22 GEORGE W. FULLER 



years. No attempt will be made here to show the great sanitary 

 benefit derived from other factors than improved water supply and 

 sewerage, as this matter is clearly set forth in standard works upon 

 sanitation and official reports from various quarters of health author- 

 ities who deal with the accomplishments of the modern health 

 officers. 



It is sufficient here to present clearly to the reader the thought 

 that modern sanitary science has greatly increased the comfort and 

 safety of living. In various cities the reductions in death-rates have 

 been far greater than as given above for the state of Massachusetts. 

 This is especially true in cities where badly polluted water supplies 

 have been replaced by improved supplies. Numerous instances 

 of this sort are on record where annual typhoid fever deaths of 50 

 to 100 per 100,000 have been reduced to about 20. These cities 

 include not only those now receiving upland waters from unpolluted 

 sources, and ground water, but also those having filtered water 

 from earlier but polluted sources; for example, Lawrence, Mass., 

 Albany, N. Y., York, Pa., and Lorain, Ohio. Intestinal diseases 

 other than typhoid fever have been so reduced as to lower the 

 general death-rate materially. For low-lying communities like 

 New Orleans modern drainage has lessened notably the general 

 death-rate, and sewerage brings safety as well as comfort to com- 

 munities, among other ways by eliminating privy vaults and the 

 likelihood of disease transmission by flies, etc. 



As to financial considerations, it is difficult to present the full 

 significance of this feature to the general reader without statistics 

 which would be out of place in a short general article like this. 

 Usually water-purification projects proper cost about $3 to $5 per 

 inhabitant served; but pumping, force-mains, conduits, reservoirs, 

 and other associated appurtenances sometimes increase the invest- 

 ment to $15 to $25 per capita. Sewage purification frequently 

 is more expensive than water purification. Upon capitalizing the 

 operating expenses, it is found that modern sanitary works, while 

 involving only small costs for the individual, reach sums of millions 

 and tens of millions of dollars for our large cities. The solution 

 of these problems has brought many added duties to sanitary author- 

 ities, to professional men who assume the responsibility for con- 



