244 
TYPHOID FEVEE IH DISTKICT OF COLUMBIA. 
From the imperfect records available, I estimate that about 30 to 40 
cases of t}^hoid fever occur here every year. Four deaths from this 
disease are recorded for 1905. 
At a point about 1 mile below the mouth of the Opequon the Chesa- 
peake and Ohio Canal, it will be remembered, enters the river a second 
time and remains one vdth it for a distance of 3 miles, to resume its 
separate course about a mile below Dam No. 4. 
The Potomac receives its next pollution at Shepherdstovm, W. Ya., 
56 miles above Great Falls. This milage, of about 1,200 souls, has 
no public water supply or sewerage. Cisterns for water are in general 
use. A small stream which runs through the tovm, and which is 
lined with and overhung by privies, serves as a sewer; into it goes 
the waste from a slaughterhouse. A few cases of typhoid occur in 
the tovm and vicinity every year. 
Six miles below Shepherdstown the Potomac receives Antietam 
Creek. 
Antietam Creek rises in the Green Kidge Mountains, Franklin 
County, Pa., and joins the Potomac at a point 58 miles above Great 
Falls. Its drainage area of about 305 square miles, though somewhat 
less extensive than that of the Opequon, has almost tvdce the popu- 
lation of the latter — 42,940, according to the census of 1900. The 
pollution that reaches the creek is mostly indirect; but at Wa 3 mes- 
boro. Pa., Hagerstovm and Sharpsburg, Md., it receives directly 
pollution of a dangerous character. 
Waynesboro, Pa., with a population in 1900 of 5,396, has a public 
water supply, but no sewerage. Cesspools are in general use, which 
take care of themselves by draining tlmough the cracks and fissures 
in the underl 3 dng limestone. The Frick Coinpan};^, however, runs 
the sewage of about 700 employees directh^ into the creek. 
Hagerstovm, Md., is the third city in the State. It is a rapidly 
growing industrial center, and was credited with a population of 
13,591 in 1900. It has a public water suppl}^ from runs on South 
Mountain, about 10 miles from the city, which is locally regarded as 
above suspicion. 
The comparatively rare cases of typhoid fever which occur here are 
considered as either imported infections or due to wells, some of 
wliich are still in use. 
There is no sewerage system in Hagerstown, but there are pipes 
wliich are intended onty for surface water and kitchen waste, but 
there is reason for believing that two or three hotels have drains into 
these pipes from their cesspools. This pollution reaches Antietam 
Creek by wsij of Marsh Kun, which receives it from Tovm Kun. Cess- 
pools are in general use, many of them being abandoned wells. Most 
of the cesspools drain themselves through the fissured limestone; the 
