Typhoid Fever and sewage tainted drinking water: An 1889 report from the Philadelphia Board of Health

NOTE FROM ADAM LEVINE
This report from J. Howard Taylor, medical inspector for the city Board of Health, focuses on typhoid fever and attempts, in its careful and somewhat archaic prose, to prove a crucial point: that the pollution of the water supply with sewage is causing this disease. This is an accepted fact today, but many people still needed to be convinced of this in 1889.

The report includes prefatory and concluding statements by William H. Ford, M.D., president of the board. It appeared on pages 60-78 of the Annual report of the Board of Health for the year ending December 31, 1889, and Third Annual Message of Edwin H. Fitler, Mayor of the City of Philadelphia, with Annual Report of William S. Stokley, Director of the Department of Public Safety, issued by the City of Philadelphia, published in 1890. You can read the full volume on Google Books.

Related resources on WaterHistoryPHL include:


WATER SUPPLY.
The continued prevalence of typhoid fever has called for investigation with the object of finding out, if possible, the true cause. Suspicion has been directed to the water-supply, as it is a well-known fact that the sources of the city’s water are exposed to contamination. The Board of Health has endeavored, without bias, to discover the possible sources of infection, and, among other inquiries, has turned its attention to the possibility of the water-supply being at fault. A line of investigation was decided upon and the medical inspector was charged with carrying it into effect. The quality of the water was studied by the aid of analyses made at various times and under various conditions, the sources of contamination investigated, the amount of sewage discharged into the Schuylkill estimated, the prevalence of typhoid fever at various places along the banks of the river inquired into, the distribution of the disease throughout the city in connection with the distribution and source of city water carefully studied, and data collected which might possibly have a bearing on the question. In making this investigation, the accepted theory of the causation and mode of propagation of typhoid fever was kept steadily in mind. The experience of other cities was made use of to help explain results. The report, which is a careful representation of existing conditions and a fair statement of warrantable conclusions, is herewith presented.

Health Office, July 23, 1889.
Wm. H. Ford. M.D., President Board of Health.
Sir: – By your direction I have to investigate the large number of cases of typhoid fever which are occurring in the city at this time, and in looking over the field of exploration present such well ascertained facts as have determined a probable cause of the disease. In accepting the germ theory for all zymotic disorders, we recognize a factor which is susceptible of culture and demonstration, and obtain a starting point from which biological research has amplified the domain and made it one of positive science. The bacilli are now recognized as vital organisms, susceptible of rapid development and propagation, producing abnormal conditions in the human system, and potent to transmit the specific derangements to which each stands as the progenitor. And bacteriological research has eliminated from sanitary effort much that was conjectural, and exalted the province of sanitation to its highest function-that of preventive medicine.

Much speculation invariably attends all efforts to prosecute investigations in new fields, but patient and long-continued research by many explorers will eventually lead to probable conditions of cause and effect. And when scientific experiments are supplemented by direct physical facts, it may be affirmed that a positive standpoint has been reached. The study of micro-organisms has been prosecuted of late years with so much assiduity and intelligence that causative relations between pathogenic bacteria and disease have been positively determined. Our investigations, therefore, commence at a definite point. We have only to determine what conditions exist here capable of producing typhoid disease. And if any, through what agencies the pathogenic germs of typhoid fever have been disseminated. The most prominent sources of infection are through water and the atmosphere.

This division is sufficiently comprehensive for the present inquiry, as it is not considered necessary to amplify the investigation by invading the domain of conjectural hypotheses. Are there any well authenticated instances on record where the prevalence of typhoid fever has been traced to the use of contaminated water? Researches have been prosecuted in Great Britain for many years by the “River Pollution Commission,” and the result of their labors published in detail. These investigations have clearly established the fact that water polluted by human excreta, has been a prolific and well-ascertained cause of the spread of typhoid fever and cholera.

The famous Millbank prison in London, prior to 1854, was afflicted with severe outbreaks of typhoid fever. Up to that time the water was supplied from the Thames as it flowed past the prison. Water drawn from an artesian well in Trafalgar Square was substituted, when immediately the health of the prison improved, and for a period of eighteen years following but three deaths from typhoid fever occurred.

“The change was carried into effect in the midst of the cholera epidemic which so severely visited London that year, and the prison was suffering from cholera at the time. Six days after the change this disease suddenly ceased. It is thus shown conclusively that the disappearance of typhoid coincides exactly with the disuse of Thames water, and as this change occurred whilst in all other respects the sanitary condition of the prison remained unaltered, there can be no doubt the two events were not coincidences only; there must have been a causal relation between them.” In further confirmation of this conclusion, it is stated that in the twenty-one years for which mortuary statements for the Pentonville prison have been furnished, there has not been a single death from typhoid fever in that institution. There have been but three deaths from disease of the bowels, all of which were contracted before the patients were imprisoned. The Pentonville prison drew its water supply until recently from a deep well in the chalk. It has been singularly free from epidemics of every kind and remarkably healthy, its death-rate rarely exceeding six per thousand. “It has never suffered from cholera, though three epidemics of that disease have visited London since the prison was established there in 1843.” This immunity from infectious diseases was considered to be wholly due to the use of pure water.

In Salford, England, in 1876, an epidemic of typhoid fever occurred in a “circumscribed” section of the city. The cases developed rapidly and among the better class of citizens. A previous sanitary inspection of the drainage of the city had been made, and where defective attended to. Sewer gas, therefore, was eliminated as a factor in the probable cause of the disease. On examination it was found that the milk distributed to the infected locality was “supplied by one dealer.” It was observed that those who used the milk largely “in its unmixed form were alone affected, whilst those who took it boiled or mixed with tea or coffee escaped altogether.”

On examining the farm from which the milk was obtained it was ascertained that the well was close to the back door of the house and very shallow; that the cesspool was within a few feet of it and separated by a porous soil which favored percolation. “The water of the well had a sickly and foetid odor, and in this condition was used for washing the milk cans and for other dairy purposes.” Typhoid fever prevailed in the farmhouse at the time. The conclusions reached by the health authorities were “that the typhoid epidemic was caused by infected milk; that water contaminated with typhoid discharges had either been added to the milk for the purpose of increasing its bulk, or had at least been used for swilling the cans.” By stopping the contaminated milk supply the epidemic was forthwith stayed, and no cases of fever occurred in any of the houses supplied with the infected milk after the supply was discontinued.

Prior to 1874 the water supplied to Vienna was largely contaminated with sewage containing excrementitious matter, and the annual death-rate from typhoid fever reached seven hundred (700). A fresh supply of pure water was introduced, when the annual death-rate from typhoid immediately dropped to one hundred and sixty-nine (169).

The pure water from the Höllengsbrige proving insufficient for the increasing population, an addition was made to it from a canal, the water of which was of “doubtful quality.” “The increase of typhoid fever since the introduction of this canal water has directed public attention to the source of supply and efforts are being made to procure an additional supply from unpolluted sources.” During an epidemic of typhoid fever in Geneva, Switzerland, in 1884, nine hundred and sixty four (964) cases were reported in one month. This outbreak was due to the temporary use of lake water, ” which had been polluted by typhoid sewage.” In the recent typhoid outbreak at Plymouth, this State, twelve hundred cases occurred out of a population of eight thousand (8,000).

This epidemic was clearly traced to the fouling of the water from the typhoid excreta of one patient. Dr. Chapin, Superintendent of Health, Providence, RI, in an address recently delivered before the State Society states that at Pierrefonds, France, was a “particularly interesting case, as large numbers [PAGE 65] of the bacilli were found in a well-twenty-five thousand (25,000) to the litre, the water of which caused typhoid fever in every one of twenty persons who came from Paris and who drank the water.”

He also relates upon the authority of Dr. Abbot, of the Massachusetts State Board of Health, “that an epidemic of typhoid fever occurred at Canton Junction last Spring, where a well belonging to a foundry was polluted from a cesspool fifty-three (53) feet up the hill, which had received the stools of a typhoid patient the Fall before. The water caused a large number of cases of fever among the workmen who used it, while the men in an adjoining building who had other water escaped.”

In November and December of last year and January of the present year a severe epidemic of typhoid fever occurred in Providence, Rhode Island. The disease prevailed in all sections of the city and gave rise to the suspicion that the public water supply was in fault. Investigation developed the fact that typhoid fever had been prevailing in “the valley of the Pawtuxet.”

That at Natick, which is three and one-half miles above the pumping station “about twenty persons had had the disease.” These families lived in tenement houses near the river, and were in the habit of throwing “slops and excrement on the banks of the stream” to be washed in with every rain. These recognized facts indicated the cause of the epidemic to be an infected water supply.

And this suspicion was verified by an additional test. “Dr. Swartz had ascertained that domestic filters are collectors and incubators of the microbes found in the water which passes through them. This fact was made use of and several filters taken from houses where there was typhoid were examined for bacilli. Two filters were examined by Dr. Prudden, of New York, and the typhoid bacilli found in one. Two were examined by Dr. Ernst, of Boston, and the bacilli found in both. Two were examined by Dr. Swartz, and the typhoid bacilli found in neither. All observers found other organisms characteristic of fees.”

At Bordeaux in 1886, Hamburg in 1885, and Cincinnati in 1887, typhoid epidemics occurred which were directly traceable to contaminated water. Many other instances might be cited where typhoid fever has occurred in consequence of a contaminated water supply, but it is unnecessary to prolong the list, as those given are so well authenticated as to leave no doubt as to the facts of infection, and the consequences resulting from the use of such water.

The important question for our consideration is the present condition of our water supply. In what respect is it analogous to the water from which such direct infection has been produced in the instances referred to? A brief survey of the sources of pollution will best elucidate this question. It is an oft-told tale, but bears repetition.

Inspections have been made up and down the Schuylkill and its pollution measured. This river and its tributaries contains a population of over three hundred and fifty thousand (350,000) persons, covering an area of over eighteen hundred (1,800) square miles, and including the towns of Conshohocken, Norristown, Bridgeport, Phoenixville, Pottstown, Reading, and Pottsville, located directly on the river bank, with all their surface and much of their cesspool drainage into the river.

Conshohocken has no direct sewer drainage, but the washings of street gutters, house slops and overflowing privies are carried to the river with every heavy rain. Last spring a case of typhoid fever occurred in a dwelling on a small stream in the upper part of the borough. The dejecta from this case and water from the washing of the soiled bedding were thrown into this stream and carried to the river.

Norristown has nine sewers all terminating in the river. Two of these are special drains, one from the prison and one from a Catholic Home for Children. I have had letters from a majority of the physicians of Norristown reporting cases of typhoid fever during the past year. The Insane Asylum, just above the city, discharges all its sewage through filter beds into Stony creek, a tributary to the Schuylkill.

The chemical analysis of the water of Stony creek, taken above and below the outlet from the filter beds, will indicate to what extent filtration has removed the organic elements.
Dr. Cresson has furnished me with the following table as the result of that analysis:

The last sample was taken from the stream when the sewage was thoroughly mixed with the water, and shows that the filter bed drainage has not eliminated the organic matter.

Bridgeport (opposite Norristown) has one sewer terminating in the river. Pottstown has one sewer to the river, draining the sewage from three hundred (300) dwellings, besides several slaughterhouses and livery stables. In addition, Manatawny creek contributes a large amount of surface and house drainage. The water-closet of the Pennsylvania Railroad Station, near the river, drains directly into the stream. I will add, here, that I could not ascertain the number of dwellings in Norristown that are connected with the sewers, as no records of such connections are kept. Any person owning property on a street in which there is a sewer can make connection therewith without notice to the municipal authorities. The Superintendent of the Street Department, however, informed me that many householders had availed themselves of the benefits of the sewers.

Phoenixville has one sewer, but French creek is an open drain for three-fourths of the surface of the town and besides the sewage of the extensive iron works on its banks. These works employ about two thousand men and from this source a large amount of pollution reaches the river. Several cases of typhoid fever occurred in Phoenixville last year and the beginning of this year. Reading has little direct sewage to the river, but the underlying character of the ground, which is composed of fissured limestone, yields a ready passage for the contents of the numerous cesspools which supply the town.

Pottsville has a sewered creek through the built-up portions of the town, and affords sewer connections to about three hundred dwellings. There are several small towns on the river between Reading and Pottsville the drainage from which has not been distinctly stated ; but they all add to the pollution of the river, and as the populations increase this contamination will be correspondingly augmented. From Reading down, the valley of the Schuylkill is actively cultivated; manures of all kinds are spread upon the surface of the ground and with the soil that is washed into the stream by heavy rains much organic matter is carried along. But this pollution is intermittent and with sufficient storage capacity could be avoided.

The daily additions of excrementitious matter are not so easily gotten rid of; they have to be taken. Some idea of the quantity of this filth discharged into the river can be estimated if we accept the report of the Water Department for 1884, where it is stated that a population of twenty-six thousand and nine hundred (26,900) “have water-closet drainage into the river.” The quantity of excrement by weight which each adult person voids during twenty-four (24) hours has been definitely ascertained, and if we apply this measure to the sewage population of the river we get, at a low estimate twenty-five thousand (25,000) pounds as the daily pollution. It does not require chemical investigation or bacteriological research to determine the character of such a water. Scientific investigators in England, who have given years of study and experiment to this subject, have formulated the positive statement that “there is no river in the United Kingdom long enough to secure the oxidation and destruction of any sewage which may be discharged into it even at its source.”

“When the sewage of towns or other polluting organic matter is discharged into running water, the suspended matters may be more or less perfectly removed by subsidence and filtration, but the foul organic matters in solution are very persistent, as the organic matter of sewage undergoes decomposition very slowly when it is present in running water.” It is always dangerous to use such water, as there is a great probability that the morbific matter sometimes present in animal excreta will be carried rapidly down the stream, escape decomposition and produce disease in those persons who drink the water. The existence of an infectious property cannot be proved by chemical analysis, and is only learned, too late, from the effects which the water produces on man. But though chemistry cannot prove any existing infectious property, it can prove, if existing, certain degrees of sewage contamination. And every sewage contamination which chemistry can trace ought, prima facie, to be held to include the possibility of infectious properties.

The frequent examinations of the Schuylkill water at the different pumping stations made by Dr. Cresson have established the existence of “previous sewage or animal contamination.” This experimental confirmation of the condition of the water establishes the fact that the pollution exists throughout the whole course of the river. That oxidation and subsidence have not eliminated the sewage.

If such water has proved hurtful to other localities, why should Philadelphia be exempt? Instances of infection from polluted water are too well authenticated to admit of question. But to produce that infection the pathogenic germs must be present in the water. Is it probable that they will lose their vitality during a passage of many days from the upper to the lower waters of the river? Experiment has thrown some light on this point, and it has been found that the vitality of typhoid bacilli may be preserved in sterilized water for more than three months; but when the water is mixed with faeces and urine they may retain their vitality four or five months. “In view of the facts presented there is no sufficient reason therefore from a bacteriological point of view of rejecting the transmissibility of typhoid fever and cholera by the medium of the drinking water.”

“Bacteria causing typhoid fever and cholera have been found and cultivated from the stools of patients affected with these diseases;” and these stools discharged into the water supply may become sources of contagion in others; certainly an unspeakably disgusting mode of infection. The propagation of disease through the atmosphere is another mode of infection which requires consideration, but there are certain conditions essential for this purpose that cannot always exist. In the first place in order that pathogenic spores may be distributed by air currents it is necessary that they should be thoroughly desiccated or dried, and as they are not cultured in the air they must come from the ground where they have been deposited in filth containing the germs, as a de novo origin is not accepted to any extent by bacteriologists of the present day.

During periods of continued rain, such as have prevailed during the present summer, it is not probable that they could disseminate to any hurtful extent. They are not considered infectious when taken into the lungs, nor can they survive for any length of time in the circulation.

To become potent during periods of heavy rain, they would have to. be washed into the sources of water-supply. It is true, however, that if these microorganisms existed in the air to any extent they might secure a lodgment on articles of food, and thus find an entrance into the alimentary tract. They might, also, find a lodgment on substances that would culture them, and thus their propagation might be multiplied. But this mode of infection is not considered by bacteriologists so certain and direct in its action as to rank it in potency with the ever-present and positive condition which obtains in a constantly contaminated water-supply. There are a few cases on record where typhoid fever is thought to have been developed through bacteria in the atmosphere, as where persons have slept in a room near a privy containing typhoid stools, or in a room in which there was defective plumbing, permitting the escape of sewer-gas. Typhoid fever is not essentially an air disease, as in the London Fever Hospital, where six thousand cases were treated in a period of twenty-two years, but four of the attendants were attacked; and “thirty-five hundred typhoid cases were treated in the same ward with five thousand other patients, and not one of the latter contracted the disease.”

When we come to consider the Delaware water, we find a much more concentrated condition of pollution than obtained in the Schuylkill. The Otis street pumping station [for the Kensington Water Works] is located between the outlets of two large sewers, and whether the tide is running up or down the sewage discharged along the river-front is constantly carried past the intake. There is no time for subsidence or oxidation before the recently-discharged sewage is taken up again to augment the water-supply.

A similar condition prevails at Lardner’s Point [location of the Frankford Water Works], different only in this, that the flood-tide sewage has a longer distance to travel before reaching the pumping station, except such pollution as discharges through Frankford creek. Typhoid fever prevails almost continuously in the district supplied from these pumping stations, and it is safe to assume that typhoid excreta is being as continuously discharged into the river. The effects are obvious, the fact of pollution so evident that it needs but to be stated to condemn the source of supply. Are there any local causes independent of water-supply, which might be supposed to operate, in certain sections, where the disease has been more prevalent than in other portions of the city, as, for instance, in the Twenty-second Ward last spring and in the Twenty-ninth Ward somewhat later. I went over the Twenty-second Ward carefully and inspected many of the dwellings where the disease was reported to exist. With few exceptions, apparently good sanitary conditions were found, and where the reverse prevailed-which are noted-it will be seen that the causes of typhoid fever could scarcely be attributed to the local sanitary defects, with perhaps two exceptions.

Typhoid fever was found in all these places, which are the only ones of special importance where the sanitary conditions were considered objectionable, and being such a small percentage out of the total cases reported that I was unable to attribute the prevalence of the fever to defective sanitary surroundings. The cause of this sudden outbreak of typhoid fever in Germantown is a question more easily asked than answered. I cannot fully account for it from such investigation as local inspection furnished. I have therefore availed myself of the facts furnished by Dr. Cresson, as the result of his chemical and microscopic examinations of the drinking water supplied to the district.

“Careful examination by chemical analysis and the microscope has eliminated the facts that during the periods of quiet flow when there is but little current large quantities of animal and vegetable organisms collect in the several dams, and that the sewage of Norristown and the surface drainage of Conshohocken and other towns is run directly into the comparatively stagnant pools, where it remains until the current in the river is increased by rainfall, when the contents of the pools are sent down the river, giving rise to lesser or greater pulsations of impurity in the Flat Rock and Fairmount Dams.

The water in the river is generally in a condition favorable to the growth and carriage of the lower orders of animal and vegetable life, and when the dejecta of persons suffering from typhoid fever is discharged into the river, whatever risks there may be to those drinking the water containing such dejecta are first run by those who are supplied from the Flat Rock Dam.

Frequently the rainfall is of such small volume that this is the limit of territory to which the hurtful material is carried ; when, however, the flow is sufficient, the carriage extends throughout the Fairmount Pool. Observation has shown me that certain bacteria, diatomacae, and ciliati accompanying the water (carrying and charged with organic matter in solution) are transferred from the upper dams by the rainfall to greater or less distances down the river. During the prevalence of typhoid fever in Norristown (for instance) certain characteristic bacteria have been found in the sewage and the pool below Norristown. I have found this bacterium when the river flow has been increased at locations miles below Norristown, and when it has reached the waters of Flat Rock Dam there has been an increase in the cases of typhoid (following the period of incubation) in the districts to which the water from that dam is supplied, and when this bacterium with certain accompanying vegetable organisms has been found in the forebays of the lower pumping stations similar effects are produced by the use of the water.

I have also gone over the Twenty-ninth Ward with the view of ascertaining if any local causes might be found for the many cases of fever that have prevailed there during the past year. In many of the houses examined there were no sewer connections, the ordinary cesspool being in use. Sewer gas was therefore eliminated as a factor in the cause of the disease. The cases were not in the recently built-up sections of the ward to a greater extent than in the older dwellings. The fresh turning up of the soil was not, therefore, an appreciable element in the spread of the disease. No apparent cause presenting itself from the local inspection, the conclusion reached was that the drinking water was largely chargeable with the infection.

I have not included Manayunk and localities below as being chargeable with the river pollution, though there must be still much of it existing, as the intercepting sewer is supposed to receive everything of a pernicious nature coming from the east bank of the river, excepting always the large volumes of storm-water from the streets of Manayunk, Roxborough, and the Falls, and the valleys and hills in the course of the Wissahickon.

The pollution of the river is sufficient, however, to demand speedy relief. How this is to be accomplished is the problem for consideration. Any other source of supply is scarcely even a remote possibility. We have to deal with the present. Can the quality of the Schuylkill water be improved to such an extent as to make it safe for dietetic use ? If it cannot be made wholly pure its character can be greatly improved by the processes of filtration and subsidence. The system of sand filtration as practiced at Berlin gives very satisfactory results so far as relates to the removal of solid impurities, and if the storage capacity was sufficiently increased to admit of additional purification by subsidence, and the water was permitted to remain in the reservoir at least twenty days before being distributed for use, we might then claim for our city a good potable water.I will state here in this connection, in reference to the purification of the water, that I have observed in many accounts of the river pollution, the opinion expressed that the sulphuric acid water from the mines is a pernicious ingredient. I am not of this opinion; the strong acid water will certainly destroy all bacteria, and the water that reaches Tulpehocken and Maiden creeks must be clear of any living micro-organisms.

When the sulphuric acid water from the upper Schuylkill and its tributaries reaches these creeks, which are largely charged with lime (plaster of Paris) in solution, a chemical union takes place, and sulphate of lime is formed, which being heavy a deposit takes place in the moving current. This precipitation continues to Reading and beyond, and whatever organic impurities are found in the water are carried mechanically to the bottom of the river, and as a legitimate hypothesis the character of the water ought to be fairly good between Reading and Pottstown. It has been stated that fish cannot live in the acid solution, nor yet in the water for some distance below where the chemical combination takes place. I do not consider this an evidence of impurity, as I investigated this subject several years ago, and found that the fish were killed by their gills becoming filled with the powdered sulphate of lime, which acted as a mechanical obstruction to their respiration. The acid water of course would be inimical to their existence. I have thus in a general way gone over the water supply in relation to its infectious properties and probable carriage of disease germs, with the character and sources of its pollution, and have instanced analogous cases where infectious properties existed in water apparently similarly conditioned, with the results of such contamination upon communities using such water.

I can only say in conclusion that I have given the subject my unbiased judgment, and only in the interest of pure water and good health.

“If thou couldst cast
The water of my land, find her disease,
And purge it to a sound and pristine health,
I would applaud thee to the very echo
That should applaud again.”

Respectfully submitted,
J. HOWARD TAYLOR,
Medical Inspector.

The water from the Delaware in front of the city is heavily charged with sewage, and absolutely unfit for domestic use. That pumped near Otis Street wharf is so objectionable that it is nothing less than criminal to subject citizens to its further use. The water taken from the river at Lardner’s Point ought not to be pumped except at ebb tide. The flood tide carries the sewage-laden water from the front of the city to the pumping station, and it is, therefore, the part of prudence to stop the pumps until after the tide has for some time started on the ebb.

The main source of the city’s water supply is the Schuylkill Rver, and this is shown to be polluted by the discharge of filth into it from cities, towns and villages along its banks to such an extent as to constantly jeopardize the health of the community. It is plainly evident that something ought to be done to procure a supply of water of good quality for the city’s use. How this is to be accomplished is the great question which interests every member of the community. It is idle to talk of any other source of water supply than the river Schuylkill for the immediate future at least. This river can be made, with the aid of impounding reservoirs, to furnish an ample supply for all time to come. The natural quality of the water is excellent. It is unwholesome because of pollution which is avoidable.

Here is the true key to the solution of the problem: Prevent contamination, and the water will be equal in quality to the best water furnished to any large city. The city is moving in this direction by diverting sewage from the river within her corporate limits. By constructing an intercepting sewer along the east branch of the river an escape has been provided for a large quantity of deleterious matter which formerly discharged into the river. Within the past two years the drainage from three hundred and sixty-six {366) factories, mills, and other large buildings has been prevented by this means from entering the river. Branch sewers are being constructed to intercept the sewage from parts of Wissahickon, Roxborough, and Manayunk. The work is progressing slowly, it is true, but in the proper direction. For want of adequate capacity of the intercepting sewer, storm overflows have been constructed to carry off the excess of surface drainage into the river during heavy rainfalls. It is true that the first discharge of surface water during a rainfall, which is most heavily charged with impurities, will be carried away by the sewer, but the surface washings of such districts as those above mentioned should, as far as possible, be excluded from the river. An additional intercepting sewer will be required in the near future, and work upon it should be commenced at once.

What is being done in Philadelphia should be done on the whole line of the river. Legislation should be procured at once for protecting the river from dangerous contamination. The towns and cities along the banks of the river should be prohibited from discharging sewage into the river until purified by filtration or chemical treatment. This plan is perfectly feasible and should be insisted on.

Additional reservoirs of large capacity should be constructed for the purpose of sedimentation as well as for storage. As another and valuable means of improving the quality of the water, the most approved system of filtration upon an extensive scale should be introduced with the least possible delay.

In order to re-establish the wholesome quality of the Schuylkill water by the simple and rational means here suggested, a commission should be appointed which should be employed continuously until the work is accomplished. To it should be entrusted the procuring of legislation, the execution of the laws pertaining to river pollution, the supervision of works for the storage, sedimentation, filtration, and chemical treatment of the water if necessary. It should cooperate with the Water Department, and relieve the officers from the additional and onerous work which is now imperatively necessary. There have been reports without number of commissions appointed temporarily to examine the question of the water supply. What is wanted is the intelligent application of knowledge already within our possession. This can best be accomplished by the employment of men thoroughly qualified for the work, who should be clothed with ample authority, and continued in office until the result is attained.

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