Fig. 595. Plenty of "deadly sewer gas," but occupants still live.

Fig. 596 was contributed to Dr. Teale's list by a physician. In this house four cases of typhus and typhoid fever had occurred, one resulting in death. The dairy was directly over the drain. The joints in the flagging were purposely left open, as shown, in order that water and any spilt milk might be swept directly into the drain, and the doctor believed the air in the house had been poisoned by emanations from the defective drain resulting from the decomposition of organic matter and milk therein.

The first case of typhoid was undoubtedly contracted somewhere from contaminated food or drink. The other cases may possibly have come from typhoid germs dissipated through the air from dried sewage from the leaky drain below the house.

Fig. 596.  Dairy Sweepings.

Fig. 596. "Dairy Sweepings."

Fig. 597 is an illustration of a gentleman's house in which typhoid fever broke out, and thence spread into the village. On examination it was found that the water-closet discharged into an ordinary stone drain, almost without any fall, which ran under a tiled entrance hall. The drain had become choked, and the sewage had found its way under the flooring of the passageway and rooms. It was assumed that disease germs were disseminated by air currents through the house from the dried sewage under the floors and formed the direct cause of the fever outbreak. But today the fatality would be explained as in the last illustration.

Another physician sent to the doctor a sketch forming the subject of Fig. 598. The living room had been built over an old forgotten drain and cesspool. Typhoid fever broke out in the house from which one patient recovered and another died, and it was supposed at the time to be directly due to disease germs in the sewer air. But it would now be said that the constant breathing of the foul air of the drain presumably lowered the vitality so that the typhoid germs, entering the system from some other source, found a soil favorable for its growth.

Fig. 597. Leakage under the tiling, and forming a large cesspool

Fig. 597. Leakage under the tiling, and forming a large cesspool under the house.

Fig. 598. Addition to a house built over an unsuspected cesspool.

Fig. 598. Addition to a house built over an unsuspected cesspool.

Fig. 599 is an illustration showing direct pollution of both air and water supply at the same time. It gave an excellent opportunity for the foul air to lower the vitality of the occupants, so that the use of polluted water found a fertile field for the inoculation of disease. The sewer connection was faulty, as were also the connections of the plumbing fixtures, the very dangerous form of bell traps being used. A maid servant and a boy were seized with typhoid fever here, the former dying, probably from drinking from the pond.

Fig. 599. Disconnected and Misconnected.

Fig. 599. Disconnected and Misconnected.

Another case of death by typhoid fever occurred in the house of a surgeon of Leeds, which Dr. Teale illustrates (Fig. 600) and describes. There had been illness in the family for some time before the attack of typhoid, from which the surgeon and a maid servant both suffered, the latter dying. Emanations from the cesspool A were supposed to have directly caused the disease.

Fig. 601 shows the manner in which a leak in a cesspool connection has polluted the cellar of a neighboring building. Dr. Teale cites the case of the death of two children from diphtheria, and of suffering from chronic sore throat in a house thus contaminated. A similar case, shown in Fig. 602, was reported to Dr. Teale by an artist, who sent him the

Fig. 600. A, Rain water tank under cellar floor, with overflow into drain. D. Workman  sounding with crowbar for suspected

Fig. 600. A, Rain water tank under cellar floor, with overflow into drain. D. Workman "sounding with crowbar" for suspected "tank" or "cesspool." sketch of the defect in drainage of a house in which a fatal case of typhoid fever had occurred.

In the first case, Fig. 601, complaints of the dampness and offensiveness of the cellar had been ineffectually made to the agent of the landlord, but they dared not complain to the landlord himself for fear of dismissal. In this manner children are sometimes sacrificed and whole neighborhoods endangered by poverty and dependency, and the need of rigid sanitary legislation in behalf of people unable to protect themselves is here strikingly exemplified. For, although in this particular case the drains may have had nothing to do with spreading the specific disease, they were nevertheless supposed at the time to have carried it, and the moral obligations were therefore the same.

Fig. 601. Dampness of house from overflow of cesspool.

Fig. 601. Dampness of house from overflow of cesspool.

Fig. 602. Danger from next door neighbor's drain.

Fig. 602. Danger from next door neighbor's drain.

Prof. Bostic Hill* in 1895 described a case of probable poisoning of about a hundred people who had eaten soup exposed to sewer air, one of whom died. Prof. Hill gives in full in the account his own reasons for ascribing the poisoning to sewer emanations. Figs. 603 and 604 illustrate the manner in which the sewer was vented by a pipe running up by the side of the building in which the soup was kept. It is not an uncommon source of danger, and an outbreak of typhoid fever at Cambridge, England, some years ago, was attributed to this cause. The picture, Fig. 604, shows a schoolhouse in which a fatal case of typhoid fever occurred. It was attributed to the entrance of sewer air through the chimney flue, as shown. The soup which occasioned the poisoning described by Prof. Hill was made heavy from beef and rabbit. An outbreak of typhoid fever could not have been produced in the manner described. If the germs could have been conveyed through the air at all, it would not have been the air of the soil pipe, but rather the air of the house or street, because the sewer and soil pipe act, as we have shown, as filters in arresting and destroying them. It would be as reasonable to attribute typhoid fever to that part of a water from a well contaminated with typhoid germs which had been thoroughly boiled and filtered, when that part which had not been disinfected had been still more freely imbibed.