
graphy, Vol.  VII.,  page  45.     London,  1891. 

A-36. — Jacobi,  A.,  "  The  Production  of  Diseases 
by  Sewer  Air."  Sanitary  Engineer,  28th 
September,  1894. 

A-37.— Latham,  B.,  "  Sanitary  Engineering,"  1878. 


90  SEWER    GAS    AND    HEALTH. — APPENDIX   I. 

A-88. — Laws,  J.  Parry,  Keports  on  Sewer-Air  Investiga- 
tions.    London  County  Council,  No.  1'26.     1893. 

A-39. — Laws,  J.  Parry,  and  Andrewes,  F.  W.  Eeport 
on  the  Result  of  Investigations  on  the  Micro- 
organisms of  Sewage.  Parts  I.  and  II.,  London 
County  Council,  No.  21(3.     1894. 

A-40. — Letheby.     Various  Eeports.     Old  publications. 

A-40a. — Manchester  Guardian,  28rd  September,  1896. 
"  Death  of  a  Man  in  a  Sewer  near  Manchester." 

A-41.-McClellan,  **  The  Sewer  Gases  Question."  New 
York,  1890. 

A-42. — Meade,  T.  de  Courcy,  ''  Fatal  Accident  in  London 

Sewers."     Vol.  XX.  Incorporated  Association  of 

Municipal  and  County  Engineers,  page  190. 
k.A^,— Medical  Times,  February,  1861.     "  Death  of  Four 

Labourers  in  the  City  of  London  Sewers." 
KA^.— Medical  Times,  July,  1861.     ''Explosion  in  the 

City  of  London  Sewers." 
A-45.— Murchison,  "  A  Treatise  on  the  Continued  Fevers- 

of  Great  Britain."     London,  1862. 
A-46. — ''Observations  on  Typhoid  or  Intestinal  Fever — 

the    Pythogenic     Theory."       British    Medical 

Journal,  1861. 

A-47. — Paget,  C.  E. :  Some  Lectures  by  Sir  George  Paget. 
Eecent  publication. 

A-48.— Page,  Army  Medical  Report.     Vol.  XV. 
A-49.— Parkes,  Louis  C,  "  Hygiene  and  Public  Health." 
Eecent  publication. 

A-50. — Parkes,  E.  A.,  "  A  Manual  of  Practical  Hygiene." 
Eecent  publication. 

A-51.— Eafter,  G.  W.,  and  Baker,  M.  N.,  "  Sewage  Dis- 
posal in  the  United  States."     1894. 

A-52. — Eead,  E.,  "  Gloucester  Sewers  and  their  Ventila- 
tion."    1884. 

A-52A.— Eoechling,  H.  Alfred,  "  Bacteria  and  their 
Importance  in  the  Household  of  Nature." 
Leicester,  1896. 

A-52B.— EoechHng,  H.  Alfred,  "Life  in  Sewers.'*' 
Leicester,  1897. 


SEWER    GAS    AND    HEALTH.— APPENDIX  I.  91 

A-52c. — Eoechling,  H.  Alfred,  "  Dissemination  of 
Typhoid  Fever."     Surveyor,  15th  October,  1897. 

A-52D.— Eoechling,  H.  Alfred,  ''A  Case  of  Typhoid 
Fever  in  a  House  with  Faulty  Drainage ;  with 
Plan  of  Premises."  Journal  Sanitary  Institute, 
Vol.  XVIII.     1897. 

A-53. — Eoscoe,  Sir  H.,  and  Lund,  Transactions  of  the 
Eoyal  Society.     1892. 

A-54. — Eowan,  Thomas,  "  Disease  and  Putrescent  Air 
and  the  Ventilation  of  Sewers." 

A-55. — Eussell,  Hon.  Eollo,  *'  Epidemics,  Plagues,  and 
Fevers."     Eecent  publication. 

A-56. — Sharp,  Gordon,  and  Summerskill,  W.,  Lancet, 
9th  December,  1893. 

A-57. — Smith,  J.  McGarvie,  "  Air  in  the  Sewers  of 
Sydney."  Sixth  Annual  Eeport  of  the  Metro- 
politan Board  of  Water  Supply  and  Sewerage, 
1893,  page  32. 

A-57A. — Smith  and  others  versus  the  King's  Norton- 
Urban  District  Council.  Contract  Journal,  12th' 
August,  1896. 

A-58.— Stevens,  F.  J.  H.,  *' Health  of  Sewer  Men." 
''  Deutsche  Vierteljahrschrift  flir  oeffentliche 
Gesundheitspflege,"  Vol.  XXVII.,  page  404. 
1895. 

A-59. — Stevenson  and  Murphy,  ''  Hygiene  and  Public 
Health,"  Vol.  II.,  page  333.     1894. 

A-60.— Style,  Mark,  Lancet,  19th  October,  1889. 

A-61.— Sykes,  John  F.  J.,  ''Public  Health  Problems." 
Eecent  publication. 

A-62.— Sykes,  John  F.  J.,  ''  Outbreak  of  Enteric  Fever 
at  the  Foundling  Hospital."     1891. 

A-63.— Thackrah,  ''  The  Effects  of  Arts,  Trades,  and 
Professions  on  Health."     1832. 

A-63a. — Tichborne,  E.  C,  "On  the  Dissemination  of 
Micro-organisms  and  the  Best  Methods  of 
Destroying  Germ  Emanations  from  Sewer 
Gas."    Journal  of  State  Medicine,  August,  1897. 

A-64. — Transactions  of  the  Epidemiological  Society. 


'92  SEWER   GAS    AND    HEALTH. — APPENDIX   I. 

A-65. — "  Treatise  on  the  Continued  Fevers  of  Great 
Britain."     London,  1862. 

A-65A. — *'Tvnemouth  Gasworks  Accident."  Shields 
Daily  News,  21st  and  23rd  January  and 
4th  February,  1896. 

A-66.— Wallace,  Army  Medical  Keport,  Vol.  XVII. 
A-67. — Whitelegge,   B.   Arthur,   '*  Hygiene   and    Public 
Health."     Kecent  publication. 

A-67A. — Widnes  Sewer  Accident.  Bwicorn  Guardian, 
29th  January  and  8th  February,  1896. 

A-68.— Woodhead,  W.  C,  ''  The  Dangers  of  Sewer 
Gas  in  our  Dwellings." 

B.  German  Literature. 

B-1. — "Andelfingen,  die  Epidemie."  In  ''Deutsches 
Archiv  fiir  klinische  Medicin,"  Bd.  III.,  1867, 
page  223. 

B-2. — Baron,  P.,  "  Einfluss  von  Wasserleitungen  und 
Tiefcanalisationen  auf  die  Typhusfrequenz 
in  deutschen  Stadten."  "  Centralblatt  fiir 
allgemeine  Gesundheitspflege,"   V.,   page    335, 

1886. 

B-3. — Baumeister,  E.,  in  "  Handbuch  der  Baukunde." 
Abth.  III.,  Heft  3,  page  284.     1890. 

B-4. — "  Berichte  ueber  die  Verhandlungen  und  Arbeiten 
fiir  Wasserversorgung  Canalisation  und  Abfuhr 
in  Miinchen."     1880. 

B-5. — Betz,  "  Jahresberichte  von  Virchow  und  Hirsch," 
1868,  page  302. 

B-6.--Biefel  und  Poleck,  '*  Zeitschrift  fiir  Biologie," 
XVI.,  3,  page  279. 

B-7. — Blumenstock,  "  Vierteljahrschrift  fiir  gerichtliche 
Medizin,''  N.  F.  XVIII.,  page  295. 

B-8. — Bockendahl,  J.,  "General  Berichte  ueber  das 
oeffentliche  Gesundheitswesen  der  Provinz 
Schleswig-Holstein. 

B-9. — Brix,  in  "  Bekiimpfung  der  Infectionskrankheiten 
von  Behring."  "  Hygienischer  Theil,"  page 
309.     1894. 


SEWER    GAS    AND    HEALTH. — APPENDIX   I  93- 

B-10. — Buesing,  F.  W.,  in  '' Handbuch  der  Hygiene/' 
von  Weyl,  2ter  Band,  Iste  Abtheilung,  page 
229.     1895. 

B-11. — Caspar,  "  Handbuch  der  gerichtlichen  Medizin," 
II.,  page  598. 

B-12. — ''Deutsches  Archiv  fiir  klinische  Medicin,"  Band 
IX."     1872. 

B-L3.— ''Deutsche  Bauzeitung,"  27  Februar,  1895.  "  Ex- 
plosion of  Sewer  Gas  in  a  Cesspit  at  Mayence." 

B-14. — Dunbar,  W.  P.,  Typhus  in  "  Ergebnisse  der 
allgemeinen  Pathologie  und  pathologischen 
Anatomie  des  Menschen  und  der  Thiere."  Con- 
tains a  complete  index  of  206  numbers  to  the 
literature  on  typhoid  fever.     1896. 

B-15. — Dunbar,  W.  P.,  Cholera  in  the  same  book  as 
above.  Contains  a  complete  index  of  282  num- 
bers to  the  literature  on  cholera.     1896. 

B-16. — Emminghaus,  "  Memorabilien,"  XIV.,  Lief  1. 
1869. 

B-17. — Erisman,  F.,  "  Gesundheitslehre  fiir  Gebildete 
aller  Stande  Miinchen,"  1885,  page  110. 

B-18. — Erisman,  F.,  *'  Ventilation  der  Siele,  Canalgase." 
In  "  Handbuch  der  Hygiene  und  Gewerbe- 
krankheiten."  von  Pettenkofer  und  Ziemssen. 
Leipzig,  1882. 

B-19. — Eulenberg,  "  Vierteljahrschrift  fiir  gerichtliche 
Medicin."     N.  F.  XXV.,  page  209. 

B-19a. — Ficker,  "  Schadlichkeit  der  Canalgase."  Referat 
von  M.  Kirchner  und  W.  H.  Lindley,  "  Deutsche 
Vierteljahrschrift  fiir  oeffentliche  Gesundheits- 
pflege."     Band  XXVIII-1.     1896. 

B-20. — Finkelnburg,  *' Vierteljahrschrift  fiir  gericht- 
liche Medizin,"  N.  F.  XX.,  page  301. 

B-21. — Fraenkel,  E.,  *' Zur  Lehrevon  der  Aetiologie  der 
Complicationen  im  Abdominal  Typhus."  **  Jahr- 
biicher  der  Hamburgischen  Staats  Kranken- 
anstalten."     1890. 

B-22. — Fruehling,  A.,  in  "Handbuch  der  Ingenieur- 
Wissenchaften."  Leipzig,  1893.  III.  Band,. 
Iste  Abtheilung,  2te  Halfte,  page  462. 


94  SEWER    GAS    AND    HEALTH.  — APPENDIX   I. 

B.23.— Goepel,  H.,  "Ein  Fall  von  Typhus  in  Frankfurt- 
an-der-Oder."  **  Deutsche  Vierteljahrschrift  fiir 
oeffentliche  Gesundheitspflege,  Vol.  XXVIII.-l. 
1896. 

B-24. — Hankel,  Ernst,  *'  Ein  Todesfall  durch  Einathmen 
von  Cloakengas."  '*  Vierteljahrschrift  fiir 
gerichtliche  Medizin  und  oeffentliches  Sanitiits- 
wesen.     1895. 

B-24a. — Heunner,  M.,  *'  Experiment elle  Studien  iiber 
die  Wirkung  faulender  Stoffe  auf  den  thier- 
ischen  Organismus."  Munchen,  1866,  pages  82, 
87,  and  88. 

B-25. — Hesse,  "  Quantitative  Bestimmung  der  in  der  Luft 
enthaltenen  Mikro  -  organismen."  Mittheil- 
ungen  aus  dem  Kaiserlichen  Gesundheitsamt. 
1884. 

B-26. — Hesse,  "  Bemerkungen  zur  quantitativen  Bestim- 
mung der  Mikro-organismen  der  Luft."  "  Zeit- 
schrift  fiir  Hygiene."     1886,  IV. 

B-27. — Hiippe,  "  Journal  fiir  Gas  beleuchtung."     1887. 
B.28.— Karlinski,    "  Fortschritte   der   Medicin,"    n.    18. 
1889. 

B-29. — Kaufmann  and  Kosenthal,  "  Archiv  fiir  Anatomie 
und  Physiologie,"  1865,  page  659. 

B.30._Kirchner,  M.,  and  Lindley,  W.  H.,  "  Schad- 
lickeith  der  Canalgase  und  Sicherung  unsrer 
Wohnraume  gegen  dieselben."  Heft  I.,  Band 
XXVIII.,  "Deutsche  Vierteljahrschrift  fiir 
oeffentliche  Gesundheitspflege."     1896. 

B-31. — Kohler,  "  Handbuch  der  speciellen  Therapie.'* 

B-32.— Kruegkula,  "  Wiener  Med.  Wochenschrift,"  1877, 

page  1,068. 
g.33. — Lebert,  "  Handbuch  der  praktischen  Medicin." 
B-34.— Lehmann,  "  Archiv  fiir  Hygiene,"  XIV.,  Heft  II. 
g,35. — Liernur,  C.  T.,  "Archiv  fiir  rationelle  Stadteent- 

wasserung,"  V.  Heft,  page  307.     1887. 

B-36. — Lissauer,  "  Ueber  das  Eindringen  von  Canalgasen 
in  die  Wohnraume."  "  Vierteljarschrift  fiir 
oeffentliche  Gesundheitspflege,"  13ter  Band. 
1881. 


SEWER    GAS    AND    HEALTH.— APPENDIX   I.  95 

B-37.--Mori,  "  Ueber  pathogene  Bakterien  im  Carial- 
wasser."     "  Zeitschrift  fiir  Hygiene,"  4  Band. 

B-38. — Naegeli,  "Uebergang  von  Spaltpilzen  in  die 
Luft."  Centralblatt  fiir  die  medizinischen 
Wissenschaften."     1882. 

B-S9. — Naegeli,  "  Die  niederen  Pilze,"  page  108. 
Miinchen,  1877. 

B-39A.— Panum,  '' Virchow's  Archiv,"  Bd.  XV.,  Hefte  5 
und  6,  page  441. 

B-40. — Pettenkofer,  Max  v.,  "  Vortraege  ueber  Canalisa- 
tion und  Abfuhr.     Miinchen,"  1876. 

B-41. — Pettenkofer,  "Die  Choleraepidemie  des  Jahres, 
1865,  in  Gibraltar."  "  Zeitschrift  fur  Bioiogie." 
Band  VI.,  page  95. 

B-42.— Port,    "Zeitschrift   fiir  Bioiogie."      Band    XI., 

page  487. 
B-43. — Prausnitz,    W.,    "  Der    Gesundheitszustand    der 

Miinchener      Canalarbeiter."        "  Archiv       fiir 

Hygiene."     Kecent  publication. 

B-44. — "  Keinigung  und  Entwasserung  Berlins."  Berlin, 

1870. 
B-45. — "  Keinigung     und     Entwasserung     der      Stadt 

Heidelberg."     Heidelberg,  1870. 

B-46.— Kenk,  Fr.,  "  Die  Canalgase."     Muncben.     1882. 

B-47. — Seuss,  A.,  "  Officielle  Berichte  von  Staats  und 
Stadtbehorden  ueber  das  Liernur'sche  Canal- 
isationssystem,  1877  Wiirzburg,"     page  75. 

B-48. — Koechling,  H.  A.  "  Technische  Einrichtungen  fiir 
Wasserversorgung  und  Canalisation  in  Wohn- 
hausern."  Heft  1,  Band  XXVII.  "Deutsche 
Vierteljahrschrift  fur  oeffentliche  Gesundheits- 
pflege."     1894. 

B-49. — Eoechling,  H.  A.,  "  Schadlichkeit  der  Canalgase 
uud  Sicherung  unserer  Wohnraume  gegen 
dieselben."  Heft  1,  Band  XXVIII.  "  Deutsche 
Vierteljahrschrift  fiir  oeffentliche  Gesundheits- 
pflege."     1895. 

B-50. — Koechling,  H.  A.,  "  Tonnen  u.  Spiilaborte  in 
ihrem  Verb  alt  en  zu  Typhus  abdominalis." 
"  Gesundheitsingenieur."  15th  September,  1895. 


96  SEWER   GAS    AND    HEALTH.— APPENDIX  I, 

B-51. — Eozsahegyi,  **  Ueber  die  Luftbewegung  inj  den- 
Miinchener  Sielen.'*  *' Zeitschrift  fiir  Biologie," 
Bd.  XXV.,  1881,  page  23. 

B-51a. — Schmidt,  C,  ''  Charakteristik  der  epidemischen- 
Cholera." 

B-52. — Senator,  **  Berhner  klinische  Wochenschrift," 
1872,  page  254. 

B-53. — Siegfried,  *'  Viertelsjahrschrift  fiir  gerichtUche 
Medizin,"  N.  F.  XXI.,  page  338. 

B-54. — Spiess,  A.,  **  Repertorium  der  in  deutschen 
und  auslandischen  Zeitschriften  erschienenen 
Aufstiize  ueber  oeffentHche  Gesundheitspflege,'^ 
see  each  volume  of  the  ''  Deutsche  Vierteljahr- 
schrift  fiir  oeffentliche  Gesundheitspflege." 

B-55. — Soyka,  Rozsahegyi,  and  Renk,  "  Ueber  Canalgase 
als  Verbreiter  epidemischer  Krankheiten." 
**  Vierteljahrschrift  fiir  oeffentliche  Gesund- 
heitspflege," 14  Band.     1881. 

B-56. — Soyka,  J.,  *'  Untersuchungen  zur  Canalisation." 

1885. 

B-57. — Soyka,  J.,  "  Zeitschrift  fiir  Biologic,"  Heft  3, 
Band  XVII. 

B-58. — Soyka,  J.,  "Kritik  der  gegen  die  Schwemm- 
canalisation  erhobenen  Einwande,  Miinchen.'*" 
1880. 

B-58A. — Thiersch,  "  Infections  Versuche  an  Thieren 
mit  dem  Inhalte  des  Cholera  Darmes." 
Miinchen.     1856. 

B-59. — Thierling,  "  Ueber  Vergiftung  durch  Cloakengas 
Breslau."     1879. 

B-60. — Uffelmann,  J.,  "  Wiener  medicinische  Presse." 
1893.     No.  47. 

B-61. — Uffelmann,  J.,  "  Berliner  klinische  Wochen-^ 
schrift."  1893.     No.  26. 

B-62.— Uffelmann,  J.,  ''Archiv  fiir  Hygiene,"  VoL 
VIII.,  page  338. 

B-63. — Varrentrapp,  "  Deutsche  Vierteljahrschrift  fiir 
oeffentHche  Gesundheitspflege,"  XII.,  page 
558.     1880. 


SEWER    GAS    AND    HEALTH. — APPENDIX   I.  97 

B-64. — Virchow,  "  Generalbericht,  page  163.  Canalisa- 
tion und  Abfuhr."     Berlin.     1872. 

B-65.  Virchow,  "  Gesammelte  Abhandlungen  aus  dem 
Gebiet  der  oelfentlichen  Medicin  und  der 
Seuchenlehre,"  Band  2,  page  285. 

B-66. — Welz,  A.,  "Typhus  auf  der  Veste  Marienberg." 
"  Aerztliches  Intelligenzblatt,"  1878,  page  61. 

B-67. — Wernich,  "  Die  Luft  als  Tragerin  entwicke- 
lungsfiihiger  Keime."  "  Virchow^s  Archiv," 
Band  LXIX.,  page  424. 

B-68. — Weyl,  Th.,  "Die  Einwirkung  Hygieni&cher 
Werke  auf  die  Gesundheit  der  Stadte  mit 
besonderer  Kiicksicht  auf  Berlin."     1893. 

B-69. — Winterhalter,  L.,  "  Zur  Canalisation  von 
Miinchen."     1880. 


C.  Fkench  Liteeatuee. 

C-1. — Bechmann,  G.,  "  Service  de  Tassainissement  de 
Paris  en  1893." 

C-2. — Chevalier,  "  Asphyxie  double  par  le  vidange  d'une 
fosse  d'aisance."  "  Annal.  d'hyg.,"  1875,  II., 
Ser  XLIII.,  page  430. 

C-3. — Gaultier  de  Claubry,  "  Annal.  d'hygiene  et  de  Med." 
Leg.  II.,  82. 

C-3a. — Levy,  "  Traite  d'hygiene."     Tome  I.,  page  636. 

C-3b. — Magendie,  "  Kemarques  sur  la  notice  precedente, 
avec  quelques  experiences  sur  les  effets  des 
substances  en  putrefaction."  Journ.  de 
Physiologie,  etc.,  January,  1823,  tome  III. 

•C-4. — Miquel,  "Etude  generale  sur  les  bacteries  de 
I'atmosphere."  "  Annuaire  de  Montsouris," 
1881,  page  40. 

•C-5. — Miquel,  "Les  organismes  vivants  de  I'atmo- 
sphere."    Paris,  1883. 

>C-6. — Miquel,  "Etude  sur  les  poussieres  organiques 
de  I'atmosphere."  "Compt  rend.  hebd.  de 
I'academie  des  sciences,"  1878. 

7 


98  sewi<:r  gas  and  health.— appendix  i. 

C-7. — Miquel,  **  Septieme  memoire  sur  les  organismes 
microscopiques  de  I'air  et  del'eau."  "  Annuaires 
de  Montsouris,"  1885. 

C-8.— Nitter,  "  Soc.  Medic,  des  Hopitaux,"  6th  March, 
1891. 

C-9.— Parent-Duchatelet,  *'  Hygiene  publique,"  1836. 

C-10. — Poincarre,  "  Etude  sur  les  circumstances  qui 
peuvent  faire  varier  la  richesse  des  egouts  en 
microbes."     "Kevue  d'hygiene,"  1889. 

C-11. — Kapports  et  Avis  de  la  Commission  de  I'assainisse- 
ment  de  Paris  instituee  par  M.  le  Ministre  de 
I'Agriculture  et  du  Commerce.  Paris,  1881, 
page  88. 

C-12.— *'  Eevue  d'hygiene,"  1881,  page  648. 

C-13.— Sanarello,  "  Annales  de  Flnstitut  Pasteur,"  1892,. 
page  721. 

0-14.— Vedi,  "  Journal  d'hygiene,"  1881,  page  10.  "  La 
revue  d'hygiene,"  1882,  pages  12,  316,  428. 

C-15. — Vidal,  *'  Annales  de  I'lnstitut  Pasteur,"  1892,  page 
755. 

C-16.— Vincent,  "  Soc.  Med.  des  Hopitaux,"  13th  Novem- 
ber, 1891,  and  "  Annales  de  I'lnstitut  Pasteur," 
1893,  page  141. 

C-17. — Zuber,  "  Des  gaz  d'egout  et  de  leur  influence 
sur  la  sante  publique."  "  Kevue  d'hygiene," 
1881. 

C-18. — Zuber,  *' De  I'influence  pathogenique  des  gaz 
d'egout."     "Eevue  d'hygiene,"  1882. 

D.   LiTEEATUEE   OF   OtHEE  LANGUAGES. 

D-1. — Agro,  "  Annali  dell'  Istituto  d'Igiene  di  Koma," 
1893,  page  477. 

D-2.— Alessi,  G.,  "  Sui  Gas  Putridi."  '' Annali  deir 
Istituto  d'Igiene  sperimentale  della  E.  Universita 
di  Eoma."  Vol.  IV.,  Fasc.  1.  See  also  the 
translation  of  this  treatise  in  the  Journal  of 
the  Sanitary  Institute,  Vol.  XVI-  (A-4  of  this^ 
list). 


SEWER   GAS    AND    HEALTH. — APPENDIX  I.  9^ 

Summary  of  Literature  referred  to  : 


84  English  works, 

papers,  etc, 

74  German       ,, 

ii        >t 

20  French 

If             a 

2  Itahan         „ 

a             a 

180  works,  etc.,  in  all. 


100 


SEWER   QAS   AND   HEALTH. — APPENDIX  II. 


APPENDIX  II. 

Table  I. — Composition  of  Sewer  Air. 


Gases  in  10,000  Volumes 

oxidise 
tter  in 
f  Air. 

Micro- 

i 

of  Air. 

organisms 
(per  litre). 

^ 

2i:. 

^^ 

s 

Author. 

Locality  of 
Sewer. 

■ 

c 

< 

"o 

B 

s 
'Z 

3 
S 
< 

•id 

6 

.2   . 

Is 

IS" 

si 

■a  M 

Quo 

c 
o 

>> 

X 

o 

o 

03 
1 
1 

i 
& 

1 

Claubry 
(G.  de) 

Paris,  choked  ... 

201 

299 

1379 

8121 

2 

jj 

„      old,  1829.. 

340 

125 

3 

1  > 

)|                   •!         

19 

230 

81 

4 

Levy     and 
Miquel 

„      1891-93.... 

4-8 

1-2 

3-63 

5 

Letheby 

London,  1857-58. 

53-2 

i'^ 

traces 

1951 

7996 

6 

Miller 

„       1867.... 

18 

10-6 

ciean  and  well-ventilated  sewer. 

7 

6 

30-7 

tide-locked  and  ill-ventilated  sewer. 

8 

Russel 

Paddington  

51 

2070 

7880 

9 

R.  Nichols 

Boston,  January 

31 

8-65 

10 

a 

„        Feb.    ... 

44 

8-16 

11 

,,       March... 

47 

11-53 

12 

,, 

.,       April  ... 

12 

10-75 

13 

if 

June.... 

8 

27-52 

14 

„      July 

8 

21-92 

15 

»» 

August . 

8 

23-95 

16 

Beetz 

Munich,  soil- 
pipes  to  cesspits 

6 

42-37 

•0004 

traces 

17 

,, 

Munich,  sewers.. 

8 

31-4 

2-2 

18 

Haldane 

Dundee,      West- 
minster,   and 
Bristol 

32 

7-5 

7-2 

8-9 

19 

" 

Bristol,     Clifton 
outlet 

2 

20-2 

20 

20 

1 1 

,,  second  outlet 

2 

11-6 

8-5 

21 

Smith 

Sydney  

20 

225 

22 

cremating- shaft 
(before  gas) 

4 

30 

23 

)) 

,,      (after  gas) 

2 

25 

24 

Laws 

London,  normal. 

8 

8-95 

5-04 

106 

610 

25 

1 1 

,,    splashing... 

3 

12-87 

2-04 

1-15 

3-19 

26 

„    disinfectmg 

8 

9-88 

0-10 

0-65 

0-75 

27 

Pimlico  (vent)  ... 

5 

16-36 

0-60 

1-59 

2-15 

28 

»» 

E  xperimental 
small  sewer 

9 

1  90 

1-46 

3 -.36 

29 

) ) 

Stagnant  sewer. . 

6 

11-24 

3-46 

1-59 

5  05 

30 

t> 

Fulham-road  ... 

3 

69-28 

0-10 

1-15 

125 

31 

«) 

,1           1 J       •  •  • 

1 

93-10 

32 

f  Average 
\         atmo 

composition  of  ) 
spheric  air         / 

300 

2090 

7910 

15 

SEWER    GAS    AND    HEALTH. — APPENDIX  II.  101 

Table  II.— Sewer  Gases   (W.  H.  Collins). 
Gages  Dissolved  in  Raw  Sewage. 
The  Results  are  stated  in  C.C.  per  Litre.      Averages  100  Samples. 


No. 

Carbon 
Dioxide. 

Carbu- 
retted 

Nitrogen. 

Sulphu- 
retted 

Oxygen. 

Ammonia. 

Hydrogen. 

Hydrogen. 

1 

2-69 

5-01 

16-2 

0-60 

1-21 

0-004 

2 

11-04 

3-27 

19-4 

1-37 

3-06 

0-006 

3 

7-32 

1-56 

15-8 

4-02 

2-51 

0-006 

4 

4-06 

6-72 

17-9 

2-49 

1-04 

0-004 

5 

17-49 

2-04 

20-6 

3-06 

3-23 

0-004 

Table  III. — Analysis  of   Mephitic  Vapours  (W.  H.  Collins). 

From  Disused  and  Unventilated  Cellar  Dwellings. 

Results  are  stated  in  Volumes  per  cent. 


No. 

Oxygen. 

Carbon 
Dioxide. 

Ammonia. 

Ammonia 

Albu- 
menised. 

Sulphu- 
retted 
Hydro- 
gen. 

Nitro- 
gen. 

Marsh 
Gas. 

1 
2 
3 
4 

I 

20-83 
20-85 
20-73 
20-71 
20-65 
20-62 

0-58 
0-64 
0-59 
0-49 
0-92 
0-95 

0-086 
0-088 
0-084 
0-087 
0-085 
0-084 

0-142 
0-139 
0-144 
0-153 
0-136 
0-146 

0-26 
1-02 
0-56 
0-64 
0-72 
1-13 

0-313 
0-206 
0-564 
0-606 
0-217 
0-393 

See  also  A-21,  Appendix  I.,  for  Tables  II.  and  III. 


102  SEWER   GAS    AND   HEALTH. — APPENDIX  III. 


APPENDIX    III. 

Micro-organisms  in   Sewer  Air. — Experimental  Kesults. 

1.  Micro-organisms  in  the  Air  of  the  Paris  Sewers  (see 
also  page  26  of  C-1  and  also  C-4,  5,  6,  and  7, 
App.  L). 

Analyses  of  the  air  in  the  Paris  sewers  are  regularly 
made  by  Messrs.  Albert  Levy  and  Dr.  Miquel,  who  have 
charge  of  the  municipal  observatory  of  Montsouris.  For 
this  purpose  an  observing  station  has  been  established 
in  the  intercepting  sewer  "  Sebastopol,"  not  far  from  the 
point  where  it  crosses  under  the  rue  Eambuteau,  which 
is  provided  with  the  necessary  instruments. 

These  examinations,  which  were  commenced  in  1891 
and  have  since  been  regularly  continued,  have  so  far 
given  the  following  results.  The  air  of  the  Paris  sewers 
contains  on  an  average  a  little  more  carbonic  acid  than 
street  air,  from  three  to  four  times  as  much  ammoniacal 
nitrogen,  but  only  half  the  number  of  germs.  The. 
actual  figures  are  as  follows: 

Sewer  Air.  Street  Air. 

Carbonic  acid  ....     4'8        3*0        in   10,000  vols,    of  air. 

Ammoniacal  nitrogen    ...     1*2        0*3  „  ,, 

Bacteria    3*630     6760  per  litre. 

It  might  not  be  uninteresting  to  mention  here  that 
there  exists  in  the  sewers  of  Paris  another  observing 
station,  which  has  been  established  since  1893,  in  the 
intercepting  sewer  '*  Kivoli,"  and  where  the  temperature, 
the  humidity  of  the  air,  the  evaporation,  and  the  tem- 
perature of  the  sewage  are  recorded.  These  observations 
have  led  to  the  following  results : 


SEWER    GAS    AND    HEALTH. — APPENDIX  III.  103 

a.  The   variations  of  the   temperature  of  the   air   and 
sewage  are  less  perceptible  in  the  sewers  than  in 
outside  air  ;  and 
h.  The   humidity  in   the   sewers   is   great,  and   practi- 
cally constant- 
's. Micro-organisms    in    the   Air   of  the    Berlin    Sewers 
(see  also  page  159  of  B-30,  App.  I.). 

Petri  found  that  the  air  of  the  Berlin  sewers  con- 
tained only  a  very  small  number  of  micro-organisms. 

3.  Uffelma7in's  Observations  (see  also  page  159  of  B-30, 

App.  I.,  and  B-60,  61,  and  62  of  App.  I.). 

Uffelmann  examined  the  air  in  house  drains  and 
public  sewers,  and  reports  that  in  house  drains  he 
could  not  find  more  than  from  0  to  0*5  germs  in  one 
litter.  He  endeavoured  to  classify  the  various  micro- 
organisms found,  and  distinguished  the  following  kinds  : 
hacillus  subtilis,  bacillus  butyricus,  bacillus  proteus 
vulgaris,  bacillus  candicans,  bacillus  liquefaciens  viridis 
lacteus,  and  staphylococcus  pyogenes  aureus.  The  latter 
germ  produces  suppuration,  and  is  a  pathogenic  micro- 
organism. It  is  important  to  bear  this  in  mind  (see 
ipage  159  of  B-30,  App.  I.). 

4.  Micro-organisms    iji    the    Sydney    Sewers    (see    also 

page  32  of  A-57,  App.  I.). 

Smith  examined  the  air  of  the  Sydney  sewers,  and 
found  on  an  average  of  20  determinations  225  germs 
per  litre,  comprising  bacilli,  micrococci,  torulse,  sarcinae, 
streptococci,  and  mould  fungi,  some  colonies  liquefying 
gelatine.  He  distinguished  the  following  kinds:  bacillus 
fluorescens,  micrococcus  rosaceus,  yellow  bacterium, 
yellow  sarcina,  mycoides,  orange  sarcina,  micrococcus 
/cinnabareus,   pink    torula.      The    maximum    number    of 


104  SEWER    GAS    AND    HEALTH. — APPENDIX   III. 

germs  found  in   1   litre  of  sewer  air  was  2,260,   and  the 
minimum  7. 

Concerning  the  slimy  skin  frequently  found  in  badly- 
ventilated  sewers.  Smith  remarks : 

*'As  noted  in  diary,  cultivations  from  the  slime  on 
the  top  and  sides  of  sewer  proved  in  every  case 
to  be  a  compact  mass  of  micro-organisms.  When 
recently  flushed  there  was  less  slime,  and  when 
dry  the  roof  was  in  places  covered  with  mould, 
fungi." 

See  page  32  of  A- 57,  App.  I. 

5.   Carnelley     and    Haldane's     Observations     (see     also' 
page  12  of  A-30,  App.  I.). 

Haldane  and  Carnelley  experimented  on  the  sewers  of 
Dundee,  Westminster,  and  Bristol,  and  the  conclusions 
they  arrived  at  may  be  summarised  as  follows : 

a.  The  number  of  germs  in  sewer  air  is  on  an* 
average  very  small.  It  amounted  on  an  average 
of  all  experiments  to  only  8*9  germs  per  litre. 

h.  Sewer  air  is,  as  far  as  germs  are  concerned,  purer 
than  outside  air.  The  latter  contained  on  anj 
average  15 '9  germs  per  litre. 

c.  The  bursting  of  bubbles  in  a  sewer  will  disseminate- 

germs.  Sir  Edward  Frankland  arrived  at  the 
same  conclusion  from  his  experiments  on  bubbles  - 
bursting  in  a  lithia  solution  (A-28). 

d.  With  an  increase  in  carbonic  acid,  the  number  of 

germs  decreases. 

This,  expressed  in  other  words,  means  that  the- 
fouler  the  sewer,  the  less  is  the  number  of  germs.. 

e.  As    the    draught    in    a    sewer    decreases,    so    alsO' 

decreases  the  number  of  germs. 


SEWER    GAS    AND    HEALTH. — APPENDIX  III.  10^' 

/,  A  decrease  in  the  number  of  micro-organisms  in 
fresh  air  is  followed  by  a  decrease  of  micro- 
organisms in  the  <  sewer  air. 

g.  The  germs  in  sewer  air  are  as  a  rule  derived 
from  the  outside  air,  and  not  from  those  con- 
tained in  sewage. 

Their  experiments  on  the  air  of  the  Bristol  sewers 
are  particularly  interesting,  as  these  sewers  are  not 
ventilated  at  all  and  only  accessible  in  two  places,  but, 
generally  speaking,  the  results  obtained  are  in  keeping, 
with  those  obtained  at  Dundee  and  Westminster.  As 
far  as  I  know,  no  attempt  was  made  to  classify  and 
distinguish  the  different  micro-organisms  found. 

6.  Laics   and    Andrewes'    Experiments  for    the  London 
County  Council  (see  also  A-38  and  39,  App.  I.). 

Perhaps  the  most  recent,  and,  so  far  as  the  English 
language  is  concerned,  the  most  careful  and  elaborate 
experiments  on  sewer  air  were  made  for  the  London 
County  Council  by  J.  Parry  Laws,  his  first  report  being 
dated  May,  1892,  and  his  second  7th  December,  1893. 
After  these  two  reports  had  appeared,  the  London 
County  Council  further  instructed  him  to  make,  in 
conjunction  with  F.  W.  Andrewes,  investigations  into 
the  micro-organisms  of  sewage.  Their  joint  report, 
which  is  dated  13th  December,  1894,  is  divided  into 
two  parts :  the  first  dealing  with  the  micro-organisms 
of  sewage  and  their  relation  to  those  in  sewer  air,  and 
the  second  with  the  bacillus  of  typhoid  fewer  and  its 
relation  to  sewage. 

As  these  experiments  have  been  freely  discussed  in 
scientific  papers  and  periodicals  and  have  given  rise  to- 
many  expressions  of  opinions,  some  of  which  cannot  be 
said  to  be  in  any  way  derived  from   them,    I  will  deal 


106  SEWER   GAS    AND    HEALTH.— APPENDIX  III. 

with  them  here  more  fully,  and  consider  the  conclusions 
at  which  Messrs.  Laws  and  Andrewes  have  arrived. 

In  his  first  report  on  sewer  air,  Mr.  P.  Laws  arrives 
.at  the  following  results: 

a.  Sewer  air  contains  a  smaller  number  of  bacteria 
than  outside  air,  but  from  two  to  ten  times  as 
much  carbonic  acid.  No  sulphuretted  hydrogen 
was  found. 

6.  "  The  micro-organisms  in  the  sewer  air  are  related 
to  the  micro-organisms  in  the  air  outside,  and 
not  to  the  micro-organisms  of  the  sewage." 

c.  "In  the  air  both  within  and  without  the  sewer, 
the  forms  of  micro-organisms  present  are  almost 
exclusively  moulds  and  micrococci ;  on  the  contrary, 
the  micro-organisms  of  sewage  are  for  the  most 
part  bacilli.  Of  the  latter  sometimes  as  many 
as  25  per  cent,  very  rapidly  liquefy  the  gelatine 
on  which  they  grow,  whereas  in  the  whole  course 
of  my  experiments  with  fresh  air  and  sewer  air 
I  only  met  with  one  colony,  and  that  a  micro- 
coccus rapidly  liquefying  gelatine." 

>d.  "Moderate  splashing  carried  out  so  as  to  imitate 
the  inflow  of  a  lateral  drain  or  house  sewer 
produces  no  variation  in  the  sewer  air  even 
within  such  a  short  radius  as  4ft.  from  the 
disturbance." 

s.  The  mixing  of  deodorants  with  sewage  or  their 
distribution  in  sewer  air  produces  no  effect  on 
the  latter  ''beyond  the  removal  of,  in  most  cases, 
the  disagreeable  smell.  In  some  instances,  how- 
ever, the  deodorants  when  added  to  the  sewage 
had  a  marked  effect  upon  the  sewage  itself, 
reducing  very  considerably  the  number  of  bacteria 
present."     Of  all  the   chemicals  experimented   on 


SEWER    GAS    AND    HEALTH.— APPENDIX  III.  107 

with    a    view    to    ascertaining    their    deodorising 
powers,    manganate    of   soda    and   sulphuric    acid 
and    carbolic   acid  were    the  most   efficient;   and 
setting   aside  the    question    of  relative    cost,  the 
former    is    decidedly   preferable    for    the    reason 
stated  above. 
From    his    second    report    on    sewer  air,    Mr.   Laws 
draws  the  following  conclusions: 
/.  A    considerable    increase    in    the    velocity    of    the 
current  in  a  sewer  does  not  produce  a  concomitant 
increase  in  the  number  of  micro-organisms. 
g.  The    conditions    in    large    sewers,    so    far    as   the 
micro-organisms     in     sewer    air    are    concerned, 
appear    to    be    the    same    as  in    small  sewers,  in 
which  the  sewage  is  intermittent  and  the  velocity 
of  the  air  current  variable. 
h.  Stagnant    and    highly    putrescent    sewage    has    no 
influence  upon  the  number  of   micro-organisms  in 
sewer  air. 
^.  The  results  of  further  investigations  strengthen  the 
conclusion    arrived   at   from  previous  experiments 
(see  conclusion  h  above),  that  the  micro-organisms 
in   the   sewer  air  are  related  to  the  micro-organ- 
isms  in    the  air   outside,  and  not    to    the   micro- 
organisms of  the  sewage. 
Mr.  Laws  has  gone  to  the  trouble  to  classify  some  of 
the   germs   found   in  fresh    air   and    sewer    air,  and   his 
results  are  given  in  the  following  statement : 

A. — Micro-organisms  in  Fresh  Air. 

1.  Micrococci. 

Sarcina  lutea. 
Micrococcus  aurantiacus. 
Micrococcus  candicans. 


108  SEWER    GAS    AND    HEALTH. — APPENDIX  III. 

Diplococcus  citreus  conglomeratus. 
Diplococcus  roseus. 
Sarcina  rosea. 
Pediococcus  acidi  lactici. 
Micrococcus  acidi  lactici. 
Micrococcus  flavus  desidens. 
Diplococcus  flavus  liquefaciens  tardus, 

2.  Moulds, 

Pencillium  glaucum. 
Aspergillus  glaucus. 
Aspergillus  albus. 
Aspergillus  repens. 
Aspergillus  nigrescens. 
Aspergillus  nidulans. 
Brown  mould. 

3.  Bacilli, 

Bacillus  subtilis. 

Bacillus  fluorsecens  liquefaciens. 

Bacillus  ochraceus. 

Bacillus  mesentericus  fuscus. 

Bacillus  arbore^cens. 

4.  TorulcB. 

Pink  torula. 
Black  torula. 
White  torula. 

5.  Cladothrices. 

Cladothrix  dichotoma. 
Cladothrix  rubra. 

B. — Micro-organisms  in  Sewer  Air, 

1.  Micrococci. 

Sarcina  lutea. 
Sarcina  aurantiaca. 
Micrococcus  candicans. 


b 


SEWER    GAS    AND    HEALTH. — APPENDIX   III.  109 

Diplococcus  citreus  conglomeratus. 
Pediococcus  cerevisiae. 
Staphylococcus  cereus  albus. 
Micrococcus  cremoides. 
Staphylococcus  cereus  flavus. 
•2.  Moulds. 

Pencillium  glaucum. 
Aspergillus  glaucus. 
Aspergillus  albus. 
Aspergillus  repens. 
Aspergillus  nigrescens. 
Aspergillus  nidulans. 
Brown  mould. 

3.  Bacilli. 

Bacillus  subtilis. 

Bacillus  aureus. 

Bacillus  arborescens. 

Bacillus  acidi  lactici. 

Bacillus  helvolus. 

Bacillus  nigrescens. 

4.  TorulcB. 

None. 

5.  Cladothrices. 

Cladothrix  dichotoma. 

The  second  report  concludes  as  follows : 

**  Although  one  is  led  almost  irresistibly  to  the  con- 
clusion that  the  organisms  found  in  sewer  air 
probably  do  not  constitute  any  source  of  danger, 
it  is  impossible  to  ignore  the  evidence,  though  it 
be  only  circumstantial,  that  sewer  air  in  some 
instances  has  had  some  causal  relation  to 
zymotic  disease.  It  is  quite  conceivable,  though 
at  present  no  evidence  is  forthcoming,  that  the 
danger  of  sewer  air  causing  disease  is  an  indirect 


110  sewi:r  gas  and  health. — appendix  hi. 

one  ;  it  may  contain  some  highly  poisonous 
chemical  substance — possibly  of  an  alkaloidal 
nature — which,  though  present  in  but  minute 
quantities,  may  nevertheless  produce,  in  con- 
junction with  the  large  excess  of  carbonic  acid, 
a  profound  effect  upon  the  general  vitality." 

In  the  first  portion  of  the  third,  or  joint  report, 
Messrs.  Laws  and  Andrewes  deal  with  the  micro- 
organisms contained  in  the  sewage  itself,  with  a  view 
to  comparing  them  with  those  in  sewer  air,  and  thus 
to  elucidate  this  subject  still  further.  It  will  not  be 
necessary,  however,  to  follow  them  into  the  details ;  it 
will  suffice  to  say  that  they  found  on  an  average  from 
about  one  million  to  five  million  colonies  in  1  ccm. 
of  sewage,  of  which  they  were  able  to  classify 
only  a  very  small  number,  given  in  the  following 
statement : 

Bacteria  Found  in  London  Sewage. 

1.  Moulds  (only  0*4    per  cent,  of  the   colonies  examined 

were  moulds). 
Pencillium  glaucum. 
A  mould  of    a   dark-brown  colour   and  identical   with 

the  species  found  in  sewer  air. 

2.  TorulcB. 

A  white  torula  allied  to  common  yeast  (S.  cerevisias)* 
A  pink  torula  liquefying  gelatine. 
8.  Micrococci. 

Small  streptococcus,  in  large  numbers. 

Micrococcus  ochroleucus. 

Micrococcus  luteus. 

Micrococcus  flavus  liquefaciens. 

Micrococcus  aurora. 

A  citron-coloured  micrococcus. 


\ 


SEWER    GAS    AND    HEALTH.— APPENDIX  III.  Ill 

Pediococcus  albus  (doubtful). 

Sarcina    colonies    of    yellow     colour,     amongst    them 
being : 

Sarcina  flava,  in  large  numbers. 

Sarcina  aurantiaca. 
Staphylococcus  cereus  albus. 

Staphylococcus  pyogenes  citreus,  in  large  numbers. 
Staphylococcus  pyogenes  aureus,  pathogenic. 
A  yellow  staphylococcus. 

Diplococcus  albicans  tardissimus,  in  large  numbers. 
Diplococcus  roseus. 

4.  Bacilli. 

Bacillus  coli  communis,  in   large  numbers. 

A  bacillus  -very  much  like   the    bac.    coli    communis, 

in  large  numbers. 
Bacillus  typhosus  (twice),  pathogenic. 
Bacillus  fluorescens  liquefaciens,  in  large  numbers. 
Bacillus  fluorescens  stercoralis,  in  large  numbers. 
Bacillus  mesentericus  ruber. 
Bacillus  aureus. 

Bacillus  janthinus,  a  brilliant  violet  species. 
Bacillus  albus  putidus,  in  large  numbers. 
Bacillus  subflavus  (doubtful). 
Bacillus  fluorescens  aureus  (doubtful). 
Bacillus  mycoides,  in  large  numbers. 
Bacillus  cloacae  fluorescens,  in  large  numbers. 
A  dark-orange  brown  bacillus. 
A  bacillus  resembling  bacillus   aquatilis  sulcatus.- 
A  bacillus  resembling  diphtheria  bacillus. 
Proteus  Zenkeri,  in  large  number. 
Proteus  cloacinus,  in  large  numbers. 

5.  Gladothrices. 
Cladothrix  dichotoma. 

For  convenience  of  reference,  I  will  give  here  the  list 


112  SEWER    GAS    AND    HEALTH. — APPENDIX  III. 

•of  bacteria  found  by  Jordan  in  the  Lawrence  sewage 
•(see  report  of  the  Massachusetts  State  Board  of  Health, 
1890,  page  821) : 

Bacillus  ubiquitus. 
Bacillus  circulans. 
Bacillus  cyanogenus. 
Bacillus  superficialis. 
Bacillus  reticularis. 
Bacillus  rubescens. 
Bacillus  hyalinus. 
Bacillus  cloacae. 
Bacillus  delicatulus. 
Bacillus  violaceus  laurentius. 
Proteus  Zenkeri. 
Bacillus  janthinus. 

Messrs.  Laws  and  Andrewes  then  contrast  the  micro- 
organisms which  they  found  in  the  air  of  some  of  the 
London  sewers  with  those  found  by  them  in  the  metro- 
politan sewage,  and  call  attention  to  the  following  main 
points  of  difference : 

A.  Moulds. 

Whereas  moulds  abound  in  sewer  air,  they  are  prac- 
tically absent  from  sewage.  In  sewer  air  64*33  per  cent, 
of  the  total  colonies  found  were  moulds ;  in  sewage,  on 
the  contrary,  only  0*4  per  cent,  of  all  the  colonies 
examined  were  moulds,  the  actual  number  found  being 
seven,  of  which  only  one  colony  was  allied  to  the 
common  species  existing  in  sewer  air. 

B.  Micrococci  and  Bacilli. 

The  bacterial  flora  of  sewer  air  consists  mainly  of 
micrococci,  bacilli  forming  but  a  small  proportion  of  the 
itotal  species  found.      In  sewage,  on  the  contrary,  bacilli 


SEWER    GAS    AND    HEALTH. — APPENDIX   III.  113 

preponderate  over  micrococci  probably  in  actual  numbers, 
certainly  in  the  number  of  species  present. 

C,  Bacillus  Coli  Communis. 

Although  bacillus  coli  communis  (from  20,000  to 
"200,000  germs  per  cubic  centimetre)  and  its  allied  species 
abound  in  sewage,  they  were  never  found  in  sewer  air. 

B,  SarcincB. 

Although  enormous  numbers    of  sarcina — in  one  case 

over  300,000  germs  per  cubic  centimetre — were  found  in 

sewage,    not    one    single    colony    of    Sarcina    lutea,   so 

common  in  sewer  air  and  fresh  air,  was  ever  discovered 
in  it. 

E. — Bacteria  Liquefying  G-elatine. 

In  sewer  air,  organisms  rapidly  liquefying  gelatine 
were  found  to  be  practically  absent,  whereas  in  sewage 
these  kinds  of  bacteria  form  so  large  a  proportion  as 
to  make  gelatine  an  impossible  medium  to  employ  in 
estimating  their  numbers. 

F. — The  Number  of  Micro-organisms  in  Sewer  Air  is 
Dependent  on  the  Number  of  Micro-organisms  in 
Fresh  Air. 

*'  The  number  of  micro-organisms  existing  in  sewer 
air  appears  to  be  entirely  dependent  upon  the  number 
of  micro-organisms  existing  in  the  fresh  air  at  the 
same  time  and  in  the  same  vicinity.  With  the  advance 
of  the  colder  weather,  and  consequent  rapid  decrease 
in  the  number  of  micro-organisms  in  fresh  air,  we  find 
:a  corresponding  decrease  in  the  number  of  the  micro- 
organisms of  sewer  air,  although  the  temperature  of 
the  sewer  air  and  sewage  suffers  but  a  comparatively 
slight  variation." 

8 


114  SEWER    GAS    AND    HEALTH. — APPENDIX  III. 

The  concluding  sentences  of  Part  I.  are  as  follows : 

*'If  the  organisms  existing  in  sewer  air  were  derived' 
from  those  existing  in  sewage,  then  the  flora  of  sewer 
air  should  bear  a  very  close  resemblance  to  the  flora 
of  sewage.  When,  however,  we  compare  the  organisms 
which  have  hitherto  been  isolated  from  sewer  air  with 
those  species  which  we  have  found  to  be  predominant 
in  sewage,  it  is  at  once  evident  that  they  bear  no 
resemblance  whatever  to  one  another — indeed,  we  may 
go  even  further,  and  state  that,  so  far  as  we  are  aware, 
not  a  single  colony  of  any  of  those  species  which  we 
have  found  predominant  in  sewage  has  been  isolated 
from  sewer  air.  We  consider,  therefore,  that  the  study 
of  the  sewage  bacteria  on  which  we  have  been  engaged 
fully  confirms  the  conclusion  previously  arrived  at  from 
the  study  of  the  micro-organisms  of  sewer  air — viz., 
that  there  is  no  relationship  between  the  organisms  of 
sewer  air  and  sewage." 

"It  is  possible  that  some  of  the  ill  -  effects  which 
have  been  erroneously  ascribed  to  sewer  air  may  be  due 
to  subsoil  air  derived  from  soil  polluted  by  constant 
infiltration  of  excremental  matter  through  a  leaky  drain. 
It  is  a  well-recognised  fact  that  subsoil  air  does  at 
times  gain  access  to  our  dwellings,  either  through  the 
pressure  of  the  wind  on  the  surface  of  the  ground  or 
from  currents  induced  by  wide  differences  between  the 
exterior  and  interior  temperatures.  Under  such  con- 
ditions it  is  possible  that  sewage  may  gradually 
extend  through  a  permeable  soil  until  its  outer  margin 
becomes  sufficiently  dry  to  give  off  micro-organisms  to 
the  subsoil  air.  Whatever  the  danger  arising  from  this 
cause  may  be,  it  would  in  all  probability  be  strictly 
limited  in  its  effect." 

Part  II.  of  the  third  or  joint  report  is  devoted  to  an 


SEWER    GAS    AND    HEALTH — APPENDIX   III.  115 

investigation    of  the    bacillus    of    typhoid   fever    and   its 
relation  to  sewage. 

After  stating  that  the  micro-organisms  contained  in 
the  London  sewage  are  derived  from  the  water  used  for 
drinking  purposes,  from  the  air,  from  the  superficial 
layers  of  the  soil,  from  the  organic  matter  in  the 
soil,  and,  lastly,  from  putrescible  organic  matters, 
Messrs.  Laws  and  Andrewes  dwell  on  the  changes 
which  the  micro-organic  life  in  sewage  undergoes  in 
the  sewers.     Various  causes  are  here  at  work  : 

a.  The  sewage  is  a  favourable  medium  for  some 
germs,  whilst  others  quickly  perish  in  it. 

h.  Through  the  activity  of  the  microbial  life,  chemical 
changes  are  brought  about  in  the  sewers  which 
favour  some  species  and  destroy  others. 

c.  In  the  struggle  for  existence,  the  healthier  and 
stronger  forms  survive,  the  weaker  ones  perish. 

Thus  it  is  brought  about  that  the  sewage  flora  of  the 
Barking  and  Crossness  outfalls  is  very  different  from 
that  of  fresh  sewage  originally  delivered  into  the  house 
drains,  etc.  This  being  so,  it  is  of  the  utmost  import- 
ance to  ascertain  the  fate  of  the  pathogenic  germs  in 
the  sewers. 

Amongst  the  diseases  which  have  been  attributed  to 
the  contamination  of  drinking  water  with  sewage,  two 
stand  very  prominently  in  the  foreground — viz.,  cholera 
asiatica  and  typhoid  fever.  Some  observers  have  also 
held  sewer  air  responsible  for  diphtheria,  but  it  would 
appear  that  but  a  small  part  in  the  dissemination  of 
this  disease  can  be  played  by  this  cause. 

As  cholera  asiatica  was  absent  from  London  at  the 
time  of  these  experiments,  Messrs.  Laws  and  Andrewea 
were  not  able  to  discover  Koch's  comma  bacillus  in  the 

8* 


116  SEWER    GAS    AND    HEALTH. — APPENDIX   III. 

London  sewage.  They  were,  further,  unable  to  find  the 
diphtheria  bacillus  in  it,  though  a  careful  look-out  was 
kept  for  this  organism. 

Concerning  typhoid  fever,  Messrs.  Laws  and  Andrewes 
state  there  is  no  question  that  the  specific  poison  of 
the  "disease  believed  on  very  good  grounds  to  be  the 
bacillus  typhosus  of  E berth  and  Gaffky  passes  from  the 
body  with  the  faeces,  and  that  the  excreta  of  typhoid 
patients  constitute  the  main  channel  of  infection  in  this 
disease."  They,  therefore,  searched  for  it  very  carefully 
in  the  ordinary  sewage  of  London,  taken  at  various 
places,  but  were  never  able  to  find  it.  They  then  came 
to  the  conclusion  that  the  mathematical  chances  of 
ever  detecting  it  in  the  ordinary  London  sewage  were 
but  extremely  remote,  as  from  an  estimate  of  the 
reported  cases  of  typhoid  fever  at  the  time  of  the 
experiments  the  sewage  from  the  typhoid-fever  patients 
could  not  form  more  than  1 -250,000th  part  of  the  whole 
sewage. 

In  consequence  of  this  they  determined  to  analyse  the 
sewage  from  the  Eastern  Hospital  at  Homerton,  where 
there  were  at  the  time  40  cases  of  typhoid  fever,  many 
being  acute  cases  suffering  from  diarrhoea.  Here  the  drains 
are  accessible  at  various  places  through  manholes  and 
inspection  chambers,  and  the  sewage,  after  its  disinfec- 
tion had  ceased  for  two  days,  was  taken  at  a  manhole 
before  it  leaves  the  hospital.  One  would  have  expected 
that  numerous  colonies  of  bacillus  typhosus  were  found 
in  this  sewage  ;  but  after  very  careful  and  most 
elaborate  investigations,  Messrs.  Laws  and  Andrewes 
only  found  two  solitary  colonies.  This  is  very  remark- 
able, as  undoubtedly  there  must  have  been  a  vast 
number  of  typhoid  bacilli  in  the  sewage  when  taken. 
In  connection  with  this,  it  is  stated  in  the  report :  **  So 


SEWER    GAS    AND    HEALTH. — APPENDIX   III.  117 

far  as  we  are  aware,  this  important  fact  (that  in  the 
sewage  from  a  typhoid  block  the  typhoid  bacillus  can 
be  found)  has  never  previously  been  demonstrated." 

After  this  result  had  been  obtained,  Messrs.  Laws 
and  Andrewes  took  a  sample  of  sewage  a  quarter  of 
a  mile  below  the  Eastern  Hospital  at  Homerton,  but 
were  unable  to  find  a  single  colony  of  bacillus  typhosus 
in  it.  We  must,  therefore,  conclude,  that  even  in 
sewage,  where  according  to  our  notions  a  great  number 
of  typhoid  bacilli  must  exist,  their  detection  is  a 
matter  of  the  extremest  difficulty. 

After  making  various  experiments  with  a  view  to 
ascertaining  the  vitality  of  the  bacillus  typhosus  in 
sewage,  the  authors  conclude  as  follows : 

"  These  preliminary  experiments  are  necessarily  very 
incomplete,  and  afford  only  an  indication  of  the  pro- 
bable fate  of  typhoid  bacilli  which  gain  access  in  a 
living  condition  to  sewage.  It  seems,  however,  clear 
that  the  sewage  does  not  form  a  medium  in  which 
much,  if  any,  growth  is  possible  for  them  under  natural 
conditions,  and  their  death  is  probably  only  a  matter 
of  a  few  days,  or  at  most  one  or  two  weeks.  But  this 
degree  of  resistance  may,  nevertheless,  be  sufficient  to 
allow  of  their  being  carried  in  the  sewage  to  remote 
distances,  and  of  their  being  able  to  reproduce  disas- 
trous results  should  they  gain  access  to  any  water 
supply.  As  our  knowledge  accumulates,  it  becomes  more 
and  more  evident  that  water  supply  and,  as  an  inci- 
dental result,  our  milk  supply  constitute  the  chief 
channels  of  infection  by  which  typhoid  fever  is  com- 
municated, and  this  is  true  also  of  cholera,  and  possibly 
of  other  infectious  diseases.  It  is,  therefore,  of  the 
first  importance  to  determine  in  an  exhaustive  manner 
how    far    sewage    is  a  possible   soil  for    the    growth  of 


118  SEWER    GAS    AND    HEALTH. — APPENDIX  III. 

these  and  other  disease  germs  which  admittedly  gain 
access  to  it,  and  also  to  determine  what  precise 
influence  their  non-pathogenic  companions  may  exert 
on  them." 

**  In  the  conclusions  to  Part  I.  of  this  report  we 
endeavoured  to  show  that  sewer  air  has  no  power  of 
taking  up  bacteria  from  the  sewage  with  which  it  is  in 
contact.  A  strong  argument  in  favour  of  this  view  is 
the  fact  that  the  very  organisms  which  are  most 
abundant  in  sewage  are  precisely  those  which  are  absent 
from  sewer  air.  In  the  course  of  previous  experiments 
on  sewer  air,  the  nature  of  the  organisms  in  some 
1,200  litres  of  sewer  air  was  carefully  determined. 
Not  once  was  bacillus  coli  communis  or  any  of  the 
predominant  organisms  of  sewage  found,  though  we  have 
shown  above  that  the  former  is  present  in  sewage  in 
numbers  varying  from  20,000  to  200,000  per  cubic 
centimetre.  If  this  be  so,  how  infinitely  improbable 
becomes  the  existence  of  the  typhoid  bacillus  in  the  air 
of  our  sewers.  That  sewage  is  a  common  medium  for 
the  dissemination  of  typhoid  is  certain ;  that  sewage- 
polluted  soil  may  give  up  germs  to  subsoil  air  is 
possible ;  but  that  the  air  of  sewers  themselves  should 
play  any  part  in  the  conveyance  of  typhoid  fever  appears 
to  us,  as  the  results  of  our  investigations,  in  the  highest 
degree  unlikely." 


SEWER    GAS    AND    HEALTH. — APPENDIX  IV.  119 


APPENDIX  IV. 

lExPERIMENTAL  KeSEARCHES   INTO    THE   CaUSAL  RELATIONS   OF 

Sewer  Gas  and  Typhoid  Fever. 

1.    Experiment     by   Dr.    T.    H.   Barker     (see   also  A-6 
and  A-50,  App.  I.). 

The  late  Dr.  Parkes  reports  in  his  "  Manual  of 
Practical  Hygiene  "  an  experiment  made  by  Dr.  H. 
Barker,  as  follows  : 

"Dr.  Herbert  Barker  has  attempted  to  submit  this 
question  to  experiment  by  conducting  the  air  of  a 
cesspool  into  a  box  where  animals  were  confined. 
The  analysis  of  the  air  showed  the  presence  of 
CO2,  hydrogen  sulphide,  and  ammonium  sulphide. 
The  reaction  of  the  gas  was  usually  neutral — 
sometimes  alkaline.  The  gas  was  sometimes 
offensive,  so  that  organic  vapours  were  probably 
present  ;  but  no  analysis  appears  to  have  been 
made  on  this  point.  Three  dogs  and  a  mouse 
were  experimented  on ;  the  latter  was  let  down 
over  the  cesspit  and  died  on  the  fifth  day.  The 
three  dogs  were  confined  in  the  box  ;  they  all 
suffered  from  vomiting,  purging,  and  a  febrile 
condition,  which,  Dr.  Barker  says,  'resembled 
the  milder  forms  of  continued  fever  common  to 
the  dirty  and  ill-ventilated  homes  of  the  lower 
classes  of  the  community.'  But  the  effects 
required  some  time  and  much  gas  for  their 
production.  Dr.  Barker  attributes  the  results, 
not  to  the  organic  matter,  but  to  the  mixture  of 
-the  three  gases,  and  specially  to  the  latter  two." 


120  SEWER   GAS   AND    HEALTH. — APPENDIX  IV. 

2.  Besearches  of  Dr.  G.  Alessi  (see  also  A-4  and  D-2^ 

App.  L). 

Perhaps  the  most  careful  investigations  which  have 
ever  been  made  into  the  causal  relations  between  putrid 
gases,  including  sewer  air,  and  typhoid  fever,  are  those 
conducted  by  Dr.  Alessi  in  the  Hygienic  Institute  of  the 
University  of  Kome,  and  reported  by  him  in  the  AnnaU 
of  this  institute  for  the  year  1894.  As  I  consider  them 
of  great  importance,  I  had  them  translated,  and  the 
Sanitary  Institute,  sharing  my  views,  was  good  enough 
to  publish  them  in  the  Journal  for  1895.  I  can  in  this 
place  only  give  the  outlines  of  these  researches,  but  all 
those  who  wish  to  consult  them  more  carefully  can  do 
so  in  the  Journal  just  mentioned. 

Alessi  states  at  the  commencement  of  his  investiga- 
tions : 

"  The  fact  (which  with  English  sanitarians  is  a. 
dogma  of  practical  hygiene)  that  infectious 
diseases,  and  especially  typhoid  fever,  are  con- 
nected with  bad  exhalations  is  most  important. 
The  English  hygienists,  therefore,  consider  as 
injurious  to  health  and  life  the  emanations  which 
may  escape  into  houses  through  defective  construc- 
tion of  sewers  and  closets,  from  accidental  flaws 
in  waste-pipes,  or  from  any  other  imperfections 
in  the  system  of  the  pipes  for  carrying  away  the 
refuse.  And  it  is  precisely  this  idea  which  has 
brought  about  the  good  hygienic  arrangement  in. 
houses  in  England,  to  which  also  sanitary  legis- 
lation has  contributed,  and  the  diffusion  in  a. 
popular  form  of  the  rules  necessary  to  protect 
houses  from  any  putrid  exhalations.  This  idea, 
of    the  J  English    hygienists    having    been  carried. 


SEWER    GAS    AND    HEALTH. — APPENDIX  IV.  121 

out,  has  given  the  most  magnificent  results; 
therefore  it  is  useful  to  see  if  it  has  any  experi- 
mental scientific  basis,  and  this  is  what  forms 
the  subject  of  this  paper." 

The  plan  on  which  Dr.  Alessi  conducted  his  experi- 
ments was  as  follows: 

He  took  rats,  guinea-pigs,  and  rabbits,  exposed  a 
certain  number  of  them  to  the  influence  of  putrid 
gases,  including  sewer  gas;  whereas  the  rest,  as  a  con- 
trol experiment,  he  kept  under  normal  conditions,  and 
after  a  while  inoculated  all  of  them  with  the  bacillus 
of  typhoid  fever  and  the  bacterium  coli  commune 
(called  by  some  bacillus  coli  communis).  He  then  most 
carefully  observed  and  recorded  the  different  results 
which  this  inoculation  produced  in  both  sets  of  animals, 
made  sections  of  them  as  soon  as  possible  after  death, 
and  besides  instituting  a  very  careful  examination  of 
the  organs  to  reveal  the  macroscopic  changes,  he  made 
cultures  of  them  on  gelatine  plates,  and  took  out 
anatomical  pieces  for  the  microscopic  research  of  the 
bacilli,  ixo^ 

After  having  thus  completed  the  first  part  of  his 
researches,  he  started  a  second  set  of  experiments  with 
a  view  to  ascertain  *' whether  the  chemical  substances 
which  are  commonly  given  out  in  a  state  of  gas  from 
putrid  fermentations  can  also  exercise  separately  a 
similar  influence  on  the  animal  organism." 

Concerning  the  way  in  which  Dr.  Alessi  exposed  the 
animals  to  the  putrid  gases  it  might  be  stated  that  the 
rats  were  placed  in  a  box,  the  wire  bottom  of  which 
closed  the  aperture  of  an  untrapped  water-closet;  they 
were,  therefore,  exposed  to  the  direct  influence  of  sewer 
gas.     The  guinea-pigs   and  the  rabbits  were  placed  in 


122  SEWER   GAS    AND    HEALTH. — APPENDIX  IV. 

a  box,  the  wire  bottom  of  which  rested  on  a  vessel 
containing  excrementitious  substances. 

It  is  not  stated  whether  these  excrementitious  matters 
were  in  a  dry  or  liquid  state,  so  that  it  is  not 
possible  to  form  an  opinion  whether  in  his  experi- 
ments with  rats  Dr.  Alessi  wished  to  imitate  the  con- 
ditions prevailing  in  the  water-carriage  system  of  faecal 
matters,  and  in  his  experiments  with  guinea-pigs  and 
rabbits  the  conditions  existing  in  conservancy  systems ; 
but  be  that  as  it  may,  no  distinction  is  made  between 
these  two  kinds  of  putrid  gases  in  the  report,  and, 
indeed,  the  results  obtained  would  not  have  warranted 
such  a  course. 

The  experiments  throughout  were  conducted  with  the 
greatest  care  and  precaution,  and  cannot  fail  to  carry 
conviction  to  all  those  who  read  them  ;  certainly.  Dr. 
Alessi  appears  to  have  spared  no  pains  to  arrive  at 
reliable  conclusions. 

For  the  inoculation  with  typhoid  bacilli,  he  used  two 
cultures,  which  he  called  A  and  B  ;  culture  A  being 
derived  from  the  laboratory  of  Prof.  Koch,  of  Berlin, 
since  1889,  and  culture  B  coming  from  the  collection  of 
the  Institute  of  Rome,  where  it  was  cultivated  since  1887. 

It  would  lead  too  far  to  follow  Dr.  Alessi  into  the 
details  of  his  elaborate  researches;  sufi&ce  it  to  say  that 
in  his  experiments  with  rats  he  used  the  A  culture 
alone,  of  which  he  says  its  virulence  might  be  con- 
sidered almost  nil,  and  that  in  his  experiments  with 
guinea-pigs  and  rabbits  he  used  both  typhoid  cultures  A 
and  B.  With  bacterium  coli  cultures  of  attenuated 
virulence,  he  inoculated  only  guinea-pigs. 

Looking  at  the  whole  of  the  experiments,  it  may  be 
said  that  the  virulence  of  the  cultures  and  the  doses 
used  for  inoculation  were  small. 


SEWER    GAS    AND    HEALTH. — APPENDIX  IV.  123 

It  might  not  be  out  of  place  to  mention  here  that 
the  bacterium  coli  commune  (called  by  some  bacillus  coli 
■communis)  is  always  found  in  sewage  in  large  numbers, 
and  is  a  common  inhabitant  of  the  bowels  of  human 
beings.  It  has  frequently  been  mistaken  for  the  typhoid 
bacillus,  but  is  now  generally  considered  harmless. 

Dr.  Alessi  gives  14  tables  in  his  report,  from  which 
I  have  compiled  Tables  I.  to  V.,  given  at  the  end  of  this 
appendix  on  pages  127  to  180. 

Table  I.^  gives  the  number  of  animals  experimented 
on,  and  the  results  of  the  inoculation.  For  convenience 
of  reference,  I  have  in  Table  III.^  summarised  the 
mortality  returns  of  all  animals.  On  reference  to  these 
tables,  it  will  be  seen  that  from  75  to  100  per  cent,  of 
all  the  animals  exposed  to  the  putrid  gases  died  after 
i;he  inoculation,  and  that  of  all  the  animals  not  exposed 
to  sewer  gas,  only  7  per  cent,  of  the  rats  succumbed 
after  this  process.  The  figures  are  highly  significant, 
and  speak  for  themselves.  It  is  further  interesting  to 
observe  that  rabbits  appear  to  be  less  able  to  withstand 
the  combined  effects  of  sewer  gas  and  inoculation  than 
guinea-pigs  and  rats. 

In  the  second  table-^  I  have  given  the  time  which  has 
elapsed  before  the  animals  experimented  on  lost  their 
natural  immunity  to  typhoid  infection  and  acquired  the 
predisposition.  From  the  facts  there  enumerated  it 
would  appear  that  again  rabbits  have  a  smaller  resisting 
power  than  guinea-pigs  and  rats.     Dr.  Alessi  observes  : 

'*  It  appears  that  generally  the  animals  acquire  the 
predisposition  to  infection  more  easily  during  the 
first  two  weeks  than  after  that  time.  In  fact, 
90  per  cent,  of  the  animals  inoculated  in  the  first 
two  weeks  died,  and  only  76  per  cent,  of  those 
inoculated  in  the  following  weeks." 

i  Page  127.  -  Page  128.  ^"Pagel^s! 


124  SEWER   GAS    AND    HEALTH. — APPENDIX  IV. 

"  This    fact  may,    in   a    certain    degree,    explain   how 

it     is     that     some     individuals     who     habitually 

breathe    air    from    sewers,    or    in    whatever    way 

corrupted,     end     by     becoming      habituated     ta 

it    and    are    no     longer    attacked    by    intestinal 

infections." 

Table   IV.^  gives  the  time  that  has    elapsed  between 

the   inoculation    and    the   death    of  the    animals   which 

had   been  exposed    to    putrid    gases.     No   special    order 

can    be  observed   here,    except,   perhaps,  that    the  rats 

after    once    they   had    lost    their   natural    immunity    ta 

typhoid  fell  quickest  a  prey  to  the  poison. 

Table  V.^  contains  the  second  set  of  experiments 
which  Dr.  Alessi  made — after  having  studied  the  pre- 
disposing action  of  putrid  gases  taken  in  their  entirety — 
with  a  view  to  ascertain  whether  the  chemical  sub- 
stances which  are  commonly  given  out  in  a  state  of  gas 
from  putrid  fermentations  can  also  exercise  separately 
a  similar  influence  on  the  animal  organism. 

"It  is  known  that  18  cubic  metres  of  excrementaL 
matter  can  give  out  in  24  hours  about  18  cubic  metres 
of  gas,  of  which  10  cubic  metres  are  of  fatty  acids 
and  hydro-carbons ;  from  5  to  6  cubic  metres  are  of 
carbonic  acid ;  from  2  to  3  are  of  ammonia ;  20  litres- 
of  sulphuretted  hydrogen." 

'*  These  gases,  considered  separately,  constitute  for 
man  and  animals  the  most  poisonous  substances,  and 
their  combination  produces  very  rapid  deleterious  effects.. 
It  interested  me  to  study  their  action  on  the  animal 
organism  in  very  small  doses — certainly  smaller  than 
the  minimum  fatal  dose — having  reference  to  the  possible 
conditions  of  air  -  pollution  of  houses,  through  gases 
arising  from  badly-constructed  closets,  filth,  and  other 
causes  where  the  doses  can  only  be  found  weakened,  as 
1  Page  129.  '^  Page  130.  ~ 


b 


SEWER    GAS    AND    HEALTH. — APPENDIX  IV.  125 

even  in   such    surroundings   natural   ventilation   is   con- 
stantly diluting  these  gaseous  productions." 

The  substances  used  for  these  experiments  were  : 

Ketilindol  (this  is  a  very  strong-smelling  product 
of  the  putrefaction  of  albuminous  substances, 
and  can  easily  be  found  in  the  intestines); 

Ammonia  ; 

Sulphuretted  hydrogen ; 

Methyl  sulphide; 

Carbonic  acid; 

Carbonic  oxide;  and 

Ammonium  sulphide. 

These  substances  were  put  with  the  animals  inside 
a  large  bell-glass,  which  was  closed  in  such  a  manner 
as  to  make  change  of  air  impossible.  After  a  certain 
time  the  animals  were  inoculated  with  typhoid  bacilli 
in  the  same  way  as  in  the  preceding  experiments. 

Dr.  Alessi  continues : 

**  Therefore  the  above-mentioned  gases  or  vapours, 
taken  separately,  do  not  predispose  animals  to 
typhoid  infection.  In  fact,  in  all  the  experiments 
only  three  animals  died,  and  those  from  other 
causes  which  it  was  impossible  for  me  to  define. 
And  not  only  did  the  gases  taken  separately  have 
no  predisposing  effect,  but  even  some  of  them 
when  mixed;  for  which  reason  I  may  be  allowed 
to  suppose  that  both  the  exhalations  arising  from 
faecal  matter,  and  the  exhalations  arising  from 
organic  matter  in  putrefaction,  are  not  composed 
of  simple  mixtures,  but  are  much  more  complicated 
than  might  be  believed.  And  the  predisposing  cause 
might  also  have  its  seat  in  those  fetid  [substances 
of  neutral  character,  which  it  is  impossible  either 


126  SEWER   GAS    AND    HEALTH. — APPENDIX   IV. 

to  understand  or  determine,  whether  from  their 
small  quantity,  the  insufficiency  of  analytical 
methods,  or  from  the  imperfection  of  those  which 
we  already  have.  In  any  case,  from  my  experi- 
ments can  be  drawn  this  useful  lesson :  that  the 
above-mentioned  gases  or  vapours  can  be  breathed 
in  small  doses  without  their  predisposing  to  typhoid 
infection." 

The  conclusions  at  which  Dr.  Alessi  arrived  are  stated 
by  him  as  follows : 

"  From  my  researches,   taken   altogether,   I    think    I 
am  authorised  to  conclude  that :  , 

1.  The    inspiration    of    putrid    gases    predisposes    the 

animals  (rabbits,  guinea-pigs,  rats)  to  the  patho- 
genic action  of  even  attenuated  typhoid  bacilli, 
and  of  bacterium  coli. 

2.  This  predisposition  is   due   to  the   combination   of 

gases  given  out  by  putrid  fermentations,  and  not 
to  any  one  separately. 

3.  It  is  probable  that  this  experimental  predisposition 

is  diminished  by  prolonged  breathing  of  the  said 


These  conclusions,  then,  serve  to  confirm  what  some 
authors  had  epidemiological^  foreseen,  and  social 
hygiene  had  practically  and  painfully  confirmed.'* 


SEWER   GAS    AND    HEALTH. — APPENDIX  IV. 


127 


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128  SEWER   GAS   AND    HEALTH. — APPENDIX  IV. 

Table  II. — Dr.  Alessi's  Researches. 
First  Set  of  Experiments. 
Time  necessary  for  the  Animals  to  Acquire  the  Predisposition. 


Kind  of  Culture 
Used. 

Animals  Experi- 
mented with. 

Time  necessary  for  the  Animals 
to  Acquire  Predisposition, 

Minimum 
Time. 

Average 
Time. 

Maximum 
Time. 

First      Series.  —  Ty- 
phoid bacilli.      Cul- 
ture A. 

Second  Series.  —  Ty- 
phoid bacilli.      Cul- 
ture B. 

Third    Series.  —  Bac- 
terium coli. 

1  Rats    

Days. 
5 

I 

5 

0 

3 

Days. 

22 

18 

5 

6 
3 

6 

Days. 

72 
58 
18 

21 
6 

12 

-Guinea-pigs  ... 
Rabbits 

1  Guinea-pigB  ... 
("Rabbits..  

> Guinea-pigs  ... 

Table  III.— Dr.  Alessi's  Researches. 

First  Set  of  Experiments. 

Mortality  Returns  of  all  Animals. 


Kind  of  Culture 
Used. 

Animals  Experi- 
mented with. 

Percentage  Mortality  of  all 
Animals. 

Animals 
Exposed  to 
Sewer  Gas. 

Animals  Kept  as 
Control  under 
Normal  Con- 
ditions. 

First     Series.  —  Ty- 
phoid  bacilli.     Cul- 
ture A. 

Second  Series.  —  Ty- 
phoid bacilli.     Cul- 
ture B. 

Third   Series. —  Bac- 
terium coli. 

1  Rats    

Per  cent. 

75-5 

79-2 

100-0 

77-8 

87-5 

83-3 

Per  cent. 
7-3 
0-0 
0-0 

0-0 
0-0 

0-0 

!- Guinea-pigs  .. 
J  Rabbits  

(Guinea-pigs  ... 
I  Rabbits 

> Guinea-pigs  ... 

SEWER    GAS    AND    HEALTH. — APPENDIX   lA^ 


129* 


Table  IV. — Dr.  Alessi's  Researches. 

First  Set  of  Experiments. 

Time  Elapsed  between  the  Inoculation  with  the  Bacilli   and  the  Death 
of  the  Animals. 


Kind  of  Culture 
Used. 

I'J'umber  of  Animals  Exposed 
to  Putrid  Gases. 

Time  Elapsed  between 

the  Inoculation  with  the 

Bacilli  and  the  Death  of 

the  Animals. 

First  Series.— 

Typhoid  bacilli. 

Culture  A. 

Second  Series.— 

Typhoid  bacilli. 

Culture  B. 

Third  Series.— 
Bacterium  coli. 

i 

[Rats  

..     9 
...  25 
...     3 

12  to  24  hours 

24      „ 
24  to  36       „ 

Total 

Average,  23  hours. 

Guinea-pigs 

j>         

...  18 
..     6 
..     6 
.,     3 
..     8 
..     8 
..     3 

..  52 

24  hours 

3  days 

4  „ 

5  ,, 
9    „ 

10    „ 
13    „ 

>i         

Total 

Average,  5  days  3  hours. 

Rabbits    

..     3 
..     4 
.      4 

..  11 

2  days 

3  „ 

4  „ 

Total 

Average,  3  days  2  hours. 

Guinea-pigs 

.    15 
..     3 
..     1 
..     1 
..     1 

..  21 

18  to  24  hours 
30      „ 
2  days 

5  >> 

6  „ 

»>         

j>         

Total 

Average,  1  day  10  hours. 

Rabbits     

>>          

..     1 
.      3 
..     3 

.      7 

24  hours 

2  days 

3  „ 

Total 

Average,  2  days  7  hours. 

/-Guinea-pigs 

..     1 
..     3 
..     2 
..     1 
..     3 

..  10 

8  hours 
20      „ 
24      „ 

2  days 

3  „ 

j>         



Total 

Average,  24  hours. 

1 

.... 

130  SEWER    OAS    AND    HEALTH. — APPENDIX   IV. 

Table  V. — Dr.  Alessi's  Researches. 
Second  Set  of  Experiments. 
Experiments  with  Various  Gases. 


Substance  Experi- 
mented with. 


Retilindol 

Ammonia  cal 


hy. 


vapours    ... 

Sulphuretted 
drogen  

Methyl  sulphide  ... 

Carbonic  acid    

Carbonic  oxide 

Retilindol  and 
methyl  sulphide... 

Retilindol,  methyl 
sulphide,  and  am- 
monia     

Sulphide  of  am- 
monia      

Sulphide  of  am- 
monia and  methyl 
sulphide 


Animals 
Experi- 
mented 
with. 


Rats. 


Guinea- 
Rats 


pigs 


Guinea-pigs 


Day  on 
which  the 
Experi- 
ment 
began. 


24th  May 
24th     „ 
7th  July 
7th    „ 

28th     ,, 
16th  Aug. 
29th     ,,' 
13th  Sept. 

21sc      ,, 


6th  Oct. 
21st  Sept. 

6th  Oct. 


Day  on 
which 
Typhoid 
Inocula- 
tions were 
made. 


5th  June 
28th     „ 
23rd  July 
30th    „ 

11th  Aug. 
25th     „ 
7th  Sept. 
21st    ,, 

2nd  Oct. 


15th     „ 
2nd    „ 

15th     ,, 


Animals 

Exposed 

to 

Sewer 

Gas. 


11 


Q 


Animals 
Kept  as 
Control 
under 
Normal 
Condi- 
tions. 


3t3 

§1 


5 

0 
0 
0 
0 

0 
0 
0 
0 


3       0 


SEWER    GAS    AND    HEALTH. — APPENDIX  V.  131 


APPENDIX    V. 

Explosions  in  Sewers  and  Cesspits. 

"1.  Explosion  in  one  of  the  London  Sewers  (see  also  A-44, 

•App.  L). 

The  Medical  Times  of  July,  1861,  reports  a  case  which 
happened  in  one  of  the  London  sewers.  It  appears  some 
thieves  entered  a  sewer  with  a  view  to  stealing  the 
stearine  which  had  run  into  it  in  consequence  of  a  fire 
the  previous  night.  When  attempting  to  light  a  match, 
an  explosion  occurred  which  not  only  singed  them,  but 
also  acted  as  a  prompt  warning  to  the  police  to  find  out 
the  whereabouts  of  these  ingenious  burglars. 

It  is  surmised  that  with  the  stearine  together  inflam- 
mable fatty  gases  entered  the  sewer,  which  exploded 
when  a  naked  light  was  applied  to  them. 

2.  Explosion  in  a  Cesspit  at  Mayence  (see  also  B-13, 

App.  L). 

The  Deutsche  Bauzeitung  of  the  27th  February,  1895, 
mentions  the  following  case : 

A  public-house  in  Clara-street,  Mayence,  had  two 
closets  on  the  ground  floor,  which  were  connected  with 
an  arched-over  cesspit  under  the  street.  The  entrance 
to  the  latter  was  closed  with  a  cast-iron  asphalted  cover 
in  the  causeway,  and  it  was  ventilated  by  a  Sin.  pipe, 
which  higher  up  joined  the  rain-water  down-pipe.  Alto- 
gether, a  not  very  sanitary  or  satisfactory  arrangement. 

One  evening  in  the  middle  of  February,  1895,  the  owner 
lighted  his  cigar  in  the  room  where  one  of  the  water- 
closets  is  situated,  and  threw*  the  Hghted  match  into  the 

9^ 


133  SEWER    GAS    AN1>    HEALTH.— APPENDIX   V. 

closet  basin  ;  whereupon,  immediately  and  without  any- 
warning,  a  serious  explosion,  accompanied  by  great  noise,. 
took  place.  The  cover  of  the  cesspit — which,  no  doubt, 
was  frozen  hard  to  the  ground — was  burst  open  and 
thrown  high  into  the  air,  damaging  in  its  ascent  portions 
of  the  cornice  and  roof  of  the  building.  Its  contents  were 
forced  out  of  the  two  closets,  and  the  owner  had  a  very 
narrow  escape. 

The  two  closets  had  had  to  be  thawed  up  every 
morning  —  February,  1895,  being  an  exceedingly  cold 
month  ;  and  it  is  surmised  that  the  rain-water  ventilating 
pipe  was  frozen  up  at  the  time  the  explosion  took  place. 
At  any  rate,  it  would  appear  that  the  gases  forming  in. 
the  cesspit  could  not  escape  through  it  and  were  forced 
up  into  the  house.  What  their  mixture  and  composition 
was  has,  unfortunately,  not  been  ascertained,  but  it  would, 
appear  as  if  coal  gas  could  have  played  no  part  in  it,, 
otherwise  the  smell  would  have  betrayed  it. 

3.  Explosion  in  a  New  Sewer  at  Burton-on-Trent 
(see  also  A-16a,  App.  I.). 

In  this  case  an  explosion  took  place  in  a  new  sewer 
at  Burton-on-Trent  on  the  11th  day  of  November,  1896, 
which  was  caused  by  a  bricklayer,  doing  some  pointing 
in  the  same,  lighting  a  match.  The  force  of  the 
explosion  was  so  great  that  the  iron  top  of  every  manhole 
in  the  street  was  uplifted,  and  three  were  displaced. 
Houses  were  shaken,  and  the  frightened  inhabitants 
rushed  out  thinking  that  an  earthquake  had  occurred. 

The  following  is  the  account  of  the  accident  as  reported 
in  the  Burton,  Ashby,  and  Coalville  Guardian  of  14thu 
November,  1896 : 

*'  People  living  in   the   vicinity  of    Alfred -street   were- 
greatly  alarmed  at  seven  o'clock  on  Wednesday  morning. 


SEWER    GAS    AND    HEALTH. — APPENDIX  V.  133 

by  a  loud  explosion  of  gas  in  the  deep  sewer  recently 
laid  in  that  thoroughfare.  It  appears  that  a  bricklayer 
named  John  Parry,  living  in  Albert- street,  and  employed 
by  Mr.  Hodges,  had  descended  the  sewer  through  a 
manhole  for  the  purpose  of  seeing  if  any  pointing  was 
required.  He  crawled  along  until  he  came  to  one  of 
the  manholes,  where  there  was  a  great  accumulation  of 
gas,  which  the  man  evidently  did  not  detect.  He  lit 
a  candle  and  held  it  up,  but  the  moment  the  light 
•  came  in  contact  with  the  gas  there  was  a  terrific 
'explosion  throughout  the  whole  length  of  the  street. 
The  force  was  so  great  that  the  iron  top  of  every  man- 
hole in  the  street  was  uplifted,  and  three  were  displaced. 
Houses  were  shaken,  and  the  frightened  inhabitants 
rushed  out  thinking  that  an  earthquake  had  occurred. 
The  unfortunate  man  in  the  sewer  managed  to  creep 
'back  to  the  spot  where  he  had  gone  down,  and  was 
there  rescued.  He  was  almost  suffocated,  and  was  at 
.once  taken  to  the  Infirmary.  He  was  severely  burnt 
about  the  face  and  arms,  and  the  back  of  his  hair  and 
his  whiskers  had  entirely  disappeared.  After  he  had 
ibeen  attended  to  by  Dr.  Sparks,  the  house  surgeon,  he 
was  sent  home.  A  boy  who  had  gone  down  with  Parry 
"ihad  a  very  narrow  escape,  for  although  he  was  not 
iouched  by  the  flame,  he  was  knocked  down." 


134  SEWER    GAS    AND    HEALTH. — APPENDIX  VU. 

APPENDIX  VI. 

Health  of  Sewermen. 
1.  General  Bemarks, 

The  statistical  information  concerning  the  health  of 
sewermen  is  generally  very  incomplete,  as  the  facts  and. 
figures  have  frequently  had  to  be  collected  years  after,, 
and  that,  too,  in  a  somewhat  haphazard  manner.  The 
results  of  such  enquiries  are,  therefore,  in  most  cases 
not  based  upon  a  proper  system  of  notification  and. 
tabulation,  and  must  be  received  with  a  certain  amount 
of  caution. 

Further,  the  information  generally  only  deals  with  the 
workmen  whilst  actually  employed  in  the  sewers,  but 
gives  no  clue  as  to  the  health  of  the  workmen  after 
leaving  this  employment,  which,  of  course,  is  of  the 
greatest  importance  when  considering  the  influence  of 
sewer  gas  upon  health. 

The  information  in  most  cases  also  refers  only  to  the 
days  lost  through  sickness,  but  does  not  give  any  idea 
as  to  the  state  of  the  health  of  sewermen  before 
actually  becoming  unfit  for  work. 

As  to  the  length  of  time  sewermen  are  employed  in 
sewers,  Prausnitz's  labours  for  Munich,  for  instance,, 
indicate  that,  out  of  the  total  number  of  men  so 
employed,  43  per  cent,  only  remain  on  an  average  20- 
months  in  the  sewers.     (B-43,  Appendix  I.). 

2.    Opinion    of   the   late    Dr.    E.    A,    Parkes   (see  also^ 
A-50,  App.  I.) 

The  late  Dr.  E.  A.  Parkes  states  on  page  139  of  the- 
sixth  edition  of  his  "  Manual  of  Practical  Hygiene"  : 


I 


SEWER    (iAS    AND    HEALTH. — APPENDIX   VI.  135 

"It  does  not  appear,  therefore,  that  at  present  the 
workmen  connected  with  fairly  ventilated  sewers 
show  any  excess  of  disease ;  at  the  same  time  it 
must  be  allowed  that  the  inquiry  has  not  been 
very  rigorously  prosecuted,  and  that  the  length  of 
time  the  men  work  in  sewers,  their  average  yearly 
mortality,  discharge  from  sickness,  loss  of  time 
from  sickness,  and  the  effect  produced  on  their 
exjDectation  of  life,  have  not  been  perfectly  deter- 
mined." 

Parkes  further  mentions  that  whereas  Guy  and  Parent- 
Duchatelet  deny  that  typhoid  fever  is  more  common 
among  sewermen  than  others,  Murchison  and  Peacock 
state  that  this  disease  is  not  uncommon  among  sewer- 
men. 

B.    Cases    reported    by    GauUier   de    Claubry    (see   also- 
C-3,  App.  I.). 

G.  de  Claubry  mentions  four  cases  of  real  asphyxia 
and  20  of  threatening  asphyxia  in  10  workmen  who 
had  been  taken  to  the  hospital  after  having  been  at 
work  in  the  sewers  for  only  about  six  months.  One 
workman  had  no  less  than  four  attacks. 

4.  Observations  of  Hankel  (see   also  B-24,  App.  I.  and 
11,   App.  VII.). 

Hankel  reports  that  cases  of  light  poisoning  through 
sewer  gas  are  very  common  amongst  the  Paris  sewermen. 
They  distinguish  two  kinds.  The  first  kind  they  call 
"  la  mitte  "  —  vapour.  This  can  last  for  several  days, 
but  leaves  no  ill-effects  behind.  It  consists  in  great 
irritation  of  the  mucous  membrane  of  the  nose,  with, 
decreasing  secretion  of  the  same,  severe  pains  in  the 
sockets  of   the  eyeballs  reaching   as   far    as   the  frontal 


136  SEWER   GAS    AND    HEALTH. — APPENDIX  VI. 

cavity,  swelling  and  inflammation  of  the  conjunctiva, 
photophoby,  leading  sometimes  to  complete  darkening 
of  the  eyesight.  It  is  probably  brought  about  by 
ammonia  or  sulphuretted  hydrogen,  or  through  a  com- 
'bination   of  both  gases. 

The  second  kind  of  poisoning  is  called  "  le  plomb  " — 
lead — and  derives  its  name  probably  from  the  feeling 
of  heaviness  in  the  head  and  limbs.  It  is  caused  by 
sulphuretted  hydrogen. 

5.  Sewermen  at  Munich  (see  also  B-43,  App.  I.). 

Prausnitz  examined  the  health  of  the  sewermen  at 
Munich,  and  came  to  the  conclusion  that  they  did  not 
suffer  more  from  illness  than  other  workmen.  From 
the  figures  given  by  this  observer  the  rather  remarkable 
circumstance  can  be  deduced,  that  out  of  a  total  number 
of  42  sewermen,  43  per  cent,  remained  on  an  average 
only  20  months  in  the  sewers.  No  reason  for  this  is 
given  in  the  report,  although  it  would  have  been  of  the 
greatest  importance  to  ascertain  whether  or  no  the 
cause  of  this  short  service  in  the  sewers  was  in  any 
way  connected  with  the  impaired  health  of  the  men. 

6.  Sewermen  at  Wiesbaden  (see  also  B-9,  App.  I.). 

It  has  not  been  observed  at  Wiesbaden  that  sewermen 
suffer  to  a  larger  degree  than  others  from  epidemic 
diseases,  but  they  are  more  subject  to  rheumatic  com- 
plaints than  other  men  employed  by  the  town  authorities. 
It  should  be  observed  here  that  the  Wiesbaden  sewers 
are  comparatively  new,  having  only  been  in  use  a  few 
years. 

7.  Health  of  London  Sewermen  (see  also  A-58,  App.  I.). 

Stevens  mentions  that  the  London  sewermen  com- 
iplain   about  sore  throats  and  rheumatism.    He  was  not 


SEWER    GAS    AND    HEALTH. — APPENDIX  VI.  137 

able  to  discover  that  they  suffered  from  typhoid  fever, 
and  only  found  one  case  of  diphtheria  amongst  them. 
He  is  of  opinion  that  the  time  lost  through  sickness 
by  them  is  not  greater  than  that  lost  by  other  work- 
men, that  they  are  able  to  work  long  in  the  sewers, 
^nd  that  their  majority  dies  at  an  advanced  age. 


138  SEWER   GAS   AND   HEALTH. — APPENDIX  VII. 


APPENDIX  VII. 

Some   Authentic  Cases  of  Mkphitic  Poisoning  through 
Sewer  Gas. 

1.  Poisoning  Case  at  Clapham  (see  also  A-18  and  31, 

App.  L). 

In  a  case  at  Clapham  the  emptying  of  a  privy  produced 
in  23  children  violent  vomiting  and  purging,  headache, 
and  great  prostration  and  convulsive  twitching  of  the 
muscles.     Two  died  in  24  hours. 

2.  Deaths  of  Four  Men  in  a   Sewer  in  the   City  oj 

London  (see  also  A-43,  App.  I.). 

The  Medical  Times  of  February,  1861,  reports  a  case 
in  which  four  men  perished  in  a  sewer  in  the  neighbour- 
hood of  the  Thames.  The  post-mortem  examination 
revealed  that  three  men  were  suffocated  by  carbonic  acid 
gas ;  but  the  late  Dr.  Letheby,  M.O.H.  City  of  London, 
expressed  at  the  coroner's  inquest  the  opinion  that  three 
men  were  killed  by  sulphuretted  hydrogen  gas,  and  that 
the  fourth  was  drowned. 

8.  Case  reported  hy  Gaultier  de  Claubry  (see  also  C-3, 

App.  I.). 

Gaultier  de  Claubry  mentions  a  case  where  12  workmen 
who  had  entered  a  sewer  uttered  cries  one  after  another, 
became  unconscious  and  asphyxial.  When  they  were 
removed  from  the  sewer  it  was  found  that  eight  were 
only  slightly  affected,  and  the  remaining  four  so  much 
that  they  had  to  be  sent  to  the  hospital.  One  of  the 
latter  died,  but  the  other  three  recovered  consciousness 
after  several  hours,  and  could  be  discharged  after  six  days. 


SEWER    GAS    AND    HEALTH. — APPENDIX  VII.  139' 

4.  Case  reported  by  Halle, 

Halle  reports  that  three  workmen  in  a  cesspit  were 
overcome  by  the  gas  and  that  two  died  before  they  could 
be  rescued. 

5.  Chevalier  (see  C-2,  App.  I.),  BlumenstocJc  (see  B-7, 
App.  I.),  and  Thierling  (see  B-59,  App.  I.)  mentiofi 
similar  cases  of  Mephitic  Poisoning. 

6.  Case  reported  by  Caspar  (see  also    B-11,  App.  I.). 

Caspar  reports  a  case  where  10  men,  working  in  a 
tannery,  bored  a  hole  in  a  tank  containing  hides  under- 
going the  process  of  maceration.  Some  of  the  liquid 
containing  13  vols,  of  sulphuretted  hydrogen  escaped, 
and  the  workman  who  endeavoured  to  ladle  it  out  of 
the  pit  suddenly  fell  down  dead.  The  others  ran  to  his 
rescue,  but  six  of  them  died  on  the  spot,  and  the  rest 
only  recovered  after  having  been  ill  for  some  time. 

7.  See   also  item  4   under   "  Health  of  Sewermen  "  in 

App.  VI. 

8.  Accident  in  the  Paris  Sewers. 

Four  men  lost  their  lives  in  the  Paris  sewers  about 
the  year  1880. 

9.  Case    reported    by     Finhelnburg     (see    also    B-20,. 
App.  I.). 

Finkelnburg  reports  a  case  which  shows  how  quick 
and  how  serious  the  action  of  sewer  gas  can  be  upon 
human  beings. 

The  basement  of  a  house  of  detention,  which  is  4ft. 
below  the  level  of  the  courtyard,  was  flooded  to  the 
depth  of  several  feet  by  the  backing  up  of  sewage  from 
the    sewer.     Not    far    from    the    rooms    thus    flooded,. 


140  SEWER   GAS    AND    HEALTH. — APPENDIX   VII. 

prisoners  were  at  work  during  the  day  making  brushes, 
:and  of  these,  13  became  so  seriously  ill  that  they  had 
to  be  taken  to  the  hospital,  whilst  some  of  the  others 
did  not  feel  the  effects  of  the  sewer  gas  in  so  decided  a 
manner.  Most  of  the  men  fell  ill  on  the  day  after  the 
sewage  had  been  pumped  out,  during  which  operation  a 
pestilential  smell  pervaded  the  premises. 

10.  Fatality  in  a  New  Sewer  at  East  Ham,  near  London, 
1st  July,  1895  (see  also  A^-25,  App.  I.). 

A  very  sad  accident  happened  at  East  Ham,  near 
London,  on  the  1st  July,  1895,  by  which  five  men  lost 
pheir  lives  in  one  manhole. 

At  the  point  where  the  main  outfall — a  new  egg-shaped 
sewer,  4ft.  Gin.  by  3ft. — enters  the  pump  well,  screens 
have  been  put  up  with  a  view  to  catch  the  rough, 
floating  matter.  These  screens  are  accessible  by  means 
of    a   shaft   27ft.    deep,   closed   with   a  ventilated  cover. 

It  appears  that  on  Monday  morning,  1st  July,  1895, 
a  man  named  Digby  went  down  this  shaft  with  a 
view  to  clean  the  screens,  after  the  cover  had  been 
removed  for  about  15  minutes.  When  halfway  down 
he  said  he  felt  faint  and  would  return  to  the  surface 
for  a  short  time.  However,  on  reaching  nearly  the  top 
of  the  ladder,  he  collapsed  and  fell  down  the  shaft  into 
the  sewage.  King,  the  man  on  the  surface  of  the  ground 
in  attendance  on  Digby,  called  at  once  for  help,  when 
three  men — named  Rutter,  Mills,  and  Durrant — went 
down  the  shaft  and  disappeared  clean.  The  last  man 
to  go  to  the  rescue  was  Jones ;  but  he,  too,  being  over- 
come by  the  gas  when  reaching  the  bottom,  fell  against 
the  grating,  and  remained  with  his  head  above  the  sewage 
perfectly  still,  in  an  apparently  lifeless  condition. 

When  the  next  man,  Herbert  Worman,  descended,  he 


SEWER    GAS    AND    HEALTH — APPENDIX  VII.  141" 

too,  had  to  return,  owing  to  feeling  ill  from  inhaling  the 
gas.  A  bucket  containing  lighted  coal  was  then  lowered 
into  the  well,  and  as  this  seemed  to  burn  all  right, 
Worman  descended  again,  and  brought  Jones  to  the 
surface,  who  was  then  still  breathing.  Efforts  were  at  once 
made  to  revive  animation,  which  proved  so  far  successful 
that  he  was  removed  to  the  West  Ham  Hospital,  where, 
however,  he  died  on  Tuesday  morning. 

When  the  other  four  bodies  were  brought  up,  it  was 
found  that  life  was  quite  extinct.  One  poor  fellow's  face 
and  head  were  frightfully  swollen,  and  various  marks 
about  the  nostrils,  mouth,  and  eyes  showed  that  he 
had  died  from  suffocation. 

A  post-mortem  examination  was  made  on  the  body  of 
Durrant,  and  at  the  inquest  Dr.  Smith  stated  that,  as 
the  result  of  the  autopsy,  he  was  of  opinion  that  Durrant 
had  died  from  asphyxia  resulting  from  drowning. 

Concerning  the  man  Jones  who,  as  already  mentioned, 
died  after  admission  to  the  hospital,  the  following  report 
of  the  inquest  is  taken  from  the  Tiines  of  the  8th  August, 
1895: 

*'  The  adjourned  inquest  on  the  body  of  Frederick 
David  Jones,  age  28,  who  died  in  the  West  Ham 
Hospital  on  the  morning  of  July  2nd,  took  place 
at  the  King's  Head,  Church-street,  West  Ham, 
yesterday  evening.  Jones  was  one  of  the  five 
men  who  went  down  a  manhole  at  the  East  Ham 
sewage  works,  and  there  became  unconscious 
through  meeting  with  foul  gas.  When  they  were 
extricated,  four  of  the  men  were  dead,  having 
been  drowned.  Jones  was  unconscious  when 
taken  out,  he  having  fallen  on  the  top  of  a 
grating.  Charles  King,  labourer  in  the  employ 
of   the    East   Ham  District  Council,    was  called^ 


k 


142  SEWER    GAS    AND    HEALTH. — APPENDIX  VII. 

and  the  evidence  he  gave  at  the  other  enquiry 
was  read  over.  He  detailed  how  the  men  went 
down  the  manhole  and  disappeared.  Dr.  Stuart 
Kyall  Blake,  house  surgeon  at  West  Ham  Hospital, 
deposed  that  after  the  deceased  was  brought  to 
the  hospital  artificial  respiration  was  resorted  to 
for  2 J  hours,  while  brandy  was  administered  and 
the  stomach-pump  used.  He  never  recovered 
consciousness,  and  died  the  next  morning. 
Witness  was  of  opinion  that  he  died  from 
poisoning  by  sulphuretted  hydrogen.  Mr.  W.  H. 
Savage,  surveyor  to  the  East  Ham  District 
Council,  stated  that  since  the  accident  a  cradle 
had  been  obtained,  and  it  was  lowered  with 
the  men,  so  that  they  could  be  taken  up  at  a 
moment's  notice.  In  addition,  acting  on  the 
advice  of  Dr.  Haldane,  a  mouse  or  a  bird  had 
been  lowered  each  time  the  men  went  down,  and 
no  foul  gas  had  been  discovered.  The  Council 
had  also  determined  not  to  have  any  part  of  the 
manhole  covered  up,  and  had  also  provided  a 
respirator  which  would  enable  men  to  go  down 
amongst  any  noxious  gas.  The  jury  returned  a 
verdict  that  death  was  due  to  suffocation  by 
sewer  gas." 
The  widow  of  the  man  W.  T.  Digby  brought  an 
-action  against  the  East  Ham  Urban  District  Council  for 
damages  for  the  loss  of  her  husband.  The  following  is 
the  account  of  the  second  trial  as  taken  from  the 
Standard  of  25th  May,  1897  : 

^*  Digby  v.  East  Ham  XJrhayi  Council. — In  this  case 
Mrs.  Esther  Martha  Digby,  the  widow  of  the  late 
W.  T.  Digby,  sued  the  East  Ham  Urban  Council 
to    recover     damages     on    behalf    of    herself    and     her 


SEWER    GAS    AND    HEALTH. — APPENDIX  VII.  U3 

•children  for  the  loss  of  her  husband.  The  deceased 
was  in  the  employment  of  the  defendants,  and  in 
July,  1895,  went  down  a  manhole  on  their  sewage 
works,  when  he  was  suffocated  in  consequence  of 
-an  escape  of  noxious  gas.  The  plaintiff's  case  was 
that  his  death  was  caused  by  the  defective  condition 
of  the  defendants'  works,  or  through  their  negligence, 
or  the  negligence  of  those  engaged  by  them  in  super- 
intendence. The  defendants  denied  the  plaintiff's 
statements,  and  a  good  deal  of  scientific  evidence  was 
called  on  both  sides.  This  was  the  second  time  the 
'Case  had  been  tried,  as  Mr.  Justice  Cave  non-suited  the 
plaintiff,  and  the  Court  of  Appeal  granted  a  new  trial^ 
Altogether  five  men  died  from  the  gas,  and  this  was  a 
test  case.  Mr.  Euegg,  Q.C.,  Mr.  J.  D.  Crawford,  and 
Mr.  Edmond  appeared  for  the  plaintiff ;  and  Mr.  Dickens, 
Q.C.,  and  Mr.  W.  ElHs  Hill  for  the  defendants.  The 
jury  found  a  verdict  for  the  plaintiff  for  £^25.  Judgment 
accordingly." 

11.  Observations  by  Dr.  Hankel  (see  also  B-24,  App.  I.). 

Hankel  states  that  in  human  beings  four  different  forms 
of  poisoning  by  sewer  gas  can  be  distinguished — viz.,  the 
mild  form,  the  fairly  severe  form,  the  severe  form,  and 
the  chronic  form. 

A.  The  Mild  Form. — In  the  mildest  cases  the  feeling 
of  a  heavy  load  upon  head  and  chest  is  experienced. 
This  feeling  is  well  known  amongst  sewermen.  If  the 
case  becomes  more  severe,  other  symptoms,  such  as 
vomiting,  severe  pains  in  the  abdomen,  breaking  of  wind 
strongly  smelling  of  sulphuretted  hydrogen,  and  eructa- 
tion, have  been  observed.  The  pulse  becomes  small,  the 
breathing  quick  and  laboured,  the  patient  feels  giddy  and 
very  weak,  especially  in  the  muscular  parts. 


144  SEWER    GAS    AND    HEALTH. — APPENDIX  VII. 

B.  The  Fairly  Severe  Form. —  In  fairly  severe  cases 
the  skin  becomes  cold  and  covered  with  cold  perspiration. 
The  patient  begins  to  feel  sick,  and  frequently  complains 
of  pains  in  the  stomach  and  joints  and  of  a  feeling  as 
if  the  throat  was  closing  up.  Delirium,  convulsive 
twitchings  of  the  muscles,  fainting  fits,  singing  and 
talking,  have  frequently  been  observed  at  this  stage. 
The  latter  is  so  well  known  to  the  Paris  sewermen  that 
they  call  it  "  chanter  le  plomb,"  which  might  be  rendered 
by  *'  the  lead  song." 

After  this  follows  unconsciousness  and  convulsions, 
chiefly  of  a  tetanic  nature.  The  pupils  of  the  eyes  become 
enlarged  and  the  lips  and  the  face  blue  and  cyanotic. 

C.  The  Severe  Form. — In  cases  of  this  kind  the  death 
of  the  workman  is  frequently  instantaneous.  He  enters 
the  sewer  or  cesspit  and  collapses  there  all  at  once  as 
if  he  had  been  hit  by  a  bullet.  Sometimes  it  has  also> 
been  observed  that  the  workman  has  uttered  a  cry 
and  then  had  severe  convulsive  fits,  with  vomiting  and 
spontaneous  secretion  of  faeces  and  urine ;  foam  covered 
the  mouth,  and  the  patient  either  died  at  once  or 
remained  unconscious  for  a  long  time. 

D.  The  Chro7iic  Form. — This  form  has  been  observed 
in  labourers  employed  in  chemical  works  who  had 
drank  water  containing  sulphuretted  hydrogen,  and  in 
miners  employed   in  the  coal  mines  at  Auzain. 

The  symptoms  were  pronounced  anaemia,  pressure  in 
the  stomach  with  pains,  and  pulse  sometimes  quick, 
sometimes  slow.  The  strength  of  the  patient  diminished, 
the  pains  in  the  stomach  gradually  ceased,  the  skin 
became  yellow,  and  profound  perspiration  commenced. 
The  stomach  became  blown,  and  the  stools  contained 
pus. 

In  the  case  of    the   miners  frequently   sudden  death 


SEWER    GAS    AND    HEALTH. — APPENDIX  VII.  145 

took  place,  whereas  in  the  case  of  the  labourers  of  the 
.chemical  works  furuncle  or  similar  diseases  in  the  neck, 
face,  and  skin  supervened. 

12.  Case  reported  hy  Hanhel  (see  also  B-24,  App.  I.). 

A  very  interesting  case  is  reported  by  Hankel,  which 
happened  at  Glauchau,  in  the  kingdom  of  Saxony,  on 
the  18th  January,  1895. 

A  plumber,  26  years  old,  and  to  all  appearances  in 
good  health,  had  been  sent  by  his  master  to  a  house 
to  thaw  up  the  water-closets  on  the  ground  floor 
which,  owing  to  the  severe  frost,  had  become  frozen. 
He  was  known  to  be  a  steady,  sober  fellow. 

At  3.30  p.m.,  when  someone  had  been  speaking  to 
him,  he  appeared  all  right,  and  made  no  complaint 
whatever,  but  at  5  p.m.,  when  the  coachman  came  to 
look  after  him,  he  found  him  dead  in  the  room  with 
his  trousers  half  off.  Although  the  coachman  had  left 
the  door  open,  upon  entering  he  felt  giddy  and  faint, 
owing  to  the  pungent  and  suffocating  nature  of  the 
air  in  it,  and  when,  after  an  hour,  Hankel,  the 
medical  officer  of  health,  examined  the  place,  he 
reports  the  air  in  the  room  made  him  feel  dazed,  and 
caused  eructation. 

In  the  house  in  question,  the  water-closets  drain 
into  a  cesspit,  and  it  appears  that  the  poor  fellow  had 
for  some  reason  or  other,  after  lighting  a  coal  fire  in 
the  room,  opened  the  cover  of  a  4in.  pipe  which  is 
directly  connected  with  the  cesspit,  and  the  only  use  of 
which  appears  to  be  for  inspecting  and  cleansing  pur- 
poses. Up  this  pipe  the  gases  seemed  to  have  found 
their  way  from  the  cesspit  into  the  water-closet  room, 
and  it  is  surmised  that  the  plumber  began  to  feel  sick 
and  wanted  to  use  the  water-closet,  but  before  he  could 

10 


146  SEWER    GAS    AND    HEALTH. — APPENDIX   VII. 

do  SO  he  fainted  and  fell,  unfortunately,  so  that  h 
face  was  close  to  the  4in.  pipe,  up  which  the  gases 
ascending  from  the  cesspit  entered  his  mouth  and  nose,. 
and  so  caused  eventually  his  death.  The  seat  of  the 
water-closet  was  covered  with  fresh  excreta,  and  the 
clothes  of  the  plumber  were  soiled  with  vomited  matter, 
defaecation  having  taken  place  of  its  own  accord.  The 
face  was  not  distorted  after  death,  and  there  is  no  reason 
to  assume  that  the  poor  fellow  had  convulsions. 

Although  efforts  were  at  once  made  to  restore  life,, 
and  were  continued  for  some  considerable  time,  they 
proved  in  the  end  fruitless. 

Hankel  then  gives  full  details  of  the  post-mortem 
examination,  which,  as  he  says,  he  was  able  to  carry 
out  under  very  favourable  circumstances,  and  comes  to 
the  conclusion  that  the  cause  of  death  was  asphyxia 
resulting  from  the  inhalation  of  sewer  gas.  The  autopsy 
seems  to  have  revealed  very  little  characteristic  for  such 
a  death. 

13.  Death  in  London  Sewers    (see  also  A-42,  App.  I.). 

Mr.  T.  de  Courcy  Meade  states  that  in  the  summer 
of  1894  two  men  lost  their  lives  in  the  London  sewers. 

14.  Death  of  Three  Me7i  in  a  Seiver  at  WidneSy 
Lancashire  (A-67A,  App.  I.). 

A  very  sad  accident  happened  on  the  27th  day  of 
January,  1896,  at  Muspratt's  Chemical  Works,  Widnes, 
Lancashire,  in  which  three  men  lost  their  lives. 

It  appears  that  Patrick  Fahey  and  Luke  Farrell  were 
engaged  in  cleaning  out  a  sewer,  when  they  were  over- 
come by  sewer  gas.  Their  dangerous  position  becoming 
known,  Thomas  Atherton  pluckily  descended  the  shaft 
to  rescue  them.     He,  however,  was  also  soon  overpowered 


SEWER    GAS    AND    HEALTH. — APPENDIX  VII.  14T 

by  the  gas,  and  before  the  three  men  could  be   got   up 
they  had  perished  by  falKng  into  the  hquid. 

At  the  inquest,  the  medical  man  who  saw  the  bodies 
when  they  were  brought  up  from  the  sewer  stated  it  as 
his  opinion  that  the  gas  from  the  effects  of  which 
they  had  died  was  sulphuretted  hydrogen. 

15.  Death  of  Five  Men  from   Sulphuretted  Hydrogeji 
at  the  Tynemouth  Gasworks  (A-65a,  App.  I.). 

A  very  sad  accident,  in  which  five  men  perished, 
happened  at  the  Tynemouth  Gasworks,  North  Shields, 
on  the  20th  January,  1896.  This  fatality  shows  what  a 
very  powerful  poison  sulphuretted  hydrogen  is  and  how 
very  quickly  it  acts. 

In  this  case,  it  appears,  the  valve  in  front  of  the 
purifiers  had  been  left  open  by  a  quarter  of  a  turn,  and! 
when  two  men  descended  into  the  tank  to  remove  the 
foul  oxide  of  iron  they  were  immediately  and  without 
any  warning  overcome  by  sulphuretted  hydrogen  and 
fell  down,  apparently  in  a  fit.  Three  men  at  once  went 
to  their  rescue,  but  they  shared  the  same  fate,  and  when 
removed  out  of  the  tank  it  was  found  that  in  every 
case  life  was  extinct. 

16.  Death  of  One  Man  m  a  Sewer  at  Harpurhey,  near 
Manchester  (see  also  A-40a,  App.  I.). 

In  this  case,  a  man  named  Charles  Jones,  aged  52, 
was,  whilst  working  in  one  of  the  Manchester  sewers, 
overcome  by  sewer  gas,  and  when  removed  to  the  surface 
life  was  found  to  be  extinct. 

The  following  is  the  account  of  the  inquest  as  reportedl 
in  the  Manchester  Guardian  of   24th   September,  1896  : 

"Mr.  Smelt,  the  city  coroner,  held  an  inquiry  yesterday 
respecting    the    death   of    Charles  Jones,   52,    a    miner,. 

10* 


148  SEWER    GAS    AND    HEALTH. — APPENDIX  VII. 

lately  living  in  Higher  Burton  -  street,  Queen's  -  road, 
who  was  poisoned  by  gas  whilst  working  in  a  sewer  at 
Harpurhey  on  Tuesday  morning.  The  evidence  was  to 
the  effect  that  the  deceased  went  down  a  shaft  which 
had  been  sunk  in  Henhurst-street,  Queen's-road,  for  the 
purpose  of  driving  a  heading  to  find  an  old  sewer. 
Jones  probed  with  a  rod  in  the  direction  of  the  sewer, 
and  an  outrush  of  gas  which  came  from  it  overpowered 
him.  Patrick  Devine,  who  was  at  the  top  of  the  shaft, 
raised  an  alarm,  and  some  men  who  came  up,  at  his 
request,  lowered  him  down  the  shaft.  Just  as  he  reached 
Jones,  he  called  out  that  he  wanted  to  be  pulled  up. 
The  request  was  responded  to,  but  when  he  had  been 
lifted  five  or  six  feet  he  fell  upon  his  mate,  being  overcome 
by  the  gas.  Another  labourer  named  Higgins  then 
volunteered,  but  he  suffered  in  a  like  manner.  Some 
buckets  of  water  were  thrown  down  the  shaft,  after 
which  a  man  named  Lewis  went  to  the  rescue  of  the 
three  workmen.  He  succeeded  in  sending  up  Higgins 
and  Devine,  and  Jones  was  brought  to  the  surface  by 
another.  Jones  and  Devine  were  taken  to  the  Koyal 
Infirmary.  The  former  died  from  the  effects  of  the 
poisonous  gas,  and  Devine  is  still  an  in-patient,  but  is 
recovering.  The  jury  returned  a  verdict  of  accidental 
death.  The  coroner  commended  Higgins  and  the  others 
for  their  bravery,  and  expressed  a  hope  that  the  attention 
of  the  Corporation  would  be  drawn  to  it.  Mr.  Miller, 
from  the  town  clerk's  office,  watched  the  proceedings 
on  behalf  of  the  Corporation." 


SEWER    GAS    AND    HEALTH.— APPENDIX   VIII.  149 


APPENDIX  VIII. 

Cases  of  Septic  Poisoning  through  Sewer  Gas. 

1.    Case    of   Poisoning    at    Sutton    Coldfield    (see   also 
A-33,  App.  I.). 

The  medical  officer  for  Sutton  Coldfield,  Warwickshire, 
Prof.  Bostock  Hill,  reports  in  the  August  number 
of  "  Public  Health  "  for  1895  a  very  interesting  case,, 
in  which  he  comes  to  the  conclusion  that  very  probably 
the  septic  poison  was  introduced  through  sewer  gas.  It 
might  not  be  out  of  place  to  give  here  a  short  descrip- 
tion of  the  leading  features  of  the  case. 

The  proprietress  of  the  Wylde  Green  Hotel,  at  Sutton 
Coldfield,  had  during  Christmas,  1894,  cooked  a  soup,  and 
gratuitously  distributed  the  same  in  the  neighbourhood 
for  the  benefit  of  the  poor.  This  soup  was  prepared 
from  a  large  piece  of  salted  beef,  pearl  barley,  peaflour, 
and  vegetables,  to  which  the  broth  in  which  a  rabbit 
had  been  boiled  was  added,  the  rabbit  itself  having 
been  eaten  at  the  hotel  for  dinner  the  previous  day 
without  any  symptoms  of  poisoning. 

The  soup  was  boiled  in  a  large  iron  boiler  in  an  out- 
house of  the  hotel  on  Friday  afternoon,  the  28th 
December,  1894,  and  left  standing  in  the  same,  loosely 
covered,  till  the  next  day,  Saturday  morning,  about 
11  o'clock,  or  about  18  hours,  when  it  was  distributed. 

On  the  1st  January  the  attention  of  Prof.  Hill  wa& 
called  to  an  outbreak  of  poisoning  in  the  neighbour- 
hood of  this  hotel,  which  was  locally  attributed  to  the 
consumption  of  this  soup,  and  which  affected  about  ]00 


150  SEWER    GAS    AND    HEALTH. — APPENDIX  VIII. 

persons,  all  of  them  having  partaken  of  it.     He  describes 
the  symptoms  of  the  illness  as  follows : 

**  The  chief  symptoms  were  pain,  swelling  of  the 
abdomen,  and  purging,  followed  in  some  cases  by 
vomiting.  The  purging  generally  lasted  a  con- 
siderable time,  in  some  instances  many  days, 
despite  medical  treatment.  Great  coldness,  with 
pains  in  the  limbs  (said  to  be  in  the  bones  by  the 
patients),  were  complained  of  in  many  instances, 
and  in  one  case  a  child  nine  years  old  was  unable 
to  use  his  legs  sufficiently  to  walk  for  many  days 
after  the  onset  of  the  first  symptoms.  I  found 
that  the  symptoms  in  nearly  all  cases  did  not 
come  on  for  many  hours,  in  some  cases  as  long 
as  30,  after  taking  the  soup,  and  this,  in  my 
opinion,  contra-indicates  the  presence  of  any  form 
of  mineral  poisoning." 
Unfortunately,  one  patient  died. 

Dr.  Hill,  who  is  at  the  same  time  professor  of  hygiene 
and  public  health  and  lecturer  on  toxicology  at  the 
Mason  College,  Birmingham,  examined  the  soup  and  its 
constituents  to  see  whether  it  contained  arsenic  or 
another  mineral  irritant,  but  found  no  such  poison  in  it. 
No  suspicion  could  be  attached  to  the  water  from  which 
the  soup  was  made,  as  this  was  taken  from  the  mains 
of  the  company  which  supply  the  district,  the  sanitary 
arrangements  of  the  hotel  were  good,  and  after  a  very 
careful  consideration  of  all  circumstances  it  appeared 
that  the  soup  had  become  toxic  independent  of  the  meat 
from  which  it  had  been  made,  and  that  the  outbreak  of 
poisoning  was  due  to  the  presence  in  the  soup  of  ptomaines 
or  other  substances  generated  from  animal  matter. 

The  boiler,  which  was  said  to  have  been  used  for  the 
boiling  of  clean  water  only,  is  fixed,  as  already  mentioned. 


SEWER    GAS    AND    HEALTH. — APPENDIX  VIII.  151 

in  an  outhouse,  which  is  under  the  same  roof  as  a  stable 
and  separated  from  it  by  a  wooden  partition,  in  which 
there  is  a  door.  On  the  floor  of  the  stable  there  is  a 
drain  grating,  and  at  the  end  of  the  outhouse  near  the 
boiler  runs  up  the  ventilating  pipe  of  the  house  drain, 
while  about  20ft.  away,  and  up  the  side  of  the  hotel 
itself,  there  is  a  large  ventilating  shaft  connected  directly 
with  the  main  road  sewer. 

Concerning  the  state  of  the  public  sewer  in  the  neigh- 
^bourhood  of  the  hotel.  Prof.  Hill  remarks  : 

''  The  sewer  at  Wylde  Green  has  been  for  years 
notoriously  a  stinking  one.  To  obviate  the  nuisance 
caused  to  residents  and  those  travelling  along  the 
road,  the  crown  ventilator  at  this  part  of  it  was 
stopped  up,  and  by  permission  a  large  6in.  shaft 
was  erected  against  the  wall  of  the  hotel.  That 
gases  of  an  offensive  kind  were  given  off  from  this, 
I  know  to  be  the  case,  because  nuisance  had  been 
complained  of  by  the  proprietress  of  the  hotel  in 
one  of  the  rooms  close  to  where  it  was  fixed  ;  and 
to  obviate  this  nuisance  a  register  grate  had  been 
put   in,    so   that   the   evil-smelling   gas   might    be 

shut  out  from  the  room " 

•^*  These  facts  may,  I  think,  throw  some  light  on  the 
matter.  It  is  quite  likely  that  on  the  Friday 
night  sewer  gas  was  discharged  from  the  sewer 
ventilators,  and  as  this  became  colder  it  would 
become  heavier,  and  therefore  fall  if  not  rapidly 
diffused.  This  being  so,  it  is  highly  probable  that 
some  descended  the  chimney  of  the  outhouse, 
,and  gained  access  to  the  soup  in  the  boiler,  and 
in  this  way  started  septic  change.  It  is,  of  course, 
impossible  definitely  to  say  that  this  was  the  case, 
ibut  bearing  in  mind  that  the  symptoms  point  to 


152  SEWJ:R    gas    and    health.— appendix  VIII. 

the    poison   being   septic,   or   of    animal   origin,   I 
cannot  at  the  present  time  discover  a  cause  more 
likely  to  have  produced  the  outbreak." 
That  the  gases  escaping  at  the  top  of  a  soil-pipe  some- 
times descend  again  is,  1  believe,  an  admitted  fact,   and 
I   have    repeatedly   observed   it   when   smoke- testing  the. 
drains  of  a  house.     In  support  of  this.  Prof.  Hill  quotes 
his    experience   on  two  occasions   in  the  winter  of  1895,. 
when  he  observed  in  his  own  house  smoke  from  another 
chimney  descending  and  entering  a  room  in  which  there 
was  no  fire.     This  happened  each   time  in   the  evening, 
and  although  the  cold  chimney  through  which  the  smoke 
descended  had  a  good  draught  when  there  was  a  fire  in  it. 

Whilst  the  medical  officer  was  engaged  in  these  inves- 
tigations one  of  the  patients  died,  and  in  consequence  a 
portion  of  the  soup  was  forwarded  to  Dr.  Klein  for 
bacteriological  examination.  It  is  to  be  very  greatly 
regretted  that  this  course  was  not  at  once  adopted  after 
the  outbreak,  as  the  soup  was  nearly  three  weeks  old 
before  Dr.  Klein  could  examine  it ;  and  although  January 
was  a  cold  month,  it  is  clear  from  Dr.  Klein's  report 
that  fermentative  changes  had  taken  place  in  it. 

As  this  report  is  of  considerable  importance,  I  will  give 
it  here  in  full,  as  follows  : 

*'  On  January  24th,  I  received  a  glass  jar  of  fluid, 
material,  tied  with  a  membrane.  The  material  in 
the  jar  had,  on  opening,  a  sour  smell,  and  gave  a. 
strong  acid  reaction.  It  was  a  thick  film,  con- 
taining various  vegetables,  fat,  and  bits  of  flesh. 
Under  the  microscope,  besides  these  substances,, 
there  was  seen  a  multitude  of  microbes ;  in 
fact,  the  whole  material  was  crowded  with  them. 
Amongst  these  could  be  recognised  various  forms 
of  bacilli,   differing  from   one   another  in  lengthy 


SEWER    C4AS    AND    HEALTH. — APPENDIX  VIII.  15^ 

and  numerous  yeast  cells.     Cultivations  were  at 
once  made,   so  as  to  isolate  the  microbe.     These 
cultivations    yielded     the    following    microbes    in. 
colonies :     (1)    torula,    or  yeast,     very     copiously 
present ;    (2)    a    short     non-mobile    bacillus,    not 
liquefying  gelatine,  fairly  abundant;   (3)  a  bacillus 
which  proved  on  sub-culture  to  be  closely  related 
to   the   typical  bacillus   coli — this   microbe   is  the 
normal   inhabitant  of   man    and   animals,   and   is 
a   prominent   microbe   in   sewage:  in  the  soup  it 
was  present  in  considerable  numbers;  (4)  a  bacillus 
which    also   proved   on   sub-culture    to   be    closely 
related   to    the   bacillus    coli,   but    must  be    con- 
sidered as  a  variety  of  the  typical  bacillus  coli — 
it   is    also   a   normal    inhabitant   of    sewage,    and 
was   present   in   enormous   numbers  in   the   soup.. 
Experiments  were  made  with  the   soup  and   with 
the    cultivations    obtained     from    it :    (a)    feeding 
mice   with   the  soup   produced    no  ill-effect;    this 
result  does  not  prove   much,   since  the   time  that 
had     clasped   since    the    consumption   by    human 
beings      at    Wylde     Green    and    the    experiment 
made  here   was  considerable,  and  as  it  is  known, 
that   organic  substances,   poisonous    at  one  time, 
lose  their    action    when    exposed    to    fermentative 
changes ;     (b)    inoculations    of    guinea-pigs    with 
cultures  of  the  microbes  (3)  and   (4)  bacillus  coli 
and  variety  proved  these  microbes  to  be  virulent,, 
particularly  microbe  (4),  which  is  highly  virulent ;. 
(c)    inoculation   of   guinea-pigs    with   microbe    (1> 
and    (2)  had  no   ill-effect ;    (d)  microbe    (4)  multi- 
plies  extremely   rapidly   in    beef-broth   kept   at   a 
body   temperature — that   is,     about    37deg.    C. — 
which  turned   the  broth  very  turbid  in  24  hours,. 


164  SEWER   GAS    AND    HEALTH. — APPENDIX  VIII. 

the  broth  being  filled  with  microbes.  In  addition, 
there  are  present  by  this  time  numerous  flocculi 
entirely  made  up  of  the  bacilli.  If  the  broth 
culture  is  subjected  to  filtration  by  which  these 
bacilli  are  separated  from  the  fluid,  and  this 
latter  is  injected  in  small  quantities  (0*5  c.  c.) 
into  guinea-pigs,  it  is  found  that  they  die  in 
from  six  to  eight  hours  under  symptoms  of  acute 
poisoning.  From  this  it  is  then  clear  that  this 
microbe  is  capable  of  rapidly  forming  in  the 
broth  a  poisonous  chemical  substance.  In  con- 
<3lusion,  from  the  foregoing  observations  the 
following  conclusions  can  be  drawn  :  (1)  the  soup 
<iontained  microbes  which  were  derived  from 
sewage,  and  it  is  thereupon  highly  probable 
that  the  soup  had  been  polluted  with  sewage. 
Amongst  the  microbes  present  in  the  soup,  the 
bacillus  mentioned  as  a  variety  of  the  bacillus 
coli  is  possessed  of  virulent  properties  on  account 
of  its  extremely  rapid  multiplication  at  the  body 
temperature,  and  the  poisonous  substance  it 
elaborates.  It  is  most  probable  that  this  microbe 
caused  the  consumers  of  the  soup  the  ill-effects 
and  the  disease.  This  bacillus,  it  will  be 
remembered  from  the  foregoing  paragraph,  was 
present  in  the  soup  in  enormous  numbers." 
After  making  further  investigations  into  the  possibility 
of  the  pollution  of  the  soup  with  liquid  sewage,  either 
intentionally  by  some  evil-disposed  person  or  accidentally 
by  leakage  from  some  pipe  or  otherwise.  Prof.  Hill 
•concludes :  [v  i, 

"  I  have  previously  remarked  that  the  night  was  a 
cold  one,  so  that  the  sewer  gas  coming  from  the 
top  of  this  shaft  would  become  heavier  as  it  cooled, 


SEWER    GAS    AND    HEALTH. — APPENDIX  VIII.  155 

rand  would  thus  tend  to  sink  lower  in  the  atmo- 
sphere ;  and  my  belief  is  that  this  sewer  gas  in 
question  did  gain  access  to  the  outhouse  by  way 
of  the  chimney,  and  that  in  this  way  the  soup 
was  contaminated  with  those  micro  -  organisms 
which  were  found  by  Dr.  Klein.  I  do  not  by 
any  means  lay  this  down  dogmatically,  but  after 
a  very  careful  consideration  of  all  the  local 
circumstances,  I  see  no  method  more  likely  of 
contamination  of  the  soup  with  the  micro-organisms 
of  sewage." 

2.  Cases  reported  by  Dr.  Fenton  (see  also  A-26,  App.  I.). 

In  the  discussion  on  Dr.  B.  Hill's  paper,  given  above, 
Dr.  Fenton,  the  medical  officer  of  health  for  Coventry, 
related  two  cases  of  meat-poisoning  which  had  occurred 
within  his  own  knowledge. 

In  the  first  case,  a  piece  of  green  salted  pork  had 
been  exposed  in  a  pantry  over  an  untrapped  drain,  and 
had  produced  choleraic  symptoms,  although  nothing  could 
be  found  by  Dr.  Klein. 

In  the  second  case,  beef  exposed  to  sewer  gas  had 
produced  severe  alkaloidal  poisoning  in  those  who  had 
partaken  of  it. 


156  SEWER    GAS    AND    HEALTH. — APPENDIX  IX. 


APPENDIX   IX. 

Cases  where  Outbreaks  of   Typhoid  Fever  have  been. 
Traced  to  Sewer  Gas. 

1.   Buchanan's  Historical  Gases   (see  also  A-13  to   16,. 

App.  L). 

It  is  not  contended  that  the  late  Sir  George  Buchanan 
was  the  first  to  trace  outbreaks  of  typhoid  fever  to- 
emanations  from  the  sewers,  but  it  is  perhaps  correct  to- 
say  that  he  was  the  first  to  systematically  investigate 
several  such  outbreaks,  and  to  attribute  them  to  this 
cause  as  a  result  of  his  researches.  It  would  lead  toa 
far  to  give  particulars  of  his  classical  investigations,  and 
such  a  course  would  be  further  hardly  necessary,  as 
they  are  well  known.  I  will,  therefore,  only  mention 
that  in  the  epidemics  of  typhoid  fever  at  Worthing  in 
1865  (Ninth  Eeport  Medical  Officer  of  the  Privy  Council), 
and  at  Croydon  in  1875  (Appendix  to  Keport  Medical 
Officer  of  the  Privy  Council  and  Local  Government 
Board,  New  Series,  No.  VII.),  Buchanan  came  to  the 
conclusion  that  sewer  gas  had  entered  the  interior  of 
the  houses  and  thus  brought  about  the  outbreak,  whereas 
in  the  local  epidemic  of  typhoid  fever  at  Caius  College,. 
Cambridge,  in  1874  (Eeport  Medical  Officer  of  Privy 
Council  and  Local  Government  Board,  No.  II.,  1874),. 
he  was  of  opinion  that  sewer  gas  entered  the  water- 
supply  pipes,  and  thus  brought  about  its  pollution. 
Concerning  the  Worthing  epidemic,  Buchanan  remarks- 
that,  in  his  opinion,  the  absence  of  any  attempt  to> 
ventilate    the   sewers,   and  the  fact  that   sewer  gas  had. 


SEWER    GAS    AND    HEALTH. — APPENDIX   IX.  157 

been  forced  up  into  the  houses  through  the  water-traps 

of  sinks  and  water-closets  was  the  cause  of  the  outbreak. 

As   a  positive    demonstration    of    this   he   mentions   the 

following  facts  : 

"The  fever  almost  exclusively  attacked  well-to-do 
houses  on  the  higher  levels,  where  the  water- 
closets  were  inside  the  houses,  and  almost 
entirely  spared  the  houses,  mostly  of  a  much 
poorer  sort,  situated  on  lower  levels,  where  the 
closet  was  put  outside  the  house.  It  was  not  so 
in  the  times  of  cesspools ;  then  these  low-lying 
poor  houses  were  far  more  attacked  with  fever 
than  the  others.  Moreover,  the  fever  subsided  as 
soon  as  openings  were  made  into  the  sewers, 
from  certain  houses  where  it  before  maintained 
itself  for  months."  (Quoted  by  L.  Parkes  in  "  Is 
Sewer  Air  a  Source  of  Disease?") 
In   reference   to   the    epidemic    in    Croydon   in    1875, 

Buchanan   remarks    (quoted   by  L.  Parkes    in  the  same 

place) : 

"  Where  sewers  are  small  and  ill-ventilated  they  con- 
stitute perfectly  sufficient  means  for  the  rapid 
distribution  of  fever  infection ;  and  places  having 
such  sewers  may  not  only  show  fever  rates  main- 
tained as  high  as  before  the  sewers  were  made, 
but  they  may  show  as  smart  outbursts  of  fever 
as  are  witnessed  where  conveyance  through  water 
or  milk  is  in  question.  Croydon  itself,  after  it 
had  made  its  sewers  and  before  it  attempted  to 
ventilate  them,  had  this  experience.  So  in  other 
instances  that  have  come  under  my  personal 
knowledge,  fever  has  maintained  itself  after  pipe 
sewers,  ill  -  ventilated,  had  been  made,  as  in 
Eugby,   in   Carlisle,  in   Chelmsford,  in  Penzance, 


158  SEWER    GAS    AND    HEALTH. — APPENDIX  IX. 

in  Worthing;  in  the  last  two  places  breaking^ 
out  in  severe,  sudden,  and  diffused  epidemics, 
without  there  being  any  question  of  other  dis- 
tribution than  by  sewers." 

2.  Cases  reported  by  Dr.  Blaxall  (see  also  A-9  to  11,. 

App.  L). 

An  outbreak  of  enteric  fever  at  Melton  Mowbray  in 
1880  was  traced  by  Dr.  Blaxall  to  the  occurrence  of  floods, 
which  caused  the  backing  up  of  sewage  specifically 
infected  by  typhoid  evacuations  in  the  flat  sewers,  and 
thus  forced  the  sewer  air  to  enter  the  houses  through 
untrapped  drain  inlets  and  dry  water-closet  traps. 

The  same  observer  reports  an  outbreak  of  enteric- 
fever  at  Sherborne  in  1882,  which,  in  his  opinion,  was 
caused  through  the  contamination  of  the  water-mains 
by  sewer  air,  the  water-closets  of  houses  being  in  direct 
communication  with  the  water-supply  pipes. 

3.  Case  reported  by  Dr.  Airey  (see  also  A-3,  App.  I.). 

An  outbreak  of  enteric  or  typhoid  fever  at  York  in 
1884  was  traced  by  Dr.  Airey,  of  the  Local  G-overnment 
Board,  to  '^  the  exhalations  from  the  ill- ventilated  sewers 
under  the  influence  of  a  very  dry  and  warm  season." 

4.  Great  Number  of  Other  Cases. 

A  very  large  number  of  other  cases  could  be  quoted — 
in  fact,  it  is  not  too  much  to  say  that  every  year  fresh 
cases  are  reported  by  medical  officers  of  health  and 
general  practitioners  in  which  the  cause  of  an  outbreak 
of  typhoid  fever  is  attributed  to  sewer  gas  ;  but,  although 
some  of  them  have  been  investigated  with  great  care, 
it  would  lead  too  far  to  mention  them  here  separately. 
It  must  suffice  to  say  that  in  this  country  it  is  almost 


SEWER    GAS    AND    HEALTH. — APPENDIX   IX.  159' 

a  doctrine  of  practical  faith  that  there  exists  a  causal 
relation  between  sewer  gas  and  typhoid  fever,  and  that 
this  doctrine  is  supported  by  strong  evidence.  Those 
who  wish  to  study  this  question  more  in  detail  will  find 
ample  material  in  the  reports  of  the  medical  inspectors 
of  the  Local  Government  Board  and  in  the  annual  reports 
of  the  medical  officers  of  health,  not  to  mention  the  cases 
which  are  from  time  to  time  reported  in  the  medical  and 
other  periodicals  {Lancet,  British  Medical  Journal,. 
Health,  etc.), 

I  will  only  quote  two  more  cases,  which  have  happened 
within  the  last  few  years. 

5.  Enteric  Fever  at  the  Foundling  Hospital,  1891, 
reported  by  Dr.  John  F.  J.  Sykes  (see  also  A-61, 
App.  I.). 

In  this  case,  Dr.  Sykes  proved  that  excreta  were 
backwatered  into  the  main  grease-trap  of  the  hospital, 
situated  near  the  kitchen,  which  was  connected  with 
the  coppers  in  which  the  food  for  the  inmates  was 
prepared,  and  he  concludes  that  in  this  way  typhoid 
stools  got  into  the  grease-trap,  which  would  undoubtedly 
form  a  very  good  incubation  chamber,  whence,  borne 
by  the  sewer  air,  the  typhoid  germs  found  their  way 
through  the  coppers  into  the  kitchen  and  house.  During 
cooking,  the  taps  in  the  pipes  leading  from  the  coppers 
to  the  grease- trap  would,  of  course,  be  closed,  and  the 
typhoid  germs  in  the  coppers  destroyed  through  the  heat 
necessary  for  this  process.  After  the  food  had  been 
served  and  consumed,  the  taps  in  the  coppers  would 
be  opened  for  cleansing,  and  it  was  probably  the  steri- 
lisation that  saved  the  food  supplies  from  infecting  the 
; whole  of  the  residents  in  the  institution. 


a  60 


SEWER    GAS    AND    HEALTH — APPENDIX   IX. 


The  report   contains  many  points  of  interest,    and   is 
well  worth  a  careful  study. 

6.  Outbreak  of  Typhoid  Fever  at   a   Fever  Hospital 
at  Leeds  (see  also  A-17a,   App.  I.). 

In  the  Surveyor  of  the  29th  October,  1897,  the 
medical  officer  of  health  for  Leeds,  Dr.  J.  Spottiswoode 
•Cameron,  reports  the  following  case  : 
■  "  The  hospital  buildings  consisted  of  three  blocks, 
roughly  indicated  on  the  diagram.  Block  A  was  a 
disused  township  workhouse,  which,  along  with  block  B, 


D?x»ju«.^wymCo»vly" 


:a  one-storey  building  erected  by  the  Guardians  many 
years  before  for  ordinary  hospital  purposes,  was  pur- 
chased by  the  Town  Council  for  treatment  of  small-pox 
in  1872.  When  the  outbreak  was  over,  these  buildings 
were  used  by  the  Corporation  for  the  isolation  of 
other  diseases.  Block  A,  the  original  workhouse,  was 
utilised  as  an  administration  block,  but  occasionally 
typhoid  patients  were  admitted,  generally  into  the  room 
■on  the  first  floor  marked  a,  less  frequently  into  that 
marked  6,  and  even  occasionally  into  c  and  d  on  the 
£rst  floor.     The  motions  of  such  patients,  after  disinfec- 


i 


SEWER    GAS    AND    HEALTH. — APPENDIX   IX.  161' 

tion,  were  passed  down  the  basin  of  a  recently-constructed 
long  hopper  water-closet  on  the  first  floor,  built  off  a 
passage  which  intersected  the  house  north  and  south. 
Eoom  e  on  the  first  floor  was  occupied  by  a  nurse,  / 
was  a  linen-closet,  g  a  nurses'  bedroom,  and  h  the 
matron's  bedroom ;  all  these  on  the  first  floor.  On 
the  ground  floor  under  e  was  a  bathroom,  adjacent  to 
which,  and  immediately  under  the  one  on  the  first 
floor,  was  a  water-closet  opening  off  the  passage.  The 
rooms  under  /  and  g  were  kitchens,  h  was  the  matron's 
sitting-room.  The  remaining  rooms  were  only  used  for 
storage.  There  was  ample  cellerage,  chiefly  under  / 
and  g.  The  bathroom  wastes  and  kitchen  wastes  were 
disconnected  from  the  drains,  but  the  keeping  cellar 
under  /  had  a  trap  in  the  floor.  In  B,  the  sink  in  the 
nurses'  kitchen  w^as  disconnected  outside  over  a  gully 
in  the  ordinary  way ;  the  two  water-closets  in  B  each 
had  a  second  trap  ;  they  were  then  connected  with  the 
drain  coming  from  the  one-storey  washhouse,  j,  and 
taking  also  the  drainage  from  the  two  water-closets,, 
the  disconnected  bath  wastes,  the  disconnected  kitchen 
wastes,  and  the  undisconnected  waste  from  the  cellar; 
all  from  the  building  A.  The  Corporation  erected  a  new 
and  separate  pavilion,  C,  which  was  opened  in  1881. 
The  drainage  of  this  building  was  conducted  by  an 
entirely  separate  drain  to  the  main  sewer  in  the  street. 
The  water-closets  in  this  building  were  entered  each 
through  a  separate  cross-ventilated  ante-room  from  the 
ward ;  each  closet  soil-pipe  was  doubly  trapped ;  the 
bathroom  wastes  were  disconnected  outside,  as  were 
also  the  waste  from  the  kitchen  and  surgery.  At  the 
time  the  limited  outbreak  of  typhoid  occurred,  block  B 
was  used  for  typhoid  patients,  block  A  only  for 
administration,     block    C     entirely    for     scarlet     fever.. 

11 


162  SEWKR    GAS    AND    HEALTH  — APPENDIX   TX. 

Within  a  few  days  of  one  another  (I  am  now  speaking 
from  recollection)  two  nurses  attending  typhoid  patients 
in  B,  and  sleeping  in  A,  but  not  in  any  way  engaged 
in  C,  two  children  who  had  gone  home  from  C  con- 
Talescent,  and  who  had  never  been  in  B,  and  a  day  or 
two  later  one  or  two  other  children  patients  in  0,  sickened, 
evidently  with  typhoid.  The  husband  of  the  matron, 
resident  as  caretaker  of  the  establishment  but  livinjj; 
entirely  in  A,  had  also  a  feverish  attack,  but  not  very 
well  defined.  The  only  food  common  to  all  these 
patients  was.  milk,  some  of  the  children  in  C  having 
had  at  the  time  of  the  attack  no  other  food  than  milk> 
and  all  the  other  patients  having  had  milk,  the  care- 
taker least.  The  first  thing  done  was  to  direct  that 
the  milk  brought  to  the  hospital  should  be  taken  to 
«ach  separate  block.  Before  it  had  all  been  taken  to 
A,  where  it  was  kept  in  the  cellar,  /.  This  pre- 
cautionary measure  was  adopted  before  the  diagnosis 
was  quite  certain.  We  then  obtained  from  the  milkman 
a  list  of  all  the  farms  from  which  he  got  any  milk. 
We  found  no  evidence  of  fever  at  any  of  them  or  among 
any  persons  working  there.  Moreover,  the  persons 
among  whom  the  same  milk  dealer  distributed  his  milk 
elsewhere  in  the  town  were  not  specially  attacked  by 
typhoid  fever,  which  existed,  but  to  no  very  marked 
degree,  in  the  borough,  and  not  more  among  this  man's 
customers  than  among  those  of  other  dealers.  It  would 
thus  seem  that  if  the  milk  were  the  cause  of  the 
typhoid,  it  had  received  the  infection  after  it  reached 
the  hospital.  No  new  case  of  typhoid  occurred  which 
could  have  received  the  infection  after  the  date  when 
the  milk  was  delivered  directly  to  the  separate  blocks. 
It  seemed,  therefore,  probable  that  the  milk  received 
the   infection    in   the    cellar.     I    am    not    able    to    say 


SEWER    GAS    AND    HEALTH. — APPENDIX   IX.  163 

■whether  there  was  any  water  in  the  trap  connecting  the 
.small  grate  in  the  cellar  floor  with  the  drain.  There 
was  no  trap  in  the  cellar,  and  it  is  not  impossible  that 
the  trap  may  have  been  dry.  My  own  reading  of  the 
^case  was  that  through  this  trap  the  milk  had  been 
infected  by  typhoid  poison  from  the  drain.  It  was 
found  afterwards  that  the  soil-pipe  from  the  block  A 
had  been  badly  connected  with  the  drain,  and  that 
faecal  matter  had  collected  at  the  base.  Three  con- 
•ditions  seemed  to  have  conspired  to  infect  the  milk:  (1) 
the  actual  typhoid  germ ;  (2)  the  culture  medium  of 
filth;  and  (3)  the  opportunity  for  sewer  gases  to  pass 
into  the  milk.  I  use  the  words  '  sewer  gases '  as  Mr. 
Koechling  does — to  signify  not  only  gases  but  solids 
•carried  by  them.  The  trap  was  in  the  cellar  floor.  The 
stone  table  on  which  the  milk  was  kept  was  some  3ft. 
higher.  If  my  supposition  be  correct,  the  bacteria  must 
have  travelled  for  a  considerable  distance  through  the 
.air  in  order  to  reach  the  milk.  The  evidence  that  it 
was  the  infection  of  the  milk  that  caused  the  outbreak 
rested  principally  upon  the  fact  that  some  children 
whose  only  food  was  milk,  and  who  were  entirely 
separated  from  the  nurses  (who  also  drank  milk,  but 
who  did  not  enter  the  block  in  which  these  children 
were),  developed  the  disease  at  about  the  same  time 
as  these  nurses,  and  that  no  fresh  case  received  the 
infection  after  the  milk  ceased  to  be  placed  in  the 
•cellar." 

7.  Case    reported    by    H.   Alfred  Boechling    (see   also 
A-52D.,  App.  I.). 

Mr.  Pioechling  reports  a  case  of  typhoid  fever  in  a 
house  with  faulty  drainage  in  the  Journal  of  the 
.Sanitary  Institute  for  1897,  Vol.  XVIII.     The  case  was 

IP 


164  SEWER    GAS    AND    HEALTH. — APPENDIX   IX. 

carefully  examined  by  him,  and  is  in  many  respects- 
interesting ;  it  is  accompanied  by  a  plan  of  the 
premises. 

8.  Gases  reported  on  the  Continent. 

A  number  of  cases  in  which  sewer  gas  is  said  to- 
have  led  to  an  outbreak  of  typhoid  fever  are  reported 
by  German  writers,  and  Dr.  Uffelmann,  who  was  a 
prominent  sanitarian  and  a  very  careful  observer,, 
maintained  that  it  was  an  established  fact,  that 
houses  into  which  sewer  gas  entered  periodically  were 
frequently  visited  by  diphtheria,  malaria,  and  typhoid 
fever.  At  the  meeting  of  the  German  Association 
of  Public  Health  in  1895,  Dr.  Goepel  (see  B-23,  App.  I.) 
reported  an  interesting  case  from  Frankfurt  -  on  -  the  - 
Oder,  where  a  house  was  never  without  a  typhoid-fever 
case  until  the  drainage  was  seen  to  and  improved. 

Further  particulars  will  also  be  found  in  the  very 
interesting  investigations  of  Dr.  Lissauer  (B-36,  App.  I.)- 
at  Danzig,  concerning  the  entrance  of  sewage  gas  into« 
houses. 


SEWER    GAS    AND    HEALTH. — APPENDIX   IXa.  165 


APPENDIX   IXa. 

Other     Effects    of      Sewer    and     Cesspit     Gas    not 
previously  referred  to. 

1.  Case  of  Blood-Poisoning  through  Sewer  Gas  (see  also 
A-21A,  App.  I.). 

This  is  a  very  sad  case,  in  which  a  Mr.  Smith,  of 
Birmingham,  is  stated  to  have  died  through  blood- 
poisoning  caused  by  sewer  gas  {cause  celehre). 

The  executors  of  the  late  Mr.  Smith  sued  the  King's 
Norton  Kural  District  Council  for  damages  for  Mr.  Smith's 
death,  and  at  the  hearing  of  the  action  several  medical 
men  expressed  the  opinion  that  the  death  was  caused 
through  blood-poisoning  brought  about  by  sewer  gas. 
This  was,  of  course,  strongly  contested  by  the  other 
side,  but  in  the  end  the  jury  found  for  the  plaintiffs, 
and  gave  a  verdict  for  ^3,500,  which  amount  was  after- 
wards reduced  to  ^2,875,  in  consideration  of  the 
^acceleration  of  the  payment  of  some  insurance  money. 

The  following  is  the  account  of  the  trial  as  reported 
in  the  Contract  Journal  of  the  12th  August,  1896,  with 
the  sketches  of  the  locality : 

At  the  Birmingham  Assizes,  August,  1896,  before 
Mr.  Justice  Collins  and  a  special  jury,  an  action  was 
I  tried  in  which  the  plaintiffs  were  Messrs.  James  Smith 
"(the  Lord  Mayor  of  Birmingham),  William  Cecil  Smith, 
and  Halliwell  Eogers,  executors  of  the  late  Mr.  Thomas 
Henry  Smith,  and  the  defendants  the  King's  Norton 
Eural  District  Council.  The  action  was  brought  in 
ihe  interest  of  the  widow  and  six  children  of  the 
leceased  gentleman   to  recover   damages   for  negligence. 


166 


SEWER    GAS    AND    HEALTH. — APPENDIX   IXa. 


The  deceased  gentleman  had  lived  at  Daylesford,  Wake- 
Green-road,  Moseley,  and  it  was  alleged  on  behalf  of 
the  plaintiffs  that  he   died  from   illness  caused  by  the- 


6fie»KfAsr    Room 


h       'i^r 


defendants  wrongfully  breaking,  and  entering,  and  putting,., 
and  continuing  to  maintain,  a  ventilating  shaft  from  a 
sewer   into   a   chimney    of    Daylesford,    or    alternatively 


SEWER    GAS    AND    HEALTH. — APPENDIX   IXa.  167 

that  the  defendants  constructed  the  work  in  a  negligent 
manner,  or  allowed  the  same  to  get  into  bad  order, 
whereby  sewer  gas,  in  or  about  January  last,  escaped 
into  the  house,  and  caused  the  illness  and  death. 

The  defendants  denied  that  damage  had  been  suffered 
through  their  negligence ;  that  they  had  been  guilty  of 
negligence;  that  they  carried  a  ventilating  shaft  from 
the  manhole  into  the  chimney ;  or  that  any  sewer  gas 
escaped. 

Mr.  Murphy,  Q.C.,  and  Mr.  Hugo  Young  (instructed 
by  Messrs.  Eyland  and  Co.)  appeared  for  the  plaintiffs; 
and  Mr.  Jelf,  Q.C.,  Mr.  Alfred  Young,  and  Mr.  Pritchett 
(instructed  by  Mr.  Edwin  Docker)  for  the  defendants. 

In  opening  the  case,  Mr.  Murphy  said  the  enquiry 
would  be  of  an  important  character  to  both  parties, 
important  to  the  executors,  who  claimed  compensation 
for  the  loss  of  a  valuable  life  in  which  they  were 
interested,  and  to  the  defendants,  because  if  the  plaintiffs' 
case  was  well  founded  there  had  been  very  great  neglect, 
for  which  they  ought  to  be  made  responsible.  The 
late  Mr.  Smith  had  been  the  tenant  since  1890  of 
Daylesford,  which  fronted  Wake  Green-road  and  School- 
road,  Moseley.  On  January  9  last  he  disclosed  symptoms 
of  blood-poisoning,  and  on  April  28  he  died.  A  post- 
mortem examination  showed  that  the  view  of  the  doctors 
was  correct,  and  that  it  was  a  case  of  blood-poisoning 
caused  by  sewer  gas.  The  defendants  were  the  King's 
Norton  Eural  District  Council,  and  by  the  terms  of  a 
recent  Act  of  Parliament  the  responsibilities  and  liabilities 
of  the  former  sewer  authority  became  vested  in  them. 
In  the  month  of  December  Mr.  Smith  suffered  from 
sore  throat,  which  might  or  might  not  have  been  con- 
nected with  the  sewer  gas.  On  January  6,  Mr.  Augustus 
Clay   was   called   in.     He   prescribed,   and   his   attention 


168  SEWER   GAS    AND    HEALTH. — APPENDIX  IXa. 

"was  drawn  to  the  possibility  of  the  illness  occurring 
from  the  state  of  the  drains.  Upon  enquiry  it  was 
found  that  the  drains  had  been  examined  in  1889,  and 
everything  that  was  then  known  to  be  necessary  was 
done.  At  a  subsequent  date  Dr.  Carter  was  called  in, 
.^nd  afterwards,  in  February,  Sir  Willoughby  Wade,  who 
came  to  the  conclusion  that  the  illness  was  consistent 
with  an  escape  of  sewer  gas.  The  family  were  alarmed, 
and  one  of  the  present  plaintiffs,  Mr.  James  Smith, 
applied  for  the  assistance  of  the  sanitary  inspector  of 
the  Corporation  of  Birmingham  to  assist  in  finding  out 
what  was  the  matter.  On  February  28  he  communicated 
with  Mr.  Houghton,  the  sanitary  inspector  of  Moseley, 
and  an  examination  was  made.  In  the  cellar  was  dis- 
covered an  escape  of  some  deleterious  gas,  which,  however, 
was  not  suJB&cient  to  account  for  the  condition  of  the 
•deceased.  Subsequently  a  more  exhaustive  inspection 
was  made,  and  as  the  defendants  would  give  them  no 
information,  the  parties  acting  for  the  plaintiffs  made  a 
trench  round  the  house,  and  found  a  pipe  running  from 
a  manhole  at  the  corner  of  School-road  and  Wake 
Green-road,  which  pipe  was  continued  up  the  flue  of 
the  house  chimney.  In  its  course  it  passed  the  library 
in  which  Mr.  Smith  passed  his  evenings  and  the  bed- 
room in  which  he  slept.  The  occupants  of  the  house 
knew  nothing  about  that  shaft,  but  Mr.  Godfrey,  the 
chief  surveyor  of  the  defendants,  knew,  for  the  flue  was 
constructed  to  his  knowledge  and  under  his  superinten- 
dence in  1885.  On  discovery  of  that,  a  smoke  test  was 
applied,  and  it  was  found  that  smoke  put  into  the  drain 
at  the  manhole  ascended  into  the  library  and  the  bed- 
room, and  when  put  in  at  the  other  end  came  out  at 
the  manhole.  The  shaft  was  constructed  in  a  most 
negligent  and   slovenly  manner.     The  joints  did  not  fit, 


SEWER    GAS    AND    HEALTH.— APPENDIX   IXa.  169 

^nd  in  one  place  there  was  a  complete  aperture.  There 
was  an  imperfect  obstruction  at  the  manhole,  consisting 
of  brickwork  with  the  mortar  still  wet.  Mr.  Murphy 
went  on  to  say  that  in  1884  the  land  was  vacant,  and 
permission  was  given  to  the  local  authority  to  run  up 
a  ventilating  shaft  by  the  side  of  a  tree.  In  1885  Mr. 
Gough  wanted  to  build  a  house  on  the  land,  and  he 
submitted  plans.  He  complained  of  the  ventilating 
shaft  against  the  tree,  and  asked  for  its  removal.  Mr. 
Godfrey  claimed  the  right  to  keep  it  there,  or  to  get 
some  exchange  for  it,  and  he  pressed  Mr.  Gough  to 
give  him  a  ventilating  shaft  to  run  up  the  chimney  of 
the  house,  and  permission  was  given.  Mr.  Murphy  then 
indicated  the  extent  of  the  deceased's  business  and  the 
pecuniary  loss  which  his  family  had  suffered. 

The  medical   evidence  was   first  taken. 

Mr.  Augustus  Clay,  surgeon,  Moseley,  said  he  attended 
the  late  Mr.  Smith  during  his  illness,  being  first  called 
in  on  December  23.  He  had  a  sore  throat  and  slight 
febrile  symptoms.  The  next  day  he  went  to  his  office 
for  a  few  hours.  Witness  did  not  see  him  again  until 
January  7,  when  he  had  a  sore  throat,  fever,  and 
bronchial  catarrh.  Witness  suspected  some  form  of 
blood-poisoning.  On  January  11  Dr.  Carter  was  called 
in  in  consultation,  and  on  February  17  there  was  a 
marked  change  in  deceased's  condition.  He  then  had 
pneumonia  of  the  right  lung,  which  continued  until  his 
death.  On  discovering  the  pneumonia,  there  was  another 
consultation  with  Dr.  Carter;  and  on  February  27  Sir 
Willoughby  Wade  was  called  in.  He  entirely  agreed 
that  deceased  was  suffering  from  blood-poisoning  in 
some  form.  On  March  2  deceased  was  removed  to 
witness's  house.  Sir  Willoughby  Wade  said  the  drains 
^bout  Daylesford  must  be  examined.     As  time  progressed 


170  SEWER   GAS    AND    HEALTH. — APPENDIX  IXa. 

the  patient  became  weaker,  and  on  April  23  he  diecf 
very  suddenly  from  blood-poisoning.  A  post-mortem 
examination  was  made.  The  blood-poisoning  was  such 
as  he  should  expect  to  find  in  a  man  who  had  been 
exposed  to  sewer  gas. 

By  Mr.  Jelf :  From  his  enquiries  he  found  that  the 
deceased  gentleman  had  had  pneumonia  about  ^Ye  years 
ago,  and  was  then  dangerously  ill.  About  the  end  of 
the  second  week  in  January  witness  formed  the  opinion 
that  deceased  was  suffering  from  blood-poisoning.  Witness 
was  assured  by  the  relatives  that  the  drains  were  all 
right.  Besides  deceased,  there  lived  in  the  house  Mrs. 
Smith,  several  children,  and  servants.  Assuming  the 
drains  at  Daylesford,  apart  from  the  ventilating  shaft, 
were  defective,  he  should  not  think  that  would  be 
sufficient  to  set  up  the  blood-poisoning;  but  assuming 
there  was  pent-up  sewer  gas  in  the  drains,  of  course 
it  would  be  very  dangerous.  He  did  not  know  that 
the  whole  state  of  the  drainage  was  very  defective,  had 
been  condemned,  and  had  had  to  be  reconstructed.  He 
should  say  deceased,  who  was  51  years  of  age,  was 
ordinarily  a  very  healthy  man. 

Dr.  Carter  spoke  to  seeing  the  late  Mr.  Smith  five 
years  ago,  when  he  was  ill  from  pneumonia.  He  was 
then  living  at  Daylesford.  In  the  last  illness,  witness 
was  called  in  on  January  11.  He  found  deceased  in 
a  very  weak  and  prostrate  condition,  without  anything: 
of  an  obvious  character  to  account  for  it.  Witness 
formed  the  opinion  that  the  cause  of  the  illness  was 
exposure  to  insanitary  influences,  and  he  made  enquiries. 
He  agreed  with  the  symptoms  described  by  Mr.  Clay. 
In  his  judgment  death  was  due  to  blood-poisonings 
which  was  such  as  would  be  caused  by  exposure  to 
sewer  gas. 


SEWER    GAS    AND    HEALTH. — APPENDIX   IXa.  ITT 

By  Mr.  Jelf  :  Blood-poisoning  might  arise  quite 
independently  of  insanitary  conditions.  Supposing  it 
turned  out  that  Daylesford  was  in  a  shockingly  insani- 
tary condition,  that  might  be  amply  sufficient  to  account 
for  all  he  found. 

By  Mr.  Murphy :  Whatever  mischief  there  might  be 
locally,  the  connection  with  the  sewer  would  aggravate  it. 

Sir  Willoughby  Wade  said  he  was  called  in  first  on 
February  27,  and  then,  from  the  state  of  the  patient's 
throat  and  from  the  history  of  the  case,  he  formed  the 
opinion  that  he  was  suffering  from  blood  -  poisoning. 
Sewer-gas  poisoning  most  frequently  attacking  the  throat, 
he  formed  the  opinion  that  the  illness  had  arisen  from 
a  cause  of  that  kind.  His  subsequent  visits  to  the 
deceased  confirmed  his  first  impression. 

Mr.  Hugo  Young :  Supposing  other  people  in  the 
house  suffered  from  carbuncles  and  boils,  to  what  would 
you  attribute  them?  Sir  Willoughby  Wade:  They  might 
arise  from  sewer  gas. — That  would  be  a  symptom  of 
blood-poisoning  from  gas  from  a  sewer  ?    It  might  be  so. 

Cross-examined  :  Sewer  emanations  of  any  kind  might 
produce  infectious  disease  in  the  absence  of  any  venti- 
lating pipe  from  the  main  sewer.  At  his  suggestion  the 
drainage  about  the  house  was  examined. 

Mr.  Arthur  Knight,  son-in-law  of  the  deceased,  said  that 
in  April,  1895,  he  stayed  at  Daylesford  for  some  time, 
and  after  he  had  been  there  a  few  weeks  he  suffered 
from  carbuncles  and  boils.  He  had  never  suffered  from; 
them  before.  In  1896  he  was  at  Daylesford  again,  and 
again  had  another  attack  of  carbuncles  and  boils. 

Cross-examined  :  He  never  noticed  that  the  cellar,  the 
closets,  or  the  bathroom  were  insanitary. 

Miss  Jessie  Smith,  daughter  of  the  deceased,  stated 
that  in   November,  1894,   she  suffered  from  an  abscess,.. 


1172  SEWER   GAS   AND   HEALTH. — APPENDIX   IXa. 

and  afterwards  from  a  succession  of  boils.  She  went  away 
from  home  and  soon  recovered. 

Dr.  Melson  was  called  to  speak  to  an  illness  of  deceased 
about  five  years  ago,  and,  in  reply  to  Mr.  Jelf,  he  said 
the  question  of  the  condition  of  the  drains  never  came 
up.  Mr.  Smith  completely  recovered  from  that  illness, 
and  witness  considered  him  a  strong  man. 

Miss  Dora  Smith,  another  daughter  of  deceased,  also 
spoke  to  suffering  from  a  number  of  carbuncles  and  boils 
in  April,  1895.  In  July,  last  year,  her  mother  suffered 
from  very  much  the  same  thing.  Up  to  1894  none  of 
them  suffered  from  carbuncles  or  boils. 

Dr.  Katcliffe  gave  evidence  to  attending  Miss  Jessie 
Smith  in  her  illness.  He  enquired  as  to  whether  the 
drains  were  right,  because  he  could  find  no  other  cause 
for  the  abscess  or  boils. 

Mr.  J.  Parker,  inspector  of  nuisances  to  the  Birmingham 
Corporation,  said  that  on  February  28  he  went  to  Dayles- 
ford,  with  an  assistant  named  Keasey,  and  made  an 
inspection.  He  found  defects,  but  not  then  sufficient  to 
account  for  the  illness.  On  a  subsequent  occasion  he 
tested  the  ventilating  shaft  and  other  pipes,  and  found 
them  very  defective.  The  fumes  from  a  ventilating  shaft 
in  the  chimney  found  their  way  into  the  library  and 
bedroom.  It  was  absolutely  wrong  to  turn  a  ventilating 
shaft  into  a  chimney,  as  was  done  in  this  case. 

By  Mr.  Jelf :  In  the  cellar,  immediately  beneath  the 
library,  there  was  a  gully  stopped  up.  In  it  there  was 
a  quantity  of  what  appeared  to  be  decomposed  urine. 
There  were  three  ventilating  spaces  in  the  cellar. 
The  walls  of  the  cellar  were  damp.  He  did  not  go  on 
the  inspection  in  any  official  capacity.  He  went  at  the 
request  of  the  Mayor,  and  at  his  expense. 

Mr.  Jelf :  Is  it  usual  for  the  officers  of  these  different 


SEWER    GAS    AND    HEALTH. — APPENDIX   IXa.  173- 

bodies  co  go  out  and  take  part  in  matters  against  local 
authorities  in  the  neighbourhood  around  ? 

Mr.  Parker  :  It  is  not  unusual. — You  are  the  inspector 
of  nuisances  for  the  city. 

Mr.  George  Eobinson,  builder's  agent,  having  given- 
evidence, 

Mr.  W.  Martin,  architect  and  surveyor,  stated  that 
on  March  7  he  made  an  inspection  of  the  house.  The 
smoke  test  was  applied  downwards  from  the  shaft  to 
the  manhole,  and  they  saw  it  coming  through  the 
"patch,"  covering  what  had  been  an  outlet  from  the 
drain  to  the  manhole.  The  mortar  was  wet.  The 
upward  test  filled  the  library  and  the  bedroom  with 
smoke.  The  jointing  of  the  ventilating  shaft  was 
defective.  On  March  19  he  saw  Mr.  Godfrey,  who  was 
very  indignant,  saying  that  the  covering  from  the  drain 
to  the  manhole  had  been  interfered  with.  The  hammering 
from  the  inside  by  a  rod  pushed  down  the  drains  would 
probably  displace  the  brickwork. 

By  Mr.  Jelf :  The  house  was  built  by  a  Mr.  Gough, 
now  deceased. — Mr.  Jelf:  Is  he  a  jerry  builder  ?  Witness : 
He  was  what  is  known  as  a  respectable  jerry  builder. 
He  was  one  of  the  best  of  his  class  in  Birmingham — 
Not  a  sort  of  man  you  would  entrust  with  any  important 
drainage?  He  was  a  man  who  would  think  of  himself. 
Witness  added  that  he  had  never  before  heard  of  a 
ventilating  sewer  in  connection  with  a  flue. — Mr.  Jelf: 
Do  you  say  it  is  never  done,  when  you  want  to  ventilate 
the  upper  part  of  a  sewer,  to  take  the  sewage  gas  by  a 
pipe  up  by  the  side  of  the  house?     Mr.  Martin:   No. — 

I  Assuming  it  had  been  taken  up  in  a  pipe  outside  the 
stack  of  chimneys,  and  not  inside,  you  would  not  say 
that  was  anything  improper  or  unusual?  If  it  is  taken 
high  enough  above  the  windows. —  Supposing  it  is  taken 


174  SEWER    GAS    AND    HEALTH. — APPENDIX   IXa. 

in  a  proper  pipe  inside  a  separate  flue,  you  would  say 
it  is  the  same  thing  ?  I  should  want  it  carried  to  a 
great  height  above  the  top  of  the  chimney.  Witness 
explained  that  if  the  pipe  were  not  carried  well  above 
the  chimney  pipe,  the  fumes,  in  the  event  of  several 
chimney  flues  standing  together,  would  be  apt  to  ascend 
one  flue  and  descend  another. 

Mr.  F.  W.  Martin,  son  of  the  last  witness,  corroborated 
his  father's  evidence. 

Other  witnesses  were  then  examined. 

Mr.  James  Smith,  Lord  Mayor  of  Birmingham,  and 
brother  of  the  late  Mr.  T.  H.  Smith,  said  the  latter  was 
a  very  strong  man.  When  at  home  his  brother  chiefly 
used  the  library.  His  business  was  that  of  wholesale 
stationer.  He  was  in  partnership  with  his  father.  By 
an  agreement  made  in  1885  deceased  was  entitled  to 
two-thirds  of  the  profits  of  the  business.  Deceased 
managed  the  business,  his  father  having  retired.  In 
order  to  carry  on  the  business  since  his  brother's  death, 
they  had  had  to  incur  expenses  to  the  amount  of  iJ389 
a  year.  The  average  profits  for  the  last  three  years 
had  been  i61,672  per  year.  He  estimated  the  decrease 
in  the  future  earnings  owing  to  his  brother's  death  at 
25  per  cent. — £418  per  year — reducing  the  total  to 
j61,254.  From  that  he  deducted  also  ^6339,  money  paid 
for  extra  assistance,  leaving  the  widow's  two-thirds 
share  at  d6610,  as  against  i61,115,  or  a  loss  of  i^505. 
Taking  the  life  of  the  deceased  at  51,  and  capitalising 
it  upon  a  3  per  cent,  table,  gave  £7,035.  Deceased 
was  insured  for  £2,500,  and  the  premiums  were 
£88.  15s.  per  annum.  He  had  passed  as  a  first-class 
life  since  his  previous  illness. 

This  completed  the  case   for  the  plaintiffs. 

Mr.    Jelf,    in    opening    the    case    for    the    defendant 


SEWER   GAS    AND    HEALTH. — APPENDIX    IXa.  175 

:authority,  expressed  their  deep  regret  at  the  termination 
of  so  valuable  a  life.  He  maintained  that  there  was  no 
liability  whatever,  on  any  theory,  on  the  part  of  the 
defendants  for  anything  that  had  happened.  He 
described  the  history  of  the  property,  and  said  that  in 
1891  Mr.  Essex,  the  architect,  asked  that  the  exit  in 
the  manhole  should  be  closed  up.  That  was  the  vent- 
hole  over  which  they  had  got  to  fight  out  the  battle. 
Was  the  opening  from  the  manhole  stopped  up  or  not? 
That  was  the  real  battle-ground.  He  should  call  Mr. 
'Godfrey  and  Mr.  Essex,  and  the  jury  would  hear  the 
: arrangements  that  were  made  with  them.  He  would 
;also  call  the  bricklayer  who  was  employed  to  put  in  the 
barrier,  and  which  was  done  in  cement,  and  by  which 
the  shaft  was  effectively  shut  off.  Since  then  several 
people  had  seen  the  manhole,  and  the  aperture  had 
always  been  closed.  Mr.  Jelf  complained  strongly  that 
the  manhole  and  sewers  were  overhauled  in  the  absence 
•of  anyone  representing  the  defendants,  and  said  that 
amongst  so  many  people  there  was  no  difficulty  in 
imagining  that  someone,  thinking  he  was  doing  a  very 
clever  thing,  pulled  out  some  of  the  brickwork  and  put 
in  other.  When  they  were  pounding  away  with  a  rod 
to  try  and  find  an  exit,  that  would  naturally  shake  the 
bricks,  and  might  even  produce  dislocations.  When 
people  went  down  into  the  manhole  once  and  could  not 
find  anything,  and  when,  three  days  afterwards,  a 
beautiful  patch  appeared,  it  looked  uncommonly  as  if 
something  had  been  done.  Mr.  Murphy  was  going  to 
try  and  put  it  on  to  his  (Mr.  Jelf's)  clients,  but  they 
would  tell  them  that  they  knew  nothing  about  it. 
Naturally,  when  Mr.  Godfrey,  the  defendants'  surveyor, 
discovered  what  had  been  done,  he  was  very  angry. 
Which    was    the    side   that    had    acted  perfectly  above 


176  SEWER    GAS    AND    HEALTH. — APPENDIX   IXa. 

board  ?  When  there  were  investigations,  the  plaintiffs^ 
agents  took  care  that  no  one  else  was  present,  wherea& 
the  defendants  always  invited  the  other  side  to  their 
inspections.  In  the  correspondence  which  had  taken  place 
the  defendants  had  called  attention  to  certain  acts  of 
trespass  and  damage  by  reason  of  the  manhole  having 
been  entered,  but  no  answer  was  made  to  this  charge. 
He  described  it  as  a  dirty  and  unhandsome  thing  for 
the  plaintiffs'  agents  to  go  to  the  premises  unknown 
to  the  defendants.  If  he  was  right  in  saying  that  the 
opening  into  the  manhole  was  bricked  up  in  1891, 
what  did  it  matter  whether  the  pipe  was  taken  up  or 
not  ?  If  the  bricking  was  effectual,  as  he  should  show 
it  was,  then  there  was  no  case.  Speaking  of  how  the 
deceased  gentlemen  met  his  death,  Mr.  Jelf  said  he  did 
not  think  there  was  much  doubt  that  it  was  due  to 
something  in  the  nature  of  a  septic  affection  in  the 
throat — that  it  was  something  which  exhibited  signs  of 
some  specific  disease.  A  specific  disease  of  that  kind 
was  not  contracted  by  being  taken  direct  from  sewer 
gas.  It  was  a  thing  which  was  apt  to  come  from  all 
kinds  of  causes,  only  it  was  most  likely  to  attack  those 
who  had  been  predisposed  to  it.  It  was  a  vicious 
complaint  which  flourished  best  on  the  soil  which  was 
best  prepared  for  it.  In  the  constitution  of  a  person 
exposed  to  insanitary  conditions,  it  was  very  likely  to 
have  very  injmrious  effects.  If  the  house  was  in  a  bad 
sanitary  condition  in  regard  to  its  own  drains — suppos- 
ing it  were  bad  enough — that  would  be  amply  sufficient 
to  account  for  the  preparation  of  the  body  for  the 
disease  which  came  to  Mr.  Smith  without  anything 
coming  from  the  shaft.  Mr.  Jelf  laid  stress  upon  the 
unhealthy  condition  of  the  cellar,  where,  he  said,  there 
was  a  gully  absolutely  stopped,  and  where  decomposed 


SEWER    GAS    AND    HEALTH. — APPENDIX  IXa.  177" 

urine  lay.  This  was  directly  under  the  library,  and 
not  far  from  the  bedroom.  The  boards  over  the  cellar 
and  forming  the  library  floor  were  so  far  apart  that 
one  could  see  through  them.  The  fire  would  be 
eminently  calculated  to  draw  up  exhalations  from  the 
place  below.  He  did  not  think  they  need  go  any 
further  than  that.  Deceased's  illness,  which  might  have 
been  caught  anywhere,  was  aggravated  by  the  conditions 
of  the  house. 

Mr.  Godfrey  (examined  by  Mr.  Jelf)  said  that  he 
remembered  Mr.  Essex,  the  architect,  calling  and 
stating  that  he  was  preparing  plans  for  the  erection  of 
certain  houses.  Witness,  on  being  asked  about  the  shaft, 
said  that  he  had  no  objection  to  the  shaft  being 
removed  from  the  tree  if  Mr.  Essex  would  give  a  new 
shaft  up  the  house.  Ultimately  it  was  decided  to  have 
the  shaft  in  the  chimney.  By  arrangement  with  Mr. 
Essex  he  laid  tapering  pipes  from  the  sewer  to  the 
boundary  of  the  house,  Mr.  Essex  undertaking,  on  behalf 
of  his  client,  to  carry  the  shaft  up  the  property.  The 
sanitary  authority  had  nothing  to  do  with  the  ventilat- 
ing shaft.  In  February,  1891,  he  was  asked  by  Mr. 
Essex  to  brick  up  the  opening  from  the  manhole  into 
the  shaft,  and  he  promised  to  do  so.  Up  to  1895,  when 
the  new  authority  came  into  power,  the  roads  were  in 
the  hands  of  the  surveyor  of  highways.  From  1891 
until  1895,  the  road  was  repaired  and  raised  from  time 
to  time,  with  the  result  that  the  manhole  became 
gradually  covered.  In  1895  he  became  surveyor  of  the 
roads,  and  having  occasion  to  find  the  manhole  he 
found  that   someone   had   interfered  with  the  brickwork, 

tand  that  mortar  had  been  removed. 
Mr.  Oliver  Essex,  the  architect,  also  gave  evidence  as  to 
the  negotiations.    He  said  that   he  did  not  understand 


178  SKWKR    GAS    AND    HEALTH.— APPENDIX   IXa. 

Mr.  Godfrey  to  insist  on  the  right  to  maintain  the  tree 
shaft  or  have  a  quid  pro  quo.  Mr.  Godfrey  suggested 
the  alternative. 

By  Mr.  Murphy :  He  should  not  like  such  an  arrange- 
ment in  his  own  house. 

Charles  Brown,  sewer  foreman,  deposed  that  in 
February,  1891,  he  received  orders  from  Mr.  Godfrey 
to  brick  up  the  connection  between  the  manhole  and 
the  shaft,  and  he  accordingly  gave  instructions  to 
Sawyer.  Witness  superintended  the  work,  which  was 
done  with  brindled  bricks  and  Portland  cement.  The 
work  was  properly  done,  and  the  cement  must  have 
set  in  20  hours.  In  1895  witness  saw  the  manhole 
in  the  same  condition  as  when  he  built  it  up  in 
1891,  the  bricks  and  cement  being  in  good  order. 
In  February,  1896,  he  examined  the  drainage  of  the 
house  from  the  outside.  The  syphon  to  the  cellar 
was  choked  and  full  of  solids,  the  result,  in  his 
opinion,  being  that  the  water  from  the  lavatory  went 
hack  into  the  cellar.  Up  to  that  time  he  had  no 
idea  that  there  was  a  cellar  drain.  The  water  fall- 
ing from  a  height  under  such  conditions  would  tend 
to  go  both  ways — into  the  cellar  and  into  the  sewers. 
The  lavatory  pipe,  however,  was  cut  off  when  it  joined 
the  cellar  drain.  Such  a  condition  of  things  would 
render  the  house  unhealthy.  There  was  also  a 
defective  soil-pipe,  and  altogether  the  house,  on  account 
of  the  state  of  its  own  drainage,  was  an  insanitary 
dwelling.  On  March  19,  under  the  direction  of  Mr. 
Godfrey,  he  examined  the  manhole.  At  one  place  he 
found  green  soft  mortar.  He  and  Mr.  Webb  took  the 
whole  of  the  bricks  out,  leaving  the  opening  as  it  was 
early  in  1891,  only  a  little  smaller.  He  saw  something 
like  whitening  trickling  out,  and  also  found  some  at  the 


SEWER    GAS    AND    HEALTH. — APPENDIX   IXa.  179 

vDack  of  the  bricks.     Mr.  Lowcock  and   Dr.   Hollinshead 

■went  down.  The  opening  was  left  open  for  about  a 
fortnight,  and  was  then  bricked  up  again.  When  he 
met  Mr.  Parker  and  others  at  the  house,  witness  had 
a    plan    of    the     house,     which    was    laid    out   on   the 

^kitchen  dresser  so  that  all  present  could  see  it.  The 
plan  was  not  kept  back  from  anybody. 

Ke-examined    by    Mr.    Jelf,    Q.C.  :    The    state    of  the 

(house  drains  would  fully  account  for  all  the  bad  smells. 
He  had  never  tried  whether  a  rod  of  the  kind  produced 
either  with  or  without  a   heavy  ball   at   the    end  would 

•  displace  a  piece  of  4|in.  brickwork. 

William  Henry  Blundell,  labourer,  examined  by  Mr.  A. 
Toung,  stated  that  under  the  direction  of  Mr.  Godfrey 
he  took  part  in  fixing  the  brickwork.  He  went  down 
;the  manhole  in  1895,  and   found  the  brickwork  all  right. 

A  workman  named  Marshall  gave  similar  evidence  as  to 
:the  state  of  the  brickwork  in  1895.  If  there  had  been 
anything  wrong  with  it,  he  would  have  seen  it. 

By  Mr.  Murphy :  He  did  not  know  anything  at  the 
.time  about  the  ventilating  shaft. 

Charles  Harry  Webb,  assistant  surveyor,  examined  by 
"Mr.  Pritchett,  said  that  when  the  manhole  was  examined 
on  March  19  he  found  that  the  joints  of  the  brickwork 
liad  been  raked  out  with  a  knife  or  something  of  the 
kind.  The  whitening  had  just  oozed  through,  but  was 
not  trickling  down  the  sides  of  the  manhole.  The  bricks 
had  been  disturbed,  and  were  set  in  green  mortar.     The 

•  old  cement,  quite  hard,  was  still  adhering  to  the  brick- 
work. That  was  his  first  knowledge  of  the  existence  of 
the  shaft.  He  had  never  heard  of  anyone  connected 
with  the  authority  interfering  with  the  brickwork,  and 
he  did  not  know  anything  previously  of  the  existence 
of  the  shaft. 

12* 


180  SEWER    GAS    AND    HEALTH. — APPENDIX   IXa. 

John  Houghton,  assistant  inspector  of  nuisances,  wha 
took  part  in  the  examination  of  the  manhole,  examined 
by  Mr.  A.  Young,  stated  that  there  was  not  the  slightest 
sign  of  percolation  through  the  brickwork.  He  did  not 
know  of  an}^  tampering  with  the  brickwork  on  the  part 
of  the  defendants.  No  objection  was  made,  as  far  as 
witness  was  aware,  to  anyone  seeing  the  plans. 

By  Mr.  Murphy:  He  knew  nothing  about  the  ventilating 
shaft  previously.  This  was  surveyor's  work,  and  he  was 
inspector  of  nuisances.  He  was  a  party  to  the  report 
made  by  Mr.  Brown  which  referred  to  some  ''serious 
defect  which  at  present  we  cannot  localise."  That  report 
was  made  on  February  28,  but  the  inspection  of  the  house 
drains  was  not  completed  until  March  3.  A  defect  in  the 
junction  between  the  iron  pipe  and  the  earthenware  pipe 
was  discovered  on  February  29.  This  was  outside  the 
house,  but  it  would  account  for  the  *' serious  defect," 
the  discovery  of  which  the  report  had  anticipated. 

Mr.  Sydney  Kichard  Lowcock,  of  35,  Waterloo-street, 
Birmingham,  Associate  of  the  Institute  of  Civil  Engineers, 
declared  the  house  to  have  been  extremely  insanitary,  quite 
apart  from  the  question  of  the  ventilating  shaft.  The 
drain  in  the  cellar,  which  was  not  shown  on  the  authorised 
plan,  was  quite  enough  to  account  for  any  illness  that 
had  arisen.  There  ought  not  to  be  a  drain  in  the  cellar 
at  all,  because  such  a  drain  was  likely  to  get  dry,  and 
so  unsealed.  On  any  defect  arising  iii  the  connections,, 
there  was  a  danger  of  refuse  and  bad  smells  backing  up 
into  the  cellar.  There  were  other  defects  in  the  drainage. 
The  emanations  from  defective  house  drains  were  likely 
to  be  a  great  deal  worse  than  those  from  a  well-built 
sewer.  The  connection  of  rainwater-pipes  directly  with 
the  drains  was  universally  acknowledged  to  be  a  source 
of  danger.    A  gentleman  sitting  up  late  with  a  fire  in 


SEWER    GAS    AND    HEALTH. — APPENDIX  IXa.  181 

his  room  would  be  very  likely  to  breathe  the  foul  gases 
from  the  cellar.  On  March  14,  attention  having  been 
called  to  the  existence  of  a  ventilating  shaft,  he  went 
down  the  manhole.  He  found  that  the  vertical  joints 
of  the  brickwork  had  been  opened  to  such  an  extent 
that  Dr.  Fosbrooke,  who  went  down  with  him,  could 
push  a  wooden  foot  rule  right  through.  If  the  rod 
produced  were  pushed  down  the  pipe,  it  would  be  quite 
sufficient  to  displace  4 Jin.  brickwork. 

By  Mr.  Murphy :  It  would  be  quite  possible,  even  if 
the  bricks  were  found  all  right  in  1895.  If  a  great 
pressure  could  not  be  brought  to  bear  with  such  rods 
they  would  not  do  for  clearing  out  drains,  which  was 
what  they  were  made  for.  Accumulations  of  soapsuds 
and  bath  waste  generally  would  cause  emanations  quite 
as  injurious  as  those  from  any  other  source.  The 
lavatory  must  have  sent  deleterious  matter  into  the 
drain  in  question. 

W.  Wright,  formerly  a  clerk  in  the  employ  of  the 
authority,  produced  a  wages-sheet  showing  that  a  man 
was  paid  in  1891  for  blocking  up  the  foot  of  the 
ventilating  pipe. 

Dr.  Saundby  expressed  the  opinion  that  the  state  of 
things  disclosed  as  to  the  house  drains  was  sufficient 
to  account  for  Mr.  Smith's  illness  and  death.  Even 
supposing  there  were  an  influx  of  gas  from  the  public 
sewer,  that  was  not  likely  to  be  more  than  a  predisposing 
cause  of  such  disease. 

Dr.  George  Fosbrooke,  medical  officer  of  health  for 
Worcestershire,  deposed  to  visiting  the  house  on  March  19, 
and  expressed  agreement  with  the  opinions  of  Dr.  Saundby 
as  to  the  cause  of  Mr.  Smith's  illness. 

By  Mr.  Murphy  :  You  would  rather  expose  a  patient 
to  a  good    blast  of    sewer  gas   than    to  what  has   been 


182  SEWEK    GAS    AND    HEALTH. — APPENDIX  IXa. 

described  as  existing  in  this  house?  I  think  that  the 
gases  emanating  from  the  drain  would  be  worse  than^ 
those  from  the  sewer. — You  would  prefer  the  sewer  ?' 
Yes. — Would  you  like  to  have  a  shaft  from  the  sewer 
in  your  chimney  ?  Not  unless  it  were  tight.  — In  a 
jerry-built  house  ?  Not  unless  it  were  perfectly  tight. — 
You  would  be  afraid  of  it  ?  Yes. — You  would  not  like 
to  have  your  children  in  the  house  ?     No. 

Dr.  Francis  Hollinshead,  medical  officer  of  health  to- 
the  defendant  authority,  also  declared  that  the  state  of 
the  house  drains  fully  accounted  for  the  illness. 

By  Mr.  Murphy :  You  agree  with  the  opinions  expressed 
by  the  other  doctors  ?  Well,  not  quite.  There  is  a. 
question  in  my  mind  as  to  whether  it  was  true  septi- 
ccemia  or  not.  It  is  very  difficult  to  say  where 
ordinary  sore  throat  ends  and  septicoemia  comes  in. 

By  Mr.  Jelf :  Don't  you  think  that  the  gentlemen  who- 
saw  this  patient  would  be  quite  as  good  judges  as  to^ 
the  symptoms  as  those  who  did  not,  if  not  better?. 
Possibly. 

This  closed  the  case  for  the  defence  ;  and  counsell 
on  each  side  having  addressed  the  Court, 

His  Lordship,  in  summing  up,  said  that  the  questions- 
to  be  decided  by  the  jury  were.  Was  Mr.  Smith's  death 
caused  by  the  escape  from  the  sewer  ventilator,  and,  if 
so,  what  damages  should  be  given?  Many  points  arising. 
in  the  case  had  been  agreed  upon.  The  case  for  the 
plaintiff  was  a  straightforward  one.  There  could  be  no 
doubt  that  Mr.  Smith,  immediately  before  these  symptoms 
appeared,  was  in  robust  health,  and  it  was  no  longer 
in  dispute  that  death  was  caused  by  blood-poisoning.. 
Neither  was  it  disputed  that  the  presence  of  sewer  ga& 
would  be  a  sufficient  cause  of  blood-poisoning  which 
might  result  in  death.     If  the  jury  found  that  sewer  gas. 


SEWER    GAS    AND    HEALTH.— APPENDIX   IXa.  185 

got  into  the  house  through  the  ventilator,  they  were 
confronted  with  another  problem — namely,  the  alternative 
raised  by  the  defence  :  that  the  more  probable  cause  of 
the  symptoms  was  the  condition  of  the  drains,  as  to 
which  a  considerable  amount  of  evidence  had  been 
tendered  by  the  defence. 

The  jury  retired  shortly  before  five  o'clock.  They 
several  times  called  for  their  custodian,  but  only  to  ask 
for  refreshment  and  to  state  that  there  was  no  prospect 
of  them  agreeing.  Ultimately  the  judge  was  sent  for^ 
arriving  at  a   quarter  to  eight. 

The  Foreman  informed  his  Lordship  that  the  jury  were 
unanimous  as  to  the  death  being  due  to  an  escape  of 
sewer  gas  from  the  ventilator,  and  that  eleven  of  them 
were  agreed  as  to   the  question  of  damages. 

His  Lordship  asked  the  jury  if  he  could  help  them 
in  any  way.  He  thought  it  would  be  a  pity  if  a. 
special  jury  in  the  city  of  Birmingham  could  not 
decide  a  question  which  was  settled  almost  every  day 
by  a  sheriff's  jury. 

The  dissentient  juryman  said  that  he  thought  the- 
damages  agreed  upon  by  his   colleagues  most   excessive. 

His  Lordship  said  that  in  assessing  damages  in  such 
a  case  they  should  take  into  account  the  time  of  life 
at  which  the  man  died,  how  long  he  might  ■  have  livedo 
and  what  he  might  have  made  for  his  family.  From 
that  they  would  have  to  deduct  his  personal  expenses; 
but,  on  the  other  hand,  they  must  take  into  account, 
the  provision  of  a  person  in  his  stead  to  manage  his- 
affairs. 

A  further  consultation  having  proved  unavailing,  his. 
Lordship  advised  the  jury  to  look  at  the  matter  in  the 
spirit  of  compromise.  It  would  be  a  public  scandal  if,, 
after  two  days  of  assize,   they  failed   to   agree   on  the- 


184  SEWER   GAS    AND    HEALTH. — APPENDIX  IXa. 

question  of  damages.  He  must  ask  them  to  address 
themselves  to  the  question  again. 

After  another  little  talk  the  Foreman  stated  that  one 
man  seemed  to  have  made  up  his  mind.  Practically 
there  was  no  hope  of  agreement  unless  the  eleven  gave 
way  to  the  one. 

"  The  one  "  informed  his  Lordship  that  he  had  already 
met  his  colleagues  by  ^61,000. 

The  Foreman :  It  is  only  a  question  of  years  of  life 
that  we  cannot  agree  upon,  and  there  is  only  a  difference 
of  two  years  between  us. 

The  jury,  after  another  short  dispute,  agreed  upon  a 
verdict  for  £3,500. 

On  Thursday  morning,  6th  August,  1896,  his  Lord- 
ship heard  the  defendants,  represented  by  Mr.  J.  E. 
Jelf,  Q.C.,  Mr.  Alfred  Young,  and  Mr.  Pritchett,  on 
the  questions  of  law.  Mr.  Hugo  Young  appeared  for 
the  plaintiff. 

In  the  first  place,  Mr.  Jelf  applied  for  a  reduction  of 
the  damages  in  respect  to  the  insurance,  pointing  out 
that,  whereas  the  jury  had  assessed  the  loss  at  d63,500 
capitalised,  the  family  would  receive,  with  the  insurance, 
j66,000,  which  passed  absolutely  into  their  own  hands. 
It  was  submitted  that  an  allowance  should  be  made  in 
respect  to  the  accelerated  payment  of  the  premiums, 
14  years  being  mentioned. 

Mr.  Hugo  Young  claimed  that  8J  years,  as  the  presumed 
basis  of  the  jury's  finding,  should  guide  his  Lordship. 
He  further  contended  that  the  policy  was  an  investment, 
capable  of  treatment  like  unto  that  of  the  rest  of  his  property. 

Mr.  Jelf  applied  that  judgment  should  be  entered  for 
defendants.  The  jury  had  only  found  on  one  single 
fact  out  of  all  the  facts  involved.  They  had  found  that 
flewer  gas  from  the  shaft  was  a  cause  of  death. 


SEWER   GAS    AND    HEALTH. — APPENDIX  IXa.  185 

The  Judge :    The  cause. 

Mr.  Jelf  submitted  not.  He  held  there  was  nothing 
to  show  that  what  came  from  the  shaft  was  not  assisted 
in  producing  death  by  other  causes. 

Eventually  the  Judge  allowed  a  reduction  in  the 
damages  of  £625  for  the  acceleration  of  the  payment 
of  the  insurance  money.  He  entered  judgment  for 
.i'2,875  as  against  the  District  Council,  and  stayed 
execution  for  21  days. — Birmingham  Post,  5th,  6th  and 
7th  August,  1896. 

2.     Case    of   Diphtheria     attributed    to     Cesspit    Gas, 
Damages  Awarded  £50, 

The  following  account  is  taken  from  the  Journal  of 
State  Medici^ie  for  August,  1897  : 

"  Deaths  from  Diphtheria — Action  for  Damages. — An 
action  has  just  been  tried  before  Mr.  Justice  Wills 
against  the  owner  of  certain  cottages  at  Bexley  Heath 
for  negligence  in  allowing  a  cesspool  to  become  a 
nuisance.  The  plaintiff  lost  three  children  through  an 
attack  of  diphtheria,  which  it  was  alleged  was  caused 
by  the  effluvium  from  the  defective  cesspool,  and  sued 
for  damages.  Mr.  Justice  Wills  held  that  the  defendant 
was  liable,  and  gave  judgment  for  £50  damages  and 
costs. 


186 


SEWER   GAS   AND    HEALTH. — APPENDIX  X. 


APPENDIX   X. 

Influence  of  Sanitary  Works  upon  the  Mortality  from 
Typhoid  Fever. 

1.  Investigations  of  the  late  Sir  George  Buchanan 
(see  also  A-14,  App.  I.). 
On  page  35  of  the  annual  report  of  the  Medical  Officer 
to  the  Privy  Council  for  the  year  1866,  the  late  Sir  George 
Buchanan  gives  the  following  classical  table,  which  clearly 
illustrates  the  influence  of  sanitary  works  upon  the  health, 
of  towns  at  that  time : 

Table  I. —Mortality  from  Typhoid  Fever    in   Various  English  Towns 
before  and  after  the  execution  of  Sanitary  Works. 

Buchanan's  Table. 


Population 
1861. 

Towns. 

Periods  of 
Comparison 

Mortality  from 
Typhoid  Fever  per 
10,000  Inhabitants. 

befor 

after 

before 

after 

the  Const 
Sanitary 

ruction  of 
Works. 

the  Const 
Sanitary 

ruction  of 
Works. 

160,714 
68,056 
52,778 
39,693 
32,954 

Bristol  

1847-1851 
1845-1851 
1845-1855 
1845-1857 
1847-1854 
1845-1850 
1845-1853 
1845-1852 
1845-1849 
1843-1853 
1845-1855 
1845-1853 
1843  1850 
1844-1852 
1843-1852 
1845-1852 
1845-1851 
1845-1852 
1845-1853 
1845-1851 
1843-1852 
1843-18.52 
1845-1852 
1845-1851 

1862-1865 
1862-1864 
1862-1865 
1860-1865 
1859-1866 
1857-1864 
1858-1864 
1857-1864 
1860-1865 
1857-1865 
1859-1864 
1857-1846 
1856-1865 
1857-1864 
1855-1864 
1859-1864 
1855-1864 
1856-1864 
1860-1864 
1856-1864 
1856-1865 
1857-1885 
1856-1864 
1855-1864 

10-00 
14-60 
21-33 

8-00 
17-33 
15-00 
10-00 
14-25 
16-33 
14-00 
1900 
16-00 

7-50 

7-50 
12-00 
10-40 
10-00 
10-00 
12-50 
13-50 
23-50 

7-50 
16-50 
13-50 

6-50 
7-75 
8-66 
4-66 

10-50 
5-50 
9-75 
8-50 

10-33 
9-00 
9-00 
8-33 
8-00 
1-75 

12-66 
4-50 
9-00 
4-50 
4  00 
8-66 

10-25 
9-25 

10-00 
5-75 

Leicester  

Merthyr  Tydfil   ... 

Cheltenham     

Cardiff  

30,229 
29,417 
27,475 
24,756 
23,108 
10,570 
10,238 
9,414 

Croydon    

Carlisle     

Macclesfield 

Newp)ort  .►. 

Dover    

Warwick  

Banbury 

Penzance  

9,080 

Salisbury 

8,664 

Chelmsford  

7,847 
7,818 
7,189 
6,823 
6,494 
6,334 
5,805 
4,490 
3,840 

Ely 

Rujjby  

Penrith      

Stratford-on-  Avon 
Alnwick    

Brynmawr    

Worthing     

Morpeth    

Ashby-de-la-Zouch 

SEWER   GAS    AND    HEALTH. — APPENDIX  X. 


187 


2.  Cases  quoted  by  SoyJca  (see  also  B-55,  App.  I.). 

In  his  paper  at  the  Vienna  Congress  of  the  German 
Association  of  Public  Health,  in  September,  1881,  Soyka 
quotes  a  number  of  German  towns  in  which,  after  the 
introduction  of  a  proper  system  of  sewerage,  the  typhoid 
mortality  has  considerably  decreased.  Concerning  Munich,, 
he  gives  the  following  interesting  table : 

Table  II.— Typhoid  Mortality  in  Munich. 


Periods. 

Year. 

Sanitary  Progress. 

Number  of 

Deaths  from 

Typhoid  Fever 

per  10,000 

Living. 

1 
2 

3 

i'      5 

1852-1859 
1860-1865 

1866-1873 

1874-1880 
1881-1885 

No  means  whatever  for  prevent- 
ing the  pollution  of  the  sub- 
soil and  air. 

Commencement  of  reforms  — 
making  of  cesspits  water- 
tight etc. 

Sewerage  in  parts  of  the  town. 

Continuation  of  the  sewerage  .. 

Sewerage  of  town  still  further 
improved. 

24-20 

16-80 

13-30 
8-90 
1-75 

In  the  first  period  it  may  well  be  assumed  that  all 
the  cesspits  were  utterly  neglected,  and  no  supervision 
whatever  exercised.  No  doubt,  cesspit  or  sewer  gas  freely 
circulated  in  the  interior  of  the  houses  without  let  or 
hindrance.  Of  those  days  it  has  been  said  that  the 
smell  of  cesspits  was  ever  present  in  the  taste  of  man,, 
and  houses  were  little  better  than  ammonia  works  on 
a  small  scale. 

In  the  second  period,  cesspits  were  more  systematically 
constructed  and  emptied.  Probably,  too,  the  question  of 
the  disposal  of  other  refuse  matters  was  more  carefully 
looked  into,  and,  generally  speaking,  in  this  period  the 
noxious  gases  from  the  decomposition  of  organic  matters 
were  more  methodically  treated  and  avoided. 


188  SEWER   GAS   AND   HEALTH. — APPENDIX  X. 

In  the  third  period,  no  doubt  all  these  questions  were 
still  further  examined,  with  the  result  that  the  town 
was  partially  sewered,  and  although  the  sewers  were 
originally  not  intended  to  convey  away  faecal  matters, 
it  is  recorded  that  the  overflow  from  the  cesspits  in 
many  cases  was  connected  with  them.  At  any  rate, 
there  is  no  doubt  but  what  the  gases  from  decomposing 
faecal  matters  were  more  and  more  excluded  from  the 
interior  of  the  houses.  In  the  fourth  and  fifth  periods, 
the  sanitary  arrangements  of  the  town  were  still  further 
improved. 

The  successive  improvements  in  the  death-rate  from 
typhoid  fever  can  be  clearly  traced  in  this  table. 

At  the  present  time  all  faecal  matters  are  passed 
direct  into  the  sewers,  and  without  the  intervention  of 
cesspits. 

3.  Investigations   by  P,  Baron  (see  also  B-2,  App.   I.). 

P.  Baron  examined  this  question  for  a  very  large 
number  of  German  towns  with  and  without  drainage, 
and  found  that  in  Berlin,  Danzig,  and  Hamburg  the 
typhoid  mortality  had  considerably  decreased  since  the 
introduction  of  the  water-carriage  system. 

He  then  compared  the  average  typhoid  mortality  for 
nine  years  in  37  towns  without  drainage  with  the 
mortality  in  46  towns  with  good  drainage,  and  arrived 
at  the  following  conclusions : 

1.  The    heaviest  typhoid   mortality  occurred  in   towns 

without  drainage. 

2.  Average    rates   occurred  more    frequently     in  non- 

seweraged  than  in  seweraged  towns  ;  and 

3.  The    lowest     typhoid     rates     were     by    far     more 

frequently  observed  in  seweraged  towns. 
Baron    further  then   subdivided  the  towns   into   those 


SEWER    GAS    AND    HEALTH. — APPENDIX  X.  189 

with  the  highest  and  those  with  the  lowest  typhoid  rates, 
and  found  : 

4.  Out   of    70   towns   with  the   highest  yearly   rates, 

51,  or  73  per  cent.,  were  not  drained ;  and 

5.  Out  of  51  towns  with  the  lowest  yearly  rates,  36, 

or  70  per  cent.,  were  drained. 

Summarising  these  results,  he  concludes  his  investiga- 
tions by  saying : 

"The  lowest  yearly  typhoid  rates  occurred  in  36,  or 
78  per  cent.,  of  the  46  seweraged  towns,  and  only 
in  15,  or  40  per  cent.,  of  the  37  towns  without 
drainage. 

4.  Typhoid  Fever  at  Berlin  (see  also  B-68,  App.  I.). 

It  might  not  be  out  of  place  to  make  a  few  remarks 
here  on  the  prevalence  of  typhoid  fever  (typhus  abdo- 
minalis)  in  Berlin  before  and  after  the  systematic  sewering 
of  the  town,  as  the  statistical  material  at  our  disposal 
appears  to  have  been  collected  with  the  greatest  care. 

In  Table  III.,  on  the  next  page,  I  have  given  the 
number  of  deaths  from  all  causes  and  from  typhoid  fever 
between  the  years  1854  and  1890,  and  with  a  view  to 
illustrate  the  movement  of  these  death-rates  I  have 
prepared  Diagrams  No.  I.  and  II.,  on  which  I  have 
also  noted  the  years  in  which  various  of  the  sanitary 
improvements  have  been  commenced  or  carried  out. 

On  reference  to  the  table  and  to  Diagram  I.,  which 
shows  the  typhoid  rates,  it  will  be  seen  that  there  has 
been  a  very  steady  decline  in  the  typhoid  mortality  since 
1856,  when  the  waterworks  were  opened,  but  that  this 
decline  has  become  considerably  more  rapid  since  the 
commencement  of  the  drainage  works  in  1875.  In 
Diagram  II.,  which,  together  with  Diagram  I.,  is  taken 


190 


SEWER   GAS    AND    HEALTH.— APPENDIX  X. 


Table  III.— City  of  Berlin. 

Mortality  from  all  Causes  and  from  Typhoid  Fever  between 
1854  and  1890. 


Mortality 

'  from  all 

Mortality  from  Typhoid 

Year. 

Population. 

Causes. 

Fev 

er. 

Deaths  in 

Actual 
Number  of 

Deaths 
per  1,000 

Actual 
Number  of 

1,000  Deaths 
from  all 
Causes. 

Deaths. 

Inhabitants. 

Deaths. 

1854 

429,390 

10,305 

25-60 

342 

34-6 

1855 

432,685 

12,328 

29-99 

483 

42-2 

*1856 

442,040 

10,889 

26-30 

397 

38-2 

1857 

449,610 

12,664 

30-16 

536 

44-1 

.1858 

458,637 

11,854 

28-03 

426 

37-3 

1859 

474,790 

12,163 

•27-78 

490 

41-1 

1860 

493,400 

10,988 

24-34 

371 

34-5 

1861 

547,571 

14,201 

28-18 

440 

33-4 

1862 

567,560 

14,044 

26-94 

467 

39-0 

1863 

596,390 

16,473 

30-21 

488 

31-8 

1864 

633,279 

17,848 

30-99 

459 

27-3 

1865 

657,690 

20,609 

33-80 

693 

35-7 

1866 

665,710 

26,305 

41-62 

599 

24-9 

1867 

702,437 

18,668 

28-96 

485 

27-5 

1868 

728,590 

23,531 

34-69 

725 

31-9 

1869 

762,450 

20,193 

26-48 

518 

25-2 

1870 

760,000 

22,984 

30-24 

596 

25-9 

1871 

825,937 

30,756 

37-24 

732 

23-8 

1872 

864,300 

26,635 

30-82 

1,208 

45-4 

1873 

900,620 

26,427 

29-34 

859 

32-4 

1874 

9.32,760 

27,423 

29-39 

691 

25 -l> 

tl875 

966,858 

31,225 

32-29 

805 

25-8 

1876 

995,470 

29,185 

29-32 

623 

21-3 

1877 

1,010,946 

29,988 

29-66 

612 

21-0 

1878 

1,039,447 

30,629 

29-47 

326 

io-« 

1879 

1,069,782 

29,545 

27-62 

296 

10-0 

1880 

1,122,330 

32,823 

29-25 

506 

15-4 

1881 

1,138,784 

31,055 

27-27 

340 

10-9 

1882 

1,175,278 

.30,465 

25-92 

355 

11-7 

1883 

1,212,327 

35,056 

28-92 

221 

6-3 

1884 

1,250,895 

32,932 

26-33 

241 

7-3 

1885 

1,291,359 

31,483 

24-38 

214 

6-7 

1886 

1,337,171 

34,293 

25-65 

181 

5-2 

1887 

1,386,562 

30,333 

21-88 

193 

6-3 

1888 

1,439,618 

29,294 

20-35 

188 

6-4 

1889 

1,495,151 

29,545 

19-76 

290 

6-4 

1890 

1,548,279 

.32,823 

2M9 

143 

4-2 

*  1856,  opening  of  waterworks,   f  1875,  sewerage  of  town  commenced. 


SEWER    GAS    AND    HEALTH. — APPENDIX  X,  195 

from  Dr.  Weyl's  book,  quoted  under  B-68,  App.  I., 
is  shown  the  rise  and  fall  of  the  general  death- 
rate  between  1840  and  1890,  and  from  this  it  would 
follow  that  whereas  since  the  opening  of  the  waterworks 
the  general  death-rate  shows,  if  anything,  a  slight  increase 
over  previous  years,  it  at  once  commences  to  fall  with 
the  starting  of  sewerage  operations  in  the  town,  and  has 
done  so  more  or  less  regularly  ever  since.  If  we  compare 
the  results  of  these  two  diagrams,  the  thought  forces 
itself  upon  one's  mind,  that  of  the  two  great  sanitary  works 
the  sewerage  has  exercised  the  greater  beneficial  influence 
upon  the  public  health  of  Berlin.  It  would  be  very 
interesting  to  investigate  this  apparent  difference  further, 
but  for  this  I  regret  there  is  no  time. 

It  is  by  no  means  contended  that  to  this  reduction  in 
the  death-rates  only  the  water  supply  and  drainage  have 
contributed.  On  the  contrary,  no  doubt,  a  great  many 
other  factors  have  added  their  quota,  but  I  think  we 
are  perfectly  entitled  to  say  that  amongst  the  beneficial 
influences  at  work,  sewerage  and  water  supply  occupy  a 
most  prominent  position. 

Dr.  Weyl  mentions,  concerning  the  reduction  of  the 
typhoid  mortality  in  the  years  immediately  preceding  the 
commencement  of  the  sewerage  and  since  that,  out  of 
1,000  annual  deaths,  there  were  on  an  average  due  to 
typhoid  fever : 

In  the  years  1871  to  1880,  23*05  cases. 
„      1881  to  1890,    7-18       „ 

This  shows  that  in  the  10  years  since  the  partial 
completion  of  the  sewerage  works  the  typhoid  rate  per 
1,000  deaths  from  all  causes  was  less  than  one- third  of 
what  it  was  in  the  previous  10  years.  The  sewerage 
of  the  town  might  be  said  to  have  been  commenced  in 
1875,  and  has  been  carried  on  ever  since. 

13 


194  SKWKH    CAS    AND    HEALTH.— APPENDIX  X. 

5.  Other  Cases. 

Innumerable  other  instances  might  be  quoted  where, 
after  the  drainage  of  the  place  had  been  carried  out, 
the  mortality  from  typhoid  fever  has  year  after  year 
•decreased,  but  this  would  lead  too  far. 

It  will  suffice  to  say  that  ever  since  Buchanan  drew 
a<ttention  to  this  connection  for  the  first  time  in  his 
memorable  report  of  186G  (A- 14,  App.  I.),  such  a  reduction 
has  in  almost  every  case  been  observed,  not  only  in  this 
•country,  but  also  abroad,  where  a  place  has  been 
systematically  sewered,  and  that  where  it  has  not  taken 
place,  special  and  local  reasons  have  been  found  to  exist 
which  prevented  it.  We,  therefore,  consider  this  reduc- 
tion in  the  typhoid  mortality  consequent  upon  the 
systematic  sewering  of  a  town  practically  in  the  light  of 
an  axiom. 


SEWER    GAS    AND    HEALTH. — APPENDIX  XL 


195 


APPENDIX  XI. 

TNOTES   ON   THE    COINCIDENCE    BETWEEN    TyPHOID    FeVER  AND 

Faulty  Drains  as  Demonstrated  by  the  Smoke  and 
Other  Tests. 

1.  Experience  at  Leicester. 

In  Leicester,  it  has  now  become  the  rule  with  the 
sanitary  authorities  to  test  the  drainage  of  a  house  with 
smoke  as  soon  as  a  case  of  typhoid  fever  has  been  notified 
from  it,  and  as  this  has  been  systematically  carried 
out  since  the  year  1893,  it  might  not  be  out  of  place 
to  give  the  results,  as  ascertained  from  the  annual 
reports  of  the  medical  officer  of  health,  in  the  following 
table. 

Table    I. — Typhoid  -  Infected    Houses    with   Defective     Drainage    in 

Leicester, 


Years. 

■ 
Typhoid-Infected  Houses. 

Total    Number    of 
Infected  Houses. 

Number  of  Houses 
with    Defective 
Drainage. 

Percentage  of  Houses 
with  Defective  Drain- 
age. 

1893 
]894 

96 
197 

30 
89 

31  -25  per  cent. 
4518  per  cent. 

2.  Experience  at  Bristol. 

The  medical  officer  of  health  for  Bristol  reports  that 
during  the  five  years,  1890-1894,  585  cases  of  enteric 
fever  occurred  in  Bristol,  of  which  548  were  single 
cases — i.e.y  occurred  in  548  houses — and  the  rest  of  37 
cases  was  distributed  over  11  houses.  Out  of  the  548 
houses,  161  showed  drainage  defects  on  the  application 
of  the  smoke  test,  so  that  for  29*38  per  cent,  of  the 
548  typhoid  -  infected  houses,  the  possibility  of  the 
■entrance  of  sewer  gas   has  been   proved. 

13* 


196 


SEWER    GAS    AND    HEALTH. — APPENDIX   XI. 


3.  Experience  at  Hornsey. 

The  medical  ofi&cer  of  health  for  Hornsey  states  in- 
his  report  for  the  year  1893,  on  pages  11  to  14,  that 
nine  typhoid -infected  houses  were  examined  with  the 
smoke  test  between  the  10th  day  of  August  and  the 
30th  day  of  December,  1893,  and  that  in  every  one  of 
them  defective  drainage  arrangements  were  discovered. 
The  number  of  typhoid  -  infected  houses  with  drainage 
defects  was  19  in  1894. 

4.  Experience  at  Leeds. 

The  medical  officer  of  Leeds,  Dr.  J.  Spottiswoode 
Cameron,  gives  a  very  interesting  paper  in  the  Journal 
of  the  Sanitary  Institute  for  1897,  ^  Vol.  XVIII.  (see 
also  A-17b,  App.  I.),  on  his  experience  with  the  smoke 
test.  All  in  all,  the  drains  of  1,121  houses,  in  which 
typhoid  or  diphtheritic  disease  was  supposed  to  be  present,, 
were  tested,  with  the  result  that  30*51  per  cent,  were 
found  defective.  The  table  of  particulars  and  the 
summary  are  as  follows : 

Table    II.— Showing    Drain  Test  Findings  in  1,121  Houses   in   which 
Typhoid  or  Diphtheritic  Disease  was  supposed  to  be  present. 


Houses. 

Percentage. 

Found  Faulty. 

Result  Negative. 

The  whole  group      

1,121 
529 
592 

30-51 
16-26 
43-24 

69-49 

83-74 
56-76 

Wastes  "severed"     

Wastes  not  "  severed  "  ... 

Convenience  outside  

Wastes  "severed"     

Wastes  not  "severed  "  ... 

994 
442 
552 

2817 
11-54 
41-49 

71-83 

88-46 
58-51 

Closet  inside    

127 

87 
40 

48-82 
40-23 
67-50 

5118 
69-77 
32-50 

Wastes  "severed"    

Wastes  not  **  severed  "  ... 

"Severed"  means  that  every  waste,  other  than  the  soil-pipe,  comes- 
through  an  outer  wall  and  discharges  in  the  open  air  outside  the  house. 


SEWER    GAS    AND    HEALTH. — APPENDIX   XI.  197 

Summary, 
"  So  far  as  these  figures  go,  it  would  appear  that : — 

1.  Nearly  one  third  of  the  1,121  houses  were  in  aerial 
"Communication  with  their  drains. 

2.  This  fault  was  more  than  twice  as  common  where 
disconnection  of  wastes  had  not  been  carried  out — namely, 
as  43  in  the  non-severed  to  16  in  those  "cut  off." 

3.  Neglecting  disconnection,  a  water-closet  inside  the 
dwelling  increased  by  four-sevenths  the  chances  of  the 
entrance  of  drain  air,  raising  the  faulty  proportion  from 
"28  to  49  per  cent. 

4.  Where  severance  of  other  wastes  was  effected,  the 
risk  of  direct  aerial  connection  with  the  sewer  increased 
from  12  per  cent,  in  houses  with  closets  outside  the 
dwelling  to  40  per  cent,  where  they  were  inside, 

5.  Where,  on  the  "other  hand,  drain  severance  was 
incomplete,  the  risk  was  greater  whatever  kind  of  closet 
ivas  in  use,  but  rose  from  41  per  cent,  in  those  without, 
to  68  per  cent,  in  those  with  an  inside  convenience. 

The  table  appended  to  the  paper  gives  the  following 
results  : 

Percentage  of  houses  in  aerial  connection  with  their 
drai7is  where: 

Wastes  were  severed  and  closet  outside...  11'5 

Wastes  not  severed,  but  closet  outside  ...  41*5 

Wastes  severed,  but  closet  inside     40*2 

Wastes  not  severed,  closets  inside  67'5 

These  figures  may  perhaps  warrant  some  of  the  following 
conclusions: 

1.  As  even  in  houses  free  from  the  special  dangers 
due  to  the  presence  of  a  water-closet  within  the  dwelling, 
and  further  protected  by  the  disconnection  of  all  other 


198  SEWER   GAS   AND    HEALTH. — APPENDIX  XI. 

waste-pipes,  drain  testing  revealed  serious  defects  in 
nearly  12  per  cent,  of  those  tested,  it  is  obvious  that 
there  should  be  a  regular,  systematic,  and  periodical 
testing  of  all  house  drains. 

2.  This  periodical  examination  by  tests  should  be 
three  times  as  frequent  where,  though  free  from  the 
special  dangers  attending  the  inside  closet,  the  other 
waste-pipes  are  not  "cut  off "  outside  the  house. 

3.  It  should  also  be  three  times  as  frequent  where,, 
though  all  other  wastes  are  disconnected,  there  is  a 
water-closet  within  or  beneath  the  dwelling. 

4.  It  should  be  six  times  as  frequent  where  there  is 
the  double  danger  of  an  inside  water-closet  and  undis- 
connected  house  wastes." 

5.  General  Bemarks  on  Sjnohe-Testing  Drains, 

In  connection  with  the  testing  of  houses  with  smoke, 
it  should  be  borne  in  mind  that  there  are  defects  in  the 
drainage  arrangements,  especially  below  ground  -  level, 
which  are  not  very  easily  discovered  by  this  test;  and, 
in  my  own  experience,  I  have  had  cases  where,  suspecting 
defects,  I  could  not  discover  them  with  smoke,  though 
I  made  repeated  trials,  and  where  I  only  succeeded  in 
localising  them  after  I  had  subjected  the  drains  to  the 
hydraulic  test.  It  would,  therefore,  be  incorrect  to  con- 
clude that  in  all  cases  where  the  smoke  test  has  shown 
no  defects,  sewer  gas  could  not  possibly  find  its  way 
into  the  interior  of  the  house,  and  in  such  a  case  the 
more  reliable  hydraulic  test  ought,  in  my  opinion,  never 
to  be  omitted. 


SEWER    GAS    AND    HEALTH.— APPENDIX  XII.  199 


APPENDIX  XII. 

Notes  on  the  Typhoid  Mortality   and  the  Ventilation 
or  the  Sewers  in  Leicester. 

It  might  not  be  out  of  place  to  record  here  some  of 
the  Leicester  experiences  in  connection  with  the  venti-- 
lation  of  the  sewers  and  the  mortaHty  from  typhoid 
fever. 

Leicester  is  supposed  to  have  led  the  way  in  the  intro- 
duction of  the  notification  of  infectious  diseases,  as  this 
came  in  force  in  the  borough  on  the  13th  September, 
1879,  after  Parliament  had  given  its  sanction 'to  this 
step  in  a  private  Act. 

Leicester  may  further  be  said  to  have  been  amongst 
the  first  towns  to  carry  out  a  systematic  drainage 
scheme,  as  this  was  commenced  under  the  late  Mr. 
Wicksteed  in  1852.  Owing  to  the  rapid  increase  of 
the  town,  however,  the  main  sewers  soon  became 
too  small  for  their  work,  and  ever  since  1870  pro- 
posals have  been  made  to  improve  them.  However, 
it  was  not  until  1886  that  the  late  Mr.  Gordon's 
scheme  was  accepted  by  the  Town  Council,  and  this  has 
now  practically  been  completed  at  a  cost,  up  to  the 
81st  day  of  March,  1895,  of  £191,197.  10s.  4d.  Besides 
this  amount,  the  town  of  Leicester  has  also  spent 
since  1885  £69,867.  6s.  6d.  for  a  new  sewage  pumping 
station  and  £68,496.  10s.   5d.  on  the   new  sewage  farm. 

Mr.  Wicksteed' s  sewers  were  practically  not  ventilated 
at  all,  and  in  1881  the  Town  Council  decided  to  open 
them  up  and  thoroughly  cleanse  and  ventilate  them 
by    open     covers    at     street  -  level.      These     operations. 


-200 


SEWER    GAS    AND    HEALTH.— APPENDIX  XII. 


were  continued  up  to  1886,  when,  owing  to  numerous 
complaints  from  the  inhabitants  about  obnoxious 
smells,  the  Sanitary  Committee  decided  to  close  the 
ventilating  covers  where  objected  to,  and  to  erect  in 
their  places  cast-iron  pipes  up  the  sides  of  houses 
wherever  the  necessary  permission  of  the  house-owners 
•could  be  obtained.  In  some  cases,  also,  the  sewers 
were  connected  with  factory  chimneys.  This  policy 
has  since  been  adhered  to.  From  a  report  of  the 
present  surveyor,  it  would  appear  that  in  September, 
1894,  the  following  was  the  number  of  open  and  closed 
•covers  in   the  borough  : 

Table  I.  —  Open  and  Closed   Manhole  and  Lamphole  Covers, 
September,  1894. 


Description  of  Sewers. 

Manholes. 

Lampholee. 

Open. 

Closed. 

Total. 

Open. 

Closed. 

Total. 

Foul  sewers    

470 

280 

980 
245 

1,450 
525 

508 
305 

1,103 
232 

1,611 
537 

Storm- water  sewers     

Totals 

750 

1,225 

1,975 

813 

1,335 

2,148 

From  this  statement  the  following  figures  follow  : 

Total  number  of  open   manhole  and   lamphole  covers  1,563 

Total  number  of  closed  manhole   and   lamphole  covers    2,560 


Grand  total 4,123 

The  borough  surveyor  also  reports  that  up  to  September, 
1894,  255  (6in.  by  4in.)  ventilating  pipes  had  been  put  up 
•on  125i  miles  of  foul  sewers,  and  52  factory  chimneys 
had  been  connected  with  them,  mostly  by  Gin.  pipes. 
Besides  the  foul  sewers,  there  were  at  that  time  in 
Leicester  36J  miles  of  surface  and  storm-water  sewers, 
a-nd  nearly  four  miles  of  storm  outfall  sewers — making 
a  total  of  about  166  miles  of  all  kinds  of  sewers. 


SfCWER    GAS    AND    HEALTH.— APPENDIX   XII.  201 

Bearing    the    above-mentioned    facts    in    mind,    three 
jperiods  can  be  distinguished : 

1.  The  period  before  1881,  when  the  sewers  were  very 

foul  and  not  ventilated. 

2.  The   period   from  1881    to   1886,  in   which  a  great 

length   of    the   old   sewers   was   cleaned    out    and 
ventilated  by  open  covers  at  street-level ;  and, 
:3.  The   period   since   1886,  in   which   practically   two- 
thirds   of    the    open    covers    at    street-level    were 
closed,  about    300    ventilating  shafts   erected,   and 
the  old  main  sewers  replaced  by  larger  and  better 
constructed  ones. 
In  1887,  when  the  complaints  of  objectionable  smells 
(from  the   sewers   became   louder  and  louder,  the  author 
was  instructed  by  his  chief  to  investigate  the  question 
What   influence   the   ventilation   of    the    sewers,   if   any, 
.had    exercised    on  the   death-rates    of    the    town?    and 
his   results  were   given   in   a  diagram,  a   copy  of  which 
.is    attached  to    this    appendix    (see  Diagram  I.).     Since 
then,    as    has    already    been    stated,    the    open    covers 
have   largely   been  closed   again,   so   that  in  September, 
1894,  out  of  the  total  number  of  manhole  and  lamphole 
•  covers,  62  per  cent,  were  closed    and  only  38  per  cent, 
were  open  covers. 

With  a  view  to  comparing  the  typhoid  rates  after  1886 
with  those  before  that  year,  the  author  has  prepared 
Table  I.^  and  Diagram  II.  in  this  appendix,  in  which  he 
has  also  given  the  number  of  certificates  received.  In 
passing,  it  might  be  mentioned  that  the  number  of 
'  certificates  received  represent  the  number  of  infected 
houses  only,  and  that  the  number  of  infected  persons 
is  probably  somewhat  higher. 

On  comparing  Table  11.^  with  Diagrams  I.  and  II.  on 
Plates  II.  and  III.,  the  following  facts  can  be  observed  : 
^  See  page  200.  -  See  page  202. 


202 


SEWER    GAS    AND    HEALTH. — APPENDIX  XII. 


Table  II. — Borough  of  Leicester. 

Mortality  from  Typhoid  Fever  and  Number  of  Certificates  for  22  Years- 

1875  to  1894. 


oid 

-2  g  00 

1^ 

|i 

°P. 

Typh 
nbera 

|s 

th  Ra 
id  Fe 
>eriod 

Typh 
•eceiv 
iber?. 

Is 

1  -§1 

Year. 

i 

Population. 

8  from 
Fever 
ual  Nui 

er  of 
ficates  r 
al  Num 

1^ 

Averag:e    Nu 
Certificat 
100,000   Inh 
in  certain  P 

Death 
Act 

Death 
Feve 
Livir 

Avera 
from 
for  c< 

Numb 
Certi 
Actu 

Numb 
recei' 
Livin 

1875 

110,000 

64 

58 

\ 

1876 

113,581 

43 

38 

1877 

117,462 

20 

17 

32-2 

1878 

119,845 

31 

26 

1879 

117,610 

21 

18 

1880 

120,325 

46 

38 

/ 

245 

204 

1881 

123,120 

29 

23 

-16-3 

179 

145 

1882 

126,275 

19 

15 

110 

87 

1883 

129,483 

10 

8 

85 

•  66 

100 

1884 

132,773 

16 

12 

55 

41 

1885 

136,147 

36 

26 

216 

159 

1886 

139,606 

19 

14 

J 

141 

101 

/ 

1887 

143,153 

31 

22 

1 

222 

155 

-y 

1888 

146,790 

32 

22 

266 

181 

1889 

150,520 

22 

14 

147 

98 

1890 

154,344 

24 

16 

165 

107 

1891 

177,353 

29 

16 

-17-9 

178 

113 

131 

•1892 

180,066 

17 

9 

116 

64 

1893 

184,547 

47 

26 

392 

212 

1894 

189,136 

27 

14 

215 

114 

1895 

193,839 

38 

20 

248 

128 

1896 

198,659 

40 

20 

J 

283 

142 

^ 

Enlarged  borough,  1st  April,  1892. 


Note. — The  systematic  ventilation  of  the  sewers  was  commenced  in  the 
year  1881,  and  the  closing  of  the  manhole  covers,  owing  to  com- 
plaints, dates  from  the  year  1887.  The  number  of  certificates 
received  represents  the  number  of  infected  houses,  the  number  of 
infected  persons  being  somewhat  higher.  The  registration  of 
infectious  disease  came  into  force  on  the  13th  September,  1879.  The 
reconstruction  of  the  main  drainage  of  Leicester  was  commenced* 
by  the  late  J.  Gordon  in  1886,  and  has  cost  up  to  the  3l8t  March, 
1895,  the  sum  of  £191,197.  lOs.  4d.  (capital  expenditure  only). 
The  sums  spent  upon  main  sewers,  pumping  station,  and  sewage- 
farm  (capital  expenditure  only,  J.  Gordon's  scheme)  amounted  up- 
to  31st  March,  1897,  to  £3.32,687.  7s.  3d. 


SEWER    GAS    AND    HEALTH. — APPENDIX  XII.  207 

1.  In  the  first  period,  with  badly  -  constructed,  very 
foul,  and  ill-ventilated  sewers,  the  typhoid  death- 
rate  was  highest — viz.,  32*2  per  100,000. 

"2.  In  the  second  period — of  cleansing  and  ventilating 
the  sewers — the  typhoid  death-rate  suddenly  went 
down  very  considerably,  and  was  lowest — viz., 
16-3  per  100,000. 

•3.  In  the  third  period,  with  new  main  sewers  of  good 
construction  and  nearly  66  per  cent,  of  ventilating 
covers  closed,  the  typhoid  death-rate  rose  again, 
and  was  higher  than  in  the  preceding  period — 
viz.,  17*4  per  100,000,  or  17-9  if  the  years  18.95 
and  1896  are  added. 

4.  The  increase  in  the  prevalence  of  typhoid  fever 
in  the  third  period  over  the  second  period  is  still 
further  illustrated  by  the  number  of  certificates 
received,  the  average  rate  per  100,000  inhabitants 
for  the  second  period  being  100  per  annum,  and 
for  the  third  period  130,  or  131  if  the  years 
1895  and  1896  are  added.  On  the  first  day  of 
April,  1892,  the  borough  of  Leicester  was  enlarged 
by  taking  in  the  outlying  suburban  districts  which 
had  sprung  up  close  to  the  borders  of  the  old 
borough.  But  as  these  were  not  so  densely 
populated  as  the  old  borough,  and  as  the  pre- 
valence of  typhoid  fever  in  them  was  on  the 
whole  not  so  great  as  in  this,  it  is  not  unlikely 
that  the  typhoid  and  certificate  rates  have  been 
favourably  influenced  by  this  step.  No  account, 
has,  however,  been  taken  of  this  in  foregoing 
remarks. 

This  increase  in  the  typhoid  rates  since  1887  is  all 
ihe  more  remarkable,  as  since  that  year  the  new  main 
sewers  (their  cost,  including  pumping  station  and  sewage 


208  SEWTCR    GAS    AND    HEALTH. — APPENDIX  XII. 

farm,  amounted  up  to  31st  March,  1895,  to  dB329,561.. 
7s.  3d.)  and  a  large  number  of  other  sanitary  improve- 
ments have  been  carried  out  in  the  town,  not  to  mention 
the  general  advance  in  the  knowledge  and  treatment  of 
infectious  diseases;  and  if  we  look  for  an  explanation  of 
this  remarkable  fact,  the  thought  suggests  itself  that 
probably  sewer  gas  had  something  to  do  with  it. 

In  the  first  period,  undoubtedly  sewer  gas  did  find  its 
way  freely  into  the  interior  of  the  houses,  forcing  the 
water  seal  of  the  traps,  as  it  could  not  escape  either 
through  ventilated  manhole  covers  or  soil-pipes. 

In  the  second  jDeriod,  the  sewer  gas,  instead  of  being 
forced  into  the  interior  of  the  houses,  was  systematically 
allowed  to  escape  through  the  ventilated  manhole  covers- 
That  this  actually  did  take  place  is  sufficientl}^  proved 
by  the  numerous  complaints  made.  It  must  further 
be  noted  that  the  typhoid  death-rates  in  this  period 
decreased  about  50  per  cent,  in  spite,  as  it  were,  of  the 
very  foul  accumulations  which  were  removed  from  the 
sewers,  and  which  have  repeatedly  been  observed  to 
cause  local  outbreaks  of  this  infectious  disease. 

In  the  third  period,  the  sewer  gas  was  more  and 
more  prevented  from  escaping  at  the  street-level  by 
the  closing  of  the  open  covers,  and  may  have  gradually, 
owing  to  insufficient  ventilation,  gained  access  again  to- 
the  interior  of  the  houses.  In  this  connection,  it  is 
very  interesting  to  observe  that  the  medical  officer  of 
health  reports  that  in  1893,  out  of  all  the  typhoid- 
infected  houses,  31*25  per  cent,  had  defective  drains, 
and  that  in  1894  this  percentage  rose  to  45*18,  the 
defects  being  discovered  by  the  smoke  test.  When,, 
therefore,  practically  for  one- third  and  one-half  of  the 
typhoid-infected  houses  the  possibility  of  the  escape  of 
sewer    gas    into    them    has    been    actually    proved,   it^ 


SEWER    GAS    AND    HEALTH.— APPENDIX   XII.  209" 

would  be  wrong  to  conclude  that  in  the  remaining 
cases  sewer  gas  could  not  have  got  into  the  houses,  as 
underground  defects  are  not  always  brought  to  light  by 
the  smoke  test.  It  must  also  be  borne  in  mind  that 
there  are  many  other  causes  besides  sewer  gas  which 
may  and  undoubtedly  have  been  at  work  in  bringing 
about  the  fluctuations  in  the  typhoid  rates. 

Whatever  our  opinions  on  this  point  may  be,  the  fact 
remains  that  in  spite  of  the  construction  of  the  new 
main  sewers,  and  in  spite  of  numerous  other  sanitary 
improvements,  the  typhoid  rate  of  Leicester  has,  since 
the  commencement  of  the  closing  of  the  open  covers  at 
street-level,  not  gone  down,  but  has,  on  the  contrary, 
slightly  increased,  and  this  fact  should  not  be  over- 
looked by  every  thoughtful  observer. 

If  sewer  gas  is  dangerous  at  all,  one  might  very 
properly  conclude  that  its  effects  will  be  more  seriously 
felt  in  confined  spaces  and  rooms  than  in  the  open 
air  of  streets,  where  it  is  diluted  at  once. 

In  the  present  state  of  our  knowledge  it  is  quite 
impossible  to  assign  for  every  specific  effect  a  specific 
cause.  It  behoves,  therefore,  in  the  author's  opinion,  all 
those  who  occupy  themselves  with  these  questions  to  care- 
fully note  all  the  circumstances  that  contribute  or  appear 
to  contribute  to  the  rise  and  fall  of  death-rates,  and  to  give 
them  their  most  careful  consideration  before  embarking 
upon  measures  the  sanitary  effects  of  which  are,  to  say 
the  least,  very  doubtful. 


14 


INDEX   OF   NAMES   AND   SUBJECTS. 


PAGE. 

-Abuse  of  Sewer- Gas  Theory    31 

Action  of  Sewer  Gas  upon  Health  Two-fold  70  to  73,  114 

-Acute  Mephitic  Poisoning  through  Sewer  Gas    37 

Advancement  in   House  and  General   Sanitation,   Kole  played  by 

Sewer-Gas  Theory 84,  85 

Aerobes,  Work  of    > 16,  17 

Aim  of  True  Sanitation 85,  86 

Air,  Ample  Supply  of  Fresh  Air  in  Sewers 47 

Air  as  Carrier  of  the  Typhoid  Bacillus 29 

Air  Examination  Methods  still  imperfect    49,  55 

Air,  Gaseous  Contents  of  Atmospheric  Air 47 

Air  is  but  seldom  the  Carrier  of  Infectious  Disease  Germs  55 

Air,  List  of  Micro- Organisms  found  in  Fresh  Air ^ 107,  108 

Airey 158 

Alessi's  Experiments,  Arguments  against    , 68,  69 

Alessi's  Experiments  on  the  Influence  of  Sewer  Gas  upon  Animals, 

2,  12,  47,  62  to  69,  120  to  130 

Allied  Subjects 74  to  79 

America  :  Views  held  in  America  concerning  Sewer  Gas   12 

Ammonia,  Presence  in  Sewer  Gas  35,  44,  46,  125 

Ammoniacal  Nitrogen  in  Paris  Sewers 102 

Ammonium  Sulphide 119,  125 

Anasmia 36 

Anaerobes,  Work  of    16,  17 

Andrews' Investigations  concerning  the  Typhoid  Bacillus  in  Sewage, 

see  under  *'  Laws." 
Animals,  Domestic,  do  not  suffer  apparently  from  Typhoid  Fever  ...     59 

Animals,  Experiments  with  Sewer  Air    59  to  69,  119  to  130 

Animals,  Lower,  Inoculated  with  Typhoid  Bacillus, 

59,  60,  61,  120  to  130 

Appendix  1 87  to  99 

Appendix  II 100  to  301 

Appendix  III 102  to  118 

Appendix  IV. 119  to  130 

Appendix  V 131  to  133 

Appendix  VI 134  to  137 

Appendix  VII 138  to  148 

Appendix  VIII 149  to  155 

Appendix  IX 156  to  164 

Appendix  IXa 165  to  185 

Appendix  X - 186  to  194 

Appendix  XI 195  to  198 

Appendix  XII « 199  to  209 

Appetite,  Loss  of  due  to  Sewer  Gas 35 

.Arguments  against  Alessi's  Experiments 68,  69 

14* 


212  SEWER   GAS    AND    HEALTH. — INDEX. 


Arguments  against  Predisposing  Action  of  Sewer  Gas    '. 73  ■ 

Arguments  in  Favour  of  Sewer-Gas  Theory    55  to  57 

Armstrong,  H.  E 22 

Asphyxia  caused  by  Sewer  Gas   37,  39,  70,  135 


B. 

Bacillus  Colis  Communis,  Experiments  with 64 

Bacillus  Typhi,  see  "Typhoid  Bacillus." 

Bacillus  Typhosus,  see  "  Typhoid  Bacillus." 

Bacteria,  see  also  "Germs,"  *'  Microbes,"  and  "  Micro-Organisms." 

Bacteriology,  Advance  of 6 

Bacterium  Coli  Commune,  Experiments  with    64 

Barker,  H.,  Effect  of  Sewer  Air  on  Animals 61.  62,  119 

Baron,    P.,    Influence  of   Waterworks    and  Sewerage  Works  upon 

Public  Health  75  to  77,  79,  188  to  189 

Beetz,  Munich  Sewer  Air „ „     46 

Berlin  Sewage  Farms  have  not  Disseminated  Typhoid  Fever   72 

Berlin  Sewer  Air,  Micro-Organisms  in 103 

Berlin  Sewerage  Works  have  brought  about  a  greater  improvement 

in  the  Public  Health  than  the  Waterworks    75,  76 

Berlin  Typhoid  Epidemics,  1889  and  1893,  no  Typhoid  Germs  found 

in  Water  57 

Berlin  Typhoid  Mortality 188  to  193 

Berlin  Water  Supply,  Discovery  of  Typhoid  Bacillus  in     57 

Bexley  Heath,  Case  of  Diphtheria  attributed  to  Cesspit  Gas 185 

Birmingham,  Abandonment  of  Pail  System  22 

Birmingham  Sewer-Gas  Case,  cause  c4lebre 34,  165  to  185 

Birmingham,  T ubs  or  Pails  and  Typhoid  Coincidence    21 

Blaxall   158 

Blood- Poisoning  through  Sewer  Gas  at  Birmingham 165  to  185 

Blumenstock    139 

Boobyer,  P.,  Report  on  Pail  System 22 

Bristol,  Air  in  Sewers  46,  104,  105 

Bristol,  Faulty  House  Drains  and  Typhoid  Fever 33,  195 

Bubbles  Bursting  in  Sewage  .t 51,  52,  55 

Buchanan  .« 30,  74,  156  to  158,  186 

Budd 4,  27 

Burglars  in  London  Sewers 131 

Bursting  of  Bubbles  in  Sewage      51,  52,  55 

Burton-upon-Trent,  Explosion  in  a  New  Sewer 132 


Caius  College,  Cambridge,  Outbreak  of  Typhoid  Fever,  1874   30,  156 

Cameron,  J.  Spottiswoode,  Drain  Testing  at  Leeds    33,  160,  196 

Carbonic  Acid  in  Atmospheric  Air    47 

Carbonic  Acid,  Presence  in  Sewer  Gas... 35, 44,  45,  46,  47,  70, 102,  119,  125 

Carbonic  Oxide,  Presence  in  Sewer  Gas 35,  70,  125 

Carnelley  45,  50,  51,  52,  54,  104 

Caspar    139 

Cave,  Justice   37,  143 

Cellar  Dwellings,  Vapours  in  Disused  and  Un ventilated    46,  101 

Cesspit  Air  and  Cesspit  Gas,  Definition  of  Term    15 

Cesspit,  Explosions  in     43,  131  to  133 


SEWER  GAS  AND  HEALTH.— INDEX.  213 

•Cesspit  Gas,  Case  of  Diphtheria  attributed  to 185 

Cesspits,  see  "Conservancy  Systems." 

Chemical  Changes  brought  about  by  Bacteria  in  Sewage    115 

Ohevalier  139 

Children,  Effect  of  Sewer  Gas  on 36 

Cholera    5.  26,  72 

Cholera  Germ  not  found  in  Hamburg  Water 57 

Clapham,  Case  of  Sewer-Gas  Poisoning 138 

•  Closing  of  Sewer  Ventilating   Covers  in   the   Centre   of   Koads  at 

Leicester 81  to  83,  199  to  209 

Clothes  as  Carriers  of  Typhoid  Bacillus 29 

Coal  Gas,  Presence  in  Sewers 43 

Colic  due  to  Sewer  Gas 35 

Collins,  Justice    34,  165 

Composition  of  Sewer  Air 100 

Concluding  Kemarks 84  to  86 

Conclusions  as  to  Existence   of  Pathogenic  Germs  in   Sewage  and 

Sewer  Air 54,55,  102  to  118 

•  Conclusions  as  to  Micro-Organic  Life  in  Sewer  Air 50 

Conclusions    of    Alessi    as    to    the    Action    of    Sewer    Gas    upon 

Animals   66,  67,  123  to  126 

•Connection    between  Sewer  Gas  and  Typhoid  Fever, 

66,  67,  69,  71,  74  to  79,  114,  118 

•  Conservancy  Methods  more  Favourable  to  Spread  of  Typhoid  Fever 

than  Water-Carriage  System   78,  79 

Conservancy  Systems  and  their  Disadvantages   20  to  25 

Contents  of  Sewer  Air  or  Sewer  Gas  44  to  58 

•Croydon,  Outbreak  of  Typhoid  Fever,  1875      30,  156 


Damages  awarded  for  Sewer-Gas  Poisoning 34,  37,  143,  165  to  185 

Danzig,  Influence  of  Sewer  Gas  on  Health 31,  164 

Darwen,  Continuance  of  Pail  System  23 

Decomposition,  Definition  of  Term    15 

Decomposition,  Products  of 17 

Dedication  to  Sir  Thomas  Wright iii. 

Definition  of  Terms  Used 14  to  15 

Deposits  in  Sewers  must  be  avoided 47 

Diarrhoea , 5,  26,  35.  72 

Difference  between  Micro- Organisms  in  Sewer  Air  and  Sewage, 

112,  113,  114 
Difference  between   Waterworks    and    Sewerage    Works   in    their 

Influence  upon  Health 74  to  79,  186  to  194 

Digestive  System,  Derangement  of,  through  Sewer  Gas 35 

Dilution  of  Sewer  Gas  and  its  Escape  in  the  Centre  of  Koads  and 

Streets  80  to  83,  199  to  209 

Diphtheria 5,  26 

Diphtheria,  Case  of ,  attributed  to  Cesspit  Gas 185 

Direct  Infective  Action  of  Sewer  Gas  probably  very  small     71 

Direct  or  Mephitic  Action  of  Sewer  Gas  70  to  73 

Dirty  Hands  as  Carriers  of  Typhoid  Bacillus 29 

Disconnecting  Traps  in  Germany 11,  23 

Disconnecting  Traps  in  Paris 12 

Disease  and  Dirt  go  Hand-in-Hand 4 

Diseases  attributed  to  Sewer  Gas,  List  of    5 


214  SEWER   GAS    AND    HEALTH. — INDEX. 


Distance  Micro-Organisms  can  be  carried  by  Sewer  Air     53^ 

Drains,  see  "  House  Drains." 

Dunbar  on  Typhoid  Bacillus  29 

Dundee,  Air  in  Sewers  45,  104,105 

Dysentery  5,  26 


E. 


East  Ham  Sewer  Fatality  24,  37,  48,  140  to  14? 

Eberth,  Discoverer  of  Typhoid  Bacillus .    27,U16' 

Emanations  from  Sewers  and  Cesspits  and  Typhoid  Fever    4 

Enteric  Fever,  see  "  Typhoid  Fever." 

Epidemiology  of  Typhoid  Fever 26  to  29^ 

Erysipelas   5,  26,  72 

Escape  of  Sewer  Gas  in  the  Centre  of  Roads  and  Streets, 

80  to  83,  199  to  209 

Etiology  of  Typhoid  Fever  26  to  29^ 

Examinations  of  Air,  Methods  for,  still  imperfect    49 

Excreta,  Human,  see  "  Faecal  Matters." 

Experimental  Researches  into  the  Causal  Relations  between  Sewer 

Air  and  Typhoid  Fever 59  to  69,  119  to  130- 

Experimental  Results  on  Sewer  Air  agree  with  its  Actual  State  in 

Sewers    65- 

Experiments  on  Animals  with  Sewer  Air  59  to  69,  119  to  130 

Experiments  on  Sewer  Air ...  49  to  58,  102  to  118 

Experiments  with  Sewage  51  to  58,  115  to  11& 

Explosions  in  Sewers  and  Cesspits 43,  131  to  133 


F. 

Facultative  Anaerobes,  Work  of    16,  17' 

FsBcal  Matters  can  develop  Poisonous  Gases  44' 

Faecal  Matters,  Changes  of,  after  Evacuation    16  to  19*^ 

Faecal  Matters,  Number  of  Bacteria  in  Fresh  Faecal  Matters 18 

Fatty  Acids,  Volatile,  Presence  in  Sewer  Gas    44 

Faulty  House  Drains  and  Typhoid  Fever  32,  33,  195  to  198 

Fenton 155 

Feverishness  due  to  Sewer  Gas      35- 

Ficker,  Experiments  on  Sewer  Air 52,  53,  54 

Filth  and  Disease  go  Hand-in-Hand 4' 

Finkelnburg     139- 

Fraenkel    59^ 

France,  Views  held  in  France  concerning  Sewer  Gas  12 

Frankfort  on-the-Oder,  Case  of  Typhoid  Fever  due  to  Sewer  Gas,  31,  164 
Frankland,  Bursting  of  Lithia  Bubbles    51 


Gaffky,  Discoverer  of  Typhoid  Bacillus  27,  59,  116 

Gases  Dissolved  in  Sewage  46,  101. 


SEWER   GAS   AND    HEALTH. — INDEX.  215 

Gases  Formed  in  Conservancy  Methods  more  Dangerous  than  those 

formed  in  the  Water-Carriage  System 7,  25 

Gases  Formed  in  Conservancy  Methods,  see  "Cesspit  Gas  "  and  **  Privy 

Gas." 
Gases  Formed  in  Sewers,  see  "  Sewer  Gas." 

Gastro-Enteritis „ 5,  2& 

Gaultier  de  Claubry  39,  45,  135,  138 

German  Association  of  Public  Health,  Magdeburg  Meeting,  1894   ...     10 

German  Association  of  Public  Health,  Stuttgart  Meeting,  1895  10 

German  Association  of  Public  Health,  Vienna  Meeting,  1881 7,187 

Gernian  Towns,  Typhoid  Mortality  in,  after  Baron 188  to  18^ 

Germany,  Opinion  of  Sewer-Gas  Theory  in  ..  6tol2 

Germany,  Outbreaks  of  Typhoid  Fever  attributed  to  Sewer  Gas      . .     30 

Germany,  Sewer-Gas  and  Typhoid-Fever  Cases    164 

Germs,  see  also  "Bacteria,"  "Microbes,"  "Micro-Organisms." 

Glasgow,  Abandonment  of  Pail  System 22 

Glauchau,  Case  of  Sewer-Gas  Poisoning ....48,  145  to  146 

Goepel,  Case  of  Typhoid  Fever  due  to  Sewer  Gas    31,  164 

Gordon,  Joseph    199 

Gordon,  Joseph,  Designs  the  Sewerage  of  Munich 7 

Guy,  Health  of  Sewermen  135 


H. 

Haldane 45,  50,  51,  52,  54,  105 

Halle 139 

Hamburg   Cholera   Epidemic,    1892,   no    Cholera   Germs  found  in 

Water    57 

Hankel 36,  48,  135,  136,  143,  144,  145,  146 

Harpurhey,  Death  of  One  Man  in  a  Sewer 147 

Harvey,  W 27 

Headache  due  to  Sewer  Gas    35 

Health,  Sewer  Gas  and  its  Influence  upon  Public  Health  ;  Literature 

in  the  English,  German,  French,  and  other  languages       ,..,.  ...87  to  99 

Health,  Influence  on,  by  Sewer  Gas 70  to  73 

Health  of  Sewermen 38,  39,  134  to  137 

Health,  see  also  "  Public  Health." 

Hesse,  Distance  Micro-Organisms  can  be  carried  by  Sewer  Air 53,  54 

Hill,  Bostock,  Case  of  Septic  Poisoning  at  Sutton  Coldfield 

40  to  42,  73,  149  to  155 

History  of  Sewer-Gas  Controversy 4  to  13 

Homerton  Fever  Hospital,  Difiiculty  of  Finding  Typhoid  Bacillus  in 

Drains 56,57,116 

Hornsey,  Faulty  House  Drains  and  Typhoid  Fever   33,  196 

Hospital  Gangrene 5,  26 

House  Drains,  Faulty,  and  Typhoid  Fever   32,  33,  195  to  198 

House  Drains  if  Systematically  Laid  and  Used  should  not  be  in  a 

Foul  Condition     23 

House  Drains,  Micro-Organisms  in  Air  of  House  Drains 50,  10^ 

House  Drains,  Testing  of 32,  33,  198 

Hueppe,  Influence  of  Waterworks  and  Sewerage  Works  upon  Public 

Health   - 77 

Hull,  Continuance  of  Pail  System     2S 

Humidity  in  Paris  Sewers  105 

Hydrocarbons,  Presence  in  Sewer  Air   43,  44 

Hydrogen  Sulphide    11^ 


216  SEWER   GAS    AND    HEALTH. — INDEX. 


I. 

Identification  of  Typhoid  Bacillus  very  difficult  28,  56,  116 

Illustration.  Leeds  Fever  Hospital,  in  which  an  Outbreak  of  Typhoid 

Fever  occurred     160 

Illustration  of  Locality  in  which  a  Case  of  Blood-Poison ing  through 

Sewer  Gasoccurred    166 

Indirect  or  Predisposing  Action  of  Sewer  Gas    70  to  73 

Infectious  Diseases  caused  by  Specific  Contagia  Animata 27 

Infectious  Diseases,  Microbes  of,  are  Specific  Germs  which  spring 

from  their  like  and  only  create  their  like 28 

Infective  Action  of  Sewer  Gas 71 

Inflammation  of  the  Lungs  5,26 

Influence   of   Sanitary  Works   upon  the    Mortality  from   Typhoid 

Fever 74  to  79.  186  to  194 

Influence  of  Sewer  Gas  upon  Health   70  to  73,  114,  118 

Injury  to  Health  from  Sewer  Gas,  Observed  Cases  ...  30  to  31,  156  to  164 
Inoculation  of  Lower  Animala  with  Typhoid  Bacillus  59  to  60,  120  to  130 

Insomnia  due  to  Sewer  Gas 35 

Instruments  as  Carriers  of  Typhoid  Bacillus 29 

Introductory  Remarks  1  to  3 

Italy,  Views  held  in  Italy  concerning  Sewer  Gas 12 


J. 

Jordan    112 

Justice  Cave 37, 143 

Justice  Collins 34,  165 

Justice  Wills 34,  185 


King's  Norton  Urban  District  Council 34,  165  to  185 

Kirchner,  M.,  Opinion  on  Sewer  Gas 10,  55 

Klein,  Report  on  Contamination  of  Soup  through  Sewage, 

40  to  42,  152  to  155 

Knowledge  of  Micro-Organisms  of  Sewer  Air  still  limited 49 

Koch,  R.,  Typhoid  Bacillus 27 


L. 

Languor  due  to  Sewer-Gas  Inhalation 35 

Lawrence  Sewage,  List  of  Micro-Organisms  in 112 

Laws  and  Andrews'  Experiments  in  London  Sewers,  etc., 

2,  49  to  58,  105  to  118 

Laws,  Conclusions  as  to  Micro-Organisms  in  Sewer  Air  106,  107 

Laws,  Difficulty  of  Finding  Typhoid  Bacillus  in  London  Sewage, 

56,  57,  116,  117 

Laws,  Distance  Micro-Organisms  are  carried  by  Sewer  Air    54 

Laws,  Gaseous  Contents  of  London  Sewer  Air 46 

Laws,  Micro-Organisms  in  London  Sewer  Air 50,  105  to  118 

Laws,  Slimy  Skin  of  Sewer  Walls  does  not  give  off  Germs 52,  53 

Laws,  Splashing  in  Sewers    52,  106 


SEWER    GAS    AND    HEALTH. — INDEX.  217 


Leeds,  Faulty  House  Drains  and  Typhoid  Fever 33,  196  to  198 

Leeds,  Outbreak  of  Typhoid  Fever  in  a  Fever  Hospital    160  to  163 

Leicester,  Abandonment  of  Pail  System 22 

Leicester,  Experience  as  to  Closing  of  Sewer  Ventilating  Covers  in 

the  Centre  of  Roads  81  to  88,  199  to  209 

Leicester,  Faulty  House  Drains  and  Typhoid  Fever    33,  82,  195 

Leicester,  Tubs  or  Pails  and  Typhoid  Coincidence    21 

Leicester,  Typhoid  Mortality  and  the  Ventilation  of  Sewers  ...199  to  209 

Letheby,  Air  of  London  Sewers  45,  101 

Leucocytes    ^ 61,  86 

Levy,  Air  in  Paris  Sewers 46,  50,  102 

Liborius,  Typhoid  Bacillus  can  live  without  Oxygen  29 

Linen  as  Carriers  of  Typhoid  Bacillus 29 

Lindley,  W.  H.,  Opinions  on  Sewer  Gas 10 

Lissauer,  Influence  of  Sewer  Gas  on  Health 31,  164 

List  of  Micro- Organisms  found  in  Lawrence  Sewage 112 

List  of  Micro- Organisms  found  in  London  Sewage  110,  111,  112 

List  of  Micro-Organisms  found  in  London  Sewer  Air 108,  109,  110 

Literature,  Index  to  Literature  in  the  English,  German,  French,  and 
other  languages  on  the  subject  of   Sewer  Gas  and  its  Influence 

upon  Healthy  and  allied  subjects  87  to  99 

Loesener    57 

London  Sewage,  List  of  Micro-Organisms  in 110,  111,  112 

London  Sewer  Air,  Gaseous  Contents 45,  46 

London  Sewer  Air,  Micro-Organisms  in    50,  105  to  118 

London  Sewermen,  Health  of 136 

London  Sewers,  Case  of  Mephitic  Poisoning  in 138,  146 

London  Sewers,  Explosion  in 131 


M. 

"Malaise  due  to  Sewer  Gas     35 

Malaria    6,  26 

Manchester,  Abandonment  of  Pail  System 22 

Marsh  Gas,  Presence  in  Sewer  Air    43,  45 

Mayence,  Explosion  in  a  Cesspit  at  Mayence      131 

Meat  Poisoned  through  Sewer  Gas     42 

Media  through  which  Typhoid  Bacillus  is  disseminated 29 

Melton  Mowbray,  Outbreak  of  Typhoid  Fever  in  1880   30,  158 

Mephitic  or  Direct  Action  of  Sewer  Gas     70  to  73,  84 

Mephitic  Poisoning   Mild  Form 35,  143 

Mephitic  Poisoning,  Severe  Form    38,  144 

Mephitic  Poisoning  through  Sewer  Gas 35  to  37,  70,  71,  138  to  148 

Metchnikoff 61 

Methane,  see  "  Marsh  Gas." 

Methods  for  the  Examination  of  Air  still  imperfect 49,  55 

Methyl  Sulphide 125 

Meyer,  Discoverer  of  Typhoid  Bacillus    ,..     27 

Microbes  and  Micro-Organisms,  see  also  "  Bacteria,"  *'  Germs." 

Micro- Organic  Life  in  Sewage  brings  about  Chemical  Changes 115 

Micro-Organisms,  Distance  they  are  carried  by  Sewer  Air     63,  54 

Micro-Organisms  do  not  rise  from  Wet  Surfaces  ^ 51 

Micro-Organisms  in  Air  of  House  Drains 50,  103 

Micro-Organisms  in  Berlin  Sewer  Air    60,  103 

Micro-Organisms  in  Bristol  Sewer  Air  50,  103 

Micro-Organisms  in  Dundee  Sewer  Air  50,  103 


218  SEWER    GAS    AND    HEALTH. — INDEX. 


Micro-Organisms  in  London  Sewer  Air 50,  105  to  IIS 

Micro-Organisms  in  Paris  Sewer  Air 50,  102 

Micro-Organisms  in  Sydney  Sewer  Air 50,  103 

Micro-Organisms  in  Westminster  Palace  Sewer  Air  50,  103 

Micro-Organisms  in  Sewer  Air  49  to  58,  102  to  118 

Micro-Organisms  in  Sewer  Air  and  Sewage,  Difference 112,  113,  114 

Micro-Organisms  in  Sewer  Air  related  to  those  in  Atmospheric  Air 

outside  Sewers,  but  not  to  those  in  Sewage    50,  114 

Micro-Organisms  in  Sewer  Air,  Knowledge  of,  still  limited   49 

Micro-Organisms,  Number  of,  in  Fresh  Human  Dejecta « 18 

Micro-Organisms,  List  of,  in  Fresh  Atmospheric  Air ., 107,  108 

Micro-Organisms,  List  of,  in  Lawrence  Sewage    112 

Micro-Organisms,  List  of,  in  London  Sewage 110  to  112 

Milk  as  Carrier  of  Typhoid  Bacillus 29 

Mineralisation  of  Organic  Matters  in  Soil  and  Water 16 

Miquel,  Air  in  Paris  Sewers 46,  50,  102 

Mixture  of  Gases,  Experiments  with,  by  Alessi 66,  125 

Mortality  from  Typhoid  Fever,  see  "  Typhoid  Mortality." 

Mosaic  Law 4 

Munich,  Decline  of  Typhoid  Fever  with  Improvements  in  Sewerage, 

78,  187  to  188 

Munich  Sewermen 38,  136 

Munich  Sewers,  Gaseous  Contents  of  Air  in 46,  lOO 

Murchison    4,  27,  39,  135 


N. 

Naegeli,  Germs  do  not  Rise  from  Wet  Surfaces 51 

Nervousness 35 

Neuralgia 35 

Newcastle-upon-Tyne,  Tubs  or  Pails  and  Typhoid  Coincidence   22 

New  Sewer,  Explosion  in  a  New  Sewer  at  Burton-upon- Trent     132 

New  Sewers,  Systematically-Constructed,  Air  in 45,  46,  47 

Nitrogen  in  A-tmospheric  Air 47 

Nitrogen,  Presence  in  Sewer  Gas  45 

Nottingham,  Abandonment  of  Pail  System    22 

Nottingham,  Keport  on  Pail  or  Tub  System 22 

Number  of  Micro-Organisms  in  Sewer  Air 50 

Nutritive  System,  Derangement  of,  through  Sewer  Gas 36 

o. 

Observed  Cases  of  Injury  to  Health  from  Sewer  Gas... 30  to  31,  156  to  164 

Observing  Stations  in  Paris  Sewers  102 

Old  Sewers,  Air  in 45,  46- 

Omne  Vivum  ex  ovo,  W.  Harvey  27 

Organic  Vapour  in  Sewer  Air 47 

Outbreaks  of  Typhoid  Fever  attributed  to  Sewer  Gas,  30  to  31,  156  to  164 

Oxidation,  Complete  and  Incomplete    17 

Oxidation  of  Organic  Matters  in  Soil  and  Water   16- 

Oxygen,  Importance  of  Oxygen  in  Decomposition  of  Organic  Waste 

Matters 16,  17 

Oxygen  in  Atmospheric  Air 47 

Oxygen,  Keduction  of ,  in  Sewer  Air 44,  45 

Oxygen,  Typhoid  Bacillus  can  live  without  it    29- 


SEWER    GAS    AND    HEALTH.— INDEX.  219* 


Paddington  Sewer  Air,  Gaseous  Contents   46- 

Pails,  see  "  Conservancy  Methods." 

Parent  Duchatelet,  Health  of  Sewermen ,  135 

Paris  Sewers,  Accidents  in  139' 

Paris  Sewer  Air,  Gaseous  Contents 45,  46,  100 

Paris  Sewer,  Micro-Organisms  in  102 

Parkes,  Manual  of  Practical  Hygiene 61,  134 

Pathogenic  Germs  are  but  seldom  carried  by  Air 55 

Pathogenic  Germs  are  Specific  Germs  which  spring  from  their  like 

and  only  create  their  like 28 

Pathogenic  Germs  do  not  Rise  from  "Wet  Surfaces    55 

Pathogenic  Germs,  It  is  possible,  but  not  very  probable,  that  they 

are  carried  about  by  Sewer  Air 55,  57 

Pathogenic  Germs  more  delicate  than  other  forms 19,  51,  54 

Pathogenic  Germ,  The  only  one,  found  [up  to  the  present  in  Sewer 

Air 50,56' 

Peacock,  Typhoid  Fever  amongst  Sewermen    89,  135- 

Petri,  Micro-Organisms  in  Berlin  Sewer  Air   50,  103 

Pettenkof er  in  Favour  of  Water-Carriage  System , .  7 

Plan  of  Leeds  Fever  Hospital  in  which  Typhoid  Fever  broke  out 160 ' 

Plan  of  Locality  at  Birmingham  (Mr.  T.  H.  Smith's  House)  where  a 

Case  of  Blood-poisoning  was  attributed  to  an  Escape  of  Sewer  Gas  166  • 

Plate  I.— Diagram  I.  :  Typhoid  Mortality  in  Berlin,  1854  to  1890, 

TO   FACE   PAGE  190 

Plate  I. — Diagram  II.  :  Mortality  from  all  Causes  in  Berlin,  1840  to 

1890    .„ TO   FACE    PAGE    190 

Plate  II. — Diagram  I.  :  Sanitary  State  of  Leicester  during  the  years 
1875  to  1886,  before  and  after  the  Introduction  of  the  Systematic 
Ventilation  of  the  Public  Sewers to  face  page  202- 

Plate  III.— Diagram  II.  :  Typhoid  Fever  in  Leicester  for  20  years, 
1875  to  1894,  before  and  during  the  Ventilation  of  the  Sewers  at 
Street  Level,  and  since  the  closing  of  about  two-thirds  of  the 
Open  Covers to  face  page  202 

Poisonous  Gases  contained  in  Sewer  Air  or  Sewer  Gas... 44  to  48,  100 

Prausnitz 136- 

Predisposing  Action  of  Sewer  Gas,.  65,  70  to  73,  85' 

Predisposing  Action  of  Sewer  Gas,  Argument  against 7^ 

Preface vii. 

Present   State   of   our    Knowledge    of    the  Changes   Faecal  Matters 

Undergo  after  Evacuation  16  to  19^ 

Press,  Daily,  takes  great  interest  in  Scientific  Questions 5- 

Privies  and  Privy  Middens,  see  "Conservancy  Methods." 

Privy  Gas,  Definition  of  Term 15' 

Prostration  due  to  Sewer  Gas    35 

Protective  Forces  of  the  System    ..  60,  61,  86- 

Public  Health,  Influence  of  Waterworks  and  Sewerage  Works  upon, 

74  to  79,  186  to  194 

Public  Health,  Interest  of  Public  in  Sewer-Gas  Controversy 5- 

Puerperal  Fever 5,  26,  72 

Putrefaction,  Definition  of  Term 15 

Putrefaction,  Products  of    17 

Putrid  Gases,  Definition  of  Term    14 

Pythogenic  Theory    ^- 


■520  SEWER   GAS    AND    HEALTH. — INDEX. 


R. 

Keference  to  the  Subject  of  the  Influence  of  Sewer  Gas  upon  Health 

difficult  up  to  the  present 3 

Relations,  Causal,  between  Sewer  Air  and  Typhoid  Fever, 

59  to  69,  119  to  130 

Renk,  Views  on  Sewer-Gas  Theory   8 

Retilindol 125 

Rheumatic  Affections  amongst  Sewermen  .^ ..39,  136 

Riecke   4 

Roads,  Escape  of  Sewer  Gas  in  the  Centre  of  Roads  ...80  to  83,  199  to  209 

Rochdale,  Continuance  of  i*ail  System 23 

Roechling,   H.    Alfred,    Typhoid   Fever  in  a   House    with  Faulty 

Drainage 163  to  164 

Roechling,  H.  Alfred,  Water  Supply  and  Drainage  of  Houses  10 

Russel,  Contents  of  Paddington  Sewer  Air 45 


S. 

Sanitary  Works,  Influence  of,  upon  Public  Health  ...  74  to  79,  186  to  194 
Sanitation,  Advancement  in  House  and  General   Sanitation,    Role 

played  by  Sewer-Gas  Theory  84,  85 

Sanitation,  Aims  of  True  Sanitation 19,  85,  86 

Scarlet  Fever 5,  26 

Septic  Poisoning  through  Sewer  Gas 40  to  42,  73,  149  to  155 

Sewage,  Bubbles  Bursting  in  51,  52 

Sewage,  Difficulty  of  finding  Typhoid  Bacillus  in     56,  57,  116 

Sewage,  Experiments  with 51  to  58,  115  to  118 

Sewage  Farms  do  not  spread  Typhoid  Fever  72 

Sewage,  Gases  Dissolved  in    46,  101 

Sewage,  List  of  Micro-Organisms  in  Lawrence  Sewage    112 

Sewage,  List  of  Micro-Organisms  in  London  Sewage   110,  111,  112 

Sewage  not  a  Favourable  Medium  for  Pathogenic  Germs 54,  117 

Sewage,  Splashing  in.  Disseminates  Micro-Organisms     51,  52 

Sewage,  Vitality  of  Typhoid  Bacillus  in  Sewage 28,  117 

Sewerage  Works  contribute  in  a  more  marked  degree  to  Improve- 
ment of  Public  Health  than  Waterworks  75,  186  to  194 

Sewerage  Works,  Influence  upon  Public  Health    74  to  79,  186  to  194 

Sewer  Air  and  Sewer  Gas  Synonymous  Terms   14 

Sewer  Air  and  Typhoid  Fever,  Experimental  Researches  into  their 

Causal  Relation 59  to  69,  119  to  130 

Sewer  Air,  Composition  of   100 

Sewer  Air,  Distance  Micro-Organisms  are  carried  by ,.  53,  54 

Sewer  Air,  Experiments  on 49  to  58,  102  to  118 

Sewer  Air,  Experiments  with,  on  Animals 59  to  69,  119  to  130 

Sewer  Air,  It  is  possible,  but  not  very  probable,  that  it  carries  about 

Pathogenic  Germs  57 

Sewer  Air,  Micro-Organisms  in 49  to  58,  102  to  118 

Sewer  Air,   Micro-Organisms  in  Sewer  Air  differ    from    those    in 

Sewage  112,  113,  114 

Sewer  Air  or  Sewer  Gas,  Contents  of    44  to  58,  100 

Sewers,  Explosion  in 43,  131  to  133 

Sewer  Gas  and  its  Influence  upon  Public  Health  ;  index  to  literature 

in  the  English,  German,  French,  and  other  languages 87  to  99 

Sewer  Gas,  Connection  between  Sewer  Gas  and  Typhoid  Fever  ...74  to  79 
uSewer  Gas,  Contamination  of  Meat 42 


SEWER    GAS    AND    HEALTH. — INDEX.  221' 

Sewer-Gas  Controversy,  History  of 4  to  13 

Sewer  Gas,  Dilution  of,  and  its  Escape  in  the  Centre  of  Eoads  and 

Streets 80  to  83,  199  to  209 

Sewer  Gas,  Diseases  attributed  to  it     5 

Sewer  Gas,  Effect  of  Sewer  Gas  on  Children 36 

Sewer  Gas,  Influence  on  Health 70  to  73 

Sewer  Gas  in   Presence   of   Specific   Contagion  cause  of  Typhoid 

Fever 27 

Sewer  Gas,  Mephitic  Poisoning  through  35  to  37,  138  to  148 

Sewer  Gas  not  the  Cause  of  Typhoid  Fever 55 

Sewer  Gas,  Outbreaks  of  Typhoid  Fever  attributed  to  Sewer  Gas, 

30  to  31,  156  to  164 

Sewer  Gas,  per  se,  Cause  of  Typhoid  Fever 27 

Sewer-Gas  Poisoning  at  Birmingham 34,  165  to  185 

Sewer  Gas  Predisposes  the  System  to  the  Pathogenic  Action  of  the 

Typhoid  Bacillus  65,  66,  70,  85 

Sewer  Gas,    Predisposing  Action  to  other  Infectious  Diseases   not 

sufficiently  investigated    71,72 

Sewer  Gas,  Septic  Poisoning  through 40  to  42,  73,  149  to  155 

Sewer-Gas  Theory,  Abuse  of  31 

Sewer-Gas  Theory,  Arguments  in  Favour  of  55  to  57 

Sewer-Gas  Theory  has  played  an  important  part  in  the  Advance- 
ment of  House  and  General  Sanitation 84,  85 

Sewermen  at  Munich 38,  136 

Sewermen,  Health  of  38,39,  134  to  137 

Sewermen,  Immunity  to  Typhoid  Fever 73 

Sewers   must  not  be  Sewers  of   Deposit,  and  ought  to   contain  an 

ample  supply  of  Fresh  Air 47 

Sewers,   Slimy  Surface  of  Sewer  Walls,   Dissemination  of   Micro- 
organisms   , 51,  52 

Sewers,   Ventilating  Covers  in  the  Centre  of  Streets,  Closing  of   at 

Leicester,  and  Typhoid  Fever  81  to  83,  199  to  209 

Sherborne,  Outbreak  of  Typhoid  Fever,  1882 30,  158 

Simmonds 59 

Slimy  Surface  of  Sewer  Walls,  Dissemination  of  Micro-Organisms...51,  52 

Smith,  Micro- Organisms  in  Sydney  Sewers    50,  103 

Smith,  T.  H.,  Case  of  Sewer-Gas  Poisoning  34,  165  to  185 

Smoke  Testing  of  Drains 32,  33,  82,  195  to  198 

Sore  Throats  amongst  Sewermen 39,  136 

Soup,  Contamination  of,  through  Sewage 40  to  42,  149  to  155 

Soyka,  Views  on  Sewer-Gas  Theory 7,  75,  187 

Specific  Contagia  Animata  cause  Infectious  Diseases    27 

Specific  Germs     28 

Splashing  in  Sewage,  Dissemination  of  Micro- Organisms 51,  52,  55 

Spores  of  Typhoid  Bacillus    29 

Stern 60 

Stevens 136 

St.  Pancras,  Outbreak  of  Typhoid  Fever  in  Foundling  Hospital... 30,  159 
Street  Sewers,  Formation  of  Gases  in  Old  and  Modern  Sewers  ...     24 

Struggle  for  Existence  amongst  Germs  in  Sewage   51,  54,  115 

Sulphuretted   Hydrogen,    Death   of   Five    Men   from   Sulphuretted 

Hydrogen  at  the  Tynemouth  Gasworks 147 

Sulphuretted  Hydrogen,  Fatal  Dose    47 

Sulphuretted  Hydrogen,  Presence  in  Sewer  Gas... 35,  44,  45,  47,  70,  125 

Sunlight  Destroys  Typhoid  Bacillus   2^ 

Survival  of  the  Fittest  as  regards  Bacterial  Life 19,  51,  54,  115 

Sutton  Coldfield,  Case  of  Septic  Poisoning,  1894 40  to  42,  73,  149  to  155 


\222  SEWER   GAS    AND    HEALTH. — INDEX. 


/Sydney  Sewers,  Micro- Organisms  in  Sewer  Air    50,  103 

.Sykes,  J.  F.  J 30,  159 


T. 

Table,  Berlin  Mortality  from  all  Causes  and  from  Typhoid  Fever 

between  1854  and  1890  190 

Table,    Buchanan's   Table  of  Mortality  from    Typhoid    Fever    in 

various  English  towns  before  and  after  the  Execution  of  Sanitary 

Works    186 

Table,  Composition  of  Sewer  Air   100 

Table,  Dr.  Alessi's  Experiments  with  Various  Gases  130 

Table,  Dr.  Alessi's  Experiments,  Influence  of  Putrid  Gases  upon  the 

Animals  experimented  with     127 

Table,  Dr.  Alessi's  Experiments,  Mortality  Keturn  of  all  Animals  ...  128 
Table,  Dr  Alessi's  Experiments.  Time  elapsed  between  the  Inocula- 
tion with  the  Bacilli  and  the  Death  of  the  Animals 129 

Table,  Dr.  Alessi's  Experiments,  Time  necessary  for  the  Animals 

to  acquire  the  Predisposition   128 

■  Table,  Gases  Dissolved  in  Kaw  Sewage     101 

Table,  Investigations  into  the  Micro-Organic  Life  in  Sewer  Air 50 

Table,   Leeds   Drain-Testing.    Findings  in  1,121  Houses  in  which 

Typhoid  or  Diphtheritic  Disease  was  supposed  to  be  present 196 

Table,   Leicester  Mortality  from  Typhoid  Fever  and  Number  of 

Certificates  for  20  years,  1875  to  1894    202 

Table,  Leicester  Open  and  Closed  Manhole  and  Lamphole  Covers, 

September,  1894  200 

Table,  Leicester  Typhoid-Infected  Houses  with  Defective  Drainage...  195 
Table,    Mephitic  Vapours     in    Disused    and    Un ventilated    Cellar 

Dwellings  101 

Table,  Munich  Typhoid  Mortality 189 

Table,  Particulars  and  Numbers  of  Animals  Experimented  on  by 

Dr.  Alessi 62 

Table,  Poisonous  Gases  in  Cesspits 44 

Temperature,  Variation  of,  in  Paris  Sewers  103 

Terms  Used  in  Treatise,  Definition  of 14  and  15 

Testing  Drains    32,  33 

Thierling  139 

Tubs,  see  "  Conservancy  Methods." 

Tubs  or  Pails  and  Typhoid-Fever  Coincidence 21,  22 

Typhoid  Bacillus,  Action  upon  Animals 60 

Typhoid  Bacillus  can  exist  without  Oxygen  29 

Typhoid  Bacillus  cause  of  Typhoid  Fever 27,  55 

Typhoid  Bacillus,  Difificulty  of  finding,  in  Water 57 

Typhoid  Bacillus  does  not  form  lasting  Spores 29 

Typhoid  Bacillus  does  not  make  great  demands  on  its  Nutritive 

Medium 29 

"Typhoid  Bacillus,  Experiments  with,  by  Alessi  62  to  69,  120  to  130 

Typhoid  Bacillus  found  in  Urine  and  Stools  of  Typhoid  Patients    ...     28 

Typhoid  Bacillus,  Identification  of,  very  difficult    28,  56,  116,  117 

Typhoid  Bacillus,  Inoculation  of  Lower  Animals  with... 59,  60,  120  to  130 
Typhoid  Bacillus,  It  is  possible,  but  not  very  probable,  that  it  is 

carried  about  by  Sewer  Air 57 

Typhoid  Bacillus,    Media  through  which  it  is  disseminated— Air, 

Water,  Milk,  Linen,  Cloths,  Dirty  Hands,  Instruments,  etc.  .....     29 

Typhoid  Bacillus  not  Cause  but  Product  of  Typhoid  Fever  28 


SEWER   GAS    AND    HEALTH. — INDEX.  223 

'Typhoid  Bacillus  perishes  quickly  in  Direct  Sunlight     29 

Typhoid  Bacillus,  Presence  in  Sewage 56,  116,  117 

Typhoid  Bacillus,  Temperature  Influence  on  Typhoid  Bacillus    29 

Typhoid  Bacillus,  Vitality  in  Indifferent  Media,  such  as  Sewage  and 

Water 28,  117 

Typhoid  Fever  amongst  Sewermen    39 

Typhoid  Fever  and  Emanations  from  Sewers   4,  6 

Typhoid  Fever  and  Faulty  Drains 32,  33,  195  to  198 

Typhoid  Fever  and  Sewer  Air,  Experimental  Kesearches  into  their 

Causal  Relations 59  to  69,  119  to  130 

Typhoid  Fever  and  the  Closing  of  Sewer  Ventilating  Covers  in  the 

Centre  of  Streets  at  Leicester  81  to  83,  199  to  209 

Typhoid  Fever  and  Tubs  or  Pails    21  and  22 

Typhoid  Fever  caused  by  Specific  Contagium  Animatum  27 

Typhoid    Fever,    Conditions    for   Spread   of    Typhoid    Fever  more 

favourable  in    Conservancy  Methods    than     in    Water-Carriage 

System  78,  79 

Typhoid    Fever,    Connection  between   Typhoid    Fever    and    Sewer 

Gas 74  to  79 

Typhoid  Fever  does  not  seem  to  affect  Domestic  Animals 59 

Typhoid  Fever,  Etiology  and  Epidemiology  of    26  to  29 

Typhoid  Fever  in  a  House  with  Faulty  Drainage. 163,  164 

Typhoid  Fever  is  not  disseminated  by  Sewage  Farms 72 

Typhoid  Fever  not  caused  by  Sewer  Gas 55 

Typhoid  Fever,  Outbreak  at  Caius  College,  Cambridge,  1874   30,  156 

Typhoid  Fever,  Outbreak  at  Croydon,  1875  30,  156 

Typhoid  Fever,  Outbreak  at  Foundling  Hospital,  St.  Pancras,  1891, 

30,  159 

Typhoid  Fever,  Outbreak  at  Leeds  Fever  Hospital    30,  160  to  163 

Typhoid  Fever,  Outbreak  at  Melton  Mowbray,  1880  30,  158 

Typhoid  Fever,  Outbreak  at  Sherborne,  1882  30,  159 

Typhoid  Fever,  Outbreak  at  Worthing,  1865    30,  156 

Typhoid  Fever,  Outbreak  at  York,  1884 30,  158 

Typhoid  Fever,  Outbreak  in  Germany 30 

Typhoid  Fever,  Outbreak  of,  attributed  to  Sewer  Gas..  30  to  31, 156  to  164 

Typhoid  Fever  Result  of  Putrid  Process     27 

Typhoid  Mortality  and  the  Ventilation  of  Sewers  at  Leicester...  199  to  209 

Typhoid  Mortality  in  Berlin 188  to  193 

Typhoid  Mortality  in  English  Towns  before  and  after  the  carrying 

out  of  Sanitary  Works  186 

Typhoid  Mortality,  Influence  of  Sanitary  Works  upon    186  to  194 

Typhoid  Mortality  in  German  Towns  after  Baron 188  to  189 

Typhoid  Mortality  in  Munich 187 


U. 

Uffelmann,  Micro-Organisms  in  House  Drains   50,  103 

TJffelmann,  Opinion  of  Sewer -Gas  Theory    30,  164 


Vapours  in  Disused  and  Unventilated  Cellar  Dwellings    46,  101 

Vaults,  see  "  Conservancy  Methods. " 

Ventilation  of  Sewers    80  to  83 

Ventilation  of  Sewers  and  the  Typhoid  Mortality  of  Leicester...  199  to  209 


224  SEWER    GAS    AND    HEALTH. — INDEX. 


Ventilation  of  Sewers,  Necessity  for 47" 

Virulence  of  Pathogenic  Germs  in  Sewage 54,  55- 

Vitality  of  Human  System  lowered  through  Sewer  Gas 36 

Vitality  of  Typhoid  Bacillus  in  Different  Media,  such  as  Sewage 

and  Water    28 

Vomiting  Due  to  Sewer  Gas 35- 

W. 

Warrington,  Continuance  of  Pail  System 23 

Water  as  Carrier  of  the  Typhoid  Bacillus    29 

Water-Carriage  System,  Advantages  over  Conservancy  Methods..  20  to  25 
Water-Carriage    System    less    favourable   to    Spread  of    Typhoid 

Fever  than  Conservancy  Methods 78,  79' 

Water-Carriage  System,  Opponents  of,  in  Germany    6- 

Water,  Difficulty  of  finding  Cholera  Germ  in      57 

Water,  Difficulty  of  finding  Typhoid  Bacillus  in 57 

Water,  Vitality  of  Typhoid  Bacillus  in  Water    28 

Waterworks  do  not  contribute  in  the  same  degree  to  an  Improve- 
ment of  Public  Health  as  Sewerage  Works    75,  186  to  194 

Waterworks,  Influence  upon  Public  Health  74  to  79,  186  to  194 

Westminster  Palace,  Air  in  Sewers 45,  104,  105 

Wet  Surfaces,  Germs  do  not  rise  from  51,  54 

Weyl 193 

Wicksteed 199 

Widnes  Sew6r  Accident  146 

Wiesbaden  Sewermen,  Health  of 136 

Wills,  Justice 34,  185 

Worthing.  Outbreak  of  Typhoid  Fever,  1865 30,  156 

Wright,  Dedication  to  Sir  Thomas iii. 


Y. 

Yellow  Fever > 5,  26 

York,  Outbreak  of  Typhoid  Fever  in  1884 30,  158 


Z. 

Zjonotic  Diseases   « 5' 

Zymotic  Diseases,  see  also  "  Infectious  Diseases." 


BIOGS    &    CO.'S    BOOK    X^IST. 


MUNICIPAL     ENGINEERS'    SERIES. 

Municipal  engineering  has  during  the  past  few  years  made  rapid  strides.  The 
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great  responsibility.  They  are  anxious  to  stand  in  the  forefront  of  those  who  serve 
their  fellow-men,  and  carefully  examine  the  claims  of  every  suggestion  for  better 
sanitation,  purer  water,  easier  locomotion,  and  more  light.  By  means  of  the 
Association  of  Municipal  and  County  Engineers,  they  are  able  to  exchange  views 
and  discuss  practice,  to  gather  and  disseminate  information  upon  every  topic  of 
interest  that  arises  in  their  daily  work.  Thus,  progress  has  been  rapid,  and  it  has 
been  deemed  advisable  to  collect  the  results  of  this  progress  in  a  handy  form  :  hence 
the  series  of  text-books  to  which  attention  is  now  drawn.  These  books  are  intended 
to  be  practical  treatises  rather  than  historical  or  theoretical,  and  avoid  the  reiteration 
of  that  which  has  appeared  in  all  the  books  for  a  century  past. 


Seweragre  and  Sewagre  Disposal  of  a  Small  Town. 

By  E.  B.  SAVAGE,  A.M.I.C.E.     Demy  8vo.     Illustrated.     Price   5s. 

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readers. " — Surveyor. 

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information  than  will  be  found  in  many  more  pretentious  volumes." — Contract  fotirnal. 

The  Construction  of  Carriageways  and  Footways. 

By  H.   P.  BOULNOIS,  M.I.C.E.,  Past- President  of  Municipal  and  County 
Engineers,  City  Engineer  of  Liverpool.     Demy  8vo.     Illustrated.     Price  6s. 

"  The  author  has  had  a  very  wide  experience  in  the  construction  of  carriageways 
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Contract  Tournal. 

Refuse    Destructors,   with   Results   up   to   Present   Time. 

Second  and  Revised  Edition.      A  Handbook  for  Municipal  Officers,  Town 

Councillors,  and    others    interested    in    Town    Sanitation.      By   CHARLES 

JONES,  M.I.C.E.,   Hon.  Secretary  and  Past- President  of  the  Incorporated 

Association  of  Municipal  and  County  Engineers,  Surveyor  to  the  Ealing  Urban 

District  Council.     With  a  Paper  on   "  THE    UTILISATION    OF   TOWN 

REFUSE    FOR    POWER    PRODUCTION,"    by  Thomas   Tomlinson, 

B.E.,  A.M  I.C.E.     With  numerous  Diagrams.     Price  5s. 

"  Mr.  Jones  has  so  many  years  made  this  subject  almost  his  own,  that  his  book 

must  participate  in  the  very  general  attention  that  is  now  being  paid  to  it  by  municipal 

•engineers,  by  those  who  are  looking  to  get  at  least  the  day  load  of  an  electric  light 

station  supplied  with  steam  from  the  heat  of  town  refuse  destruction." — Engineer. 

Jloonomics  of  Iron  and  Steel. 

By  H.  J.  SKELTON.     Illustrated.     Price  5s. 


BIGGS  &  CO.'S  BOOK  LIST  (continued)  : 
Tables   and   Diagrrams. 

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The  Contractors'  Price-Book. 

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House  Drainagre. 

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Water  Supply  in  Rural  Districts. 

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Street  and  Town  Sanitation. 

By  C.  MASON,    M.I.C.E.,    Surveyor,  St.   Martin's-in-the-Fields,  London,. 
W.C.     In  preparation. 


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« 

!    i 


BIGGS    &    Cp.'S    SOOK    LIST. 

ELECTRICAL    ENGINEERS'    SERIES. 
Practical  Electrical  Engrineering. 

In  Two  Vols.  Bound  in  Dark-Green  Cloth  Oold  Lettered.  By  well-known 
Writers.     Price  £2.  2s.  the  Set. 

Dynamos,  Alternators,  and  Transformers. 

By  GISBERT  KAPP,  M.Inst.C.E.,  M.Inst.E.E.  Fully  Illustrated. 
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The  book  gives  an  exposition  of  the  general  principles  underlying  the  construction 
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Electrical  Distribution :  Its  Theory  and  Practice. 

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First  Principles  of  Electrical  Engineering. 

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Theory  and  Practice  of  Electro-Deposition: 

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**  THE  ELECTRICAL  ENGINEER." 

A  Journal  of  Electrical  Engineering,  with  which  is  incorporated  "Electric 
Light."     Edited  by  C.  H.  W.  BIGGS.     Published  FRIDAY.     Price  3d. 


BIGGS  AND  CO.,  189-140,  Salisbury  Court,  Fleet  Street,  London,  E.G. 


mt^ 


k.