It is, as a rule, during the winter months that the largest number of bacteria are present in the filtered water, and it is therefore of especial importance that during this season, when the raw river water is generally richest in bacterial life, and when, therefore, the filters are most taxed and the consequences of frost are most to be apprehended, that those entrusted with this responsible task should be unremitting in their endeavours to obtain a good filtrate.
That waters submitted to exhaustive natural filtration, such as those derived from deep wells sunk into the chalk, and usually almost entirely devoid of bacterial life, may at times become the carriers of disease has been proved by the disastrous outbreak of typhoid fever which occurred some years ago at Worthing.
This town has long been supplied with water of the very finest quality for dietetic purposes, and nothing could have been more unexpected than this most fatal epidemic. It must, however, be borne in mind that such deep-well waters are not necessarily immaculate, for in the event of any fault in the water-bearing strata occurring, the filtration becomes inefficient, and the water may then, as in the case of Worthing, be the bearer and disseminator of zymotic disease.
The bacteriological methods for the examination of water, although when first introduced but a few years ago were lightly looked upon, and by many opposed, have now become of paramount importance in all questions of water-purification. The immense mass of evidence of a purely bacteriological character which was taken, and indeed required by the Royal Commissioners of 1893 on the London water-supply, indicates clearly enough the change which has taken place in the public estimation of the value of these methods; and it is highly significant that in their report the Commissioners lay stress upon the importance of extensive storage and efficient filtration, two factors the meaning and worth of which rest almost entirely on the results of bacteriological research.
Cholera is not, however, the only water-carried disease which has borne eloquent testimony to the services rendered by the efficient purification of public water-supplies. The experience of the State of Massachusetts in America, in regard to typhoid fever and drinking-water, is also exceedingly instructive.
Massachusetts has, by creating a Board of Health, and affording the same every facility for the prosecution of hygienic investigations of the greatest importance, laid the whole scientific world under a deep obligation. The reports issued have a very wide circulation, and embrace a variety of subjects, but second to none in interest and importance is the account of the experimental work carried out by the officials of the Board on the purification of water and sewage. These experiments have become classical, and have been conducted with a zeal and thoroughness which deserve the highest praise. It is in looking at the results achieved by the city of Lawrence in regard to its water-supply that some conception can be obtained of the immense importance to the community of the scientific experiments conducted in the State Laboratory. No expense has been spared, and for years past elaborate and costly experiments on a large scale have been carried out to determine the most efficient manner in which water may be rendered fit and safe for drinking.
Now the death-rate in a community from typhoid fever may be taken as an index of the general sanitary conditions prevailing in such a community, the character of the public water-supply, not without justification, being regarded as a prime factor in its determination. One of the most significant points in the sanitary history of the State of Massachusetts is the almost uniform decline in the mortality from typhoid fever in proportion as measures have been taken to introduce better water-supplies and to improve those which already exist. Thus in the twenty years, from 1856 to 1876, the death-rate from this disease was 8·6 per 10,000 of population, whilst in the period from 1876 to 1895 it had fallen to 4·1 per 10,000, the improvement in respect of typhoid-mortality being coincident with the improvement made during the last twenty years in providing public water-supplies. In the words of one of the State reports, "The death-rate from typhoid fever has generally fallen as the per cent. of the population supplied with public water has risen, for the reason that the majority of the deaths from this disease have occurred among communities and portions of communities not supplied with public water."
That this improvement is being maintained is seen from the fact that in the four-year period 1896-99 the deaths from typhoid fever in Massachusetts were further reduced to 2·6 per 10,000.
It is, however, in the city of Lawrence that the most striking insight is obtained as to the manner in which typhoid fever may be controlled by conditions surrounding the water-supply to the community. Thus, whereas the death-rate from typhoid fever reached a mean of 11·2 per 10,000 in 1886-90, it fell to 7·7 in 1891-95 and to 2·5 in 1896-99. It was in the autumn of the year 1893 that the raw river-water supplied to the city from the Merrimac River was first begun to be filtered, and since that time the sand-filters have been subjected to systematic and most elaborate bacterial supervision, and improvements have been constantly introduced so as to secure the most efficient purification possible of the water before distribution, and the results are reflected in the marked diminution in typhoid fever which has followed these strenuous efforts to obtain the best water-supply available.
The splendid example set by the State of Massachusetts, in promoting the welfare of the people by the encouragement of original researches in practical hygiene, has stimulated other American States to create Boards of Health and enact laws for the protection of their rivers and streams. In view of all that has been done to promote sanitary science in the United States, it is surprising to learn that Lake Michigan, which receives the untreated sewage of municipalities and small towns aggregating over two million people, still furnishes Chicago with its drinking water, and undergoes no preliminary purification before distribution. The city of Chicago, by constructing the Chicago Drainage and Ship Canal, opened in January, 1900, has diverted its own sewage from Lake Michigan, but this great sewer has only been made possible because of its advantages as a commercial waterway; and it has been stated, on high authority, that every project for the drainage of Chicago into the Illinois which has not recognised the waterway features has been predestined to failure. Dr. Egan, of the Illinois State Board of Health, however, points out that "with the present increase in population the Great Lakes, if they continue to be used as common sewers, will soon become totally unfit for use as drinking water, … and one of two alternatives must be followed—either every source of water-supply must be filtered, or the sewage of the towns must be efficiently purified before it is allowed to flow into the lakes."