Hard water is said by some to be hurtful, but the salts causing hardness are probably innocuous when not amounting to more than 12 or 16 grains per gallon. Persons in the habit of drinking hard water find soft water unpalatable. Hard water has been thought to favour gout and calculus (stone), but this is not so. The salts producing permanent hardness are said to be injurious, producing indigestion, but this is doubtful in the amounts ordinarily drunk.
Goitre, a swelling of the thyroid gland in the neck, is often associated with the use of drinking water from magnesian limestone formations; but that any kind of excessively hard water causes goitre is very doubtful.
Lead dissolved in water may produce serious and lasting ailments, and they are often present for a long time before their cause is detected. The amount of lead capable of producing poisonous symptoms has been as little as 1 ∕ 100 grain per gallon of water (Dr. Angus Smith). According to De Chaumont, 1 ∕ 10 grain per gallon, that is 1 part in 700,000 is usually required to produce such symptoms. In the well-known case of the poisoning of Louis Phillippe’s family at Claremount, there was 7 ∕ 10 grain of lead in a gallon of water; and this affected 34 per cent. of those who drank it. The symptoms produced by lead poisoning are those of indigestion, accompanied by colic; a blue line at the junction of the gums with the teeth; “wrist drop,” a paralysis of the muscles of the forearm, or some other paralysis; and if the poisoning is continued, attacks of gout, followed by its usual consequences, chronic kidney disease. The latter affections chiefly occur when the poisoning is continued for a long time, as in the case of painters or type-setters: poisoning from water is generally discovered before any other than dyspeptic symptoms and colic are produced.
The presence of traces of iron in water may give it a slightly astringent taste; and such water is liable to cause headache and constipation.
2. Effects of Vegetable Impurities.—Living plants are unobjectionable, but decomposing vegetable matter may produce diarrhœa and other severe symptoms.
3. Effects of Animal Impurities.—Animal impurities of water are by far the most important from a sanitary point of view. They are most commonly derived from leaky drains or cesspools, or from surface accumulations of filth. The quality of the contamination is more important than its quantity; and this will explain why water containing a large amount of sewage may be drunk for a prolonged period with impunity, while at another time the least trace, if it contain the active germs of disease, will lead to serious mischief.
Suspended animal impurities are much more dangerous than those completely dissolved. Hence the examination of the colour and turbidity of drinking water is very important. Fæcal contamination is by far the most dangerous of all, and chiefly so when it is derived from a patient suffering from some communicable disease, like enteric fever or cholera.
Certain Parasites occasionally are swallowed with water in the form of embryo or egg. The liver fluke, round worm, and less frequently other kinds of entozoa have been introduced in this way. The occasional swallowing of small leeches has occasionally given rise to hæmorrhage.
Diarrhœa may be caused by animal contamination of water. It most often occurs in summer, when all the circumstances are favourable to active fermentative changes. The summer diarrhœa of infants is caused by similar changes in milk or other foods. The presence of fœtid gases in water may lead to diarrhœa. This may occur when the overflow pipe of a cistern opens into the soil pipe or into the trap of the W.C.
Dysentery, like cholera and enteric fever, may be propagated by water contaminated with the stools of a patient suffering from the same disease.