298 
TYPHOID FEVER IX DISTRICT OF COLUMBIA. 
flows by gravity to the storage cistern. This cistern is made of brick 
and cement and has a capacity of 80,000 gallons. It communicates 
with the outside air by means of a terra-cotta pipe of large diameter, 
3 feet in height above the roof of the cistern. This pipe is freely 
open to the ah and might occasionally be the means of conveying 
pollution to the water in the cistern, although we were assm’ed by the 
engineer in charge that a careful watch was kept over it. 
These wells have been in use for over two years, during which time 
they have supplied the institution vdth an abimdance of pure water. 
The results of the chemical analyses of this water supply are given in 
Table 27. It will be observed that the water of the wells is low in 
total solids, and also in free and albuminoid ammonia, nitrites and 
nitrates, and oxygen consumed. Like most of the deep-well waters 
of this locality, it contains small amoimts of iron, and while the 
amount of chlorine is somewhat larger than we have found in many 
of the deep wells throughout the District, it is really of no significance. 
The results of our analyses indicate that the present water supply of 
St. Elizabeth’s is pure and wholesome, and this conclusion is borne 
out bv the bacteriological findings and bv the freedom of the insti- 
tution from typhoid fever and other water-borne diseases contracted 
in the institution since this water supply has been in use. 
The following report on typhoid fever in relation to sanitary 
improvements at this institution was submitted by Assistant Surgeon 
H. D. Long, Public Health and Marine-Hospital Service: 
Year 
ending — 
Sanitary improvements, remarks, etc. 
June 30,1900 Se-srer plant completed 
Attendants. 
Cases. 
Patients. 
2' deaths; number 
of cases not 
stated. 
June 30,1901 
June 30,1902 
Six artesian wells drilled 
1 death; number 
of cases not 
stated. 
Report states that the six wells are insufficient. 
River water stiU used. Milk supply practi- 
cally all from hospital dairy. Report states 
eight cases under treatment at time of writing 
report. Ao employee of dairy has had ty- 
phoid before employment in hospital. 
30 Widal tests made; positive in 14 
cases; 1 death. 
June 30,1903 
Jime 30,1904 
Report states: In April, 1903, number of cases i 
in hospital exceeded entire number of cases in 
the District of Columbia. Hydrant water 
found constantly contaminated with sewage. 
Traced to the fact that as mhk supply was m- 
sufficient forty gallons of condensed milk 
were used per diem. This was diluted with 
hydrant water. When this error (the dilution 
of condensed mOk: with hydrant water) was 
corrected, only two cases developed subse- 
quently. Eight weUs in use, four redrilled; 
average depth, 376 feet. 
Complete pasteurizing apparatus purchased 
and is being installed. Water tank com- 
pletely scraped, painted, and cleaned. Whole 
water system hushed out in J une, 1904, since ! 
which time the water supply has been taken i 
wholly from artesian weUs. Separate drink- j 
ing and general water supply recommended. ' 
Total absence of typhoid inieption. i 
29 positive Widal tests; 5 deaths. 
I 
