IRLF 
 
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 THE LIBRARY 
 
 OF 
 
 THE UNIVERSITY 
 OF CALIFORNIA 
 
 PRESENTED BY 
 
 PROF. CHARLES A. KOFOID AND 
 MRS. PRUDENCE W. KOFOID 
 
 ?fi&4&j>> &fcMft^&Pfelfet*r aDO^ft i-^ 
 
 
OUTLINES 
 
 OF 
 
 RURAL HYGIENE 
 
 FOR PHYSICIANS, STUDENTS, AND 
 SANITARIANS. 
 
 HARVEY B. BASHORE, M.D., 
 
 INSPECTOR FOR THE STATE BOARD OF HEALTH OF PENNSYLVANIA. 
 
 WITH AN APPENDIX 
 
 ON 
 
 The Normal Distribution of Chlorine. 
 
 BY PROF. HERBERT E. SMITH, 
 
 OF YALE UNIVERSITY. 
 
 ILiLiUST^ATED. 
 
 PHILADELPHIA, NEW YORK, CHICAGO : 
 THE F. A. DAVIS COMPANY, PUBLISHERS. 
 
 1897. 
 
COPYRIGHT, 1897, 
 
 BY 
 THE F. A. DAVIS COMPANY. 
 
 [Registered at Stationers' Hall. London, Eng.] 
 
 Philadelphia, Pa., U. S. A.: 
 The Medical Bulletin Printin--!!, 
 1916 Cherry Street. 
 
PREFACE. 
 
 <rteM+j 
 
 THE almost absolute neglect of sanitary rules in districts 
 outside of the great cities, and the absence of special atten- 
 tion to this branch of sanitation in the larger and more 
 elaborate treatises, have called forth this work. 
 
 That it may aid in the diffusal of sanitary knowledge 
 where most needed, and that it may assist those who labor 
 in rural districts, is the earnest wish of the author. 
 
 Much of the substance of the work has appeared from 
 time to time in various medical periodicals, but all has been 
 carefully revised. 
 
 The author has drawn largely from numerous Health 
 Reports, and hereby acknowledges his obligation to all such 
 as are not especially mentioned. 
 
 HARVEY B. BASHORE. 
 
 WEST FAIKVIEW, PA., 
 November 1, 1897. 
 
CONTENTS. 
 
 CHAPTER I. 
 
 PAGE 
 
 WATER-SUPPLY 1 
 
 Wells. Cisterns. Rivers, Lakes, and Springs. 
 Examination of Wells and Well-water. 
 
 CHAPTER II. 
 
 WASTE DISPOSAL 25 
 
 Excreta, Slop-waters. Kitchen Refuse (Garbage). 
 Ashes, Crockery, etc. Sewage Disposal. 
 
 CHAPTER III. 
 
 THE SOIL 48 
 
 Surface-soil. Ground-moisture. Ground-water. 
 Ground-air. 
 
 CHAPTER IV. 
 
 HABITATIONS 5(1 
 
 Dwellings. School-hygiene. Hospitals. 
 
 CHAPTER V. 
 DISPOSAL OF THE DEAD 68 
 
 APPENDIX. 
 THE NORMAL DISTRIBUTION or CHLORINE 71 
 
 INDEX 79 
 
 (vj 
 
CHAPTER I. 
 
 WATER-SUPPLY. 
 
 Wells. Almost the whole of the rural population de- 
 pends upon shallow wells for its water-supply, and much 
 of the sanitary oversight occurring in these districts centres 
 about this point. Many an epidemic has been traced to such 
 a source, small household epidemics they generally are; 
 sometimes, however, the "town-pump" becomes infected, 
 and a whole village suffers. A case of this kind lately hap- 
 pened in one of the small towns of Pennsylvania; almost 
 the entire population drank water from a single well; this 
 became infected, and, as a result, sixty out of the eighty 
 inhabitants became ill with typhoid fever and ten died. 
 Another striking case of well-water infection is that re- 
 ported by Volz, which occurred at Gerlachsheim, in Ger- 
 many. Here, in three weeks, fifty-two persons were attacked 
 with typhoid fever. On investigation it was found that 
 these had all gotten their water from a certain well, which 
 had been polluted by the discharges of the first patient. 
 
 In one of the State Health Eeports there occurs the fol- 
 lowing very instructive note, which illustrates the point 
 hi question: "While riding with Dr. - , on his way to 
 see a patient, he pointed to a farm-house which he said 
 had a strange history. He had practiced in the adjoining 
 village for thirty years; the farm was occupied by tenants, 
 
 CD 
 
2 OUTLINES OF RURAL HYGIENE. 
 
 who were changed every few years, and during these thirty 
 years every family that lived on the place passed through 
 typhoid fever/' Surely here was a house with a "skeleton 
 in the closet"; rather, I suppose we ought to say, in the 
 well; for there can be no reasonable doubt, from what we 
 know at present of the genesis of /yphoid fever, that this 
 trouble was caused by an infected well or spring. Almost 
 everyone of us who has an acquaintance with the country 
 can point to certain districts where, year after year, as 
 autumn approaches, we have had one or two fever cases. 
 
 The source of infection in these old wells is, of course, 
 the infected ground-water, which, in its turn, has been 
 poisoned by some leaking cess-pool, or privy, or surface- 
 washings; in this connection it must not be forgotten that 
 the discharges from a single case of typhoid may be the 
 source of danger. Such was the fact in the famous Plym- 
 outh epidemic, which, while not well-water infection, was 
 in a body of water vastly larger than many wells, and shows 
 how much greater the danger in a narrow, shallow well. 
 
 The distance from the well at which a source of infec- 
 tion becomes dangerous cannot be readily expressed in fig- 
 ures without the most careful study, for it depends entirely 
 on the character of the strata and the direction and velocity 
 of the ground-water currents. I recall to mind a very good 
 illustration of this, in which a well, situated hardly fifty 
 feet from a privy, shows almost absolutely no pollution, 
 while another, almost two hundred feet from the nearest 
 privy or other means of pollution, shows thirty times the 
 
WATEK-SUPPLY. 3 
 
 normal chlorine of the region. In the first instance the 
 well is in a bed of compact impermeable clay, and, in the 
 second, a stratum of loose slate. 
 
 It is, perhaps, needless to state that the mere pollution 
 of a well by sewage is likely of no danger whatsoever unless 
 the germs of disease f ^d. an entrance; but, when a well is 
 exposed to leakage from human waste, it is so easy for 
 germs to follow, and so easy for them to grow in water laden 
 with organic material, that there is always an element of 
 danger in using a water which is at all subject to privy leak- 
 age; the danger may not be very great, ordinarily it is 
 not, but it exists, nevertheless. There are wells in every 
 town which, though undoubtedly polluted by leakage from 
 adjoining privies, have furnished drinking-water for many 
 years and have never yet been accused of conveying disease. 
 This, however, is no argument against the case; only a proof 
 that none or few germs have entered the well. 
 
 A point of much importance, as indicated before, is the 
 geological character of the strata which are pierced by the 
 well; yet this very rarely receives much more than a passing 
 attention. Modern investigation along this line has shown 
 that, for example, the distinction which the older works on 
 hygiene used to draw between deep and shallow wells 
 is of but very limited value. Deep wells, according to 
 the definition, are those which pass through an imper- 
 vious stratum and draw water from a deeper layer be- 
 neath; but this can only happen in a geological basin, and 
 geological basins are few and far between. At London and 
 
OUTLINES OF RURAL HYGIENE. 
 
 Paris there happens to be just such a formation, and con- 
 sequently deep wells are a great improvement over shallow 
 ones. On Manhattan Island, however, on the other hand, 
 a well may be a thousand feet deep and still not be a "deep" 
 well in a sanitary sense, for the strata there are more or less 
 perpendicular, which, of course, in a measure, excludes an 
 impervious layer; so it is over almost the whole of the vast 
 Appalachian region. Along the coast, however, the strata 
 
 Fig. 1. Section of the Strata Underlying Paris and its Environs. 
 Horizontal scale, eighty miles to an inch ; vertical scale, two 
 thousand feet to an inch. (From Humberts " Water-supply 
 of Cities and Towns.") 
 
 are in places, more or less horizontal, or, rather, they are 
 parts of some great basin, and are available for deep wells. 
 Whenever these Artesian wells are possible, they gener- 
 ally yield a very pure water. Much work has recently been 
 done in this subject on the Atlantic-Coast plain, and 
 maps are now being prepared by certain of the State 
 Geological Surveys which locate the water-bearing zones. 
 In Xew Jersey, for example, there have been found to be 
 
WATER-SUPPLY. 5 
 
 three very important horizons. The first, 300 to 400 feet 
 deep, in miocene strata; the second in the cretaceous; and 
 the third still lower. These beds all furnish excellent water, 
 and are used practically in many places along the coast, 
 especially by large manufacturing plants. 
 
 Geological investigation, too, has shown that in a region 
 of upturned strata not only are deep wells impossible, but 
 
 Fig. 2. Cross-section of a Region of Upturned Strata. (Original.) 
 
 that wells of any sort are especially dangerous, unless much 
 attention is given to the location of the sources of pollution, 
 for the cleavage-lines of the rock-layers afford most excel- 
 lent drains for any surface or cess-pool waters which may 
 happen to be in the locality if the strata should incline in 
 the direction of the well. This is shown in the following 
 practical sketch, which represents a region in which the 
 rock-layers are almost perpendicular. In places like this, 
 
OUTLINES OF RURAL HYGIENE. 
 
 if you are going to dig a well, it makes a great difference 
 whether the ever-present privy or cess-pool is located at 
 A or B. Suppose it is at B or in any place within 90 on 
 either side; then the well will almost certainly be contami- 
 nated, for the leaking water will only have to follow the 
 cleavage-lines in order to reach the well, and this it will 
 do most readily. 1 The only possible location for a filth- 
 receptacle in the neighborhood of the well C is in the 
 direction of A, where the cleavage runs away from the well, 
 instead of to it as on the opposite side. The privy, if there 
 is one in the direction of B, should be absolutely no nearer 
 than in fact, not so near as the calculated distance, 1 for, 
 if it is, there is sure to be pollution. 
 
 1 In a region like the one described it is very easy to calculate just 
 how far beyond the well in the direction of B (Fig. 2) the danger-line 
 extends. Knowing the depth of the well and the angle of dip of the 
 strata (this is told by an instrument known as the " clinometer " ), we 
 construct a triangle as follows : 
 
 8 
 
 B A = depth of well ; angle C = dip of strata, i.e. the angle 
 made by a horizontal line on the surface with the cleavage-lines of the 
 slate. B is, of course, a right angle. To get angle A we add C and B 
 
WATER-SUPPLY. 7 
 
 Important points these are; yet it is very rare indeed 
 that they are considered in making a well; but they must 
 be heeded if one expects to get water at all approaching 
 purity. 
 
 The author's attention was recently called to a well 
 situated in just such a region,, a tube-well, about a hun- 
 dren feet deep, with its upper twenty or thirty feet sur- 
 rounded by an iron tube, and yet this water yielded 10.4 
 parts of chlorine per 100,000, while the normal chlorine of 
 the region is only 0.15 per 100,000. Neighboring privies 
 rested on the upturned slates within the region indicated by 
 B (Fig. 2), and, of necessity, the well was polluted. That 
 the well was deep only increased its drainage-area without 
 increasing in proportion its filtering properties, for water 
 filters very little in passing through the fracture-lines of a 
 rock-bed. Incidentally I might mention that a number of 
 cases of typhoid fever have been recurring yearly in the 
 vicinity of this well. 
 
 In a limestone region wells are likewise dangerous on 
 
 and subtract the result from 180. Then, according to trigonometric 
 formula, we have side B A and angle A to find side a. This is solved 
 by the formula a = c X tan. A. Example : We have a well 80 feet 
 deep represented by B A or c. We find the dip of the strata to be 43 ; 
 add this to 90, a right angle, and subtract this from 180, we get 
 47 for angle A . Now, by substituting the figures in the formula, we 
 have a = 80 X tan. 47, or a 80 X 1.07 = 85 feet. That is, that 
 within 85 feet of the well in the direction of B there is exceptional 
 danger, as within that distance all the cleavage-lines of the slate fall 
 within the well ; beyond this distance these lines fall short of the well, 
 and, of course, the danger is not nearly so great. 
 
8 OUTLINES OF RURAL HYGIEXE. 
 
 account of the many underground seams which transmit 
 \\ater with great facility; when water passes through these 
 caves it is not benefited by the natural filtering properties 
 of the soil, and infection in this way may travel a great 
 distance. A limestone country is generally honey-combed 
 by caverns of vast extent. In the limestone bluffs west of 
 Harrisburg I was once shown a cave into which a dog had 
 disappeared in pursuit of a fox; the story runs that the 
 dog came to the surface thirty miles away, and I think it 
 not altogether impossible. In such regions there are a great 
 many "sink-holes/ 7 which are simply surface connections 
 with underground caverns; through these, surface-water 
 pours in its downward course, infecting ground- water which 
 may come to the surface in some far-distant spring. A case 
 of this kind happened some time ago at Bethlehem, Pa. 
 This town suffered from a typhoid epidemic which was 
 finally traced to its water-supply; but how this became in- 
 fected was a puzzle, for their water-supply came from one 
 of those wild, virgin springs which, to all outward appear- 
 ances, is the synonym for purity: but at last large water- 
 bearing courses were discovered (it was a limestone region) 
 which had carried the infection from far-away privies. 
 
 Another formation worth study by the rural well-driller 
 is the clay: these beds are almost impervious to water, and 
 what does pass through a short distance is generally filtered; 
 many a well owes its freedom from disease-producing germs 
 to the fact that it is surrounded by a stratum of clay. 
 
 Gravel, on the other hand, presents directly opposite 
 
WATER-SUPPLY. 9 
 
 qualities. The same property which makes a gravel-bed 
 good for building purposes i.e., because drainage is good 
 and a dry foundation is obtainable makes it very bad for 
 wells, for it is so porous that there can hardly be any hope 
 of its yielding an uncontaminated water,, if there is any 
 means of contamination within a reasonable distance. 
 
 Such are some of the considerations which arise when 
 one is in search of a good well-water; but, irrespective of 
 any of these and without care or study, wells have been 
 dug everywhere, and consequently are almost everywhere 
 polluted. The question is at once asked: Can anything be 
 done with these old wells whereby they may be rendered 
 safe as a source of drinking-water? If possible, it would 
 be best to completely eliminate them and obtain some other 
 supply. When this is not feasible, the well, if not too 
 grossly polluted, may be rendered more or less safe by a 
 method devised by Dr. Koch. 
 
 Koch's Method. Suppose that we have one of these 
 wells which yields a polluted water. To begin with, we 
 take out the pump, if there is one, and pour in sand until 
 it reaches within a foot or two of the lowest water-level; 
 the lowest level of the ground-water generally occurs at 
 the end of a dry, hot summer, and for this reason such a 
 time should be selected for the application of this method. 
 We now place in the centre of the well an iron tube three 
 or four inches in diameter, with its lower end expanded and 
 perforated. This end of the tube rests on the sand and, 
 while it is held in place, a bushel or two of fine gravel is 
 
10 
 
 OUTLINES OF RURAL HYGIENE. 
 
 thrown in immediately surrounding it, and the well is then 
 completely filled with sand. Fig. 3 is the section of such 
 a well, the dotted line representing the water-level. If 
 now a pump is attached to the tube, we have a very good 
 tube- well, which differs from an ordinary one in that it is 
 
 Fig. 3. Section of Well Treated by Koch's Method. (Original.) 
 
 surrounded by a filtering layer of sand; probably this is the 
 best that can be done with a dug well. For a polluted tube- 
 well our only resource is to seek another supply. 
 
 The next question to be answered is: How may a well 
 be constructed, if at all, in order to meet modern sanitary 
 
WATER-SUPPLY. 11 
 
 requirements? While we must admit that this is hard to 
 do, in the face of probable ground-water contamination, 
 still, under certain conditions, there are certain kinds of 
 wells which seem to give satisfaction; for example, in some 
 places deep Artesian wells will yield the best possible re- 
 sults; but this, of course, is only over regions in which the 
 strata are approximately horizontal. The ordinary tube- 
 well cannot be recommended any more than a dug well, if 
 the strata incline much from the horizontal; in such a case, 
 if there is no other supply available, a dug well, filled with 
 sand after Dr. Koch's method, would be far safer than any 
 ordinary boring; this is true not only for regions of dis- 
 located strata, but also for beds of limestone, sandstone, or 
 loose rock of any kind. 
 
 In other places a shallow well, made according to the 
 directions of Professor Poore, of University College, Lon- 
 don, might give complete satisfaction, and, though the 
 places where this could be used are limited, the method is 
 worth some study. The following description of this ex- 
 perimental well made by Professor Poore is taken from the 
 Lancet: "The well was sunk in the very centre of a garden 
 which is rather profusely manured with human excreta; it 
 is placed at the intersection of two paths, a broad, green 
 one, bordering one of asphalt. The situation was chosen 
 for two reasons: (1) that it was, as far as possible, removed 
 from any accidental pollution from the sewer in the street, 
 and (2) that in the centre of the garden it would theoreti- 
 cally run the greatest chance of fecal contamination from 
 
12 OUTLINES OF RURAL HYGIENE. 
 
 the manure used. As the well was sunk wholly for experi- 
 ment, this was essential. The garden is on a river-bank 
 (Thames) and very slightly raised above the level of the 
 water. The well is only 5 feet deep, and the water 
 stands at a level (which varies slightly) of about 3 feet 6 
 inches from the bottom. The well is lined throughout 
 from the very bottom to a point some five inches above the 
 ground with large, concrete sewer-pipes 2 feet 8 inches 
 in diameter, and these pipes have been carefully cemented 
 at their junction; outside the pipes a circle of cement con- 
 crete about four inches thick has been run in. It will thus 
 be evident, the sides being perfectly protected, that no 
 water can possibly enter this well except through the 
 bottom, all contamination by lateral soakage through the 
 walls being rendered impossible. The well is surrounded 
 by an asphalt path about three feet wide and slightly slop- 
 ing away from it; around this is a hedge about five feet 
 high except at those points where the hedge is cut by the 
 paths. There is a closely-fitting cover of oak, which has an 
 outer casing of lead, and thus all contamination from above 
 is prevented. 
 
 "The water is drawn through a two-inch lead pipe which 
 passes through the outer concrete and the concrete lining- 
 pipe, the cut passage for the pipe being carefully closed with 
 cement. The pump is behind the hedge and is provided 
 with a sink and waste-pipe which takes the overflow some 
 twenty or thirty yards to a neighboring stream. In this 
 way the constant dropping of water in the neighborhood 
 
WATER-SUPPLY. 
 
 13 
 
 of the well is prevented. I regard the question of overflow 
 one of greatest importance, which is too often neglected. 
 The nearest point to the well upon which any manural 
 deposit of excreta is likely to be made is on the far side 
 of the hedge; and the distance of this point from the bottom 
 of the well is seven feet. All water which finds its way 
 into the well must have passed through at least six or seven 
 
 Fig. 4. Section of Professor Poore's Well, Showing Concrete 
 Lining and Position of Pump. The diagonal line on the right 
 is to mark the distance from nearest garden-bed to bottom 
 of well. (London Lancet.) 
 
 feet of earth, and, of course, the greater bulk of the water 
 has passed through a far greater length. Three chemical 
 analyses of this water one by Professor Frankland and 
 two by Dr. Kenwood testify to its organic purity, and 
 three bacteriological investigations have given similar indi- 
 cations of purity." 
 
 While this well which Professor Poore constructed yields 
 pure water, it is no proof that all wells so constructed will. 
 The banks of the Thames are composed of an alluvial clay, 
 
14 OUTLINES OF RURAL HYGIENE. 
 
 which, of course, is very impervious to drainage and leakage; 
 and it is very likely that Professor Poore has made his well 
 in this deposit. As he has taken great pains to keep out 
 surface waters, any drainage which may soak through the 
 adjacent soil would, of necessity, be considerably purified. 
 So much for this kind of w r ell when made in clay-beds; 
 but suppose it is dug in a stratum of slate or sandstone; 
 suppose that the strata are tilted on edge, as represented 
 in Fig. 2, which would be a very likely case almost any- 
 where in Eastern United States. From what has been said 
 before one would hardly feel safe in drinking the water 
 from such a well, if human excreta were scattered over the 
 adjoining fields in the locality of B (Fig. 2); assuredly not, 
 if the excreta contained typhoid or cholera germs. 
 
 The fact is that one can never construct a perfect well 
 by any given rule; he must make a careful study of the 
 locality and the nature and dip of the strata if he would 
 have a pure water, and even then it is hard to get it un- 
 polluted from wells of any kind except, perhaps, Artesian. 
 Far better to select some other source of supply, preferablv 
 the one next mentioned, which seems to the author to be 
 the ideal one for many isolated places. 
 
 Cisterns. In most localities in the United States, rain- 
 water stored in properly-constructed cisterns furnishes a 
 substitute for well-water, which is practicable and easily 
 available, for all we need is a suitable collecting surface and 
 a suitable cistern. 
 
 In the Atlantic States the annual rain-fall is about 
 
WATER-SUPPLY. 15 
 
 thirty-seven inches, an amount which, with the ordinary 
 house-roof for the collecting surface, is amply adequate and 
 absolutely reliable; of course, if we live in a district where 
 the rain-fall is less, a corresponding increase in the size of 
 the cistern and collecting surface is necessary to meet the 
 requirements of a continuous supply. If the house-roof 
 is something like one thousand square feet, and many 
 houses will furnish even more, the yearly yield of rain- 
 water collectable will be, if the annual precipitation is 
 thirty-seven inches, about 20,000 gallons, which, at ten 
 gallons per head per day, is more than sufficient for the 
 wants of an ordinary family. For this amount the cistern 
 need not be excessively large; one ten feet in diameter and 
 five feet deep will hold 2000 gallons, and this would last, 
 under usual conditions, more than a month; the danger 
 of exhausting the supply would not be great, for it is rare 
 indeed that a month passes, in most parts of the country, 
 without some precipitation. 
 
 The construction of the cistern is of the utmost impor- 
 tance, for in its ability to keep out soil-water rests the 
 superiority of the cistern over the well. If made of bricks 
 and thoroughly cemented it will be proof, in most cases, 
 against this contamination from the soil. I have known 
 such a cistern to last many years without leakage. 
 
 In the next place, we need a filter, for rain-water, unless 
 it is collected from a purer source than is generally the case, 
 has a peculiar flavor and odor. In order to make a filtering 
 cistern out of an ordinary one it is first necessary to build 
 
16 
 
 OUTLINES OF RURAL HYGIENE. 
 
 a partition from the bottom almost reaching to the top; 
 at the bottom there are several openings connecting the two 
 
 Fig. 5. Section of Filtering-cistern. (Original.) 
 
 sides. Another way to do this filtering is to make two cis- 
 terns side by side and connect them by pipes, but the method 
 of having one cistern with a partition is cheaper, and, per- 
 
WATER-SUPPLY. 17 
 
 haps, better, as there is less danger of leakage. In 
 ing the filter, which is placed on either side of the partition, 
 we may use a variety of substances; three or four feet of 
 common sand is probably the best and the cheapest material 
 that can be obtained. When a natural sand-filter is used 
 in the open air the upper layer of sand becomes covered by 
 a film of nitrifying bacteria, which is of the greatest value 
 in purifying the water. Although this sand-layer in the 
 cistern is cut off from sunlight, it gets an ample supply of 
 oxygen, and it is likely that it acts, in a measure, like the 
 open-air filters. Of all the different materials which we 
 may use, the one I prefer is made of three layers, each con- 
 sisting, from above downward, of sand, polarite, and gravel. 
 Whether this, however, is much better than one made of 
 ordinary sand is a question. Into the side containing the 
 filter the leader from the roof discharges, and into the other 
 is fixed the pump. This arrangement is readily understood 
 by reference to the figure. The water which passes to the 
 pump in a cistern like this is securely filtered, and we get a 
 good, pure, and harmless drinking-water. The sink under 
 the pump-spout may be perforated and empty directly into 
 the side of the cistern containing the filter, so that there 
 is no waste of water. 
 
 While this method of procuring drinking-water is less 
 expensive than any other way, it is almost universally ne- 
 glected by the very people whom it would most benefit, 
 the rural population. As long as the cistern is impervious 
 to the ground-water, there is no danger of its contents be- 
 
18 OUTLINES OF RURAL HYGIENE. 
 
 coming infected except by gross carelessness, filth is some- 
 how or other gotten in at the top. 
 
 One can very readily tell if the cistern leaks by making 
 a simple chlorine examination of the water and then com- 
 paring it with the amount of chlorine found in rain-water 
 collected in a clean receptacle somewhere on the surface. 
 It is evident that much deviation of the chlorine from the 
 average of a surface collection will point to leakage in the 
 cistern. 
 
 Cistern- water, even without a filter, is vastly better and 
 vastly safer than any well; and if the collection is made from 
 a tin roof kept moderately clean, the water will be almost 
 odorless, fresh, and palatable; such water the writer has 
 frequently used. 
 
 The collecting surface whether tin, wood, or slate 
 should be protected from overhanging trees, and a "cut-off" 
 should be placed in the spouting, so that the first washings 
 from the roof may be turned into the street gutter; in this 
 way dust, droppings of birds, etc., are washed away before 
 the water is allowed to run into the cistern. 
 
 The use of rain-water, too, furnishes a means whereby 
 the rural householder may have water under pressure in his 
 house, if he so desires. To have this great comfort people 
 generally think it necessary to have an hydraulic ram, a 
 force-pump, or some other expensive arrangement. By using 
 rain-water all one needs is a tank placed in one of the upper 
 vacant rooms and a series of distributing pipes to the bath, 
 kitchen, or wherever one wishes running water. The tank 
 
WATER-SUPPLY. 19 
 
 is large or small according to the needs of the service. Into 
 the tank a branch pipe with a "cut-off" leads from the 
 roof -spouting; when the tank is filled the "cut-off" is turned 
 and the water goes in another direction. The only care 
 necessary is to see, from time to time, that the tank does not 
 get empty and that it is cleaned at proper intervals. In 
 one instance where this kind of water-service was used, the 
 stable-roof was also utilized. A tank was placed in the loft 
 and the leader from the roof turned into it; by this means 
 the stable was furnished with water and there was a plenti- 
 ful supply for watering the adjacent garden and lawn. 
 
 Rivers, Lakes, and Springs. Many small towns are be- 
 ginning to seek a public water-supply from neighboring 
 rivers, lakes, or springs. Such a source would seem desir- 
 able in a good many cases; but giving a town water-pipes 
 without sewer-pipes is like putting the cart before the horse, 
 unless we first teach the people how to make suitable drains- 
 and how to make and use earth-closets; if they use cess- 
 pools and that is what they always do use when there is a 
 public water-service the polluted soil-water will event- 
 ually soak into the water-pipes, and the "last state will be 
 worse than the first." 
 
 While any ordinary mountain-stream would seem, on first 
 thought, to furnish a pure and undefiled water, there are 
 certain points to be considered before selecting such a 
 supply. On account of the limited gathering-grounds of a 
 small stream, there is much more danger of infection than 
 in a large river. The discharges of one typhoid patient, 
 
20 OUTLINES OF RURAL HYGIENE. 
 
 placed on the banks of the Susquehanna or the Delaware, 
 is not likely to cause danger to any great extent, but similar 
 discharges on the banks of a narrow mountain-brook caused 
 the fearful epidemic of Plymouth; so, on this score alone, 
 the "babbling brook" is not as ideal a source of supply as 
 some large river. In selecting a stream, lake, or spring, 
 other things being equal, we should take one having a wild, 
 uncultivated, and uninhabited gathering-ground, and this 
 should be, by all means, under the supervision of the people 
 using the water. 
 
 The pollution of public water-supplies is an interesting 
 and instructive study; sometimes the water is actually 
 fouled by sewers from the very town itself; the people are, 
 in fact, drinking their own waste. This is the case with 
 Harrisburg, Penna., where the intake of the city-works 
 opens into the river only a short distance from the shore 
 and directly below the mouths of several sewers. 
 
 In rivers flowing through coal regions there is another 
 kind of pollution which sometimes enters into the question 
 of a water-supply; while the regions where this occurs are 
 not very numerous, it is still worth noting. This pollution 
 is caused by drainage-water from coal mines; it consists 
 chemically of a solution of protosulphate of iron, and forms, 
 when concentrated, a black, turbid stream from its sus- 
 pended coal-dust; when more diluted, it is of a peculiar sul- 
 phury color, and gives a white deposit on rocks lining its 
 course. In Pennsylvania this goes by the name of "sulphur- 
 water"; but this is a misnomer, for the color is due, not to 
 
WATER-SUPPLY. 21 
 
 sulphur, but to oxide of iron. The protosulphate, which is 
 about the only important chemical constituent, decomposes 
 under the influence of sunlight and oxygen, and yields a 
 sequisulphate and a hydrated oxide; so much we know from 
 the laboratory of the chemist, and there is no reason to 
 believe that the result is any different outside of the labora- 
 tory. The oxide, however, is not a bad thing, for it assists 
 somewhat in purifying the water, but the sesquisulphate 
 is an astringent which, when it comes in contact with tannic 
 acid of tea or coffee, has a tendency to make tannate of iron, 
 and tannate of iron is popularly known as "ink." For this 
 reason waters contaminated with mine-drainage are not suit- 
 able for town-supplies, and not only that, but they destroy 
 more or less the vegetable and animal life in their respective 
 courses. 
 
 I have seen small streams in Northern Pennsylvania 
 which were as black, as ink, and a good deal thicker, from 
 this drainage. No living thing inhabits their waters nor 
 seeks their banks, a Nineteenth Century representation of 
 the fabled Styx. 
 
 To purify a stream encumbered by mine-drainage, it is 
 necessary to filter it through beds of limestone; by this 
 means the sulphate of iron is changed into sulphate of lime, 
 which is harmless, although it adds some hardness to the 
 water. The excessive amount of free coal-dust which these 
 waters sometimes carry may be removed by any kind of a 
 gravel or broken-stone filter. In some of the large rivers 
 this drainage occupies only a small part of its width, and 
 
22 OUTLINES OF RURAL HYGIENE. 
 
 water for drinking may be obtained by extending the water- 
 pipes beyond the "sulphur-stream." 
 
 Examination of Wells and Well-water. The physician 
 in isolated localities is frequently called upon to give an 
 opinion as to whether or not a certain well is fit for use. 
 He has to depend upon his own resources, and it is neces- 
 sary that the examination be as simple as possible and at 
 the same time reliable. Each well is a factor by itself, and 
 should be studied as to the geological strata which it pierces, 
 the position of the sources of possible pollution, and the 
 relative amount of chlorine it contains. The old idea that 
 a well drains a cone-shaped area whose base is from fifty to 
 one hundred times its depth approximates, perhaps, the 
 truth, but so much depends on the character of the rock- 
 strata that ij$ is impossible to lay down any definite rule; 
 it makes all the difference in the world whether the well 
 taps the ground-water through a thick, heavy clay, or 
 whether it draws its supply from a gravel-bed, from slate, 
 sandstone, limestone, or a more impervious rock; it makes 
 much difference whether the strata are horizontal or "turned 
 on edge." The proximity of a source of pollution count? 
 for little as to a distance in feet; the position studied in 
 regard to the slope of the strata and the direction of the 
 ground-water currents mean much more in laying bare a 
 source of trouble. 
 
 In examining the water we want to find out if it con- 
 tains pathogenic germs or if it is likely to. The detection of 
 these is probably not available to many country practition- 
 
WATEE-SUPPLY. 23 
 
 ers. Disease-germs only come into a drinking-water through 
 the medium of organic waste, and, in the absence of our 
 ability to detect the germs, we have to be satisfied with the 
 detection of the pollution with which the germs are asso- 
 ciated, sewage, privy, stable leakage, etc. If a well shows 
 that it is not polluted with such material, it is most likely 
 free of pathogenic germs, and is almost certainly not a 
 factor in producing disease. 
 
 To find out this kind of pollution a simple chlorine ex- 
 amination is generally all that is necessary. I do not, for 
 a moment, depreciate the elaborate analyses for organic 
 matter, nitrates, etc., but these are not available in the out- 
 lying districts, and they are not actually necessary in a good 
 many cases of well-water examination, especially in times 
 of epidemics. If we know the normal chlorine of the region 
 (see "Appendix") i.e., the amount of chlorine present in 
 unpolluted springs and rivers we can readily judge the 
 amount of pollution of a given water; of course, chlorine in 
 a water may represent only past pollution, but in a sanitary 
 way this does not count for much, for we can never tell at 
 what moment the old lines of drainage might not be re- 
 established, and for that reason a well once polluted pre- 
 sents an ever-present danger, unless the source of former 
 pollution can be absolutely abolished. 
 
 Although we judge the amount of pollution by the vari- 
 ation from the normal chlorine, we should not make this 
 absolute and condemn every well which shows excess, for 
 some excess above the normal, although pointing almost 
 
24 OUTLINES OF BUBAL HYGIENE. 
 
 positively to pollution, is allowable and does not necessarily 
 mean dangerous pollution. 
 
 What each physician should do, if he lives in a locality 
 supplied by well-water, is to ascertain the chlorine normal 
 of the district, and, if a well shows a water containing 
 chlorine much above this amount, it should be viewed with 
 suspicion and judgment passed accordingly. 
 
 The following list, taken from several Health Keports, 
 gives an idea of the amount of chlorine in certain waters 
 not excessively polluted: 
 
 Naugatauk Eiver, 0.16 parts per 100,000. 
 
 Charles River, 0.43-0.80 
 
 Housatonic Eiver, 0.16 
 
 Croton Eiver, 0.44 
 
 Schuylkill Eiver, 0.57 
 
 Delaware Eiver, 0.25 
 
 Spring, Penna., 0.50 
 
 Spring, Conn., 0.17 " " 
 
 Well, Penna., 0.20 
 
CHAPTER II. 
 
 WASTE DISPOSAL. 
 
 THE disposal of waste in country places presents features 
 entirely different from that of a city, inasmuch as in the 
 country this duty depends upon individual effort, and indi- 
 vidual effort, be it ever so good, is a poor substitute for 
 municipal oversight where sewage and garbage disposal and 
 e \~ery other sanitary requirement must conform to a definite 
 rule. 
 
 Excreta. First in order, and perhaps, too, in impor- 
 tance, comes the disposal of human excreta; and this, in the 
 absence of water-service, is very important, for we have 
 learned that one of the most common causes of preventable 
 diseases in the country comes from well-water polluted by 
 leakage from cess-pools and privies. If there is one sanitary 
 necessity which stands pre-eminently above all the rest, it 
 is, probably, the substitution of the earth-closet for these 
 foul privies and cess-pools, which undoubtedly contaminate 
 the ground-water. We know so little about the changes of 
 the water in the soil and so little about the life-history of 
 the germs of certain water-borne diseases, that there is 
 danger whenever the ground-water is exposed to excreta. It 
 is a fact that the privies in most villages are rarely emptied, 
 and one sanitarian has explained this on the supposition 
 that the wells draw a good deal of their water from the 
 
 (25) 
 
26 OUTLINES OF EURAL HYGIENE. 
 
 urine of neighboring privies; and this can very readily be 
 the state of affairs in many places. 
 
 Privies should be absolutely abolished unless they are 
 placed far from any well and made perfectly water-tight. 
 Instead of a privy-vault, it is better to use dry earth-closets. 
 In the average country town not one person in a thousand 
 uses an earth-closet or, in fact, seems to know anything 
 about it. If we could get village dwellers to understand the 
 sanitary value of this method of excretal disposal, it would 
 be a great step in progress. There are very many ways and 
 methods of making these dry closets. The following, which 
 is one of the simplest, is that recommended by the Penn- 
 sylvania State Board of Health; it is so easily made that 
 there is no excuse why every rural dweller should not have 
 one: 
 
 "The body is a plain pine box; its sides are 14 inches 
 high, its depth 18 inches, and length about 30 inches. It is 
 divided into two compartments, one 18x18 inches and the 
 other 18x12 inches. The larger of these compartments has 
 no bottom; the smaller is a tight one. On top are two 
 covers. The lower one, hinged to the upper edge of the 
 back, extends all the way across both compartments. In 
 this lower cover is cut the seat, over the centre of the 
 larger compartment. The upper cover is hinged to the 
 lower one and may be raised independently; it is made the 
 size of the large compartment, and both have a little edge 
 projecting to facilitate lifting them." The receiving vessel 
 is a galvanized-iron bucket (an old coal-bucket will answer) 
 
28 OUTLINES OF RURAL HYGIENE. 
 
 as large as will stand in the compartment with the covers 
 down. The small compartment is filled with dry, sifted 
 anthracite coal ashes, or whatever else is used, a scoop placed 
 in it, and the commode is ready for use. 
 
 After using, the lower cover is raised, exposing both 
 compartments. A small quantity of the ashes is then taken 
 in the scoop and scattered over the contents of the hod. A 
 closet such as this may be placed anywhere in the house 
 or in the old privy, and with proper care is absolutely odor- 
 less. The material for use in these closets may be either 
 ashes or dry earth; in summer dry earth may be taken 
 directly from the garden-bed, exposed to the sun for a short 
 time, and, for use in winter, stored in barrels. Ashes - 
 finely sifted from anthracite coal are perhaps better, if 
 the closet is in the house, for the ashes are lighter and more 
 absorbent; dry earth, if much urine is allowed to pass into 
 the hopper, becomes muddy and heavy. 
 
 The disposal of the contents of the closet is, perhaps, 
 the stumbling-block to many. This material, whether ashes 
 or earth has been used, may be placed on a corner of the 
 garden-bed and covered with a little earth, or it may be 
 buried a few inches under the soil; lastly, it may be kept 
 in a dry place, covered with earth and carted away at some 
 suitable time by the farmer for use as fertilizer. In places 
 where earth or ashes are scarce the contents may be allowed 
 to humify in a dry shed and this humus used again; this 
 may be repeated many times. The agent of disposal in all 
 cases is the nitrifying bacteria. To be sure, if too much ash 
 
WASTE DISPOSAL. 
 
 is used, nitrification is delayed; but with the mixture of a 
 little, earth the organic matter all disappears in due time. 
 
 Last year I made some experiments in regard to the 
 length of time required for the disposal of excreta when 
 
 Fig. 7. A Model Dry Closet. (Original.) 
 
 buried under four or five inches of soil. In summer the 
 time was about two weeks, which corresponds to the time 
 observed by Professor Poore. In January in the coldest 
 month of the year the excreta, when mixed with ashes 
 
30 OUTLINES OF KUKAL HYGIENE. 
 
 and buried, had completely disappeared in four weeks, al- 
 though most of the time the surface-soil was completely 
 frozen, and at the time of examination was so hard that I 
 had to use a pick. 
 
 If one desires a more elaborate commode it may be made 
 somewhat after the manner of the modern water-closet. A 
 design of this fashion is shown in Fig. 7. The pail is made 
 of ornamental agateware, and upon this rests the seat of 
 mahogany, walnut, or oak, exactly the same as is used in 
 the water-closet. A pail which is open in this manner pos- 
 sesses the advantages of the open water-closet in that there 
 is no hiding-place for dirt. The ashes may be kept in a 
 box beside the pail. 
 
 Another way of using the earth-closet, especially .for 
 schools or large dwellings, is to have a privy constructed 
 with what is called a "dry catch." A pit is dug, about three 
 feet deep, which has its two sides, front, and back lined with 
 brick; in the back an open space is left for a door of wire 
 netting, and an inclined pathway is made from the bottom 
 of the closet to the surface, unless the privy should happen 
 to be built on the side of a hill, when this would not, of 
 course, be necessary. 
 
 The floor of the vault is concreted and inclined as in- 
 dicated in the drawing. The urine which is voided flows 
 backward into a gutter, which is filled with some absorbent, 
 sawdust, ashes, or dry earth. 
 
 The pan under the seat is made of galvanized iron, and 
 a flap is attached to the lower end to prevent an upward 
 
Fig. 8. " Dry-Catch " Privy. (Modified, after Poore.) 
 
32 OUTLINES OF RURAL HYGIENE. 
 
 draft; this flap may be balanced so as to work automatically, 
 or may be worked by a chain. After use, earth or ashes is 
 put in the pan just as in any other closet. 
 
 In a privy of this sort the humification of the faeces will 
 continue, although no earth is added. Poore narrates a 
 case where, by neglect of the scavenger, the "contents had 
 not been removed for two months; still the bottom of the 
 mass had. humified and become inoffensive." The proper 
 way for such a closet to be utilized by country schools 
 would be to have a reservoir filled with an absorbent, so 
 arranged that pulling a chain would throw a sufficient 
 amount into the pan, or what, perhaps, is better, is simply 
 to have the janitor throw earth over the contents of the 
 closet once every day; every week or two, according to cir- 
 cumstances, the mass should be removed. 
 
 To get people to use dry closets is more a question of 
 education than of legislation. A town that purposes this 
 innovation should have printed circulars sent to all house- 
 holders, showing the advantages of the method. Then they 
 might order the construction of all privies after the method 
 shown in Fig. 8, and have a public scavenger clean them 
 every week. The personal influence of the physician and 
 his example in these sanitary matters will do much to en- 
 lighten the people to a correct understanding of the value 
 of sanitary appliances; and, until the people are educated 
 to this point, legislation will hardly do much good. 
 
 Slop-waters. For the purpose of studying this part of 
 our subject we have to consider three classes of country 
 
WASTE DISPOSAL. 33 
 
 houses: First, those which have water-service and use 
 water-closets for the disposal of excreta just as in the city; 
 this, of course, necessitates the use of sewers, in which the 
 slop-waters are also disposed of. With these we have noth- 
 ing to do, so far as the individual treatment of waste-water 
 is concerned. Secondly, those in which, although having 
 water-service, the excreta are disposed of by some form of 
 dry closet; in this class sewers are not needed, but drains 
 are necessary for carrying the waste-waters from the kitchen 
 sink and bath. Thirdly, those which have no water-service, 
 no bath, etc. This comprises, by far, the greater number of 
 houses outside the cities and large towns. In the latter 
 class all slops which amount in a family of four or five to 
 about fifteen gallons daily are collected in buckets and 
 are generally emptied out the kitchen door, irrespective of 
 where the filthy water may flow. In such a house a slop- 
 bowl should be put in some convenient location either in 
 the house, on the porch, balcony, or elsewhere, and con- 
 nected with a surface- or subsoil- drain, both of which have 
 points of excellence. 
 
 In the simplest form of a drain the pipe from the slop- 
 bowl may lead to a furrow in the vegetable bed. A better 
 arrangement is that shown in the accompanying photo- 
 graph, which was taken from a small drain in actual use. 
 This drain was made for one of our third-class houses, 
 which have no water-service. A box about a foot square, 
 lined with tin or galvanized iron, was placed in a suitable 
 location in this instance, at the corner of the bed to be 
 
 3 
 
34 OUTLINES OF RURAL HYGIENE. 
 
 used to serve as a receptacle for the slop-waters which are 
 collected in buckets; from this extends an old tin roof -gutter 
 in any direction available. The bottom of the box is per- 
 forated by twenty or thirty small holes, which serve to let 
 the water into the gutter. A number of small holes is 
 better than a few large ones, as the small tend to keep solid 
 particles out of the gutter and prevent clogging. The 
 gutter is twenty feet long; it is nine inches above the ground 
 at the upper end and three inches at the lower, in order to 
 give sufficient fall for its rapid emptying, a very necessary 
 factor in cold weather. The gutter is pierced every three or 
 four inches by one-fourth to one-half inch holes, which per- 
 mit the liquid to flow on to the soil, where it is quickly 
 absorbed. The soil needs a little raking now and then to 
 favor absorption and evaporation. Along each side of the 
 drain may be planted a hedge of laurel, a row of sunflowers, 
 or any vegetable which happens to be desirable, only that 
 all debris from overhanging plants must be kept out of the 
 gutter. This kind of a drain will do very well in houses 
 having water-service, by simply having the waste-pipe from 
 the kitchen and bath discharge into the gutter. 
 
 An important point in the use of this drain as, in fact, 
 of any drain is to keep solid and liquid refuse separate, 
 for a liquid containing many solid particles tends to choke 
 it and to interfere with its efficiency. This separation is 
 readily accomplished by keeping two buckets in or near the 
 kitchen, one for solids and one for liquids. Over the one 
 is placed a tin basin with a perforated bottom; the semi- 
 
Fig. 9. One Form of Surface-drain, Made of a_Tin Roof-gutter. 
 
WASTE DISPOSAL. 37 
 
 liquid waste, as it comes from the kitchen, is placed in the 
 basin, the water drains through, and the solid refuse is 
 emptied into the other bucket. In Fig. 9 these buckets are 
 shown adjoining the drain. 
 
 In the winter a surface-drain may cause trouble unless 
 some care is taken. In the first place, it should be kept 
 clean of snow, and, in the next, the liquid must be emptied 
 into the drain before it is chilled by long exposure to the 
 cold; but if proper attention is paid to these points and to 
 the thorough emptying of the drain each time that it is 
 used, it will give complete satisfaction, even in the coldest 
 weather. 
 
 Another way of making a surface-drain is to construct 
 a gutter of perforated bricks, the space underneath the 
 gutter being prepared by trenching and filling with small 
 stones, cinders, and the like, to favor absorption. Instead 
 of perforated bricks, the ordinary ones may be used by leav- 
 ing an interval of half an inch or so between each brick. A 
 drain of this sort has the advantage of being easily cleaned 
 by sweeping. A number of English physicians are said to 
 favor this plan very much. 
 
 A very good drain, too, may be made by digging a trench 
 a foot or so deep and a couple of feet wide, and lining it with 
 small, round, cobble-stones, such as are used in some street 
 gutters. The space, of course, underneath the drain should 
 be prepared with some absorbent material, and the waste- 
 pipe should discharge a foot or so above the bottom of the 
 gutter, so as to permit no undue accumulation of ice in 
 
38 OUTLINES OF RURAL HYGIEXK. 
 
 winter; the length of such a gutter should be fifteen or 
 twenty feet for a family of four or five. In this, as in all 
 surface-drains, the waste-pipes need not be trapped. 
 
 A surface-gutter may be protected from freezing by 
 covering with some old boards and a little earth, making it 
 practically a subsoil-drain, for the time being. 
 
 In some places, for various esthetic reasons, and espe- 
 cially in a very cold climate, a surface-drain may not be 
 practicable. Then we have to resort to a subsoil-drain, 
 which is made as follows: 
 
 For this method several hundred feet of land are neces- 
 sary if all the waste-water from the house is disposed in one 
 place; but in many instances different places for different 
 drains will be more suitable. In calculating the amount 
 of tiles, we may count one or two feet, depending on the 
 soil, for each gallon to be disposed daily. A trench is dug 
 about two feet deep, and in this ordinary two-inch drain- 
 tiles are placed; it is best to rest the tiles on a narrow piece 
 of board in order to get them on a regular pitch, which 
 should be at least five inches in twenty feet. The tiles are 
 placed about half an inch apart, and the joints are covered 
 with broken stones or half -pipes; then the whole trench is 
 filled with stones, coarse coal ashes or cinders completely 
 surrounding the tiles, and finally covered with earth. The 
 delivery-pipe from the house is connected to the drain by 
 a lead or iron pipe, which projects into the end tile. At the 
 far end of every line of tiling a pipe should be inserted, and 
 project above the ground, so as to allow the free circulation 
 
Fig. 10. Surface-drain Made of Ordinary Bricks, Showing De- 
 livery-pipe from Kitchen Sink and Bath. 
 
WASTE DISPOSAL. 
 
 41 
 
 of air through the drain. Subsoil drains, if made in this 
 way, cause very little odor in the room; but, as a precaution- 
 ary measure, they should be trapped. In a case in which 
 more than a single line of tile is necessary the field may be 
 
 IX 
 
 ( 
 
 Fig. 11. Method of Laying Tiles for Subsoil-drain. 
 
 laid out in a variety of ways; the only point necessary is to 
 have a sufficient interval two or three feet between each 
 line. 
 
 The kitchen sink and the bath may be directly con- 
 nected to such a drain, either together or separately. 
 
 Fig. 12. Plan of Subsoil Irrigation-bed. 
 
 For the disposal of the bedroom-slops a slop-bowl may 
 be placed in the bath-room, or wherever most convenient. 
 
 In some such manner as this we dispose absolutely of all 
 the waste-waters of a house just as well, perhaps a good deal 
 better and safer than we could with sewers. 
 
42 OUTLINES OF RURAL HYGIENE. 
 
 In the first class of houses those having water-service 
 and sewers there comes up the question of sewage disposal, 
 which almost invariably means a cess-pool. Instead of a 
 cess-pool, a small shallow tank should be built at some suit- 
 able place, more or less distant from the house, and at the 
 edge of some cultivated field, counting about one hundred 
 square feet of land for each individual. There are flush- 
 tanks constructed for placing underground; but this is 
 hardly necessary, unless the location selected should happen 
 to be very near the dwelling. The house-sewer is connected 
 with the tank, and an automatic flush controls the distri- 
 bution of the sewage, which should be discharged inter- 
 mittently. A gutter made of cement, or half-pipe, is laid 
 from the tank along the field to be used, and every dozen 
 feet or so there is a little branch gutter to guide the sewage 
 over the land. In front of each of these branches there is 
 a barrier of broken stones, to check the flow and prevent 
 washing, and beyond this the land to be used, which should 
 be planted with corn, as this does not keep out sunlight as 
 much as grain, and sunlight is an important factor in sew- 
 age farming. 
 
 Garbage. Sweepings, paper, rags, ashes, and solid 
 refuse from the kitchen make another chapter in waste dis- 
 posal. In cities this goes under the head of garbage and is 
 disposed by various methods, in many cases destruction by 
 fire giving the greatest satisfaction. In cities under good 
 sanitary control ashes are kept separate from the other 
 material, and we do likewise in the country. Most of the 
 
Fig. 13. Photograph Showing Distributing-gutter and Stone Barrier 
 of an Irrigation-field. (New Jersey State Board of Health 
 Report.) 
 
WASTE DISPOSAL. 45 
 
 solid refuse, save the ashes, is probably best gotten rid of 
 by fire, and it is generally recommended that the kitchen 
 range be the medium of disposal. To do this properly there 
 must be a good fire in the range, and too much waste must 
 not be put in at once. With proper care almost all kitchen 
 refuse, orange- and potato- parings, egg-shells, bones, etc., 
 can be destroyed without trouble. The only disadvantage is 
 that this sometimes causes an odor. To obviate this an 
 apparatus has been devised for attachment to the stove-pipe, 
 whereby the material is first carbonized by the heat passing 
 up the chimney, before throwing it into the fire. I have 
 no practical experience with this arrangement, but judge 
 from the various reports that it answers well. 
 
 Kitchen waste may also be disposed of by simply bury- 
 ing it a few inches under the soil. A hole several feet 
 square may be dug in the garden-bed and the refuse emptied 
 into it and covered with earth from time to time. In this 
 way the material is disposed of by nitrification, in a month 
 or so, and the soil is made the richer. When land is avail- 
 able, and it does not take much, this method is the most 
 efficient means, perhaps, for disposing of putrescible gar- 
 bage. Combustible waste as rags, paper, sweepings, bones, 
 and the like can be disposed better by fire. 
 
 The following is another method for the destruction of 
 putrescible waste, which may be of value in certain places: 
 "Take a piece of galvanized wire netting three or four feet 
 wide, and with it inclose a circular space about three or four 
 feet in diameter, the netting being fastened and supported 
 
46 OUTLINES OF KURAL HYGIENE. 
 
 by two or three iron or wooden stakes driven into the 
 ground. Into this little wire inclosure throw all refuse from 
 the house and garden which is capable of rotting, the par- 
 ings and waste of vegetables and other food, the mowings 
 and sweepings of the lawn and paths, weeds, fallen leaves, 
 etc. Such a heap as this, exposed on all sides to the air, 
 is not offensive, and the component parts of it undergo 
 humifaction. When the wire inclosure will hold no more, 
 a little earth must be thrown on top, and the heap must be 
 left for several weeks freely exposed to the weather. It will 
 settle down and diminish in bulk,, and finally is entirely con- 
 verted into fine garden-mold suitable for potting or for 
 enriching the soil. The final act in the management of this 
 refuse heap is to sift it and consign the residue to the garden 
 bonfire. When one netting inclosure is filled, a second 
 must be formed; so that in connection with a house there 
 must always be two heaps, one forming and the other 
 ripening. Such heaps, if freely exposed on all sides, are not, 
 it the smallest degree, offensive." 
 
 The other part of the garbage the ashes, broken crock- 
 ery, tin cans, etc. should be kept separate and used for 
 filling. If an ash-closet is used almost all the ashes will be 
 disposed in this way. 
 
 The waste, then, of an ideal country house would be 
 disposed somewhat as follows: The material from the dry 
 c ] ose t which is the only method of excrefal disposal rec- 
 ommended when there is no water-service is to be used 
 ae fertilizer by burying a few inches in cultivated soil either 
 
WASTE DISPOSAL. 47 
 
 on the garden-bed or on a neighboring farm. The waste- 
 water from the kitchen sink and the bath run into lines of 
 surface- or subsoil- drains. The garbage that is, the putres- 
 cible part which comes from the kitchen is burned in the 
 range or buried in a pit in the garden-bed. The combust- 
 ible part rags and paper is burned. The non-combust- 
 ible part ashes, tin cans, oyster-shells, etc. is put into 
 bags kept for the purpose, and at intervals is taken away 
 and used for filling. In houses where there is water-service 
 and water-closets excreta and slop-waters are disposed to- 
 gether in the form of sewage, and for this the only means 
 of disposal is irrigation. The cess-pool should not be 
 thought of. 
 
CHAPTEK III. 
 
 THE SOIL. 
 
 THE study of the soil and rocks used to belong strictly 
 to the geologist, but lately the biologist and the sanitarian 
 have taken up the work, and we are finding that there are 
 factors in the soil which have much bearing on health. For 
 example, there is the surface-soil, with its peculiar filth- 
 destroying properties; ground-moisture and ground-water 
 present problems to be solved; ground-air, too, is a question 
 of vast importance. 
 
 The surface-soil is composed of the debris of the subsoil 
 mixed with more or less humus; this humus is the black 
 sdil, or mold, which is produced by the decomposition of 
 the organic matter of plants and animals; surface-soil, 
 though to a superficial observer apparently dead, is filled 
 with all varieties of lowly life, worms, bacteria, bugs, and 
 beetles, which work out the problem of their existence vastly 
 better than some forms of higher life. 
 
 It is only in the upper few feet of the soil that is carried 
 on all the various processes for the feeding and clothing of 
 the race, a vast laboratory, as it were, of which we know 
 very little. 
 
 As far as sanitarians are concerned, the most important 
 part played by this "living earth," as it has been called, is 
 its ability to destroy waste-material and to break up such 
 (48) 
 
THE SOIL. 49 
 
 matter into its primary elements, rendering them harmless, 
 and fit to be taken up by growing plant-life. 
 
 The process of decay and disorganization was noted long 
 ago, but we never knew exactly what it meant until very 
 recently. Now we call it nitrification, and the world has to 
 thank Schloessing, Miintz, Warrington, and Winogradski 
 for the work that they have done; but much yet remains 
 unknown, for not one of these nitrifying organisms has been 
 isolated, unless we except the bacillococcus of Frankland; 
 not one has been cultivated. These bacteria, only known, 
 as yet, by their effects, are the great scavengers of the world, 
 for they are present in all natural and cultivated soils. 
 
 The products of nitrification are ammonia, nitrites, 
 and nitrates, and the last is plant-food. It is not just yet 
 settled whether nitration the formation of nitrites into 
 nitrates is chemical or biological, but the evidence seems 
 to point to the former, and that it is brought about by the 
 action of the carbon dioxide and the oxygen of the ground- 
 air. Sewage-farms, filter-beds, earth-closets, and all like 
 destroyers of filth depend, for their efficiency, on nitrifica- 
 tion. When we add earth to the dry closet we simply add 
 nitrifying bacteria plus an absorbent. Could we isolate these 
 bacteria it might be better to add them separately, but we 
 have not progressed so far; so we add the bacteria in their 
 natural habitat. 
 
 The nitrifying properties of different soils depend on 
 various circumstances, such as the nature of the soil, aera- 
 tion, moisture, and heat, the thermal life-point varying 
 
50 OUTLINES OF RURAL HYGIENE. 
 
 with different organisms. Excessive heat destroys the nitri- 
 fying bacteria; so that earth dried in an oven is absolutely 
 useless save as an absorbent for the earth-closet. 
 
 Germicides kill them; so that adding carbolic acid to a 
 compost-heap or a privy is useles as far as the ultimate dis- 
 posal is concerned, for, while the acid might kill some path- 
 ogenic germs and destroy noxious odors for the time being, 
 it also impedes the nitrifying germs. 
 
 Ground-moisture. If one digs into the earth he finds 
 tli at the upper layers are moist, containing both air and 
 water. This dampness is derived from percolating waters 
 from above and from the ground-water below, which tends 
 to rise by capillary action and hydrostatic pressure. Ground- 
 moisture is directly proportional to the absorptive power of 
 the soil, and inversely as its permeability, both of which 
 depend on the character of the soil and varies accordingly; 
 for example, humus will retain about 50 per cent, of water; 
 slate, 4 to 10 per cent.; sandstone, 3 to 8 per cent.; lime- 
 stone, only 2 to 3 per cent. It is evident that by increasing 
 the permeability of the soil we can diminish its dampness; 
 to do this we fill trenches with some loose rock or debris of 
 any kind, or we may lay a course of drain-tiles. Water pre- 
 colating through the soil will collect in these trenches or 
 tiles, flow off rapidly, and the soil will become drier. 
 
 This undue dampness of the soil is, no doubt, a factor 
 in certain diseases. The prevalence of rheumatic com- 
 plaints in rural districts, where the houses are almost uni- 
 versally damp, is a well-known fact, strikingly different 
 
THE SOIL. 51 
 
 from its prevalence in a well-drained city. Of course, there 
 are other factors at work; but soil-dampness is certainly one 
 not to be ignored. 
 
 It has been claimed that there is a relationship between 
 dampness and phthisis. According to some English statis- 
 tics, there seems to have been a great lowering of phthisical 
 mortality following subsoil-drainage in certain localities. 
 We now know that phthisis is a specific disease; but it 
 appears likely that continual exposure to dampness so lowers 
 vitality that the bacilli find a better breeding-ground than 
 in the normal condition. 
 
 One other disease namely, malaria has much depend- 
 ence apparently on excessive ground-moisture; this, with 
 heat and organic matter, seems to be a primal factor in the 
 breeding of the plasmodium. It has been noted that in- 
 creased dryness of the soil, which is brought about by sur- 
 face- and subsoil- drainage, is a potent factor in the destruc- 
 tion of malaria. Eucalyptus, sunflowers, and other plants 
 which absorb much moisture are great aids to drainage. 
 Sunflowers, especially, as they will grow almost anywhere, 
 are to be recommended for wet places about country homes. 
 
 Ground-water, as explained before, is that underground 
 sheet of water which completely fills all the interstices of 
 the soil at a certain depth, extending from several feet to 
 hundreds of feet below the surface; its height is readily 
 told by the height of water in the wells of the district. This 
 ground-water does not flow in rivers, as is generally sup- 
 posed, but extends underneath the soil in one broad, 
 
52 OUTLINES OF RURAL HYGIENE. 
 
 tinuous sheet; it is for this reason that wells sunk almost 
 anywhere yield water. 
 
 The origin of the ground-water is, of course, the rain 
 sinking through a porous soil; its level varies from time to 
 time and does not extend in a horizontal line, but in an 
 irregular one, the fluctuations depending on the geological 
 character of the rock and the precipitation and height of 
 adjoining water-courses. At Munich, for example, there is 
 a difference of ten feet between the highest and lowest 
 
 Fig. 14. Showing Ground-water Level in an Elevated Region 
 Between Two Streams. (Original.) 
 
 levels. In summers characterized by long droughts the 
 water-courses become very low, and consequently the 
 ground- water sinks below its usual place; as a result, many 
 wells get "dry." The proper time to dig a well, if such 
 things must exist, is during a dry summer, when the ground- 
 water is at its lowest point. 
 
 The sheet of ground-water is also in continual motion 
 toward the nearest water-courses; five to ten feet per day 
 gives some idea of its velocity, which changes with the 
 porosity of the bed. In some regions of limestone, slate, 
 
THE SOIL. 
 
 53 
 
 and sandstone there are large underground cavities and fis- 
 sures, through which water-movement is greatly facilitated. 
 Much has been said about the relation of the ground- 
 water to diseases, and especially its connection with typhoid 
 fever. The theory of Professor Pettenkofer, that low 
 
 / 
 
 
 Fig. 15. (From Miers and Crosskey.) 
 
 ground-water and epidemics of typhoid fever occur simul- 
 taneously, cannot be verified for all places. The following 
 sketch of these relations for the city of Zurich in 1872 
 shows the exact opposite. Of course, if a city uses wells or a 
 polluted drinking-water of any kind, Pettenkofer's theory 
 rests on a logical basis, for the increase of drainage and 
 
54 OUTLINES OF RURAL HYGIENE. 
 
 consequent wider area of infection brought about by low 
 ground-water will readily explain the spread of the disease. 
 
 The truth of the ground-water question seems to be that 
 unless its level is very near the surface it has little to do 
 with health save in the pollution of water-supplies. I recall 
 a town where the ground-water is generally twenty-five to 
 fifty feet below the surface, yet almost every house in that 
 town is damp and unhealthy, because faulty construction 
 has permitted ground-air and ground-moisture to permeate 
 the foundations. Much has been said about lowering the 
 ground-water by drainage; but ordinarily it is a difficult 
 tiling to do this. When people speak of lowering the 
 ground-water by building sewers and drains, they generally 
 mean that they lessen ground-moisture and dampness. 
 
 Ground-air. More important than ground-water is the 
 air w r hich occupies the upper layers of the soil and fills all 
 the interstices as far down, at least, as the surface of the 
 ground-water. The composition of this air and its move- 
 ments are the two factors which interest sanitarians. De- 
 composition and putrefaction are constantly going on in 
 the soil, and the gases arising from these processes diffuse 
 through the soil. The carbon unites with the oxygen of 
 the atmosphere, and carbon dioxide is formed, which is 
 always greater in the ground-air than in the atmosphere; 
 for example, at Dresden, where experiments were made, at 
 six feet beneath the surface there was found to be 2.99 per 
 cent., and at eighteen feet 7.96 per cent., of carbon dioxide. 
 Oxygen, on the other hand, is decreased, and falls as low as 
 
THE SOIL. 55 
 
 10 per cent, in some soils. Nitrogen remains at about the 
 same proportion as in the atmosphere. 
 
 These gases, together with certain amounts of ammonia, 
 hydrogen, ammonium sulphide, and marsh-gas, make up the 
 air in the soil. Thus, differing in composition from the 
 atmosphere, it is not suitable for breathing purposes, and is 
 too damp. On the other hand, we are not certain that it 
 does not, at times, contain the spores of certain disease- 
 germs. 
 
 The second disturbing factor of the ground-air namely, 
 its movement is of considerable sanitary importance. It 
 has been proved that winds blowing against the surface set 
 this underground-air in motion; likewise, too, any change 
 in the ground-water level will occasion fluctuations in the 
 air above. Also during a heavy rain the surface-waters 
 flowing downward press upon the ground-air and compress 
 it; underneath a dwelling, if the cellar is not properly con- 
 creted, there is an area of diminished pressure, and conse- 
 quently the ground-air pours into the cellar and thence 
 into the house. In winter, during heavy frosts, when the 
 frozen ground is more or less impervious, the warm, un- 
 frozen part underneath a house facilitates the ascent of the 
 ground-air; hence the reason for urging more careful build- 
 ing of cellars and foundations than at present. 
 
CHAPTER IV. 
 
 HABITATIONS. 
 
 Dwellings. The first thing in the building of a house, 
 not only to the architect, but also to the sanitarian, is the 
 foundation. That very little attention is paid to this will 
 bo apparent to anyone who will watch the construction of a 
 foundation, especially in the rural districts. Whether the 
 land to be used is wet or dry, clay or gravel, sandstone, slate, 
 or granite, the method is nearly always the same, simply 
 a hole in the ground, walled with stone, upon which is to 
 rest the superstructure. 
 
 The foundation is intended to serve, not only as a firm 
 support for the building, bu t also as a barrier to the moist- 
 ure and the damp, unwholesome air of the soil. 
 
 After a building site is selected it is necessary to see 
 that it is thoroughly drained by surface- and subsoil- drains; 
 the latter consist of tiles or ditches partially filled with 
 broken stones, gravel, or sand, and is graded, if possible, to 
 a suitable outlet. Colonel Waring, the eminent sanitary en- 
 gineer, has so well described the details of this work that 
 I take the liberty to quote him without reserve: "In the 
 case of a country house, or of a town house standing in the 
 centre of a considerable area, it is often the most efficient 
 means for securing satisfactory drainage to apply a very 
 thorough system of underdraining to the whole area about 
 (56) 
 
HABITATIONS. 
 
 it and for some distance away, by laying different lines of 
 drains, not necessarily under the house at all, but so as to 
 surround it on all sides from which water flows toward it, 
 and in all cases at a depth of several feet below the level of 
 the cellar-bottom. In the construction of these drains two 
 courses may be pursued with, perhaps, an equally good 
 result. One is, after having excavated the ditch and cleared 
 
 ill U if 
 
 Fig. 16. Gravel Drain Under Cellar-floor. (From " The Principles 
 and Practice of House-drainage," Century Magazine.) 
 
 its bottom of all loose dirt, to fill in to a depth of a foot 
 with sand or gravel, and even fine sand will answer the 
 purpose. The other is to use agricultural drain-tiles, pref- 
 erably of the smallest size; say, an inch and a quarter in 
 diameter, laid at the bottom of a well-graded trench and 
 continued to point of outlet. When tiles are used, the 
 joints should be wrapped twice around with strips of muslin 
 drawn tight. This makes a perfect collar, holding the tiles 
 
58 OUTLINES OF RUKAL HYGIENE. 
 
 in line and affording much the best protection that has yet 
 been devised against the ingress of sand or silt, which usu- 
 ally finds its entrance at the lower part of the joint, flowing 
 in with the water which rises with the ground-water level, 
 and flows off over the floor of the tile. A tile an inch and 
 a quarter in diameter will carry more water than can usu- 
 ally be collected for a constant flow from the subsoil of half 
 an acre of ground. A body of sand or gravel ten or twelve 
 inches wide and of equal depth cannot be so compacted 
 provided clay and loam be kept out of it that it will not 
 afford a free outlet for all the water that can reach it, under 
 these circumstances, from the soil of an ordinary lot. As 
 a rule, the tile will be found to be much cheaper than the 
 other material. It is better always that the depth of the 
 drain should not be less than three feet below the level of 
 the foot of the foundation. The more rapid the descent 
 the better, but even two inches in a hundred feet, with 
 perfect grading, will remove a very large flow." 
 
 The ground-air, which nobody wants to have in his 
 house, is also kept out by proper attention to the founda- 
 tion; and I again quote from Colonel Waring a very effective 
 method of remedying this defect, which is universal in most 
 country houses and in a good many of the older city houses: 
 "One of the safest materials for a cellar-bottom and for 
 the external packing of foundation walls is a clean, smooth, 
 compact clay, one T^which may be beaten into a close mass, 
 and which has a sufficient affinity for moisture always to 
 maintain its retentive condition, for, when used in the damp 
 
HABITATIONS. 59 
 
 atmosphere of a cellar or about a foundation, it seems to 
 constitute a good barrier to the passage of impure air. In 
 the cellar it may, of course, be covered with concrete for 
 cleanliness and good appearance; but six inches of clay, 
 well rammed while wet, will impede the movement of air 
 to a degree with which ordinary cellar concrete can furnish 
 no parallel. When clay is not available, a good smearing of 
 asphalt over the outside of the foundation-wall, and a thick 
 layer of asphalt between two thicknesses of concrete for the 
 cellar-bottom, will afford a complete, though more costly 
 protection. Asphalt used in substantially the same way, 
 especially if in connection with a solid course of slate or 
 North River blue-stone, in the foundation above the ground- 
 level, will prevent the soaking up, into the structure, of the 
 moisture of a heavy soil." 
 
 Another way is to cover the cellar-floor with brick, on 
 edge, and then run melted pitch over this, and finally cover 
 with a layer of concrete or cement. 
 
 The ventilation and heating of country houses are points 
 worth considering, inasmuch as the majority of these houses 
 are heated by stoves and, as a result of defective arrange- 
 ment, the floors are always cold. In these stove-heated rooms 
 the floor is from six to eight degrees colder than it is four 
 or five feet above the floor. This means that one's feet are 
 just that many degrees colder than the head and shoulders. 
 
 To obviate this difficulty each room should be built so 
 that it has an open grate or its equivalent, simply an air- 
 shaft connected with the chimney and opening into the 
 
60 OUTLINES OF RURAL HYGIENE. 
 
 room at the floor-level; by this means good ventilation can al- 
 ways be obtained. Yentilating-stoves, although of value in 
 school-houses, are not necessary in private houses; with an 
 open grate, or an air-shaft, as indicated, a room may be very 
 well heated with an ordinary stove. 
 
 In Fig. 17 is shown the effect of heating a room with a 
 stove with and without a foul-air shaft. In the upper room 
 the heated air rises and fills the upper parts of the room, 
 while the floor remains cold; if the heating is brought to 
 such a point that the lower part does become warm, the 
 upper part is too hot, and, if a window is opened, the heated 
 air rushes out without warming the room, and leaves a lot 
 of foul air to be breathed. If now, as in the lower room, 
 there is an open grate, or an air-shaft in the chimney, the 
 heated air creates a partial vacuum, and a draft, conse- 
 quently, is constantly going up the chimney; in the room 
 this, of course, creates movement toward the opening, and, 
 as a result, the foul air is "sucked up" the chimney and 
 the upper, heated air is more diffused about the room, mak- 
 ing the temperature more uniform; in these cases fresh air 
 enters at the windows and doors. If the house is heated by 
 hot air, steam, or hot water by direct or direct-indirect 
 method (if there is no open grate), there should be an ex- 
 traction shaft at the lowest part of the room near the source 
 of entrance of the heat, as will be apparent from a study of 
 the diagrams in Fig. 19. 
 
 School-hygiene. School -build ings in the country are 
 excessively defective in sanitary arrangements; there are 
 
Fig. 17. Showing Effect of Heating a Room With and Without 
 Air-shaft. (Original.) 
 
62 OUTLINES OF RURAL HYGIENE. 
 
 very few model schools, even in the great cities. In the first 
 place, the site for a school-house, as for any other human 
 habitation, should be located on a dry, well-drained soil, 
 and this is generally available in rural districts. There 
 should be ample play-ground around the building, and if 
 trees are planted they should not be placed so close as to 
 interfere with the lighting of the room, and the building 
 should be so planned that the windows face north and south, 
 for by this means we get the best light. 
 
 In the construction of the building we should be guided 
 by the same sanitary rules laid down for dwellings, and pro- 
 vision should be made for sufficient air- and floor- space. 
 Each pupil should have about 300 cubic feet of air-space 
 with about 20 feet of floor-space; by changing the air in the 
 room say six times an hour we would give each indi- 
 vidual 1800 cubic feet of air per hour, which is surely not 
 too much. In New York City each pupil gets from 80 to 
 100 cubic feet of air-space, but it is generally conceded that 
 this is by far too little. 
 
 The floor should be of polished, hard wood, with no 
 rugs nor carpets. The walls and ceiling should be painted 
 some green tint, as this is probably the easiest for the eyes; 
 above all, they should not be white. 
 
 Each room should not be more than 40 feet long, for 
 beyond this the distance to the blackboard becomes too 
 great. The windows should occupy one-fourth the floor- 
 space, should reach to the ceiling, and should not be covered 
 with shades; inside blinds are much better, 
 
HABITATIONS. 63 
 
 Water should be plentifully supplied, but the usual 
 method of having an open bucket and a common cup for all 
 should be abolished. The water should be kept in a covered 
 bucket or a pitcher, and each pupil should have a small tin 
 cup attached to his or her desk. 
 
 Among other faults to be corrected are the seats, which 
 are often too high, and the crowding of too many children 
 in one room, thirty pupils being considered enough for one 
 teacher and for one room. 
 
 The ventilation and heating of country schools are yet 
 done in the crudest possible manner. A stove furnishes the 
 heat, and ventilation, such as it is, is obtained through open 
 doors and windows. In winter, when we need heat for the 
 school-room, ventilation and heat may be obtained at the 
 same time by means of a ventilating-stove. This consists of 
 an ordinary stove inclosed by a cylinder of tin or galvanized 
 iron. The front part is movable on hinges, so as to allow 
 opening in order to get at the stove proper. Underneath 
 the stove a hole is cut into the floor, at least two feet 
 square, if possible, and this should be continued to the 
 outside air by a shaft made of wood or tin. 
 
 For the removal of foul air an opening should be made 
 into the chimney at the lowest part of the room, and not 
 farther removed than is actually necessary from the centre 
 of heat, as indicated in the heating of dwellings. An open- 
 ing at the top of the room which is the place usually rec- 
 ommended for a foul-air shaft only permits the escape of 
 heated air before it has been properly diffused, and conse- 
 
64 
 
 OUTLINES OF RURAL HYGIENE. 
 
 quently does little good; if each room had an open grate 
 which it ought to have we would need nothing more. 
 
 Fig. 18. Showing Arrangements of Air-shafts for Ventilating-stove. 
 
 Heating a room by means of a stove is not an ideal way, but 
 it is the most available for country schools. 
 
 The privy attachment of these schools is even more 
 
HABITATIONS. 65 
 
 primitive than the heating and ventilation; it is generally 
 situated in the most public place in the yard, without any 
 covered passage-way or any other means to obviate exposure; 
 this is simply abominable. In place of the old-fashioned 
 privy the dry-earth system should be used (such as is men- 
 tioned on page 30), and should be connected with the build- 
 ing by a covered path; if there is someone to look after this 
 dry closet^ it will yield most excellent results. The material 
 can be disposed to the neighboring farmer for fertilizer. 
 
 Emergency Hospitals. Although in the larger towns 
 and cities a permanent isolation hospital is needed, this is 
 hardly necessary in the small towns and villages, for the 
 simple reason that when such a thing becomes necessary we 
 can use an ordinary tent, which makes the best kind of an 
 emergency hospital, and tents are always procurable. If 
 the tent has a board floor and arrangements made for a, 
 stove, it may be made very comfortable in any kind of 
 weather. 
 
 The plot selected for the erection of a hospital tent 
 should be dry and sheltered as much as possible, and the 
 free space surrounding the tent should be as large as is con- 
 veniently obtainable, not only for the sake of the fresh air, 
 but on account of the danger of contagion. Contagious dis- 
 eases, when isolated, do not appear to spread the disease, 
 save in the case of small-pox, and, as this is the one disease 
 which most likely would require isolation in the inland dis- 
 tricts, the proximity of human habitations is an important 
 question. 
 
B^ 
 
 */" ' 
 
 - A 
 
 ZA 
 
 Fig. 19. Diagram Showing Correct and Faulty Methods of Heat- 
 ing and Ventilation. (From Reports of United States Bureau 
 of Education.) 
 
 A. Inlet for heated air. 
 B Outlet for foul air. 
 
 0, D, E, F, G, Faulty. 
 H, Correct. 
 
HABITATIONS. 67 
 
 Dr. Powers, of the Local Government Board (England), 
 during an investigation of this subject found that, in the 
 neighborhood of the London small-pox hospitals, the num- 
 ber of cases in the surrounding districts increased almost 
 in a direct ratio to the nearness of the hospital; this in- 
 crease, too, was independent of the lines of human inter- 
 course. 
 
 For diseases like typhus fever, when fresh air is most 
 necessary, nothing is comparable to tents for isolation. I 
 happened to be assistant on Blackwell's Island during the 
 last epidemic of that disease, and, although it was in winter, 
 tents were used for all cases, and they did remarkably well. 
 
CHAPTEK V. 
 
 DISPOSAL OF THE DEAD. 
 
 WHILE in many places cremation of the dead presents 
 some advantages, there seems to be no doubt that in most 
 suburban districts, at least, earth-burial, if properly per- 
 formed, meets all sanitary requirements of the present, and 
 is ample proof against the transmission of disease. 
 
 In the first place, it must be recognized that the main 
 point in earth-burial is not the preservation of the body, but 
 its resolution, as rapidly as possible, into its primitive ele- 
 ments, with the minimum amount of discomfort and danger 
 to the living. 
 
 The prevalent custom of constructing a cemented brick 
 vault for the coffin is not desirable, for it delays decomposi- 
 tion; the sooner putrefaction is over, the sooner is the 
 danger past. 
 
 It has been found that in proper earth-burial the body is 
 destroyed rather rapidly by the action of numerous insects, 
 worms, and nitrifying bacteria, From experiments of Dr. 
 Poore we find that it takes something like two years for the 
 earth to dispose of the carcass of a cow or a horse; of course, 
 it should take no longer for a human cadaver, unless it is 
 piotected by the embalmer's art or by a vault. 
 
 "We hear a good deal about the dangers of graveyards; 
 but all of these may be avoided by ordinary care. One of 
 (68) 
 
DISPOSAL OF THE DEAD. 69 
 
 the dangers seems to come from embalming; for example,, 
 the water of a certain creek which flows through Forrest 
 Lawn Cemetery in Buffalo was found, some time since, to be 
 impregnated with considerable quantities of arsenic of the 
 kind used by the embalmer, and had it not been discovered 
 might have been a factor in the death-rate. 
 
 Another danger which is supposed to come from grave- 
 yards is that of the transmission of contagious diseases. Sir 
 Spencer Wells quotes the following,, which is worth repeat- 
 ing: "Some people living in a mountain country and hav- 
 ing very little communication with each other were in the 
 habit of quenching their thirst at a neighboring well after 
 the Sunday attendance at the district church. A young 
 man died of diphtheria and was buried in the yard. The 
 drinking from the well continued, and in a short time 
 twenty of those peasants were carried off by the same 
 disease. If asked how we are to account for this accident, 
 but on the presumption that the germs of this disease found 
 their way into the waters of the well, various explanations 
 such as milk outbreak or personal communication may 
 bo imagined; but none so exactly corresponds with the cir- 
 cumstances as leakage from the corpse." That such danger 
 as the above may exist, and be scientifically possible, it is 
 only necessary to refer to the investigations of Dr. Lossener, 
 who has shown that certain pathogenic germs exist for some 
 time in buried cadavers, even when decomposition is not 
 delayed. His results are as follow: 
 
 Typhoid germs lived 96 days. 
 
70 OUTLINES OF RURAL HYGIENE. 
 
 Cholera germs lived 28 days. 
 
 Tubercular germs lived 95 days. 
 
 Tetanus germs lived 234 to 361 days. 
 
 Anthrax germs lived 365 days. 
 
 These experiments of Lossener were carried on in nitri- 
 fying soils; but it must be remembered that a good many 
 graveyards are placed on the cheap non-nitrifying clays, 
 because they are cheap and not good for agriculture. Such 
 soils should not be selected for this purpose, for we are not 
 certain but that pathogenic germs may live much longer in 
 those cases in which decomposition is delayed; and in these 
 soils it is delayed very much, for nitrifying germs are absent. 
 It is recorded that in cutting through St. Andrew's church- 
 yard, Hoborn (England), which is situated on a heavy clay, 
 some of the bodies which had been buried even a hundred 
 years showed very little decomposition. 
 
 To have earth-burial effective then 
 
 1. There should be no embalming, save for transporta- 
 tion. 
 
 2. The body should not be placed, if avoidable, in a 
 sealed coffin or vault. 
 
 3. Burial should not be deep. 
 
 4. The cemetery should not be placed on a non-nitrify- 
 ing soil. 
 
APPENDIX. 
 
 THE NOEMAL DISTRIBUTION OF CHLOKINE. 1 
 
 BY PROF. HERBERT E. SMITH. 
 
 WATER, as it is found in springs, streams, lakes, etc., 
 always contains chlorine in solution, chiefly, if not wholly, 
 in the form of common salt. Sometimes there is much, 
 sometimes little, but always some, (even in waters which are 
 entirely free from the possibility of contamination by man^ 
 Hence we must recognize that there are natural sources from 
 which water does derive chlorine. But there are also arti- 
 ficial sources, for the waste-fluids of certain manufacturing 
 processes, sewage, and even the drainage from inhabited 
 areas, contain considerable quantities of chlorine. The ad- 
 ditions of such liquids to a stream or pond must add to the 
 total amount of its chlorine. 
 
 If one knew the amount of natural chlorine in. a given 
 water, it would only be necessary to subtract this from the 
 total amount found in analysis to determine the amount of 
 chlorine added from artificial sources. This at once gives, 
 as can readily be seen, a measure of the amount of the con- 
 tamination to which a water has been subjected, for chlorine 
 
 1 Professor Smith has kindly permitted the author to use his article 
 for this appendix. The article was originally a report to the Connect- 
 icut State Board of Health. 
 
 (71) 
 
72 APPENDIX. 
 
 once added to water remains in it, since it is not removed 
 by nitration, by sedimentation, or by the growth of plants. 
 by which means the other constituents of sewage contami- 
 nation may be largely or entirely removed. 
 
 A knowledge of the amount of natural chlorine, or, as 
 it may be better called, the normal chlorine, of the waters of 
 a region is of great importance, therefore, as giving data for 
 correctly interpreting one of the important items of a sani- 
 tary water-analysis. That it is possible to determine within 
 reasonable limitations the normal chlorine of a region was 
 first demonstrated by the Massachusetts State Board of 
 Health, as one of the important scientific deductions from 
 the systematic analysis of the drinking-waters of that State. 
 In 1891, in the Report of the Connecticut State Board of 
 Health, there was also published a small map of this State. 
 containing data which had been obtained in the analysis of 
 our drinking-waters. These data showed that the chlorine 
 in the pure waters of Connecticut presented the same regu- 
 larity of distribution as in Massachusetts. Since that time 
 many more analyses have been made, and from the data 
 now at hand the accompanying map has been prepared. 
 
 On this map is shown the average amount of chlorine 
 found in waters which are considered suitable for the pur- 
 pose in various parts of the State. It will be seen that the 
 amounts vary from about one to six parts per million, and 
 further that the amounts are largest along the southern 
 border of the State, and decrease as one goes north and west. 
 The lines on the map are drawn through places which 
 
THE NORMAL DISTRIBUTION OF CHLORINE. 73 
 
 appear to have the same average normal chlorine, i.e., they 
 are isochlor-lines. By locating a source of water on the 
 map, therefore, one can determine the amount of chlorine 
 which may be expected to be in it from natural sources. 
 
 The limitation of the use of such a map will become evi- 
 dent by a consideration of the sources of normal chlorine, 
 and an inspection of the data on which the map is founded. 
 
 The natural sources of chlorine in waters found in 
 springs, streams, ponds, and fresh-water lakes can only be: 
 First, from compounds of chlorine existing in the rocks and 
 soil with which the water has come in contact, and from 
 which it has dissolved them. Second, deposits of chlorine 
 compounds on the surface, as from spray blown in from 
 bodies of salt water. Third, from chlorine existing in rain- 
 water as it falls. "What may be spoken of a geological chlo- 
 rine might come from deposits of common salt, and in cer- 
 tain regions this would certainly be an important source of 
 chlorine in many spring-waters. If the normal chlorine of 
 our waters was derived from small quantities of salt, or other 
 chlorides diffused in our rocks, or from minerals which 
 yield chlorine on decomposition, then spring-waters, after 
 percolating through the soil, would contain more chlorine 
 than small fresh-water ponds supplied with surface-water 
 from adjacent water-sheds. But this is not the case, for the 
 ground-waters do not contain more chlorine than spring- 
 waters of the same region; of course, this does not apply to 
 certain deep waters, which furnish, sometimes, large 
 amounts of chlorine, probably of geological origin. If the 
 
74 APPENDIX. 
 
 normal chlorine of our surface- and spring- waters is not 
 geological in character, we must turn to the sea as its 
 source. That it is of marine origin is clearly shown by a 
 study of the maps, for the amounts rapidly diminish in 
 zones marked by lines approximately parallel to the coast- 
 lines. 
 
 Whether the salt is blown up from the surface of the 
 ocean as spray and carried inland by the winds in the form 
 of dust which, falling to the earth, is dissolved by the fallen 
 rain, or whether the chlorine is blown inland during rain- 
 storms, is not significant. It would seem that salt might be 
 carried inland in both ways. 
 
 If the normal chlorine of our waters is due to that con- 
 tained in the rain, it is clear that it must exceed that found 
 ir the rain-water in proportion to the concentration effected 
 by evaporation. The amount of this evaporation may be 
 inferred from the relation of the flow of streams of a region 
 to its rain-fall. 
 
 The flow of Connecticut streams may be placed at about 
 60 per cent, of the annual rain-fall; consequently that part 
 of the normal chlorine due to chlorine in rain would be 
 expressed by increasing the chlorine of the rain according 
 to the ratio of 60 to 100. In the following tables is given, 
 in parts per million, the average chlorine in the rain at each 
 of the stations, and also the figures obtained by correcting 
 for evaporation in the ratio of 60 to 100, together with the 
 normal chlorine of the station, as derived from the chlorine 
 map. 
 
THE NOEMAL DISTRIBUTION OF CHLORINE. 75 
 
 The agreement between the observed normal chlorine 
 and the figures calculated from the observations on the rain 
 is rather surprising, considering the errors to which the 
 method was subject. 
 
 TABLE SHOWING AVERAGE CHLORINE IN RAIN IN COM- 
 PARISON WITH NORMAL CHLORINE AT 
 THE SAME STATION. 
 
 Station. Rain Cl. Corrected Normal 
 
 Cl. Cl. 
 
 Canaan 0.8 1.3 1.3 
 
 Waterbury 1.2 2.0 2.0 
 
 Hartford 1.3 2.2 1.8 
 
 Bridgeport 1.6 2.7 3.0 
 
 New Haven 2.0 3.3 3.2 
 
 New London 2.2 3.7 3.5 
 
 From the observations and considerations which have 
 been presented we must accept the proposition that the 
 normal chlorine is of marine origin, and is mostly conveyed 
 inland during rain-storms. This conclusion at once shows 
 us that the normal chlorine cannot be a fixed quantity at 
 any one place, but must vary from time to time with the 
 character of the storms. Eain-storms accompanied by high 
 southeast winds would appear especially favorable for carry- 
 ing salt inland over Connecticut. That the chlorine found 
 in our uncontaminated waters is not constant at any one 
 place is clearly shown by the various series of analyses form- 
 ing the data on which the map is based. The results from 
 any one source may vary as much as 50 to 100 per cent., 
 
76 APPENDIX. 
 
 especially when the amount of chlorine is small. Usually., 
 however, the variations from the average are less than this, 
 and for the most part do not amount to more than 0.5 part 
 per million. Obviously samples from small streams which 
 would he greatly influenced by any considerable rain-fall 
 must be less regular in the amount of chlorine which they 
 contain than samples from large reservoirs or lakes in which 
 the rain from many streams will be mixed. From this it 
 follows that, while the true condition of a large body of 
 water may be shown by a single analysis, a series of exami- 
 nations might be required from a small stream to obtain a 
 reliable average. 
 
 It is also obvious that the natural chlorine of a long 
 stream is not that of the locality from which a sample may 
 happen to be taken, but is rather that of the average of its 
 water-shed above the place in question. For instance, the 
 average chlorine in the Connecticut Eiver at Goodspeed's 
 Landing during 1890-'91 was 1.4, while the normal waters 
 of that region show about three parts of chlorine, and yet 
 the river receives large quantities of sewage from Hartford, 
 Middletown, and other towns draining into it. 
 
 The natural chlorine of the Connecticut River must be 
 somewhat under one part per million, for the bulk of its 
 water comes from Massachusetts and above. In the light 
 of its normal, therefore, the contamination that exists at 
 Goodspeed's Landing is clearly seen, although the contami- 
 nation is not great enough to raise the chlorine from a low 
 normal up to the figures which would be normal at that 
 
THE NORMAL DISTRIBUTION OF CHLORINE. 77 
 
 place, this being due to the great bulk of water which flows 
 in the river. Even a large amount of sewage discharged 
 into a stream may not increase the chlorine beyond the 
 natural variations during periods of large flowage. Usu- 
 ally, however, the effect becomes obvious in dry weather. 
 Along the sea-coast the variations in natural chlorine are 
 greater than they are further inland. This is seen in the 
 greater variations in the samples from the same source at 
 different times, and especially in the marked difference in 
 samples a short distance apart. This seems to depend, in 
 some instances, on local conditions which favor the pre- 
 cipitation of the salt-laden rain or spray. 
 
* .& T 2~ jg 
 
 Fig. 20. Map of Connecticut, Showing Distribution of Chlorine. Chlorine 
 is expressed in parts per million. The heavy lines indicate the normal 
 chlorine. The figures show observed chlorine iu waters which are 
 normal or nearly so. 
 
INDEX. 
 
 Air-space in schools 62 
 
 in New York City schools 62 
 
 Artesian wells 4 
 
 Atlantic-Coast plain 4 
 
 1'uffalo graveyard, dangers at 69 
 
 Cess-pools 42 
 
 Chlorine, examination for 23 
 
 in rain 75 
 
 natural 71, 72 
 
 normal 23, 24, 71-77 
 
 sources of 73 
 
 Cisterns 14 
 
 construction of 15 
 
 filter for 15, 16, 17 
 
 leakage of 18 
 
 size of 15 
 
 Cistern-water 18 
 
 collection of 18 
 
 examination of 18 
 
 size of roof for collecting 15 
 
 Clay 8 
 
 Clays, non-nitrifying . 70 
 
 Country houses, class of 32 
 
 Dead, disposal of ) . . . 68 
 
 Poore's experiments on 68 
 
 Distance of v, ell from privy, calculation of 6 
 
 Drain, subsoil 38, 41 
 
 amount of land needed for 38 
 
 amount of tiles 38 
 
 construction of . . 38. 41 
 
80 INDEX. 
 
 PAGK 
 
 Drain, surface 33, 37 
 
 of cobble-stones 37 
 
 of ordinary bricks 37, 39 
 
 of perforated bricks 37 
 
 of tin roof-gutter 34. 3.5 
 
 "Dry-catch" privy 30 
 
 Dry closet, model 29, 30 
 
 Dry earth-closets 26-28 
 
 absorbent for 28 
 
 contents, disposal of 28 
 
 Dwellings 56 
 
 drain for foundation of 57 
 
 foundations of 56 
 
 ground-air in 58 
 
 materials for cellar- bottom o: r^ 
 
 ventilation and heating of 59 
 
 Earth-burial 68-70 
 
 Lossener's experiments on 69 
 
 Emergency hospitals 65 
 
 Excreta 25 
 
 disposal of ! 28 
 
 experiments on disposal of 29 
 
 Floor-space 62 
 
 Foundations 56 
 
 asphalt in 59 
 
 Colonel Waring on 57, 58 
 
 external packing fur 58 
 
 Xorth River blue stone in . 59 
 
 Garbage 42. 47 
 
 combustible part of 47 
 
 non- combustible part of .47 
 
 putrescible part of 45, 47 
 
 separation of 42 
 
INDEX. 81 
 
 PAGE 
 
 Geological strata 3 
 
 basins 3, 4 
 
 Germs, pathogenic, life of, in soil 69, 70 
 
 Graveyards, dangers of 69 
 
 Ground-air 54, 58 
 
 composition of 54 
 
 movements of 55 
 
 Ground-moisture 50 
 
 and malaria 51 
 
 and phthisis 51 
 
 Ground- water 51 
 
 and disease 53 
 
 level 9, 52 
 
 lowering of 54 
 
 movements 52 
 
 origin 52 
 
 Pettenkofer's theory of 53 
 
 Harrisburg sewage in river at 20 
 
 Heating 59 
 
 by stoves 59 
 
 with and without air-shafts 60, 61 
 
 of schools 63 
 
 Hoborn, Eng., church-yard at 70 
 
 Humus 48 
 
 absorptive power of 50 
 
 Irrigation bed, plan of subsoil 41 
 
 Irrigation field 42, 43 
 
 Isochlor-lines 73 
 
 Kitchen sink 41 
 
 Koch, on treating old wells 9 
 
 Lakes 19 
 
 "Living earth," the 48 
 
 Lossener, on life of pathogenic germs 69 
 
82 INDEX. 
 
 PAGE 
 
 Malaria 51 
 
 Manhattan Island, strata on 4 
 
 Mine drainage 20, 21 
 
 Miintz, on nitrification 49 
 
 Nitrification 49 
 
 products of 49 
 
 N itrifying bacteria 49 
 
 Pettenkofers theory 53 
 
 Phthisis 51 
 
 Plymouth, Pa., typhoid epidemic at 2, 20 
 
 Polarite 17 
 
 Poore, on disposal of excreta 29 
 
 on dry-catch privy 30, 31 
 
 on earth-burial of cadaver 68 
 
 on humification of faeces 32 
 
 on shallow wells 11 
 
 Privy leakage 2, 3 
 
 Privy vault 26 
 
 Rain-fall, annual 14 
 
 Eain-water 18 
 
 storage of 14 
 
 River- water 19 
 
 Rooms, heating with stoves 60 
 
 Schloessing, on nitrification 49 
 
 School-buildings 60 
 
 construction of 62 
 
 floor-space for 62 
 
 heating of 63 
 
 privy attachments of 64 
 
 seating capacity of 63 
 
 ventilation of 63 
 
 School-hygiene 60 
 
 "Sink-holo?" . 8 
 
INDEX. 
 
 PAGE 
 
 Slops, bed-room 41 
 
 disposal of 41 
 
 Soil, the 48 
 
 life of 48 
 
 nitrifying properties of 49 
 
 surface 48 
 
 Springs 19 
 
 "Sulphur- water" 20, 22 
 
 Tiles, mode of laying, for drains 41 
 
 Typhoid fever at Bethlehem, Pa 8 
 
 at Gerlachsheim 1 
 
 at Plymouth, Pa 20 
 
 Ventilating-stove 60, 63 
 
 arrangement of air-shafts for 64 
 
 Ventilation 59 
 
 Waring, Colonel, on drainage of building sites 56, 57 
 
 on foundation making 58, 59 
 
 Warrington, on nitrification 49 
 
 Waste disposal 25 
 
 Waste, kitchen 45 
 
 combustible 45, 47 
 
 non-combustible 45, 47 
 
 putrescible 45, 47 
 
 separation of solid and liquid 34 
 
 water 47 
 
 Water "under pressure" 18 
 
 Water-bearing zones, in cretaceous strata 5 
 
 in miocene strata 5 
 
 in New Jersey 4 
 
 Waters, slop- 32 
 
 disposal of 33 
 
 Water-supply 1 
 
 in coal regions 20 
 
 pollution of .20 
 
84 INDEX. 
 
 PAGE 
 
 Wells 1 
 
 artesian 4, 1 1 
 
 deep 3, 4 
 
 in clay . . . 8 
 
 in gravel 8 
 
 in horizontal strata 11, 4 
 
 in limestone 7 
 
 in slate 3 
 
 in upturned strata 5, 14 
 
 shallow 11 
 
 tube 7, 11 
 
 Wells, Sir Spencer, on graveyard leakage 69 
 
 Well-water, chlorine in 23 
 
 examination of 22 
 
 Winogradski, on nitrification 49 
 
 Zurich, typhoid fever at 53 
 
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