Am.  Jour.  Pharm. 
July,  1910. 
State  Control  of  Diseases. 
335 
Sixty-seven  modern  sewerage  disposal  plants  have  been  either  built 
or  are  in  the  progress  of  construction  as  approved  by  the  state.  Two 
hundred  and  five  other  municipalities  and  private  sewerage  corpora- 
tions are  preparing  to  submit  plans  for  sewage  treatment,  for  only 
on  condition  of  their  so  doing  have  they  been  permitted  to  extend 
their  sewerage  systems.  Already  thirty-five  modern  water  filtration 
plants  have  been  approved  by  the  state  and  are  either  built  or  being 
erected. 
The  people  are  beginning  to  appreciate  that  sanitary  methods  of 
sewage  disposal  and  water  purification  are  not  costly  compared  with 
the  money  outlay  that  typhoid  fever  demands  of  our  State  every 
year,  not  to  speak  of  the  awful  harvest  of  misery,  suffering  and 
death  that  it  reaps. 
In  view  of  the  work  that  has  thus  been  done  in  cleaning  up  the 
streams  of  Pennsylvania,  it  is  encouraging  to  note  that  1908  showed 
a-  decrease  of  1088  deaths  from  typhoid,  compared  with  1907,  in 
which  year  there  were,  also  fewer  deaths  by  379  than  in  1906.  This 
is  in  the  face  of  a  rapidly  increasing  population,  so  that  the  actual 
decrease  in  point  of  numbers  does  not  represent  the  full  saving  in 
lives. 
Distribution  of  Diphtheria  Antitoxin. — I  know  of  no  work 
that  the  department  has  done  which  has  been  more  gratifying  to  me 
personally  than  the  saving  of  lives  of  little  children  by  the  free  dis- 
tribution of  diphtheria  antitoxin  among  the  poor  of  Pennsylvania. 
Since  October,  1905,  the  Health  Department  has  distributed 
49,443  packages  of  antitoxin.  It  has  treated  19,929  sick  people, 
mostly  children,  who,  but  for  the  state's  intervention,  would  have 
been  neglected.  In  the  old  days  about  10,000  of  these  children 
would  have  died;  as  a  matter  of  fact,  only  1725  died.  Nearly  all 
those  who  died  were  children  who<  did  not  receive  the  antitoxin  until 
the  late  stages  of  the  disease.  The  detailed  statistics  of  the  depart- 
ment show  that  the  earlier  the  sick  child  receives  the  antitoxin,  the 
greater  his  chances  of  recovery.  These  facts  should  emphasize  the 
pressing  need,  in  all  cases,  not  only  of  antitoxin  treatment,  but  of  this 
treatment  at  the  earliest  possible  time.  The  department  has  also 
thoroughly  tested  the  powers  of  antitoxin  as  an  immunizing  agent. 
Diphtheria,  as  every  one  knows,  is  one  of  the  most  virulently  con- 
tagious diseases.  It  travels  like  lightning  from  the  sick  to  the  well. 
In  the  crowded  homes  of  the  poor,  many  of  them  ideal  culture  tubes 
for  the  growth  of  the  microbes,  its  virulence  is  especially  marked. 
