Previous to 1883 very little attempt was made to compel physicians to report typhoid cases to the Pittsburgh Bureau of Health; hence no reliable morbidity records are available up to that time. But in the year 1882 an ordinance was passed requiring such reports to be made. It is very certain that several years elapsed before a majority of the cases was actually reported, and even at the present time, in spite of prosecutions and a more enlightened sentiment, many cases never reach the bureau. Yet the number of cases actually reported in Pittsburgh proper, since 1883, reaches the astounding total of 54,857. In other words, within the past twenty-five years, one person to every six of the total population has had an attack of typhoid fever.
But even more telling in its significance is the fact that out of these 54,857 reported cases, 8,149, or 14.8 per cent died as a result of their illness. Over eight thousand men, women and children were sacrificed here in Pittsburgh in the last twenty-five years to a disease known by modern science to depend for its very existence upon lax methods of handling food, drink and waste. Over eight thousand graves have been dug, half of them (4,069) since February 6, 1899, more than nine years ago, when the report of Pittsburgh's Filtration Commission, advising the necessity of a pure water supply, was placed in the hands of the Pittsburgh councils. In life, these eight thousand people, standing single file, four feet apart, would form a line six and one-sixth miles long, extending from the court house in a straight line to the Filtration Plant; or from the Point Bridge down the Ohio as far as the Borough of Emsworth.
II.—THE COST.
In order to establish a sure ground for estimate as to the economic drain of this disease upon this community, a concrete study of the cost of typhoid in six selected wards of Greater Pittsburgh was undertaken by the Pittsburgh Survey. The sections of the city chosen are fairly representative of living conditions among the wage-earning population. Wards 8 and 11, in what is commonly known as the Hill District, represent a congested quarter made up largely of Russian Jews, Austrians and Italians, with a considerable number of Americans and American Negroes. The residents of these two wards are chiefly employes of the small trades and the sweating and stogie industries, clerks, factory hands, common laborers, etc., who are rather below the average scale of earning capacity. They number about 22,000 for the two wards and among them there were forty-four per cent of the cases studied.
Wards 25, 26 and 27 are on the South Side. Their total population is about 33,000; mill hands, mostly of Slavic origin, occupy those parts of these wards bordering the Monongahela River, and a better-off class of Americans occupy the hilltops overlooking the river. The wards would, therefore, represent a rather uneven population, as based on nationality or wage scale, but were not a large factor in this study, as only eight per cent of the cases covered were found in these wards.
