TYPHOID FEVER 
AND 
Water Supply in Omaha 
bY 
W. F. MILROY, M. D., 
Professor of Histology, Pathology and Hygiene, Omaha Medical College 
Reprint: From The Omaha Clinic for April, 1889. TYPHOID FEVER 
AND 
Water Supply in Omafia* 
BY 
W. F. MILROY, M. D., 
Professor of Histology, Pathology and Hygiene, Omaha Medical College. 
When the report of the Board of Health 
of Omaha for the last six months of 1887 
appeared, I was greatly astonished at the 
number of deaths that had occurred from 
typhoid fever during that time. 
A man of such world-wide reputation as 
Dr. Edmund A. Parkes, F. R.S., of London, 
has said of typhoid fever that it is a disease 
“altogether and easily preventable.” I believe 
this statement to be the truth, and therefore 
that ninety deaths should have occurred from 
this disease, in a city the size of Omaha, in one 
brief half year, is positive evidence that some- 
thing is fatally wrong. I believe that of those 
ninety persons whose bodies are now rotting 
in the ground all, or nearly all, might to-day 
have been living and occupying their allotted 
place in the family and community if only the 
knowledge had been acted upon, which that 
noblest of sciences, Hygiene, has placed within 
the reach of every community. 
Deeply impressed with the importance of 
these truths I imposed upon myself the task 
of discovering, if possible, wherein lay the evil 
and on whom rested the responsibility of this 
useless slaughter. 
Speaking with scientific exactness, it is 
impossible in most diseases to assign a cause 
with absolute certainty to any specific case, 
but I stand here to-night to demonstrate to 
all within the sound of my voice, to within 
the smallest degree of a certainty, that the 
sickness and deaths in Omaha from typhoid 
fever in 1887 were wholly unnecessary, 
because it was within the power of that com- 
munity to prevent them. 
The detective who is detailed to the duty 
of tracing out a mysterious murder case first 
makes a deliberate and careful study of all the 
facts that are known concerning the matter 
in hand, endeavoring to assign to each its due 
importance, weighing each circumstance in 
the light of all the others and even consider- 
ing the theories advanced by those more or 
less interested in the crime that has been com- 
mitted. From all these facts and figures duly 
digested he takes his clue, and, this done, 
proceeds upon the more active pursuit of the 
criminal. Likewise, we, in seeking to establish 
the identity of the cause ol the fatal outbreak 
in question, must first get clearly in mind all 
the established facts and well substantiated 
theories relative to the causation of typhoid 
fever, and then in the light of these we may 
proceed to apply them to the circumstances 
as we find them in the city of Omaha. 
The time at my disposal forbids all dis- 
cussion of problems that still remain unsettled 
concerning this disease. I shall therefore limit 
my remarks to such facts as all acknowledge. 
Typhoid fever is found in all countries. It 
is favored by the conditions of civilization, 
though these are not essential to its existence. 
The predisposition to it is greater before 
thirty years of age, though it may occur late 
in life. New-comers in an infected locality are 
much more liable to the disease than old resi- 
dents. In other words, habitual exposure to 
the causes of it render a degree of protection 
against their effects. Occupation or station 
in life have no influence in themselves. Its 
occurrence is more frequent in the late sum- 
mer and early autumn. Most authors agree 
that typhoid fever is unusually prevalent after 
summers remarkable for their dryness and 
high temperature, but the amount of precipi- 
tation is of much more importance than the 
temperature. 
“ The exciting cause of typhoid or enteric 
fever (in the words of fDr. Edwin R. Maxon) 
♦Read before the Medical Society ot the Missouri Valley, March 21st, 
1889, at Council bluffs, Iowa. 
|N. Y. Medical Journal, August 15, 1885. 2 
doubtless consists of a poison generally de- 
rived from a pre-existing case, probably the 
typhoid bacillus, which has been found in the 
lymphatics,blood and tissues; but sometimes 
arising, as all contagious diseases did orig- 
inally, from an equivalent poison, ‘generated 
anew by the decomposition of sewage and 
of other forms of animal filth.’ In either case 
the typhoid poison is reproduced in the sys- 
tem during the fever, and it appears that its 
chief, if not exclusive outlet, is in the intestinal 
discharges.” 
Such being the origin of the disease, it is 
evident that if this danger can be guarded 
against the disease will cease to exist. Thus 
the whole matter for the consideration of the 
Sanitarian, with respect to typhoid fever, is 
reduced practically to two questions: First, 
by what means do the stools of typhoid fever 
patients, or an equivalent poison, find access 
to the bodies of healthy individuals; and, 
secondly, by what means can the access of 
this poison be cut off. 
A statement in full of the answer, which I 
believe to be the correct one, to the first of 
these questions, together with the evidence 
which may be offered in support thereof, 
would occupy many hours. I will therefore 
answer it by quoting from a number of 
authors, among whom are those who have 
done more than all the world besides to solve 
these difficult questions, and whose opinions 
must be accepted as final. 
At the Congress of Hygiene, September, 
1887, M. Brouardel opened the discussion 
on the mode of propagation of typhoid. 
“*Brouardel was sustained in his opinion 
that the vehicles for the transmission of 
typhoid fever germs were water, air, and 
clothing in contact with the sick; that the 
great source of the transmission of the disease 
was the pollution of drinking water.” 
fDr. Edwin R. Maxson, LL.D., of Syracuse, 
N. Y., states: “The most common vehicle 
of the poison appears to be drinking water 
contaminated through sewage, either when 
drank alone or with milk, with which it has 
been mixed.” 
*Dr. Frank P. Foster, editor of the New York 
Medical Journal, remarks : “ The water used 
for drinking is so commonly recognized as the 
chief vehicle of the germ of typhoid fever that 
even isolated instances in which it is evidently 
not at fault are of interest.” 
The eminent sanitarian, fMr. Jas. C. Bay- 
liss, states: “In country districts the germs 
of typhoid fever are most frequently commun- 
icated to the human system through drinking 
water drawn from wells and springs contam- 
inated with impurities. This also occurs to a 
great extent in cities and small towns not 
provided with water works, and in which the 
inhabitants are dependent on wells necessarily 
sunk in close proximity to privy vaults, and 
cess-pools for the reception of house drain- 
age.” 
:|:The English Rivers Pollution Commission- 
ers in their sixth annual report,remark: “The 
investigation of the epidemic of typhoid fever 
at Lauzen proves that very efficient filtration 
does not prevent the propagation of typhoid 
fever by water. Nothing short of abandon- 
ment of the inexpressibly nasty habit of 
mixing human excrement with our drinking 
water can confer upon us immunity from the 
propagation of epidemics through the med- 
ium of potable water.” 
§Dr. Henry B. Baker, Secretary of the Mich- 
igan State Board of Health, after speaking 
of other causes of typhoid fever, says : “ That 
disease is not frequently traced to transmis- 
sion through the air, but is frequently traced 
to the use of bad water.” 
UProf. V. C. Vaughan, Director of the Mich- 
igan State Laboratory of Hygiene, in con- 
cluding a report upon an investigation of 
suspected water, remarks : “ There are on an 
average about one thousand deaths and ten 
thousand cases of sickness from this disease 
(typhoid fever) annually in Michigan. These 
figures can be greatly reduced if people will 
cease polluting the soil about their houses 
with slops, garbage, cess-pools and privy 
*New York Medical Journal Oct. 22, 1887. 
■(•House Drainage and Water Service. 
JTreatment and Utilization of Sewage, Corfleld, p. 291. 
§ Typhoid Fever and Low Water in Wells: Reprint from Annual Report 
for 1884 of the State Board of Health of Mich. 
1 First Quarterly Report of the Mich. State Laboratory of Hygiene, 1888. 
*>ajoils’ Annual of the Universal Medical Sciences, 1888, vol. v, p. 252. 
fLoco Cit. 3 
vaults, and will see to it that their drinking 
water is pure beyond all question.” 
A *circular published by the State Board 
of Health of Illinois contains the following 
statement: “ Where there is a polluted water 
supply, where there is undrained ground, con- 
taminated with excrementaj filth, where foul 
overflowing or leaky privy vaults soak the 
earth for rods with their contents, where 
defective, unventilated sewers and ‘ skin ’ 
plumbing abound, there does typhoid fever 
find its most numerous victims. From such 
localities the contagion, finding its way by 
various unsuspected channels, may invade the 
most cleanly and carefully ordered house- 
hold. The frequent mode by which it is spread 
is through the water supply. A small quantity 
of the infectious matter of the disease is suffi- 
cient to poison the contents of a well or 
cistern and thus to give rise to an outbreak 
among the susceptible who depend upon such 
source of supply. Or this may, as has fre- 
quently been proven, be used for dairy pur- 
poses, and so introduce the infection into 
families supplied with milk from such dairy 
miles away from the source of danger.” 
In a fdocument issued by the Michigan 
State Board of Health in June of last year, 
concerning the prevention of typhoid fever, is 
the following: “Water chemically pure does 
not necessarily cause the disease, but drinking 
water contaminated with the fecal discharges 
of a typhoid fever patient is believed to be the 
most common source or vehicle of typhoid 
fever. While the possibility of its originating 
in other ways is not denied, the frequent out- 
breaks of this disease which are traceable 
directly and unmistakably to a contaminated 
water supply, seem to point to this as the 
chief source of danger. The disease has also 
been traced to milk diluted with infected 
pump water and apparently to emanations 
from sewers and cess-pools.” 
As long ago as 1879 the statement is made 
in the Annual Report of the State Board of 
Health of Massachusetts, that, “So far as 
Massachusetts is concerned impure water is 
one of the most common sources of infection 
from typhoid fever.” 
Dr. George Wilson, Fellow of the Sanitary 
Institute of Great Britain, etc., *says, in 
speaking of typhoid fever: “Although there 
are still some who do not believe in the com- 
municability of the disease, there is a con- 
stantly accumulating amount of evidence 
which goes to prove not only that the poison 
of the fever may be conveyed through the 
agency of water from the sick to the healthy, 
but that this is the most common mode of 
propagation. Sir W. Jenner (he further 
states), than whom no higher authority could 
well be quoted, in commenting upon this 
point, says: ‘The spread of typhoid fever is 
if possible less disputable than the spread of 
cholera by the same means. Solitary cases, 
outbreaks confined to single houses, to small 
villages and to parts of large towns—cases 
isolated, it seems, from all sources of fallacy— 
and epidemics affecting the inhabitants of 
large, though limited localities, have all united 
to support by their testimony the truth of 
the opinion that the admixture of a trace of 
fecal matter, but especially the bowel excreta 
of typhoid fever, with the water supplied for 
drinking purposes, is the most efficient cause 
of the spread of the disease, and that the 
diffusion of the disease in any given locality 
is limited or otherwise, and just in proportion 
as the dwellers of that locality derive their 
supply of drinking water from polluted 
sources.’ ” 
In the freport in November, 1888, of the 
committee on the pollution of water supplies, 
appointed by the American Public Health 
Association, is the following statement: “In 
the records of Sanitary Science are to be found 
many epidemics of typhoid fever chargeable 
to wells that have become contaminated by 
sewage. Indeed, the more the transmission 
of typhoid fever is studied, the more evident 
is it that the water supply is the main agency 
concerned in its propagation. Hence sanitary 
officers have not only closed up wells into 
which sewage has entered, but those which 
from their situation are merely exposed to 
this danger.’’ 
I might go on almost indefinitely with this 
line of evidence, but enough has been said, 
*111. State Board of Health Preventable Disease Circulars, No. 4. 
of Typhoid Fever. 
♦Handbook of Hygiene, flftli edition, p. 208. 
fReprint.for the Michigan State Board of Health, p. 13. 4 
and the answer to my first question, By what 
means do the stools of typhoid fever patients 
or an equivalent poison find access to the 
bodies of healthy individuals? must be ap- 
parent to all. Barring exceptional cases, it is 
by means of polluted drinking water. So that 
we must conclude that there is in use by a 
large number of the citizens of Omaha a pol- 
luted drinking water, and that if this practice 
could be stopped we would have no more 
deaths from typhoid fever to record. Can we 
discover the source of this death-dealing fluid ? 
We shall see. 
With the facts in mind to which I have 
thus far called attention, it was at once ap- 
parent that my task of locating the evil 
sought and the responsibility therefor, lay in 
the direction of a study of the water supply 
of Omaha and its relation to the sickness and 
deaths in question. To this end I procured 
from the records of the Board of Health a list 
of the names of all the persons who had died 
from typhoid fever during the last six months 
of the year 1887, ninety-six in number, to- 
gether with the address at which the death 
had occurred, and such other data as the 
records furnish. This done, I set about the 
laborious task of making a personal inspec- 
tion of the premises where each death had 
taken place. I made note of the source of 
water supply and the possible sources of con- 
tamination of the same, and also the general 
condition of the premises with respect to san- 
itation. 
At the outset I was met by a very serious 
obstacle in the inaccuracy of the addresses 
given. Many were indefinite, many absolutely 
wrong, and a few not given at all. 
Moreover, the fact that a year had elapsed 
since the sickness occurred rendered the diffi- 
culty in tracing the cases greater. And just 
here I desire to respectfully urge upon our 
Board of Health the necessity of adopting 
measures to secure a full and accurate report 
of all deaths occurring in the city. The chief 
merit or demerit of any statistics lies in the 
degree of their accuracy. 
The following are the results of my investi- 
gation : The whole number of deaths which 
occurred during the six months was ninety- 
six. In my opinion, and I suppose that of 
most of those whom I address, the typhoid 
poison is just as truly a causative agent in 
the production of those cases called “typho- 
malaria” as in those called simply typhoid. 
Though, to avoid any ground for dispute, I 
have omitted these, were they included it 
would bring the entire number of deaths up to 
one hundred and ten. Of the ninety-six, fifty- 
four were males and forty-two females. The 
average age was twenty-three and one-half 
years, about. There were thirty-four native 
to the United States, and fifty-nine foreigners, 
and three not specified. The deaths occurred, 
in July, thirteen; August, twenty-eight; Sep- 
tember, twenty-two ; October, twenty-one; 
November, seven; and December, five. Of the 
ninety-six cases, thirty-five died in St. Joseph 
and the Child’s hospitals. As neither of these 
institutions preserves a record of the former 
residence of their patients it was impossible to 
trace them. Of the remaining sixty-one cases 
the address in seven was so incorrectly given 
that I found it impossible to find a clue to 
them, though neither time nor labor was 
spared in an effort to do so. There were, 
therefore, only fifty-four remaining of the 
whole ninety-six whose former residence I was 
able to examine. It will be observed from the 
above statement that there was no opportun- 
ity for the exercise of a prejudice in the selec- 
tion of cases. 
In forty-seven cases, in which the sanitary 
condition exclusive of water supply was 
noted, it is marked bad in one, fair in five, 
and good in forty-one. Of the fifty-four cases 
the water supply in three was from cisterns, 
in four from the public supply, and in forty- 
seven from wells. The alleged quality of the 
well water is noted in forty-five cases. It 
was in thirty-eight good, and in seven sus- 
picious or bad. Aside from the fatal cases, I 
have learned of seventy-nine other cases of 
typhoid fever among those using the water 
from twenty-two of these wells. In the case 
of eleven of the wells, a history is given of 
sickness among those using the water; from 
diphtheria, a large number of cases, quite a 
number of which were fatal; from malaria 
and typho-malaria, a great number of cases ; 
and from bowel troubles and other more or 
less ill-defined symptoms, very many cases. 5 
Of the cisterns referred to, one had no cover, 
and at the time of inspection contained but 
little water, with sticks and other rubbish 
floating in it, probably thrown there by a 
number of neglected children who were play- 
ing about. The other two appeared to be 
fairly well cared for, but it is worthy of note 
that in each of these families there was 
another case of typhoid fever at the same 
time. They were all cement cisterns, which 
are very liable to contain cracks through 
which soakage from without may pass and 
mix with the contents of the cistern. Of the 
cases where city water was used, No. 1 was 
a girl of seventeen, who slept in a room 
through which passed the soil pipe from the 
closet above, and this was defective, as was 
shown by an offensive odor whenever the 
house was not ventilated. Her brother had 
a mild attack of the disease afterward. No. 
2 was a woman of thirty-five, who occupied 
a flat above a store. At the rear of this all 
the garbage, waste water and human excre- 
ment of the families in the row was thrown, 
thus creating such a stench that at least one 
tenant on the lower floor moved out on ac- 
count of it. From the information gained I 
am unable to offer any explanation of the 
mode of infection in the other two cases. I 
am aware that there are many who will 
pooh-pooh the idea that in the remaining 
cases the wells have been the cause of the 
sickness and deaths. I am aware, also, that 
I am unable to offer an absolute demonstra- 
tion that this is true; but is not this alone a 
significant fact, in view of the testimony 
which I have presented respecting the usual 
mode of transmission of the disease, that of 
the fifty-four cases examined the city water 
was used in only lour? 
Space will not permit me to relate specifi- 
cally each of the fifty cases in which the city 
water was not in use, but of many in which 
the clinical evidence was very convincing I 
will mention as an example the following: A 
dressmaker on the premises employed eight 
women. Her own family consisted of three 
persons—eleven all told. From the surround- 
ings of the well she judged the water to be 
unfit for use, and used, for drinking and 
cooking, melted ice which she bought for 
that purpose. Six of the employees also 
drank the ice water, but two of them, believ- 
ing the well water to be better, drank this. 
Both of these were taken sick and died from 
typhoid fever. None of the others took the 
disease. Among those using this well there 
were at least thirteen other cases of typhoid 
fever. 
It might be mentioned in this connection, 
that the proprietor of the dressmaking house 
asked of the landlord the privilege of putting 
in, at her own expense, the city water, which 
was in the street upon which the property 
fronts. This he refused on the ground that 
the other tenants, depending upon the well, 
would also demand city water and this would 
cost too much money. 
It is well known that it is for the most part 
among the less wealthy people of our city 
that wells are in use. I fancy that some one 
may seek to shield the wells by attributing 
this peculiar distribution of the fatality from 
typhoid fever to inferior attendance and nurs- 
ing which the sick among poor people are 
likely to receive. I will answer this objection 
only by the following quotation* from the 
exhaustive article of Dr. James H. Hutchinson, 
of Philadelphia: “The rich are not only as 
liable to contract typhoid fever as the poor, 
but the disease is also quite as fatal among 
them. Murchison found from the statistics of 
the London Fever Hospital that the mortality 
is not greater among the destitute than 
among the better class of patients, and ex- 
presses the opinion that in private practice 
enteric (typhoid) fever is probably more fatal 
among the upper classes than among the very 
poor. Chomel and Forget seem to have 
reached a similar conclusion.” 
Being desirous to test Omaha’s water sup- 
ply by actual analysis, and that by a chemist 
of such acknowledged ability and reputation 
that his conclusions could not be gainsayed, I 
corresponded with Prof. Victor C. Vaughan, 
director of the Michigan State Laboratory of 
Hygiene, at Ann Arbor. Through his interest 
in the subject in hand I am enabled to present 
a report of ten analyses by him. Thesamples 
were collected by myself, care being exercised 
to get a fair specimen of each. From each 
♦Pepper’s System of Medicine, Vol. I, p. 320. 6 
source of supply a new one-half gallon glass 
demijohn was filled, stoppered by a new cork 
and hermetically sealed. These were labeled 
by number. 
They were taken from the vicinity of the 
following places : Nos. 1 and 2, Cuming and 
20th .St.; No. 3, Vinton and 11th st.; No. 4, 
Martha and 13th st.; No. 5, Grace and 22nd 
st.; No. 6, Charles and 18th st.; No. 7, Marcy 
and 7th st.; No. 8, Dodge and 17th st.; No. 
9, Davenport and 10th st., and No. 10 from 
the hydrant of the City Water Co., in my own 
house, without filtration. 
Prof, Vaughan writes as follows : 
REPORT ON ANALYSES OF WATERS SENT FROM OMAHA BY 
PROF. W. F. MILROY, M. D. 
I. Chemical Analysis.—In all the waters the free 
ammonia, albuminoid ammonia, chlorine, nitrites, ni- 
trates and hardness were determined with the following 
results: 
(d) No. 3 is the only one which exceeds the limit 
given in the fourth rule. 
In concluding from the sum of the evidence furnished 
by the chemical analyses we may, I think, decide that 
No. 10 is the only good water among the samples 
examined. 
II. Bacteriological Examination.—Plate cultures 
were made, and the number of colonies counted, and pure 
cultures made from the plates. 
A. The number of bacteria in a drop of each kind oi 
water. 
No. of sample 
... 1 1 | 2 
3 | 4 | 5 
6 1 7 | 8 
9 1 10 
No. of colonies in a drop 
... | 50 | 46 
120 | 50 | 20 
18 | 18 1 36 
20 1 8 
B. Nature of the bacteria. 
We have found the following germs: (1.) Liquefying 
bacillus, present in all the samples. It is a short, thick 
rod with rounded edges. It is not pathogenic. 
(2.) Greenish—yellow bacillus, small fine rods, which 
liquefy gelatin rapidly—found in No. 4. It is non-patho- 
genic. 
(3.) Micrococcus candicans—found in 1, 3 and 4. It 
does not liquefy gelatin, and is not pathogenic. 
(4.) A gas forming bacillus; a small rod, very motile, 
liquefying gelatin and non-pathogenic. 
(5.) A fluorescing bacillus; a short rod with roundtd 
ends, does not liquefy gelatin and is non-pathogenic. 
Besides these we have two germs, one from No. 2 and 
the other from No. 4, which we have not as yet been 
able to identify with any known germ. These we will 
study farther. 
I can send you cultures of the germs isolated if you 
desire them. V. C. Vaughan, M. D., 
Director of the Michigan State Laboratory of Hygiene. 
While it is true that these wells were se- 
lected from premises upon which typhoid 
fever had occurred, a year had elapsed after 
the occurrence of the sickness before the speci- 
men was taken, and we would therefore 
expect to find in the water only those ele- 
ments which are its usual constituents. 
Furthermore, it is of the utmost importance 
to bear in mind that these wells were not 
selected as being those most befouled, but 
were estimated to be a good average of all 
those examined. And I must add that, so far 
as I am able to conclude after extended obser- 
vation and study of the matter, these wells 
are no worse than hundreds upon hundreds 
of other wells that are now in daily use in 
Omaha and highly esteemed for their ex- 
cellence. 
When objection is made to the water of a 
well, the reply will often be heard: “I will 
have the well cleaned out immediately,” 
thinking that thus the evil can be remedied. 
This is a false notion that is very widely 
t-‘OCC-J©Ol^COtO‘-‘ 
3 I 
o 
1.168 
.08 
.664 
.162 
.094 
.028 
.022 
.172 
.054 
.032 
Farts 
Per Million. 
Free Am- 
monia. 
.0098 
.0047 
.0387 
.0098 
.0055 
.0016 
.0013 
.0100 
.0032 
.0019 
Grains 
Per Gallon. 
©aoooto©M>©©£».co 
Parts 
Per Million. 
Albumin- 
oid Am’nia 
.0069 
.0072 
.0134 
.0068 
.0065 
.0053 
.00595 
.0051 
.00397 
.0056 
Grains 
Per Gallon. 
COCOOOOOrt- WOltO-^l© 
Parts 
Per Million. 
Chlorine. 
7.523 
5.656 
6.998 
2.624 
1.341 
1.982 
2.799 
2.799 
5.715 
.4605 
Grains 
Per Gallon. 
-2 * 
3 - s = i ; = T : = 2 
o P 
Nitrites. 
Good test. 
None. 
Good test. 
Slight trace. 
Good test. 
Trace. 
Good test. 
Trace. 
Nitrates. 
‘-*COCOCdtObOCOCOCOCO 
COrf-WCOCOttCOKCOW 
Clark’s scale 
H ard- 
ness. 
No absolute standard for the chemical purity of water 
can be given, but good authorities agree upon the follow- 
ing rules: 
(1.) The chlorine ought not to exceed ten parts per 
million. 
(2.) Thefree ammonia ought not to be morethan.05 
part per million. 
(3.) If .10 part of albuminoid ammonia is present the 
water should be regarded as suspicious. 
(4.) The presence of .15 part or more of albuminoid 
ammonia in a million ought certainly to condemn the 
water. 
Judging the waters by these rules we must conclude: 
(a) According to the first rule, all the waters except 
No. 10 should be condemned as drinking waters. 
(b) By the second rule, all save 6, 7 and 10 would be 
excluded. 
(c) By the third rule, all save G, 8, 9 and 10 would 
be excluded. 7 
received, and in order to call attention to this 
point, well No. 1 was chosen because it had 
been “thoroughly cleaned out” only three 
weeks prior to the taking of the sample; and 
No. 6 was cleaned only three days prior to 
taking the sample, and yet both of these wells 
are excluded by the chemical analysis, and 
No. 1 by each of the rules save the last. 
It is by many erroneously supposed that 
if a well have sufficient depth all danger of 
contamination is eliminated. To illustrate 
the falsity of this position I selected No. 3, a 
well that is upwards of 130 feet deep. The 
analysis shows it to be the worst of all, being 
condemned by every rule. 
The nearest neighbor to well No. 1, counted 
not less than twenty families who are sup- 
plied with water from this well, it being con- 
sidered the best in the neighborhood, and yet 
its analysis condemns it by every rule save 
the fourth. The occupant of the house near- 
est well No. 8 stated that there is scarcely a 
time in the day when someone is not drawing 
water from it, but by two of the four rules it 
is condemned. The owner of No. 4 stated 
that a great many people use the water from 
it, but all the rules save the last condemn it. 
I have chosen these wells to show that it is 
an error to suppose that the use of an abund- 
ance of water from a well is a guarantee of 
its good quality. 
In every instance, with the exception of 
Nos. 3 and 7, the wells examined were thought 
to contain the best of water. It is a fact that 
cannot be too strongly emphasized that the 
taste and appearance ol a water furnish no 
guide whatever as to its quality for drinking 
purposes, even when sewage is present in 
large amount. The very elements which 
prove to the chemist that a water is danger- 
ous, also contribute to that water a peculiar 
sparkling brilliancy and in many cases also 
an agreeable taste. This may be a hard blow 
to the fancied security of many, who will tell 
you that “ Our well has splendid water; just 
as clear and sweet as can be.” And yet we 
dare not stop even here. 
The committee appointed by the American 
Public Health Association, on the pollution 
of water supplies, in its *report read at the 
annual meeting of that assoeiation at Mil- 
waukee in November last, says: “We ac- 
knowledge that typhoid fever is propagated 
by an infected sewage in a well water when 
all organic trace of the sewage has disap- 
peared through the instrumentality of the 
agencies referred to. [Chemical and biologi- 
cal changes.] 
“There are two kinds of organic matter 
in the dangerous sewage—matter which, by 
the absence of life, is given up to decomposi- 
tion and reduction to harmless inorganic 
forms; and matter which, by its vitality, is 
preserved from these influences; and we ac- 
knowledge that in the well water the former 
may be reduced, while the latter retains the 
full measure of its virulence.” 
Elsewhere, referring to its last annual re- 
port, the committee says: “Chemical analysis 
was shown to be, in most instances, inade- 
quate to the detection of sewage, unless the 
sewage was present in unusual quantity, or 
the water unusually free from other organic 
matters; and the conclusion was reached that 
the inability of the chemical methods is of no 
practical importance, as the presence of sew- 
age in the water supply can be determined by 
the sanitary inspector; and, further, that for 
protective purposes the knowledge that sew- 
age enters the water is all that stems to be 
required, because where there is sewage there 
is danger of typhoid infection. Your com- 
mittee desires to give special emphasis to the 
last stated clause, because it believes that the 
endemicity of typhoid fever in our cities is 
in great part due to the sewage in water 
supply.” 
Upon this question, Dr. Charles Smart, 
Major and Surgeon U. S. Army, makes the 
following *statement: “ Usually in such wells 
(those contaminated by typhoid excreta) the 
sewage inflow is so great that the chemical 
results show an undesirable contamination; 
but in many instances the inflow is so small, 
or the purifying influence of the percolation 
through the soil is so great, that the infected 
water may give a fairly good showing on its 
analytical record. In other words, the quan- 
tity of infected sewage necessary to the spread 
of typhoid by a well water is so small as to 
♦Reprint for the Michigan State Board of Health. 
♦Annals of Hygiene, March, 1887. 8 
evade detection by chemical methods ; or the 
influence of a filtration, which effects the 
destruction of ordinary organic matter, leaves 
the specific poison unaffected and in full 
potency. So well are these facts recognized 
and acknowledged, that the health officers of 
many cities, having a trustworthy general 
supply, have not hesitated to close up the 
wells within their jurisdiction.” 
Prof. Chas. F. Chandler, of Columbia Col- 
lege, *says : “As a rule there is but little faith 
to be placed in analyses of well water if there 
is reason to suspect that the water is con- 
taminated. I myself never feel like assuring 
a man that, because I find his water in a fair 
condition, he is safe from typhoid ; it may be 
that at the time his water may be good, but 
the next week it may be bad. So much de- 
pends upon the state of the soil, the level of 
the cesspool, the season of the year, and so 
forth, that it is always rather against my 
conscience when I tell a man that his well is 
safe.” 
It will be worth while in this connection 
to give attention to some of the circumstances 
under which it is possible for wells to become 
contaminated. 
In 1880 the National Board of Health in- 
augurated an elaborate series of experiments 
to determine the filtering power of various 
kinds of soils. Owing to the action of Con- 
gress they were discontinued in the summer 
of 1882, though far from completion. Never- 
theless, valuable work was done. The follow- 
ing is from the report! of this Board. “ From 
these results it appears very clearly that sand 
interposes absolutely no barrier between wells 
and the bacterial infection from cesspools, 
cemeteries, etc., lying even at great distances 
in the lower wet stratum. * * * At this 
point in our work it seems as though the 
filtering capacity were wholly dependant on 
the size and intricacy of the interstitial cavi- 
ties; and that in the drv-air filters there is a 
critical limiting point, beyond which there is 
no filtering. And the same remarks seem to 
be true in different degrees with regard to the 
filtration of liquids. Here far greater fineness 
and compactness of grain and intricacy of 
passage are needed than are requisite for 
air filtration. While sand of 20° is an ex- 
cellent air filter, sand of 100° in long columns 
is worthless for water, and the critical limit- 
ing point below which soils begin to exercise 
any filtering action probably verges on the 
size of grain of an impalpable powder.” 
Farther on this *report states as follows: 
“It would appear that the first inference from 
these experiments is that no substance suffi- 
ciently porous to allow of the passage of 
water can eliminate spores or bacteria from 
that water, even when moving upward by 
capillary attraction. There is no current so 
gentle that it can not buoy these infinitesimal 
bodies.” 
After a discussion on the subject of filtra- 
tion which time does not allow me to repro- 
duce, the committee of the American Public 
Health Association on Pollution of Water 
Supplies in its report in November last, uses 
these words:f “Since natural filtration is 
powerless against the infection of typhoid it 
is evident that artificial methods can give no 
guarantee of protection.” 
The Illinois State Board of Health says :$ 
“ The contaminating distance varies according 
to the nature of the soil and the depth of the 
well; in a loose, porous soil a well 30 to 40 
feet deep will be dangerons if within 100 feet 
of typhoid premises.” 
According to experiments made by 
Prof. Victor C. Vaughan,§ “The excretion 
from one adult person’s kidneys would be 
sufficient to poison one cubic foot of soil for 
that width if you had any water passing 
through it. Now with these facts we can 
easily estimate the time that any ordinary 
family with privy vaults would take to fur- 
nish enough effete matter to thoroughly 
permeate all the soil for a distance around it. 
The time yrould not be very long to render 
thoroughly impure every cubic foot of soil in 
the yard.” 
The same investigator examined samples 
of soil in the neighborhood of a privy vault 
issolated from other sources of contamina- 
tion. The samples were taken from a point 
*Loco Cit., p. 591. fLoco Cit. 
|Preventable Disease Circular, No. 4. 
to the Annual Report of the Michigan State Board of 
Health for 1886. 
*Women, Plumbers and Doctors, p. 78. 
f Annual Report of the National Board of Health, 1882, p. 582. 9 
three feet below the surface, and in his own 
words:* “Without going into details, suffice 
it to say, that the contamination of the soil 
from that single privy, built upon nearly level 
ground, could be detected 50 feet from the 
vault, plainly.” 
Prof. Chandler, of New York, in his laconic 
way, says:* “You may take it as a rule that 
unless your cess-pool is as tight as a bottle 
the sewage will find its way to your own or 
your neighbor’s well.” 
Prof. James H. Shepard, now chemist to 
the Dakota Agricultural College and Experi- 
ment Station, writing at Ypsilanti, Mich., 
fremarks: “I venture to say that not one 
person in fifty knows at what distance he 
lowers the level of the ground water when he 
lowers the water in his well by excessive 
pumping. It has been demonstrated that in 
soils somewhat similar to ours the level of 
the ground water is lowered for a distance of 
200 feet in all directions from the well, while 
under the most favorable conditions the 
circle of influence may have an influence of 
over 2,000 feet. (Nichols Water Supply, pp. 
109-114.) Now, for the sake of illustration, 
let any owner of a well in this town take a 
line 200 feet long, and with his own well as 
a centre, let him strike a circle, then let him 
count the privy vaults, old and new, cess- 
pools, old and new, and all other sources of 
pollution within the circle; then he may 
know, approximately, upon how many res- 
ervoirs of death he is drawing when he works 
the handle of his pump.” 
The soil on which Omaha is built must be 
even more easily penetrated than that re- 
ferred to by Prof. Shepard, and the diameter 
of the circle he describes consequently greater. 
The soil of Omaha is a rather rare geologi- 
cal formation known as Loess. Of it Prof. 
Samuel Aughey, formerly State Geologist of 
Nebraska, $says: “Its drainage, which is the 
best possible, is owing to the remarkably 
finely comminuted silica of which the bulk of 
the deposit consists. Where the ground is 
cultivated, the most copious rains percolate 
through the soil, which in its lowest depths 
retains it like a huge sponge. When droughts 
come, the moisture comes up from below by 
capillary attraction.” However, there is no 
scientific knowledge necessary to realize the 
remarkable facility with which water passes 
into the ground, as we see it all around us. 
In a paper published in the New York 
Medical Record of October 29, 1887, I called 
attention to the great advantage afforded by 
a soil, possessing such rare qualities of 
drainage, in reducing the rate of sickness and 
mortality from consumption. - In the present 
study, on the contrary, the opposite position 
must be taken. This property of soil, when 
rightly guarded and utilized, is a boon that 
few localities enjoy and no art of man can 
supply. But let disease breeding centers in 
the form of privy vaults and cesspools be 
scattered thickly through it and this perfec- 
tion of drainage, which ought to exert so 
salutary an influence upon the health of the 
community, becomes, by so much, an addi- 
tional danger wherever wells are used. The 
distance that filth may travel to a well and 
the certainty of its reaching it is, by so much, 
increased. 
From the foregoing testimony I have care- 
fully excluded all save that which is admitted 
to be authoritative upon the points at issue, 
and the conclusion is to my mind unavoidable: 
(1.) That the great majority of the wells in 
the city of Omaha have sewage draining into 
them ; (2.) That no possible filtration, which 
this sewage may receive by passing through 
the soil from its source to the well, can re- 
move from it its dangerous and perhaps fatal 
qualities. 
The question is naturally suggested: ‘ ‘What 
was the reason of the unusual outbreak of 
typhoid in 1887?” 
The mortality records give the number of 
deaths from typhoid fever in Omaha year by 
year, as follows: In 1880, 20; in 1881, 33;in 
1882, 32; in 1883, 17; in 1884, 17; in 1885, 
17; in 1886, 18; in 1887, 103, andin 1888, 56. 
In 1869 Prof. Pettenkofer clearly establish- 
ed the fact of a rythmical variation in Munich 
of the death rate from typhoid fever to corres- 
pond to the height of the ground-water, i. e.} 
high ground-water with low death-rate and 
low ground-water with high death-rate. 
*Loco Cit. 
fSupplement to the Annual Report of the Michigan State Board ot 
Health for the year 1885. 
of the Physical Geography and Geology of Nebraska, 1880. 10 
From a vast accumulation of evidence Petten- 
kofer showed that the mathematical proba- 
bility was as 36,000 to 1 that there existed a 
causal relation between the low ground- 
water and the increased typhoid. 
In October, 1884, Dr. Henry B. Baker, 
Secretary of the Michigan State Board of 
Health, read a paper* before the American 
Public Health Association at its meeting in 
St. Louis. In this admirable essay Dr. Baker 
clearly demonstrated that in Michigan the 
same relation exists of the ground water to 
typhoid as was pointed out by Prof. Petten- 
kofer. Dr. Baker, however, accounts for this 
causal relation upon a different theory from 
that proposed by Pettenkofer, viz: That it is 
the low water in wells to which it is attrib- 
utable. His exceedingly interesting argument 
I have not space to reproduce. To me, his 
conclusion appears unavoidable, that the 
increased typhoid rate which accompanies a 
fall in the ground-water, is brought about 
directly through the accompanying fall of the 
water in the wells, chiefly by producing 
greater concentration of the sewage therein. 
It will be seen at once that this theory is not 
out of harmony with the supposition that the 
wells were the main cause of the typhoid 
fever in Omaha in 1887. But if it be true, as 
I allege, that this outbreak was caused by the 
wells, and if it is also true that Dr. Baker’s 
theory is correct, we would expect to find a 
marked lowering of the water in the wells 
during that year. Now, there having been no 
measurements taken with reference to this 
point, so far as I am aware, I have consulted 
the records of the U. S. Signal Service for light 
upon this matter. Through the courteous 
assistance of the Observer at the Omaha sta- 
tion. Mr. L. A. Welsh, I have ascertained the 
following facts: 
1. The normal (average) annual rainfall 
at this station, computed from the observa- 
tions of sixteen years, is 35.73 inches. 
2. During the last nine months of 1886 
there was a deficiency of 13.03 inches, equal 
to 36% per cent, of the normal for the whole 
year. 
3. During 1887 there was a deficiency of 
15.83 inches, equal to 44 per. cent of the 
annual normal, or almost one-half. In other 
words, during this year and three-quarters of 
the preceding one, the amount of precipita- 
tion fell short of the usual precipitation for 
that period by about thirty inches. Thus, 
though not a well was measured, there can be 
no doubt that so prolonged and severe a 
drought must have very decidedly lowered 
the water in the wells; and the delectable 
sewage mixture must have been proportion- 
ately concentrated, as explained by Baker. 
In conclusion, it must be admitted that 
typhoid fever is absolutely controllable and 
preventable, and that, in the light of the 
present day, its occurrence, unless it be in 
isolated instances, is a reproach to the com- 
munity which suffers by it. 
If the excuse of ignorance has heretofore 
carried any merit, I trust that I have been 
able to put that aside. 
And yet, however much we may proclaim 
the danger in such insanitary conditions there 
will be many who believe that by their own 
unaided intuition, they are so wise that all 
the research and experience of a quarter of a 
century, conducted by the most earnest and 
scientific workers, can teach them nothing. 
Such persons will go on drinking poison until 
they are stricken down by the ghastly fever, 
and then they will blaspheme a good and 
merciful God by ascribing to “a mysterious 
Providence,” that which is a direct result of 
their own criminal ignorance. A popular doc- 
trine of such individuals is briefly stated and 
answered by Prof. J. H. Shepard as follows:* 
“That these Boards of Health and Water 
Analyses, etc., etc., are simply new-fangled 
crazes, which are untrustworthy and soon 
doomed to decadence.” 
With us, alas, they are new-fangled, but 
for any one to denominate them as crazes is 
simply to expose his ignorance. Go to Ger- 
many, England, or France and ask if these 
are crazes. We are simply ignorant of their 
value, and may God shield us from knowing 
their value by passing through the horrors of 
the plague. The water supply of such cities 
as London is daily subjected to analyses to 
determine its purity, while the mandates of 
the health officers in plague-stricken Europe 
are more absolute than those of the king. 
If I might venture to make a suggestion 
♦Typhoid Fever and Low Water in Wells. 
*Loco Cit. 11 
I would respectfully urge upon our Health 
Board the prompt adoption of energetic 
measures for the remedy of this evil. Many 
towns having such a difficulty as this to over- 
come have been brought face to face with the 
problem of securing an adequate and pure 
public water supply, which could only be 
done at enormous expense. But this we are 
spared, for such a supply is already flowing 
through the mains in our streets. 
The only obstacle, then, to the removal of 
this menace, which daily threatens with 
typhoid fever every man, woman and child 
in Omaha, who has not had the disease, is the 
expense attendant upon filling up wells and 
introducing the public supply. 
In 1887 there were not less than 1,000 
cases of typhoid in Omaha, and over 80 per 
cent, of these were persons in the self-support- 
ing period of life. If these were disabled from 
work an average of sixty days each, and were 
each capable of earning one dollar per day 
(both low estimates), the actual loss of time, 
without regard to the unprofitable labor of 
nursing, expense of physician, medicines, etc., 
amounted to $57,600. Saving money by 
drinking sewage is a form of economy which 
no community can afford. Let information 
upon this subject be disseminated among the 
people. Provide for the inspection and chem- 
ical examination of their wells and many of 
the people will voluntarily close them. But 
to enjoy life is a privilege guaranteed to every 
citizen, by the constitution of the United 
States, and wells which are a menace to the 
lives of the community should be closed by 
the power of law when this power must be 
invoked to accomplish that end. So shall 
valuable lives be saved to the city and the 
world, and a reproach be removed from the 
fair name of Omaha.