THE EFFICACY OF FILTERS AND OTHER MEANS EMPLOYED TO PURIFY DRINKING-WATER. A Bacteriological Study. BY CHARLES G. D., OF NEW kUKK." FROM THE MEDICAL NEWS, April 20 and 27, 1889. [Reprinted from The Medical News, April 20 and 27,1889.] THE EFFICACY OF FILTERS AND OTHER MEANS EMPLOYED TO PURIFY DRINKING-WATER. A Bacteriological Study.1 By CHARLES G. CURRIER, M.D., OF NEW YORK. Water, even after having been exposed to various chances of contamination, is very generally drunk as it is received from lakes or rivers, wells or springs, tanks or hydrants; and, despite the most disinter- ested warnings, people are not ready enough to believe that clear, sparkling water may at times be the most harmful of beverages; that it can carry with it, and introduce into the systems of a portion at least of those who drink it, the immediate causes of various impairments of health. Polluted water may be agreeable to the taste and have no visible sediment, yet cause many deaths. Such water the unskilled are slow to suspect, and but for the ad- vance in sanitary science and the warnings conveyed by those familiar with hygienic studies, pure sup- plies of drinking-water in cities would be much more of a rarity than they are. 1 Read before the Section on Public Health of the New York Academy of Medicine, April 5, 1889. 2 CURRIER, At the Hygienic Congress in Vienna, in 1887, M. Brouardel stated that he knew of over sixty epi- demics of typhoid fever which had been induced by the drinking of infected water.1 From typhoid fever thousands of deaths occur every year; and, although scientific physicians are constantly urging these facts, it seems to be necessary that the danger present itself in the form of an epidemic before the people fully realize the immense harm which may result from impure drinking water. The epidemic which ravaged Plymouth,2 in Pennsylvania, four years ago, attracted great attention at the time, but the history of several similar “visitations” since then would indicate that the full value of this severe lesson has not been properly appreciated. Water may be very highly colored, and yet, if freshly collected near its source, show no very large number of bacteria. Such is the case with the best of the peaty “juniper” water which I have examined in various parts of the Dismal Swamp of Carolina and Virginia. Although having a large propor- 1 Dr. A. Ollivier: Rapport au Conseil d’Hygiene Publique (etc.), Paris, 26 mars, 1886. A valuable monograph on typhoid fever by a scientific practitioner. As different parts of Paris receive water from rivers of very different quality, the careful health reports from garrisons and institutions, which vary only in the purity of the water supplied, are very instructive. From the abundant evidence as to the influence of polluted water in inducing typhoid, may; be cited the report of the Zurich Water Commission of 1885. 2 Biggs and Breneman : N. Y. Med. Journal, vol. xli. (1885), May 23 and June 6. French and Shakespeare: ibid., June 13. I,. H. Taylor: The Medical News, vol. xlvi. (1885), May 16 and June 20. THE EFFICACY OF FILTERS. 3 tion of organic matter, this water is reputed emi- nently wholesome, and an inquiry among a portion of those drinking this exclusively, appears to show an unusual degree of immunity from the manifesta- tions of diseases which might be attributed to the effects of improper drinking-water.1 On the other hand, the turbidity which is common at this season of the year in the streams furnishing the water supply of many of our cities, is almost always accompanied by a large number of bacteria, as in these bottles of water which you see here from the Mississippi and from some of the rivers flowing into the Atlantic. The melting snow and the rain, which wash into the streams an increased amount of organic matter, introduce with it other germs (perhaps pernicious), and bring more nutriment than usual to the micro- organisms already in the water, thus increasing their vitality and numbers. It is believed that, like most of the varieties of bacteria found in water, the still larger forms of animal and vegetable life, ordinarily existing in lakes and rivers, are not prejudicial to hea'th. It is through the products of the decomposition of 1 If harmful bacteria be introduced into it, such water favors their increase, while they would not be so apt to multiply in a very pure water having much less organic matter. Despite the gcod reputation which this water has had. and its wholesomeness near Lake Drummond, one who has seen the whole length of the canal down to the lower end, from which the supply for vessels is taken, can realize that the water may undergo considerable con- tamination before it reaohes that part. I am sure that the present use (in our navy) of distilled water, kept in proper receptacles, is safer than the employment of the swamp water. 4 CURRIER, many of these, when their life has ceased, that they may become harmful. Chemistry has long furnished a means of recog- nizing polluted water, even when it yielded no sedi- ment visible to the unaided eye, and the presence of considerable quantities of chlorides, nitrites, and ammonias, determined by the chemical tests, has shown that many a water had more organic impurity than was permissible; and, when far below the ac- cepted standard in this respect, such a water is very justly condemned. Yet it seems as though enough of the infective element of cholera or typhoid to diffuse an epidemic throughout a community can be added to a drinking-water and not be detectable by chemical tests. A perusal of the very complete and instructive paper by Professor J. W. Mallet (in the report of the National Board of Health for 1882) shows how widely such determinations may vary and how unreliable chemical standards may be. The known disease-producing bacteria, however, do not appear to increase in water1 in which there is not more organic matter than the proportion that chemists of constant and large experience regard as permissible in waters which they pronounce to be of fair quality, although these harmful bacteria, if once 1 In my tests, when I prepared an artificial water, I added the germs directly from a pure culture, unlike Bolton, and like Wolfif- hiigeland Riedel (Arb. aus d. Gesundheitsamte, 1886, i. p. 45s), with whose results, however, I cannot so well agree as I can with those of Bolton (Ztsch. f. Hygiene, 1886, i. p. 76). I have in but two out of many trials, with disease-producing species, found typhoid bacilli to increase in sterile pure water, and then only to the extent of thirty per cent. THE EFFICACY OF FILTERS. 5 introduced there, may long retain their vitality and remain dangerous.1 Since, as yet, chemistry, when called upon to aid in solving the question of the purity of a water, can at its best only approximately estimate the amount of organic matter present and its state of oxida- tion, while it fails to inform us whether infective matter be present or not in a given water, it has been hoped that a sure means of recognizing whether a water be in any degree infected was reached when Koch introduced the bacteriological test. This test, while very definite and conclusive under favorable conditions, has thus far been able to decide abso- lutely in only a small portion of the cases of disease apparently coming from the use of drinking-water. 1 Chantemesse and Vidal (Gaz Hebdomadaire de M6d. et de Chir., 1887, pp. 146-150) kept typhoid bacilli alive for “months ” in sterilized water from the Ourcq, which is the worst water sup- plied to Paris, and much impurer than the Croton, in which, when it was sterilized, I have been able to keep typhoid bacilli alive for only two weeks, and usually not over eight or nine days. I have observed that the greater the variation of temperature it was ex- posed to, the shorter time did this microorganism live in water. It has been found by all observers that oscillations of tempe- rature around the freezing point were much more destructive to these than freezing them in water and allowing the ice to re- main frozen. So, I have observed several times that of two flasks of the same typhoid water, the one which was kept at a temperature varying from 370 C. to io° C., had, at the end of three days, many fewer than were in the flask kept between 160 C. and io° C. In my last test of this sort, the flask of which the temperature varied most had, after two days, only a few more than a third of those in the one kept at the evener temperature. Herasus : Zeitschrift fur Hygiene, i., 2, p. 193. Hochstetter: Arb. aus d. Gesund- heitsamte, ii., 1, p. 1. 6 CURRIER, Yet in those cases where the bacteria characteristic of distinct disease have been detected in the sus- pected water, the isolation, culture, and identifica- tion of the disease-producing species furnish a con- vincing proof of the great value of the method. The method employed is a simple one. Usually one cubic centimetre of the water to be tested is added to ten cubic centimetres of nutrient jelly, made by solidifying very nutritious beef-tea by the incorporation of one-tenth its weight of gelatine. Everything being done with rigid precautions, the water to be tested is added to the nutrient jelly, which has been softened by being warmed to a little more than 30° Centigrade. This is then quickly mixed and poured upon a cooled glass plate, where the fluidified gelatine soon becomes quite solid. Then the germs in the water, being scattered evenly throughout the mass, exercise their functions of rap- idly multiplying at the room temperature; and, in the nutritious medium, the minute microscopic indi- vidual has perhaps by the third day become a dot as large as a pin-point, or much larger, containing thousands or millions of newly formed bacteria. These are called “ colonies,” and vary considerably in appearance, as will be seen by comparing the plates made with various waters. With a glass ruled into centimetre squares the number can be counted or estimated. If a large number of thousands be present, as in waters artificially prepared for tests and in sewage contamination of water, the only way to arrive at an accurate estimate is to employ in the eye-piece of a microscope a micrometer square, as THE EFFICACY OF FILTERS. 7 first used, I believe, by Dr. Edw. K. Dunham, who combines with it the aid of an automatic counter. After determining the number we isolate and iden- tify the species as in general bacteriological study. There are many features of the subject which must be omitted in a paper of this scope, for they may not interest all, while the limits of the usual time allowed must be respected; and as the important points are to be discussed by eminent experts, I will not linger over the still unsettled question as to the absolute value of mere numbers of ordinary water bacteria in determining the sanitary merits of a water.1 It is, however, admitted that the fewer the varieties present, the less is the likelihood of sources of contamination affecting the water. In examin- ing a considerable number of samples of water from various sources, I have observed that the less chance of contamination there was, the fewer bacteria have I found in the waters. Thus, fine mountain lakes and springs have never in my experience, unless under very unfavorable conditions, shown as many as one hundred bacteria in each c. c., while the same quantity of water from a river draining thickly peopled valleys may show more than fifty times as many. While it offers less striking extreme differ- ences than I have seen in the Hudson Valley and 1 Gartner: Correspondenz Bl. d. allg. arzt. Ver. von Thuringen, 1888 ; Nos. 2 and 3. Centralbl. f. Bakt. und Par., iii., 5, p. 161 et seq. Wolffhiigel: Arbeiten aus dem Gesundheitsamte, Band i., iii., 5 Heft (1885), p. 546. Plagge und Proskauer, Ztschr. f. Hygiene, 1887, pp. 470 and 486. 8 CURRIER, elsewhere, the Passaic water-shed may be briefly in- stanced as illustrating what I have just said. I give it because it is the smallest one near us offering every phase of importance in this connection, and because the subject of a supply to come to New York from that source has been seriously considered. The best of the upper lakes of this system showed on a pleas- ant day of the past winter only fifty-seven germs developing in the nutrient gelatine, while the Pequan- nock and other tributaries into which these lakes flow showed, in the samples collected as nearly at the same time as possible, over three hundred and fifty germs, which number increased as the water was taken further down stream; while at the Passaic Falls, in Paterson, over a thousand were detected in each c. c. Water from the hydrant in Newark, at the same time, showed nearly four thousand germs of bacteria in each c. c. The Newark water supply is at present derived from the Passaic, some miles below the place where sewage from Paterson is dis- charged into the river. As in chemical, so in bacteriological water exam- inations, those who have had the broadest experience and who are most careful are best in a position to pronounce an opinion. Apart from any personal equation, there are still limitations to the entire com- prehensiveness of the method. I may mention that bacteria are recognized as present in the human body and in its products and changed tissues, which bacteria are never found to live on the gelatine or other water plates. Then, too, a water may be sub- mitted for examination when all the obvious infec- THE EFFICACY OF FILTERS. 9 tion has disappeared, or has become exceedingly diluted, and hence a most painstaking test then fails to reveal the presence of the characteristic micro- organism. The period of incubation, after the in- fection and before the symptoms are recognized, may in Asiatic cholera occupy the greater part of a week, and in typhoid often lasts for two weeks or more, so that all traces of the harmful bacteria may have left the water before it is suspected. By reason, also, of its likeness to various harmless species, and its ten- dency to be overwhelmed by other more rapidly developing forms, the “colony” of the disease-pro- ducing species may be hard to identify. In this respect typhoid is decidedly more difficult than cholera to recognize in ordinary water. For those who believe that bacteria of certain kinds living in water, and with this introduced into the alimentary canal, can in many cases induce disease, this test, being so precise and delicate as it is, must appear the best way of determining whether the fil- ters and other means in common use are efficient or otherwise in removing the dangerous elements from impure water passed through them—in short, whether they act as “ disinfectants ” of the water. As various other agencies are used in conjunction with, or as supplementary to, filtration, it is proper that I here indicate how far they serve to purify drinking-water. One of the most prevalent means directly resorted to for this ostensible purpose is the admixture of wine (usually red). Adding this to an equal amount of Croton water, I find that a vary- ing proportion of the bacteria are killed, sometimes IO CURRIER, less than half, even after the mixture has stood for days. The spirituous alcoholic beverages (having from 45 to 68 per cent, of alcohol), mixed with Croton hydrant water in equal parts, cannot be de- pended upon to kill all of the bacteria, especially when “ earth ” bacteriaare present, and a small per- centage of whiskey (less than 20 per cent.) has very little effect in this direction.1 In malt liquors, as lager beer, the prolonged boiling in the brewer’s kettle has destroyed the bacteria of the original water, even if they be of the most harmful and re- sistive species which we meet here. Various kinds, however, if present in vats, kegs, and bottles (be- cause of imperfect cleansing), will live in beer.2 Almost all the artificial mineral waters that I have examined are made of unsterilized water. Pressure of carbonic acid gas, and contact with it for days, 1 Koch (Fliigge, Chapter V., sec. 3) found that the spores of Bacillus anthracis were alive even after months of exposure to the action of absolute alcohol. Pasteur and Joubert (Comptes Rendus des Stances de 1'Acade- mic des Sciences, 9 and 16 juillet, 1877) stated long ago that the spores of anthrax would remain alive in absolute alcohol. Anthrax, however, need not be expected to occur in the water supplied here, and several recent experiments show that it is pos- sibly destroyed by other bacteria which may occur in the water. Anthrax spores are employed in such tests because they are con- sidered the most resistant of all disease-producing forms of bac- teria. 2 The bacteria from this source which I have found in examin- ing a limited number of beers were mostly of non-liquefying kinds, and there were notably many iridescent “spreading” colonies. [Jan. 1889.] In these cases water from old surface wells was used to wash out the kegs. THE EFFICACY OF FILTERS. 11 reduces greatly the number of bacteria in a mineral water, yet the typhoid bacillus and others will live •or days in Seltzer water. In New York I have found many bacteria in the few carbonated beverages that I have examined. Of the various acids which it is occasionally safe to employ, chemically pure hydrochloric acid must be used in the strength of at least one-half of one per cent, to destroy all the germs in Croton water to which B. subtilis, B. typhoid, and other bacteria have been added; and may fail- to sterilize the water even after hours of standing thus acidulated. Sul- phuric acid is more than twice as potent, and usually in the strength of one part to five hundred of water will render this free from living germs. Sometimes, however, it has to be used still stronger, as it is in a certain extensively advertised nostrum, in which, under a fanciful name, it plays the principal part. Alum, lime, and the other chemicals which, by in- ducing sedimentation of organic and mineral con- stituents, carry down many of the bacteria in water, do not (as is often believed) insure the annihilation and destruction of organisms present.1 It is the me- chanical action of the film, which the presence of a 1 Residents of the Mississippi Valley, where the principle of set- tling water by adding alum has been extensively made use of, have expressed to me their belief that many digestive irregularities are caused by the use of alum. The danger lies in the use of an ex- cess, and probably does not exist with the small amount which is permissible (2: 100,000). As was just noted of absolute alcohol, Koch also found that the spores of the B. anthracis were not destroyed by prolonged ex- posure to the action of a four per cent, solution of alum (or a con- centrated solution of chloride of lime). 12 CURRIER, minute amount of these causes to settle sooner thaii would otherwise occur upon sand in certain large sand filters, which insures their excellence, and the scarcity of bacteria must here not be attributed to a coarse chemical action. When chemicals are added in sufficient strength to destroy speedily all the bac- teria which may be present, the water thus treated cannot be recommended as a beverage. With the imperfection of all other methods, we have in prolonged boiling a sure disinfectant of any water. I have usually found that maintaining a water at the boiling point for even less than fifteen minutes sufficed to prevent any of its germs from developing in gelatine, and this even with bad waters1 1 The employment of silk threads, in and upon which are dried living bacteria with spores, seems to endow these germs with greater resistance to the action of steam heat than when the bac- teria are