LOCAL CAUSES 
OF 
Insanitation in Baltimore. 
BY 
Y 
JOHN MORRIS, M. D. 
Member of the American Public Health Association, &c., <Pc. 
Reprint from the State Board of Health Reports, January, 1878. 
BALTIMORE : 
The Sun Book and Job Printing Establishment. 
1878. It O C A. I C A USES 
OF 
Insanitation in Baltimore, 
JOHN MORRIS, M. D. 
Member of the American Public Health Association, &c , &■V. 
Perhaps there is not a city in the United States, certainly not 
one of equal size, the topographical position of which is so well 
adapted to secure health to its citizens as Baltimore. That its 
death rate is not as low as the lowest in the country can readily 
be understood when the many preventible causes of disease which 
exist within its limits are pointed out and the manner in which these 
causes operate fully explained. The investigation of this subject 
is the object aimed at in this paper. 
Among the diseases of a zymotic character due to unsanitory 
local conditions are, as is well known, diptheria, typhoid fever 
and scarlatina, all of which prevail to a very serious extent in Bal- 
timore. One hundred and eighty-four deaths from typhoid fever 
alone occurred during the past year, while deaths from the same 
cause in the city of New York, with a population three times 
greater, numbered but two hundred. This is a startling statement 
when taken in connection with the fact that every case of typhoid 
fever is due to a local cause, and that that particular cause can, 
in nearly every instance, be ascertained and prevented, if due 
pains be taken; and, further, that as a consequence, every case of 
death from this disease is the result of recklessness or ignorance. 2 
Diptheria, too, has its origin in filth. Dr. Snow, the Health 
Superintendent of Providence, R. I., one of the best sanitarians 
in this country, says in his last report: 
“ The evidence constantly accumulates in this city, that dipthe- 
ria depends for its existence and prevalence upon foul air, arising 
from local conditions of filth. Though it is innoculable, and in 
that way contagious, and is, perhaps, to some extent, infectious, 
there is no evidence that practically the disease is propagated by 
innoculation, or contagion or infection. We may expect that dip- 
theria will continue through the winter, though perhaps with less 
severity than during the last two months; but it will still continue 
to search out its victims among those whose constitutions are pre- 
pared for it, by breathing foul air and other depressing causes.” 
Slight epidemics of diptheria and scarlatina have also prevailed 
in the southern and southwestern part of the city of Baltimore. 
To account for this ucusual prevalence of disease it will be neceS' 
sary to seek out the causes most likely to operate injuriously, and 
see how far they obtain in our midst. To do this requires a 
thorough examination of the drainage and sewerage system of the 
town, as well as the condition of wells, cellars, pavements, water 
closets, privies, &c. 
DRAINAGE. 
The drainage of Baltimore, as is well known, is largely of a 
surface character, to which the city is well adapted, owing, as I 
have before stated, to its topographical advantages. The subter- 
ranean drainage is peculiar and will be fully described hereafter. 
I am convinced that very little disease arises from bad drainage 
in the city proper, save that arising from defective kitchen drain- 
age, but in the suburbs and outlying grounds there are numbers of 
low vacant lots, the foci of malaria. These are to be found in 
every portion of the city, even in the neighborhood of such well 
improved sections as Franklin, Lafayette and Harlem Squares. 
To the existence of these beds of miasmatic poison may be 
ascribed the great amount of malarial fever that has prevailed in 
Baltimore in the year 1877. It is a notable fact, that whilst the 
small towns and the country in the vicinity of Baltimore have been 
unusually free of malaria, the city itself has suffered in a very marked 3 
degree. (Diptheria has prevailed at Waverly, owing to the fact 
that the sewerage of the village is suffered to empty into a large 
open lot.) The digging of new sewers, particularly the extensive 
one in Carey street, no doubt added to this cause. In this last 
locality there was an unusual amount of sickness, including dip- 
theria. The drainage in the neighborhood of the Spring Gardens 
is notably bad, and, unless remedied, must always prove a fruitful 
source of disease, most certainly so when other factors, hereafter 
to be mentioned, are added. The drainage in the eastern part 
of the city from Loudenslager’s Hill in every direction is wretch- 
edly bad, and though somewhat improved, through measures 
taken by the Health authorities, is still defective and a reproach 
to an enlightened community. I shall dwell more in detail upon 
this when I come to speak of Harris’ Creek and the outlying 
spaces north of Loudenslager’s Hill. Another portion of the city 
that is badly drained is a small peninsula- north and east of Lan- 
caster street, which was the seat of the late outbreak of malignant 
yellow fever. 
SEWERAGE. 
The sewerage of the city is extremely defective, and is no doubt 
the source of a great deal of the disease that prevails during the 
summer and autumn months. The sewers are too few in number, 
badly constructed, and when not flushed offensive to the smell. 
The condition of Harford Run, that of Chatsworth street, and also 
that of the filthy stream running from Cross street to Spring Gar- 
dens, is exceedingly bad, and the attention of the municipal 
authorities was called to it by the Health Commissioner in his last 
annual report. 
The study of the evils of the drainage and sewerage systems of 
Baltimore, and the means for their correction, have engrossed my 
attention for a length of time; and, with a view to secure the most 
enlightened judgment concerning them, I have conferred with 
accomplished engineers and gentlemen skilled in sanitary science. 
One of them, Mr. Richard Randolph, C. E., has kindly furnished 
me his views on the important matters referred to, which I here 
subjoin, deeming them of the utmost importance, from the fact 
that they are based upon an intelligent examination of the whole 
subject: 4 
“ The city of Baltimore, owing to the nature of the ground upon 
which it is built, possesses advantages, up to a certain point, for 
health and cleanliness, not surpassed by any city in the world. It 
is provided by nature with a complete and efficient subterranean 
drain, ready at any and every point, wherever a well may be made 
to penetrate it, to receive the waters which are used to wash away 
its effete products, and to conduct them and the matters with which 
they are charged to the nearest outlets at tide level. Flowing at 
a depth below the influence of the sun, they are maintained at a 
temperature so low as to preclude decomposition and the genera- 
tion of gases until they have issued into the harbor; where they 
accumulate and stagnate in the heat and drought of summer. 
“The testimony of those whose occupation it is to make perfora- 
tions for sinks and wells all over the city, and of those who have 
dug foundations and dredged out docks along the water front? 
establishes the fact, that at about twenty feet below tide level, 
extending under the harbor and the city, there is a thick stratum 
of clay, through which no water can find its way downwards, and 
through which all lower water will rise wherever wells are bored 
deep enough to reach those veins; that upon this bed of clay 
there rests a stratum of very coarse gravel, overlaid, in the higher 
parts of the city, with a heavy deposit of sand; that all of this 
deposit of gravel and sand is thoroughly pervious to water, which, 
arrested by the clay, flows through the gravel at the bottom in 
innumerable and copious streams; and that the tide rises and falls 
over a large district of this subterranean water, as can be observed 
in many of the wells in the lower part of the city, many squares 
from the Basin or Falls. 
“ Taking advantage of these conditions, the citizens of Baltimore 
have long been in the habit of getting rid of all effete matters with- 
out effort or thought, after once establishing a well which commu- 
nicated with the underlying porous strata. With so much facility 
and obscurity has this object been accomplished that consequences 
were no more thought of than if they had been cast into the mid- 
dle of the ocean. Even the Health Commissioner, who presides 
over the department whose duties require a study of such ques- 
tions, would only recognize that they passed off in subterranean 
streams to unknown regions, and ignored the fact that the harbor 5 
of Baltimore was the final receptacle of the contents of the ever- 
replenished sinks. And most of those whose attention has been 
called to this fact could not divest themselves of a conviction that 
this subterranean conduit had a mysterious power of annulling the 
laws of chemistry, and of converting all the elements of an offen- 
sive decomposition into pure water. 
“ Upon the hypothesis that this enormous mass of corruption 
supplied by many thousand of these wells had gone out of exis- 
tence, the most strained chemical theories were invented to account 
for the annual exhalations of offensive gases from the harbor. But 
the history of science proves that whenever a remarkable phenom- 
enon is observed, the cause of which is entirely unknown, scientific 
men will always invent a cause and uphold their theory with the 
most scientific reasoning until new light forces them to abandon it 
in favor of either the true cause or a more plausible one. Influ- 
enced by the reports of the chemists who contradicted each other, 
and who contradicted themselves in different reports, in their en- 
deavors to draw a correct conclusion from mistaken premises; and 
by the opinions of sea-captains whose experience taught tiiem 
that bilge water in the hold of a vessel, charged with the molasses 
which drips from a cargo of sugar during a voyage from the tropics, 
amounting sometimes to ten per cent, of the weight, gave out an 
odor similar to that of the Basin in summer, public opinion fixed 
upon the operations of the Calvert Refinery as being the principal 
cause of the condition of the harbor. This establishment had the 
misfortune to be situated at a point where Jones’ Falls, after pen- 
etrating the most populous sections of the city and collecting from 
the sewers and porous strata of all that region their polluted dis- 
charges, concentrates them in a stagnant pool called the City 
Dock, to be acted upon by the summer’s heat The condition of 
this dock and of the water of the harbor at its outlet, enveloping 
the refinery with its fumes, led the imagination to assign their origin 
to that building; notwithstanding the fact that the water immedi. 
ately at the point of the discharge of the waste fluids was com- 
paratively free from these maiftfestations. The justice of this 
accusation is only equaled by that of the wolf who accused the 
lamb of disturbing the stream at a point above where he stood. 
And this charge was insisted upon, although any one with eyes 6 
and a nose could perceive the generation of the black and seeth- 
ing fluids at Baltimore street and far above, and their flowing in a 
perpetual current towards the refinery. And with equal distinct- 
ness at Schroeder’s Run, in proportionate quantity, flowing into 
the Spring Gardens—a locality remote and isolated from all refine- 
ries or other factories. And notwithstanding that indisputable 
documents were on record to prove that the same evil was loudly 
complained of before the refineries were started. 
“ Upon the disappearance of the odors last summer, coinciding 
with the restrictions laid upon the Calvert Refinery and also coin- 
ciding with frequent and heavy showers of rain; which latter 
coincidence the editors, steamboat-men and chemists completely 
ignored; public opinion under their guidance was satisfied that 
the refining of sugar had been the true cause of all the evil- 
The editors collected the testimony of the habitues of the wharves 
to the effect that the cure was complete and the chemists main- 
tained that their theory was confirmed. But when the rain ceased 
and an unbroken drought prevailed for three weeks (which had 
always been a necessary condition of the development of the 
gases), the local columns of the papers commenced to record the 
offensiveness of the air and the blackness of the water; and in a 
few days the evil manifested itself in all its accustomed force; 
notwithstanding that the gates of Lake Roland were opened, post- 
poning the effects for a few days but giving rise to a water panic. 
Thus were all of their expectations falsified. And refusing to give 
credit to the rain as they did in the summer of 1876, they were 
driven to the absurd conclusion that the refineries must have sus- 
pended operarions during the month of clear water and pure air 
last summer as they did during the summer of 1876. 
“ At this time the Mayor having made a visit to Newport, and 
having occasion to observe the effects of a sewer emptying into the 
harbor there, returned impressed with the fact that sugar refining 
was far from being responsible for all the subject of complaint. 
He might have read the Sanitary reports of some of the largest 
cities in Europe and in this country, particularly London, where 
he would have seen described precisely the same effects that are 
so noticable in Baltimore and to the same or greater extent, and all 
ascribed without a question to the same cause as that existing at 7 
Newport. He has since recommended the construction of the 
intercepting sewer which had been projected some time before: 
which shows that he was at least moving in the right direction. 
And had he remained in office two more years he probably might 
have gotten down to the true source of nearly all the offence. 
But he and his advisors would have had to penetrate with their 
investigations to a depth of twenty feet below the level of tide. 
They would have had to recognize the fact that at that point there 
was a thick stratum of impervious clay extending under nearly the 
whole of the city and harbor, and that upon this rested a stratum 
of coarse gravel through which the water percolated with facility, 
carrying with it all matters held in solution or suspension, and that 
about forty thousand sinks discharge their contents continually into 
it, and that there was no possible outlets for these fluids except 
into the harbor; either directly or by way of such streams as 
Jones’ Falls, Shroeder’s Run and Hartford Run. 
“ If the intercepting sewer is built, as it has been designed, the 
great expenditure will be made without abating the nuisance to an 
extent that tvill be appreciable. It may carry off the compara- 
tively innocent fluids flowing in the gutters and the contents of the 
sewers in its neighborhood; but what is to become of the enor- 
mous product of the sinks which will continue to increase in num- 
ber and efficiency every year, and of the many sewers that will be 
required in some of the northern sections, and which must dis- 
charge into Jones Falls? It can not be expected that the people 
of Baltimore will throw away the great boon which nature has 
conferred upon them, by filling up their wells, and, abandoning 
their natural drain, substitute a network of sewers over the whole 
city, at an enormous and ruinous expense, which, in consequence 
of its being subject to the heat of the surface and its numerous 
vent holes, will become a vast generation of noxious gases, far 
more dangerous than those which escape from the Basin. They 
will contruct sewers only where wells can not be made to act, and 
discharge them by the shortest route into the Falls. 
“ Although nature has done so much for the convenience, clean- 
liness and health of Baltimore, she has left something for the citi- 
zens to do for themselves. They must supplement her plan, if 
they wish to abolish that scourge to the senses which at every dry 8 
period in summer forbids the stranger to stop over night, and 
threatens to drive away the most desirable class of residents. But 
what can be done ? is the question asked by many who dispair of 
any relief. To answer this question is the object of this paper. 
“ If it is established, as stated from the testimony of those 
mechanics who have dug wells and foundations at innumerable 
points in the city, that the water which pervades the underlying 
gravel does not penetrate the clay upon which it rests; then a dike 
or wall of clay, erected upon this floor of clay, connecting with 
it at the bottom and rising above the level of tide, will prevent such 
water from passing beyond and compel it to seek an outlet at 
the nearest point where this wall does not intervene. Therefore, 
if a trench, beginning at the base of Federal Hill and extending 
along Light street and Pratt street to the Falls, were dug down to 
the clay bed and then the trench filled up with impervious clay, 
the foul waters, percolating through the gravel, would be prevented 
from passing into the Basin. They would seek the nearest outlet 
into Jones’ Falls above Pratt street. Communication by percola- 
tion might still be open to the harbor below Federal Hill, or to 
the more distant Spring Gardens; but the resistance offered by 
such longer distances would determine the great bulk to issue at 
the nearer points along the Falls, especially if the head were con- 
stantly drawn down by an artificial current emptying that stream. 
The more this dike of clay is extended along the harbor margin 
the more perfectly will it be intercepted and diverted into the 
Falls, but carried out to the extent just mentioned, it would cause 
the whole of the fluids, which have been the cause of the nuisance, 
to issue into the bed of the Falls, where the greater part of them 
have always gone. This stream must necessarily, for all time, be 
the great conduit for the surface and subterranean drainage of, by 
far, the largest and most populous part of the city, and will drain 
all its future extensions towards the north. 
“ Having forced all the foul waters into this one receptacle, and 
having shut it off from the harbor by a gate, so constructed as to 
fall and lie upon the bottom when all the water-way might be 
required by a flood, or when it was necessary to admit a boat; it 
would then be necessary to construct a conduit from above this 
gate and connecting with the Falls, to the broad and moving 9 
waters of the Patapsco beyond the quarantine line, giving it a 
capacity and establishing a flow sufficient to carry off the volume 
of the Falls, at its low stages during droughts; thus depriving it of 
the opportunity to become foetid by stagnation and heat. 
“ This volume will never reach the capacity of the conduit from 
the Gupowder River. A large portion of the supplies derived 
from the Gunpowder and Lake Roland will flow directly into the 
harbor and the Middle Branch, and another large portion will be 
evaporated upon the streets and pavements. The water which 
falls in rain and snow, washing off the dust of the streets and 
flushing the gutters on the surface and swelling the volume of the 
Falls beyond the capacity of the diversion conduit, would flow 
into the harbor with no worse consequence than a temporary tur- 
gidness, as it would transport so few substances capable of offensive 
decomposition. 
“ But as we have to go below the level of tide in order to inter- 
cept the waters to be removed, we cannot expect the force of 
gravitation to do the work of transportation unless the external 
pressure of tide water at the outlet of the conduit is removed by 
steam or other power. This would entail but a small expense 
and need be used but for a short time each year. 
“ When the new supply from the Gunpowder is introduced it 
will flow through a circular conduit whose transverse area is 113 
square feet, and with a descent of one foot in 5,000, causing it to 
flow at the rate of about 125 feet per minute. Now the power 
applied by gravitation to cause such a column of water 5,000 feet 
long to move at this rate is the same which an engine and pro- 
peller would be required to apply in lifting 113 cubic feet of water, 
or 7,000 pounds, 125 feet per minute, or 875,000 pounds one foot 
per minute. And as one horse power is the raising of 33,000 
pounds one foot per minute, the engine and propeller would have 
to apply the power of horses. If the column of water was 
20,000 feet long on the same inclination, 105 horses would repre- 
sent the power applied by gravitatiojn. Therefore an engine 
which would apply a power of 105 horses to the removal of the 
pressure of tide water at the outlet of the conduit of this capacity 
and inclination, connecting Jones’ Falls at Pratt street with the 
Patapsco beyond the Lazaretto, would cause the same quantity of 10 
water to be discharged as that which will flow naturally through 
the tunnel of the Gunpowder supply. Which is to say that a 150 
horse engine driving a propeller wheel in this conduit at its outlet 
will cause to be discharged beyond the Lazaretto all the contami- 
nated water which gives rise to the discoloration of the harbor 
and the offensiveness of the air when the city has reached its 
utmost anticipated population. If it were not for the objection of 
causing wet cellars in the very low districts, and that of forcing 
some of the foul water to issue where there was no intercepting 
dike of clay, the engine and wheel could be dispensed with by 
maintaining a head of four feet above tide in Jones’ Falls above 
Pratt street. 
“ Such a conduit would not require to be built in the expensive 
manner of an ordinary sewer; which, generally resting upon the 
upper strata of yielding and uncertain character, requires masses 
of masonry for its foundation to insure it against fracture; and 
being above the level of permanent water must necessarily be 
hermetically sealed with cement to prevent its contents from 
escaping into the adjoining soil or rising to the surface. But 
founded upon the firm stratum at a depth of ten or -fifteen feet 
below tide level, and constantly submerged, it will require only two 
parallel walls of large stone masonry, without mortar, surmounted 
with a semi-circular arch of rough stone or brick. These walls 
should be pervious to water in order that the polluted under drain- 
age of the south-eastern section of the city, including Canton, 
which will become more populous and sanitary as time advances, 
may find its way into the conduit to be discharged with the rest 
at the outlet. It would also be necessary to contiune the clay 
dike from the Falls at Pratt street along the lower side of the 
conduit so as to prevent the foul water from issuing into the har- 
bor and that of the harbor from being drawn into the conduit, to 
the partial exclusion of that desired to be removed. 
“ If the city continues to grow and the western sections become 
populous, it is only a question of time when the Spring Gardens 
and the Middle Branch will present the same conditions as that 
of the basin and harbor at present. When that time arrives the 
same remedy can be applied of interception and diversion either 
by discharging at Ferry Bar or connecting with Jones’ Falls. 11 
“ Such in brief is the outline for a plan for intercepting the 
whole of those matters of the present and the future which are 
the cause of the pollution of the harbor and the atmosphere. It 
contemplates the general use of sinks to be made efficient by 
depth of penetration and the avoidance of all sewers except 
where these are impracticable. That such a practice is consistent 
with the highest degree of health, the renown which Baltimore 
has heretofore had for cleanliness and salubrity is sufficient proof. 
And the large amount of water which can be commanded at all 
elevations will render it the most convenient and sanitary for the 
whole population. 
“Nearly all the elements for calculating the cost of such an 
improvement can be obtained by borings and other investigations. 
But enough is now known to warrant the assumption that the cost 
will be less than that estimated lor the proposed intercepting sewer, 
and will not much exceed that of the perfectly useless temporary 
supply. 
“This plan requiring the expenditure of three-quarters of a mil- 
lion, is predicated upon the present absence of renovating supplies 
of fresh water during the droughts of summer, or in contemplation 
of the future expansion of the city, when its increased population 
will proportionately aggravate the causes of the evil and the neces- 
sity of a remedy—a time when a larger portion of the water to 
be derived from works now in progress will be applied to domestic 
uses. But, as we have seen so often, the nuisance mitigated by a 
few showers of rain and entirely abated by a continued and heavy 
rainfall, as happened in 1875 while the refineries were in extensive 
operation although financially suspended; and in 1876, aided by 
the removal of a year’s accumulation of foul deposits, and, as 
happened last summer, after the heavy rains which succeeded the 
orders of the Health Commissioner to the Calvert Refinery, and 
as was witnessed after the drought of last summer, the postpone- 
ment of the revival of the nuisance for several days, simply by the 
general flushing of the sewers from the meagre supply of Lake 
Roland, there is ground for the hope that the daily flow of one 
hundred and fifty superfluous millions, which will be available 
when the new works are complete, will have the effect of prevent- 
ing the Basin from reaching that degree of pollution which causes 12 
so much complaint. If that much water had been at hand last 
summer instead of the petty store of Lake Roland it is almost 
certain that those holding to the sugar refining theory would have 
had it in their power to seemingly maintain their position by keep- 
ing down the odors after the Health Commissioner’s injunction to 
the Calvert refinery—for in a week the rains came to their relief. 
“ It is only at periods of prolonged drought, such as occurred 
in 1874, when the Gunpowder river itself will be reduced to a 
volume less than half of the capacity of its conduit to the city, or 
when the city has become much more populous, that the plan here 
proposed, or one accomplishing the result in view, would be 
demanded by the taxpayers. 
“ At the present time when taxation has become so onerous, 
economy will dictate the postponement of all heavy expenditures 
on account of the Basin evil until the extent of the relief to be 
afforded by the new water supply is experienced and its efficiency 
tested. When other measures are imperatively demanded by the 
great majority of the citizens it is probable that their numbers and 
the taxable basis will have much increased. 
“ It will not require any special arrangements or extraordinary 
outlay in order to take full advantage of the surplus water of the 
new works in renovating that of the Basin and Falls. Tliere is no 
need of its being made to rush in under a head, creating a local 
stirring up, or of admitting it at very many points. The more 
quietly it is admitted the better; the only thing requisite being 
quantity. It would be impossible with any quantity attainable to 
cause a current in the broad expanse of the Basin sufficient 
to carry off solid matters stirred up at the bottom by the force of 
water emitted from pipes under pressure. They would all be 
deposited at a short distance from the point of disturbance. But 
the water itself, charged as it is with the elements of the foul 
gases in solution and very fine suspension, being gently pressed 
outward and replaced by pure water will become so scattered and 
adulterated by that of the harbor as to rapidly diminish the devel- 
opment of odors. Therefore if the water is admitted by way of 
the street gutters and the sewers which now empty into the Basin 
the object will be accomplished. 
“But the bed of Jones’ Falls is the receptacle of by far the 
larger portion of these impurities; which, being a long and con- 13 
tracted channel, need only have the fresh water admitted at the 
nearest and most convenient point to the outlet of the new reser- 
voir at Montibello. It would find its way just as well by a ravine 
as by a pipe and would b£ just as serviceable for all purposes of 
flushing and renovating.” 
These views of Mr. Randolph are well worthy the attention of 
the municipal authorities. They intelligently point out a ready 
and practical mode of getting rid of a great and increasing evil. 
So far as they relate to the offensive stench of the Basin, during 
the summer months, I am not prepared to adopt them, though I 
do not deny their correctness. It is not my purpose to discuss 
the subject of- the Basin at this time, inasmuch as I have not 
deemed it absolutely one of the local causes of the city’s insanita- 
tion. The matter, however, attracts a great deal of attention, and 
is looked on as a vital one by many of our citizens. This interest 
will increase from year to year, and, therefore, any investigation 
that serves to throw light on the subject cannot fail to prove a 
boon to the community. The authorities of the city of Baltimore 
must be aroused in some way to a sense of the importance of their 
duties in connection with the health and lives of the people. 
Judging from their past indifference and neglect, it would appear 
that nothing save a visitation from Heaven, in the shape of some 
fearful scourge, will prove sufficient to awaken them to a knowl- 
edge of their responsibilities. 
The first of these streams, if so turbid and tideless a water course 
can be called a stream, is the greatest nuisance in the city, and, in 
my judgment, is a prolific source of disease. It is the receptacle 
of all the vegetable and animal debris of the eastern portion of 
Baltimore, including the refuse of the slaughter houses on Louden- 
slager’s Hill. As long as it is suffered to remain in its present 
condition, it must necessarily be a factor in the production of local 
diseases. 
Jones’ Falls is not so narrow and sluggish as Harris’ Creek, but 
at certain seasons of the year, and under certain conditions, does 
give rise to diseases of a malarial character. I have, as a medical 
man, watched for more than thirty years the origin and spread of 
HARRIS CREEK AND JONES’ FALLS. 14 
epidemics in Baltimore, and I have always thought I could trace 
out an influence arising from Jones’ Falls—a wave of disease, so 
to speak, adding to, if not producing, the original trouble. The 
improvements at present being made on this stream, expensive as 
they are in character, may add to the security of property in the 
vicinity, but will prove of very little service in a sanitary point 
view. An open bed like Jones’ Falls for the sewerage of a city 
cannot fail to be unwholesome. Central avenue, formerly Canal 
street, was many years ago an open run. Intermittent and remit- 
tent fevers ot a very serious nature prevailed every year along its 
course. Since the filling up of the street and the erection of the 
sewer these diseases have almost entirely disappeared. At the 
time to which I allude animal refuse did not form a part in any 
large degree of the decaying matter, and, consequently, typhoid 
fever was not common. (It may be added, however, that the 
sewer or culvert that has been built to take the place of the open 
run on Central avenue is inadequate, and not at all adapted to 
the purpose for which it was constructed.) 
Doctor Thomas H. Buckler always contended that Jones’ Falls 
is the source of the malarious diseases prevailing in the lower por- 
tion of the city, and in his last brochure, written before his depart- 
ure for Europe, he advocated the theory that the gases of the 
Basin are rendered innocuous by the counteracting and antagonizing 
influence of the malarial poison arising from the bed of this stream. 
Be this as it may, the Falls will always be looked on with appre- 
hension by medical men. The great expenditure now being made 
for its improvement is made entirely without reference to the 
health of the people, and in that view must be considered as 
money recklessly thrown away. 
PRIVIES AND CESS POOLS. 
The privy system of Baltimore is perhaps as bad as that of any 
city in the United States. It is a memento of the past, the well- 
preserved and filthy relic of a village history. The existence of 
forty or fifty thousand of small superficial holes, denominated 
privies, a few feet in depth, poisoning the atmosphere with their 
putrid gases, is not a boon to a great city; and yet the citizens of 
Baltimore appear to cherish this peculiar institution with as much 15 
pride as they do their monuments and the memories of their brave 
men and fair women. These privies are no doubt the most posi- 
tive and prominent of all known factors in the production of local 
diseases in Baltimore. The gases, alone, would account for much 
of the sickness found to prevail at certain seasons; but apart from 
this, owing to the proximity, in many instances, of the out-door 
hydrants so commonly in use, the water, otherwise pure and 
wholesome, is rendered unfit for use and the source of zymotic 
disease. My attention was drawn to this evil, some years ago. by 
the circumstance that I was called on to treat a whole family of 
patients, suffering from typhoid fever, in a small tenement in the 
neighborhood of Belair market. On an examination of the prem- 
ises, I discovered an overflowing privy within a few feet of the 
hydrant. I could not, at the time, understand how the poisonous 
excrement could find its way into the water of the hydrant, though 
I felt convinced it was the cause of the severe malady that had 
prostrated a whole family. Mentioning the subject in one of the 
medical societies of the city, my friend, Doctor Erich, in the course 
of the discussion, stated that his attention had been called to this 
matter by a similar experience, and that he had investigated the 
subject, and believed he had discovered the modus by which pois- 
onous gases and morbid material contaminated the water con- 
sumed by thousands of the people of Baltimore. At my request, 
the Doctor has kindly furnished me the explanation which I sub- 
join ; it is a plain and clear statement, and will, no doubt, claim 
the attention which it merits: 
“ In compliance with your request, I have the pleasure of fur- 
nishing you a short summary of the results of my investigations 
in reference to the pollution of hydrant water by local causes. 
“ My attention was first directed to the subject by a lady to 
whom I had pointed out the dangers of using pump water. She 
assured me that she had frequently drawn earth worms, hair and 
sand from the hydrant in her yard, and proved her statement by 
actual demonstration. After an examination of the mechanism 
of the ‘ non-freezing hydrants,’ such as are found in the yards 
attached to dwellings, I am convinced that they are all liable to 
admit impurities after they have been in use for some time. They 
are provided with vacuum chambers for the purpose of drawing 16 
or ‘ sucking ’ the water contained in the pipes after each discharge 
under ground, below the freezing point. This action, being fre- 
quently repeated, causes the plunger, as well as the leather or 
rubber packing surrounding it, to wear and become leaky. The 
vacuum chamber, being constantly immersed in stagnant water, 
derived from the gutter in front of the hydrant, and in some 
instances from adjoining privies, a portion of this filth is sucked 
in whenever the hydrant is turned off, and is then discharged with 
the water the next time the hydrant is turned on. 
“ The correctness of this statement may be readily verified by 
emptying a bottle of the ordinary washing blue into the top of the 
box surrounding the hydrant, when, after a few forward and back- 
ward turns of the crank, we will have its presence in the water 
plainly apparent to the eye. I would venture the opinion that not 
less than nine out of every ten of the hydrants in use will be thus 
found to be leaky. As a remedy I would suggest the abolishment 
of ‘non-freezing’ and the general adoption of in-door hydrants.” 
The true remedy, however, to obviate the whole trouble is to 
dig down low enough in the construction of privies, if these cloacae 
are still to be retained, to prevent superficial drainage as well as 
the generation of noxious gases. 
WATER CLOSETS. 
The water closets in many of the private houses and some of 
the small hotels, particularly those erected some years ago, are 
very defective in .construction. This fact is made apparent to 
medical men in attendance on the families residing in these houses 
and hotels by the presence, at times, of offensive gases, This is 
particularly the case in those houses, not a few of which are to be 
found in the city, in which the closets are placed in the very cen- 
tre of the building. These are not lighted or ventilated. A 
number of cases of typhoid fever, among the better class, have 
had their origin from defective traps and overlooked leakages in 
these closets. The wells into which they empty are entirely too 
superficial, as has been before pointed out, and the whole system 
of their construction bad and insanitary. These closets, in my 
judgment, play an important part in producing infantile diseases 
in the families of the wealthy. 17 
KITCHEN DRAINAGE. 
The drainage from the kitchens in Baltimore is not carried oft' 
to the gutters by pipes, but flows most commonly over a large 
space of intermediate ground, permeating the soil through the 
interstices between the bricks, where it remains covered and hid- 
den to be acted on alternately by the rain and sun. The offen- 
siveness of these accumulations when the bricks are moved can 
scarcely be conceived, a fact that I discovered on making some 
repairs in my own yard. How far this condition of things is 
prejudicial to the health of the city I am not prepared to say, but 
it certainly is an evil that should be corrected. 
CELLARS. 
No cellars in the world can be constructed in a worse manner 
than those of Baltimore. The pre-requisites for a good cellar, 
cleanliness, dryness, light and ventilation, are almost entirely 
wanting. Not one thousand of the eighty thousand cellars of Bal- 
timore, I will venture to say, possess these qualities so indispensa- 
ble to health. Owing to the peculiar nature of our subsoil, 
heretofore described, they become the receptacles of noxious 
gases which course through the houses, permeating and contami- 
nating carpets, beds, clothing, &c. In tracing out the local causes 
of typhoid fever in the families which I have been called on to 
attend (and I always endeavor to seek out a local cause) I have 
been compelled in the majority of instances to attribute it to the 
condition of the cellars, and, therefore, I am convinced they play 
a greater part in producing the insanitation of the city than 
drainage, sewerage, or many of the other causes which are sup- 
posed so produce the diseases of large towns. During the past 
year a slight outbreak of typhoid fever which took place in several 
of the tenement houses on President street, near Eastern avenue, 
was due, in my judgment, to the foul condition of the cellars and 
outbuildings. I was compelled to report twice to the Health De- 
partment before the landlord would do his duty in the premises, 
and then it was done with the utmost reluctance. Three cases of 
typhoid fever, one ot them fatal, occurred in the house adjoining 
my own on Franklin street, from the same cause during the pre- 
vious year. No part of a dwelling requires so much care in its 18 
construction, and, after construction, in its sanitary supervision, as 
the cellar; and yet not the slightest attention is exercised in the 
matter. I venture the assertion, that if all the cellars of Balti- 
more were examined at this moment, not one in one hundred 
would be found free from causes, which, under certain conditions, 
would be likely to generate disease. When the Inspector of 
Buildings is a man possessing some sanitary knowledge, and it is 
made his duty to reject buildings not built in accordance with 
known health laws; and when the sanitary inspectors, that is, the 
vaccine physicians, are properly paid and do their whole duty under 
the law, and, further, when the police are made conservators of 
the public health, this will not be the case, and thus one of our 
most potent, if not the most potent, of our sanitary evils will be 
forever removed. 
IRON FLATS. 
Another source of mischief, the more dangerous because over- 
looked and insiduous, is the existence of the iron flats covering 
the gutters introduced into our city during the past few years. 
These flats, owing to their peculiar construction, become the cen- 
tres of contagion—they catch and hold to the exposure of the sun 
a portion of the vegetable and animal debris intended to pass 
through them, and thus become sources of disease. My attention 
has been particularly directed to one of these nuisances on Frank- 
lin street, corner of Larew’s alley, the stench from which during 
the past summer drove the neighbors to the country weeks before 
the usual time, and which is believed by some persons living in 
the vicinity to have engendered typhoid fever in the neighbor- 
hood, no less than five persons dying in one house in Larew’s 
alley. 
OYSTER SHELLS. 
An additional cause of sickness of a typhoid character is the 
presence of large collections of oyster shells which are suffered to 
remain and decay at different points in the eastern part of the 
city. My friend, Doctor Arnold, reports to me that he treated 
seven cases of typhoid fever in Philpot alley during the past year, 
due, in his judgment, to this cause. The proprietors of the oyster 19 
packing establishments in the city and suburbs should be com- 
pelled to remove the shells and refuse on their premises daily. 
FILLING UP LOTS AND STREETS WITH REFUSE. 
A very objectionable practice, highly detrimental to public health, 
has prevailed in Baltimore during past years, viz: the filling up 
lots and the beds of streets with garbage and refuse. This is an 
evil that must be permanent, for the processes of decay are ever 
going on, provided the necessary elements of heat and moisture 
are brought into action. I do not know that at the present time 
this practice is allowed to continue, but certain portions of the 
city, markedly those of north Charles street beyond the bridge and 
the north east end of Washington street, were filled up in the 
manner indicated. These accumulations may prove inocuous for 
years, when suddenly, if a spark of contagion is allowed to fall 
into them, a fearful outbreak of disease is sure to occur. This was 
the case at Norfolk and Portsmouth in 1855. The accumulations 
of chips and shavings and other debris at the navy yard were suf- 
fered to remain for years without evil results, when a ship from 
South America communicated the spark which lighted up the 
fearful outbreak of yellow fever that decimated those two cities. 
Lots that have been filled up in the manner described are now 
built over, and may, in the end, prove a serious scourge to a 
whole community. Even if not productive of sickness, they are 
unsightly and unpleasant frequently to the senses. 
DRINKING WATER. 
The drinking water of Baltimore is as pure as possible, and no 
portion of the disease of the city can rightfully be attributed to it, 
when not exposed to contamination. The wells formerly used 
have been to a great extent abolished and their places supplied by 
public hydrants and fountains. In the eastern part of the city, 
in the vicinity of Thames street, owing to the want of public 
fountains, the abandonment of the old wells has not unfortunately 
taken place, and they are still largely used. It was believed that 
after the startling analysis of the character of the water of these 
wells made by Professor Tonry the authorities would take some 
action looking to their abolition, but, so far, nothing has been done. 20 
The physicians practicing in the neighborhood believe them to be 
necessarily dangerous to the public health, and the Health Com- 
missioner of the city, in his report, expresses the same judgment 
and earnestly urges their condemnation. One or two fountains in 
other portions of the city supplied by springs are used by wayfar- 
ers, but not so constantly as to give rise to apprehensions from 
their use. One of them, quite near me on Calvert street, below 
Franklin, is saturated no doubt with organic matter, but it is not 
much used by the neighbors. Twelve liquor saloons in the same 
block are necessary, however, to protect strangers from its noxious 
influences. 
PREVALENCE OF DIPTHERIA AND SCARLATINA. 
The prevalence of diptheria and scarlatina to an unusual degree 
in the southern and southwestern portions of Baltimore has been 
before alluded to. To discover a reason for this fact it is only 
necessary to examine the filthy stream running from Cross street 
to the Spring Gardens, as well as the condition of the intervening 
ground between these points. If Doctor Snow is right in stating 
(and I believe he is undoubtedly so) that diptheria is preeminently 
a filth disease, and that it occurs most frequently, and in the most 
malignant and fatal form, where dampness and filth do most pre- 
vail, then no spot in the whole world could be better selected for 
the propagation of this disease than this part of our good city. 
Another factor has, however, been added during the past year to 
its already existing foulness. I am assured, on reliable authority, 
that large quantities of night soil have been dumped into the 
Patapsco at this tideless point, without the knowledge of the health 
authorities. The excrement could at times be seen floating on 
the lazy stream, proving offensive to those living in the neighbor- 
hood, and adding to the of the surroundings. Our 
Health Commissioner, Doctor Steuart, in his last report, called 
attention to the noisome state of the Cross street stream, but he 
was not aware, of course, of this additional element of danger to 
the citizens of South Baltimore- How much longer this section 
of the city is to be neglected rests alone with the people them- 
selves. Unfortunately, owing to their ignorance of sanitary laws, 
they are unconscious of the many dangers that surround them. 21 
SANITARY INSPECTORS. 
The law in relation to the inspection of the houses of the people 
of Baltimore is as perfect as possible. The only difficulty is, it is 
not enforced. Under its provisions the police and the vaccine 
physicians are made the custodians of the public health. The 
vaccine physicians are required to visit and examine every house 
in their respective districts, and to report on their sanitary condi- 
tion. Were this statute properly enforced, and a conscientious 
and thorough examination made of all the houses, cellars and out- 
buildings, including the hydrant in the yard, typhoid fever would 
become a rare disease. 
The police can only be agents in a very rude way to carry out 
sanitary laws. They have not the special knowledge which the 
vaccine physician is presumed to possess; but they have noses, 
and eyes, and common sense, and, from the possession of these, 
can be of great service in discovering insanitary conditions. They 
can also see that health laws are executed faithfully. 
The present sanitary inspectors, though respectable and excel- 
lent men, are a heritage of a system of village insanitation, and 
are utterly useless as far as the prevention of disease is concerned, 
and, moreover, completely inefficient, owing to their entire igno- 
rance of sanitary science, to remedy existing evils, to which their 
attention may be drawn. They are appointed solely for political 
reasons, and possess about as much knowledge of hygiene as they 
do of the Pandects. They search out nothing, investigate noth- 
ing, unless directed to do so. In a word, they are a heritage of a 
bad system, having its origin and growth in political patronage— 
an evil which should never be suffered to affect the health and 
lives of a community. 
Let it once be understood that every case of typhoid fever has 
a local cause, that some one is responsible for it, that some public 
functionary is to blame, and then the trouble will cease. 
CONCLUSION. 
In the foregoing observations I have endeavored to point out a 
portion, perhaps the most prominent portion, of the obstacles to 
the perfect healthfulness of the city of Baltimore. Were these 22 
removed, and a complete system of sanitary rules enforced, I am 
convinced, as I have stated in the beginning, that Baltimore would 
become one of the healthiest, if not the healthiest, of the cities of 
the world. To secure this, however, it is important that the exec- 
utive officers of the city connected with its improvements should 
all be men versed in sanitary science. The Commissioner of 
Public Works, in addition to being a civil engineer, should be a 
sanitary engineer. The Inspector of Buildings should also be a 
man possessing sanitary knowledge. The Sanitary Inspectors 
should be competent medical men, particularly versed in matters 
pertaining to the laws of health. 
Let men of this character be appointed to these places, and 
rigid sanitary laws be enacted (the Councils in the meantime 
doing their duty), and, as sure as anything in the future can be 
predicted, Baltimore will surpass even the inland towns of the 
West in salubrity, and exhibit to the world the lowest possible 
death rate attainable in a great city.