PREVIOUS REPORTS UPON TYPHOID FEVER. 
221 
Also: 
The daily pollution of the soil by the fecal discharges of our patients suffering from 
typhoid feVer with the resulting contamination of well water must be recognized as 
the chief source of the diffusion of the disease. 
They recommend : 
1. The immediate abandonment of all wells within the city limits, exception only 
to be made in case of absence of Potomac supply and when the wells, after repeated 
chemical and bacteriological examinations, have been found to be free from all possible 
sources of danger; but even these to be abandoned as rapidly as possible. 
2. Purification of the sewerage system already existing by replacing as rapidly as 
possible all damaged and defective drains. 
3. The introduction of new sewers in advance of other improvements in parts of the 
city not now supplied with drainage and the system as far outside of the city limits 
as the rapidly growing population demands, so as to prevent soil contamination. 
4. The adoption of some system by which the lower sections of the city can be more 
completely drained and risks arising from the backing up of tide water and sewage 
prevented. 
5. The final and safe disposal of sewage. 
6. To make all existing privies, vaults, or other receptacles of human excreta water- 
tight, and by rigid inspection and penalties to prevent the danger from leakage and 
overflow. 
7. The early completion of the plans recommended by Colonel Elliott, in charge of the 
Washington Aqueduct, and now in course of execution, which have in view the 
sedimentation of the Potomac water, and ultimately the completion of works for 
filtration, the only proper method of purification. 
8. The suppression of all privies and the enforcing of the law to make sewer 
connections. 
9. Careful inspection of all dairies in the District from which our milk supply is 
drawn, and the enactment of a law by which no milk shall be sold in- the District 
without a permit from the health office. The inspection should cover an examination 
at the dairies of all possible sources of infection, including the water supply. 
10. The urging upon the members of the profession of a careful collation of all the 
facts bearing upon the mode of infection in each case and the advantage of reporting 
such facts to the society, and the propagation of the doctrine that immediate disin- 
fection of the stools is the first duty of the physician as guardian of the health of the 
community. 
RELATIONS OF WATER SUPPLY AND SEWERS TO THE PUBLIC 
HEALTH OF CITIES, WITH SPECIAL REFERENCE TO THE CITY 
OF WASHINGTON.® 
[By George M. Kober (1897).] 
Dr. George M. Kober, in an address before the Civic Center, Jan- 
nary 15, 1897, referred to the unusual typhoid situation in the Dis- 
trict of Columbia, and submitted the f ollo^ving resolutions, which were 
passed by the Civic Center: 
VTiereas the statistics of the health ofiicer of the District of Columbia indicate an 
almost uniform increase and excessive prevalence of typhoid fever during the past 
fifteen years; and 
® Public Health Reports, U. S. Marine Hospital Service, vol. 12, Feb. 26, 1897, 
p. 197. 
