Newspaper Page Text
14
PUBLIC HEALTH IN PERIL
DR. R. J. NUNN’S LETTER TO MAYOR
M’DONOUGH.
The Causes to Which Be Attributes
the Existence of Typhoid Fever In
Savannah —An Estimated Total,
fcased Upon Physicians’ Statements,
of 266 Cases Last Year—The Pre
valence of Scarlet Fever and Diph
theria a Forerunner of More Serious
Conditions Some of the Dancers
Which Threaten tte City's Health
Pointed Cut.
At a recant meeting of the eauitary board
a letter was read from Dr. R. J. Nunn in
reference to the sauitary conditions of the
city, dwelling at length upon some of the
causes, which in the minds of leading sani
tarians are productive, to a great extent, of
much of the slcxr.ess in Savannah, and
which, if permitted to continue, are likely
to result more seriously than most people,
by whom the causes and effects of a lack of
sanitation are given little thought, imagine.
The letter was written in reply to tue in
vitation to Dr. Nunn, among ot era, to he
present at the meeting of physicians called
by the mayor last December for the purpose
of locating the causes of the fever which
prevailed in the city last year. The three
days intervening between the invitation
anil the date of the meeting, in which the
physicians were expected to obtain the in
formation asked for by the mayor, was re
garded by Dr. Nunn too short to permit of
sufficient investigation uco:, which to base
any reliable statement, and in consequence
be did not attend the meeting. His subse
quent investigation# reach a different result
than that reached by the physicians who
did attend, as stated in the resolution
adopted at the meeting.
From careful, personal inquiry of twenty
five of the forty-nine practicing physicians
In Savannah Dr. Nunn found there were
186 cases of true typhoid fever in the city
last year distinct from the other classes of
fevers,sometimes called typhoid. Allow
ing the same percentage of cases to the
other twenty-four physicians gives an esti
mated total of 2(56 cases of true typhoid lu
Savannah during 1892. Following the sta
tistics Dr. Nunn dwells at length upou tbs
causes productive of typhoid and other kin
dred diseases which exist in Savanuab and
which threaten the health and oommeroial
prosperity of the city.
The letter was read at a recent meeting
of the Citizens’ Sanitary Association, and
has received the hearty indorsement both
of the sanitary association and the sanitary
board. Mayor MoDonough is strongly im
pressed with the facts it contains, and has
authorized its publication. The letter is as
follows:
Savannah, Ga., Feb. 14, 1891 I
119 York Street, j
To His Honor the Mayor of the City of
Savannah:
Dear Sir—On Deo. 9, 1892, I received
from his honor the mayor, through the
oierk of council, an invitation to be present
at a meeting of physioians, to be held Dec.
12, which was called to locate the cause of
the fever which prevailed in the city dur
ing the summer of that year.
The Interval of time between the receipt
of the invitation and the date set for the
meeting was alt getber too short to admit
of a thorough investigation of the subject,
and all the information I have sought has
cot been received even yet, but there is
enough at hand to enable conclusions to be
drawD whioh may be valuable as guides id
some of the future sanitary workings of the
city government.
But before entering upon this inquiry, I
desire to draw a dear distinction between
two classes of minds which are not uufre
qnently mistaken for one another. These
are the pessimists and the precautionists.
The former see nothing but evil as the out
come of all occurrences. The latter, when
danger and disaster are ahead, do not
ignore the fact of their existence, but seek
to avoid them by every legitimate means.
With the former class I have no sympathy ;
but I hope always to be permitted to oount
myself as eurolled in the ranks of the latter.
It is proper when discussing a matter of so
much importance to the city as is the one now
under consideration, to proceed slowly and
cautiously, examining carefully each step
as we proceed, to the end that the conclu
sions reaohed uiay tie the truth, or as near
thereto as it is possible to arrive. To pur
sue any other course would be culpable in
the extreme. It would be deceiving the
public into a sense of false security; it
would be jeopardizing the health of the peo
ple, and trifling with the lives iutrusted to
the keeping of the authorities. •
Assertions upon one side and denials upon
the other, unsupported by evidence, will
never beoome fact, no matter how often re
peated.
The first question to be asked is: Was
there any unusual amount of sickness dur
ing the summer of 1892? To this the
auswor invariably returned by physicians
of whom I have inquired has been in the
affirmative, and here it may be well to ob
serve that the mortuary reports are not
sure guides to the amount of slokness pre
vailing in a loca ity during a season, for
the reason that such reports show only tbe
fatality; nor can more be done with them
than to show the character of diseases caus
ing deaths, and the proportion of these to
the population. But as to the prevalence of
non-fatal diseases, such as dengue, or as to
the proportion existing between the num
-ler of cases of a disease, and the deaths re
sulting therefrom, the puLlio mortuary re
ports can show nothing.
2. Were the diseases prevailing during
the summer of 1892 of an unusual type or
types? Answer, from the same sources:
Yes; the types were unusual, and chiefly of
two varieties (a), continued fever, some
times called typho-malanal fever, and lo
cally erroneously called typhoid fever; (b)
true typhoid fever.
The mortuary reports are neces<arily
misleading and unreliable as to the exist
ence of true typhoid fever in Savannah, for
the reason just pointed out, viz.: that con
tinued fever has been locally known as
typhoid.
Here it may be well to observe that the
fever called here typbo-malarial is com
paratively new in Savannah, the more
virulent types of malarial fever which were
usual in tne early 'sos having gradually dis
appeared before tbe milder, but far more
protracted, forms which are seen at present.
The causes which brought about this change
may be tbe same which culminated iu the
typhoid fever of last summer, but these I
will not now disousi, beoause, according to
the terms of the invitation, tbe investiga
tion is to be oonfiued to typhoid fever.
It is proper here to remark that the medi
cal profession in this city is much divided
on the relationship existing between con
tinued fever and typhoid fever; one por
tion believing tbat our continued fever 1s
in reality typhoid fever, and differs from it
only in tbe mildness of the attaok. A sec
ond portion looks upon our ooutinued fever
and typhoid fever as separate, independent
and distinct diseases, and inoline to the be
lief tbat our ooutinued fever is a disease
coming from the deoi imposition of vege
table matter, but tbat typhoid fever is
caused by decaying animal matter; while a
third portion rejects the idea of the possi
bility of tbe existence of even a
single case of typh id fever in the
city and would classify all forms of
continued fever or protracted fever st ma
larial. Finally there are some nhysioians
wbo believe that a malarial fever and a
typhoid fever can ooexlst in the same in
dividual, and run each its course independ
ently.
The difference of opinion existing as to
the pathology of these phases of disease can
only be settled by autopsies, an l to t itse
the patients have a decided objection.
While, however, doctors differ about tbe
classification of these diseases, there is not
tbe least difference of opinion as to the san
itary measures which should be put in prac
tice at once to prevent their origination or
their spread.
3. Was true typhoid fever present to any
considerable extent in Savannah during the
eam i er of 1892?
Answer: A copy of the following letter
was sent to each physician in the city
(forty-oine In alb:
Savannau, Ga , Jn. 28,1883.
Hr.
My Dear Doctor—l desire to arrive at an
approximation ot the number of cases of true
typhoid fever which occurred in Savanr ah in
an,l would be much oblige! if you wnuld
a ,1 me Py letting me know the number of eases
which came under your observation Sincerely
yours. It. J. Nunn.
I have to thank twenty-five of these
gentlemen who have had the courtesy to
favor me with replies, some of whom have
not seen any cases of typhoid, but
the total number reported is 126
cases, whioh would be an average
of 5.44 for each of the twenty-fire who re
ported. Allowing the same average for :
each one who did not honor mo with a re
ply (24), would give a total of 266 oases
of undisputed typhoid fever as bavlDg oc
curred here in 1892.
From the tenor of the letters received It
Is safe to say that the number of doubtful ,
cases would far exceod the figure just given, ,
say by double at least, and these again ;
would be comparatively few if compared I
with tbenumbero! casesof continued fever. !
Should any replies be hereafter received ;
which would materially alter the estimate 1 )
have made I will change the figures given j
so that they may then be equally as acou- j
rate as are the above.*
4. Were the causes atmospherio?
Answer: Under date of Jan. 25. 1893, |
Mr. P. H. Smyth, observer weather bureau
in this city, was kind enough to furnish me
with the maximum, minimum and mean
temperature and the rainfall for April,
May, June, July aud August for the past
seven years. From this table the following
summary has beeu computed:
AVERAGE TEMPERATURE.
1883 .76F j 1890 75F
1887 74 1391 76
1888 74 1892 76
1389 74 I
TOTAL RAINFALL IN INCHES.
1886 28. fl 1890 19.12
1887 22.16 i 1891 28 00
1888 16 56 1892 18.00
1889 26.15 !
From this It will be seen that the temper
ature has been higher aud lower, and the
rainfall greater and less than in 1892; con
sequently the fever of 1892 cannot be at
tributed to atmospherio conditions.
In view of the very popular Impression
that the temperature and rainfall might
have some connection with the prevalence
of tbe fever under consideration, this dis
cussion would have been incomplete with
out an analysis of the meteorological ele
ments which are so often referred to as
potent factors of disease.
5. Was the fever of local origin, or was
It general throughout the country !
This is a most important question, b ecause
upon the reply depends the preventability
of the disease in the future.
To determine this point I wrote to Bruns-
wick, Charleston, Augusta and Macon. Tbe
importance ot tbe replies from Brunswick
Induces me to attach copies of them for
your consideration, for although they make
no mention of typhoid fever, they show
conclusively that the same neglect of sani
tary laws whioh was seen in Savannah in
1892 was also practiced in Brunswick. They
show the same disregard of tbe public wel
fare; the same ignoring of public warning;
tbe same transgression of oity ordinances
by the very officers who were sworn to en
force them; and, stranger than all, they
show that like results followed these acts in
Brunswick as in Bavannab.
But these letters show something more,
whioh is of vast,imp irtance to our oitizens,
in that they point to the faot that the peo
ple are not entirely at the mercy of muni
cipal authorities iu sanitary matters. That
designing politicians or greedy money get
ters, blinded by avarice, cannot usurp the
place of science and use their power for
their own selfish ends regardless of the lives
of the people, but that the courts will, upon
application, grant a mandamus compelling
those in charge of the sanitation of a locality
to do their duty in this most important
particular.
From Charleston, Dec. 30, 1893, Dr. F.
Peyre Porcher writes: “We have been
singularly free from the prevalence of any
special disease in this city for the last year.”
Dr. Eugene Foster, p esidentof the board
of health of Augusta, writes Jan. 10, 1898:
“There were oases of continued malarial
fever, and of typhoid fever iu our oity dur
ing tbe summer and fall seasons, but not
more than is usual with us. I feel satisfied
that we had fewer of these oases in 1893
than for any year in the past five years. ”
Dr. Wiiliam F. Holt writing from Macou
Jan. 4, 1898, makes no mention of the exist
ence of typhoid fever iu that city during 1893.
From this evidence it will be seen that
typhoid fever ia not general all over the
country and the conclusion is Inevitable
that the oause or causes are local.
This leads up to the question sixth. In
what respect did the circumstanoes in 1893
differ from those of say, five previousyars?
Answer: In extensive street grading and
digging, aud spreading of thousands of tons
of oyster shells during the hot months from
May to September, and repairing stone
paved streets during the same period.
7. The next important Btepln this investi
gation is to Inquire if suoh work at suoh a
season of the year would be likely to propa
gate or originate typhoid fever.
To give to this inquiry an intelligent
answer it is necessary to review briefly the
theories of disease.
THR DERM THEORY OF DISEASE
presupposes the existence of germs as fungi,
bacteria, bacilli and cocci ot various kinds,
whioh, finding within the body suitable re
quirements for their reproduction, rapidly
multiply and produoe the phenomena which
wo call disease, each variety of mioroscopio
organism producing a different ailment.
It will thus be evident, that, according to
this theory, wbat we call disease is but the
outward manifestation of the development
of a orop of these mioroscopio bodies; iu
fact the germs of diseases are the analogues
of the seeds of a crop, and, os the latter will
not produoe a orop unless the climate and the
soil are suitable thereto, so with the former,
and therefore it follows that, to have a
disease, there must be the seed, the soil and
the surrounding*. One can no more grow a
orop of bacilli upon a clean plate than one
could grow a erop of wheat in the earns
situation, even supposing one to have the
seed to commence with. The keeping of
the soil in such condition that the seed 9 or
germs of disease wilt not germinate is oalled
sanitation.
DE NOVO THEORY.
It must not be supposed for a moment
that the germ theory is universally ac
cepted, although it is just now the most
fashionable, but there are those who believe
that diseases cau and do originate “denovo”
under suitable circumstanoes, and they can
point to certain experiments of Pasteur
himself, and of others, demonstrating the
truth of their position.
Pasteur takes a poisonous bacillus and, by
propar cultivation, be develops an Innocu
ous one; but then he oau take one of these
innocuous bacilli and, by cultivating it iu
suitable soil, he can redevelop its poisonous
properties.
Again, Dr. Dollinger, president of tho
Royal Microscopical Society, has taken a
bacillus whioh, growing vigorously at n
comparatively low temperature, is killed by
a slight rise of 5° or 10°, and by careful cul
tivation has so changed its nature that,
from beiug unable to endure a temperature
of 90“ Fahrenheit, he was able to keep it
alive and vigorous ot 180* Fahrenheit.
These experiments, it is claimed, demon
strate the immense power of adaptability
possessed by these low forms of microscopic
life, and they further show that the power
of reaction upon the animal economy, so as
to produce the phenomena whioh we call
disease, can be modified in either direction
of virulence or inuocnouiness, according to
surrounding circumstanoes.
The proper surroundings for the propaga
tion of disease germs, if the igerm theory is
*1 regret very much to be oompelled to
state that even at this late date I have not
received responses from ail the physicians,
seven having still failed to give me tbeir
returns I am therefore unable to vouch
for the absolute accuracy of the above esti
mate, but from what I can now see the ex
act number would not depart widely from
tbe calculation given.
THE MORNING NEWS: SUNDAY, MARCH 19, 1893—SIXTEEN PAGES.
adopted, or for tbe origination of disease, it
tie “de novo” theory is preferred, are pre
cisely the the same. viz.: Heat, moisture
and a suitable sell, which latter, In tbe case
of typhoid fever, is decaying animal matter.
No better culture bed for tbe propagation
of the germs of typhoid fever, or for its
origination could be desired than miles of
stree ts freshly shelled during the hottest
months, faithfully watered by city water
carts and heated by a midsummer sue.*
In Brunswick, according to tbe letters ap
pended, it is not thought that tbe shelling
of the streets did any harm, but there, be it
observed, tbe shelling was done in winter,
while in Savannah summer was selected for
that purpose.
A letter from Dr. 8. F. Dupon upon this
subject gives the result ol his experience
when digging out shells as far ba:k as 1848,
when he lost four of the hands engaged in
that work from fever, which he could trace
to no other oause and which disappeared
when the work was stopped.
From all this lam forced to the conclu
sion that the digging, grading and shelling
of the streets In midsummer seems proba ly
to have been conoerned In the origin, spread
or continuance of typhoid fever in .Savan
nah In 1892.
8. If the germ theory is adopted the
probable habitat of the germ must be
sought out.
In a city like Savannah, In whioh are
travelers from every part of this continent
and of Europe, the germs of disease ore not
likely to 1 e wanting. Falling on a paved
street they would tie carried under the pav
ing stones by the rains, where they would re
main until brought to the surface, when, It
they found suitable surroundings, they
would quickly multiply. Suoh was the case
last summer.
Or falling upon a sandy street, they
would be washed into tbe soil and would be
exposed during the process of such work as
pipe laying or street grading.
But then it must not be overlooked that,
aooordlng to the evidence of Dr. Dupon, the
germß of disease may bain ovstersholls pro
cured from localities In the immediate vi
oinity of the city, and the probabilities of
this being a source of contagion is vastly
increased when these shells are imported
from a locality where typhoid fever is com
mon.
So much for the immediate cau-e of the
fever of 1892, but other sources of contami
nation have been suggested, as, for exam
ple, the mixture of a small percentage of
river water with tbe artesian water, with
which the city is supplied.
To argue against the possibility of infec
tion from this soui oe would be absurd, but
it is safe to say that Us probability Is in
finitesimal.
The river water was used in the oity from
1853 until a few years ago, altogether for a
period of say thirty-five years, aud no suoh
result obtained during all that time, yet
during much of that time the Bource of sup
ply was much nearer to the city than it has
been In tbe last few years.
Of the other means of tbe propagation of
disease germs, suoh as privy vaults, dry
wells, Improper sewers, damp and dirty
lanes, unsanitary plumbing, want of house
drainage, tbe Bilbo and Ogeeohee canals,
tbe drinking of sewage by oows, tbe bath
ing of children in the water of sewers, the
raising of the level of tbe lanes above that
of tbe adjoining lots, the filthy cellars, cat
tle marts and scabies, tbs dirty houses of
some sections of the city, the crowded lodg
ing bouses, the uadrained lands around the
city and other.things of like character, I can
not now speak. They have all been brought
to tbe attention ot the authorities frequently
for years, but altnough all of these, and
other like conditions are elements of danger,
they do not seem hitherto to have be in pro
ductive of any positive results of a serious
character, but they may have been tbe steps
which led up to the fever of 1892; or, in
other words, prepared the soil for Its intro
duction.
What has been or will be tbe effect of
covering up the vast filter bed upon which
tbe oity stauds with impervious pavements,
aud of tbe destruction of tbe shade trees, it
it impossible to say; but the possibility of
these being sources of danger was pointed
out In my pamphlet, “A Medical History
of Savannah,” in 1887. +
Here 1 may be permitted to suggest that
the method of cleaning the asphalt pave
ment by scraping only Is, In my opinion,
dangerous to health, as it leaves germs of
disease and irritating matter to be blown
into the air aud inhaled by the people.
These pavements should be thoroughly and
frequently washed.
This is a suitable occasion to draw atten
tion to the extraordinary sanitary advan
tages conferred upon this oity by the Im
mense sand bed upon which it is built. For
more than a century the whole of the con
tents of the vaults were burled in the sand
of the streets, and during all this
time the people drank drainage water
from wells sunk In the same soil
without knowiDg anything of typhoid
fever, scarlet fever, diphtheria (see
letter of Dr. Morel in ’ ‘Medical History
of Savannah”). 8o thoroughly was the
magnificent work of this grand filter done,
that although the presence of the salts com
ing from the vaults and dry wells (which
were also permitted) was plainly demon
strable in the drinking water, yet the dis
ease genus were always exoluded. In vari
ous ways, we in these later days, are shut
ting off this great filter aud interfering
with its usefulness, and the results do not
seem to be to our advantage.
From this careful analysis of the causes
and conditions whioh preceded the out
break of typhoid fever In 1892, I am satis
fied that it was direotly due to a neglect of
proper sanitary precaution and a disregard
of those iooal traditions touching summer
street work, which now amount aunoat to
scientific certainties, but Indirectly to a
mass of other causes which have been ac
cumulating for years.
To prevent the recurrence of an epidemic
of like character would, I am convinced, be
no ditfioult task in a city so byglenioally
favored as is Savannah,and the same meas
ures would undoubtedly have the effect of
freeing the community from typho-malarial
fever, from diphtheria, scarlet fever and
other filth diseases. The same fearlessness
and energy displayed by the executive in
*The following streets haye been paved
with oyster shells during 1892: Jefferson
street, from Charlton to Henry street,
83,423 bushels; length 8,750 feet by 27 feet
roadway.
Jones street, from Tattnall to East Broad
street, 116,334 bushels; leugth 3,850 feet by
40 feet road wav.
Bolton street, from East Broad to West
Broad street, 90,684 busheis: length 3,220
feet by 30 feet roadway.
Summarizing tbe anove figures, which
are official, it will be seen that there were
290,440 bushels of shells, some of which were
! brought from Baltimore where typhoid
[ fever is prevalent, spread over a surface of
over 7Uj acres (7.61) duriug 1892.
+The passage referred to reads as follows
(R. J- N.l:
“There will probably, during the coming
generation, be ample opportunity to judge
as to what extant the immunity from dis
ease enjoyed by Savannah has been the re
sult of her porous soil, wide, unpaved streets,
profuse forest growth and numerous squares.
“For in the march of improvemenf.lt is in
contemplation to pave the streets, and pav
iug tbe streets has, so far, oarried with it
the total, unsparing, destruction of the
shade trees.
“Then, too, some of the citizens loudly de
nounce what they are pleased to call the
waste of ground given up t > wide streets
and open squares, aud would willingly see
buildings locate! in the squares and soma of
the streets closed up and appropriated to
the same purpose; in faot, so great has been
tbe pressure brought to bear that the mu
nicipal authorities. In laying out an exten
sion of the o:ty, felt forced to abandon the
old plan, which has proved so good, and
have adopted a more compact design.
“Whether or not this is best tbe irrefuta
ble loglo of evonts must determine: the
facts of tbe future will be the basis of the
verdict; but, unfortunately, should it be
on the wrong side, there will then be no
redress, it will be too late to retrace the
Steps taken or undo the injury inflicted.
“How much wiser would It have been to
have adhered to the plan whioh has already
borne the test of time and been found to bo
all that could be desired.”
stamping out small-pox after it had been
P-rmlttea to spread, will. If turned In this
direction, show equally as satisfactory re
sults.
Systematize the health department, evoke
the aid and advice of the most experienced,
professional sanitarians; inaugurate a
system of house drainage with
closed drains to the point of discharge,*
which should be as tar from the oity as pos
sible; fill up all try wells;* abolish privy
vaults, and eubs'.ituie either water cloaeta
or ths pail system;s restore and maintain
the relative levels of the lots and the lanes;
inspect plumbing; keep the sewer traps
clean; suppress ths canal nuisanoe; inspect
all cellars, and the houses of the lower
classes; drain all wet and sobby lands; iso
late ca*os of infectious diseases, and keep
physicians informed of the location and
character of all occurring in the city. All
of Ibis has been said time and again by
others duriug the uast decade or two, but
without effect.
As ignorance is no doubt the principal
came of sanitary mistakes, educate the
people: let ths principles of sanitation be
taught in the public sohoois and encourage
private sanitary associations. When every
person is a skilled sanita ian, and appreci
ates the danger, the anxiety aud the suffer
ing resulting from sanitary sine, then there
will be less use for constant watenfuioess
on the part of the authorities. This will
be in the long run a vast saving to tbe oity.
A word touching the health of the com
ing summer (189.7.
Those who have made a study of the
period of a cholera epidemic, put it at three
years from tbe time of its appearance in
the east to ita ultimate disappearance. The
epidemio whioh has touched our shores, be
gan in 1891 and has expended the violence
of its second year in Europe, having barely
shown Itself in America, but having
reached this side of the Atlantic, and
having another year to run, it is safe to
say that it is exceedingly probable that it
will spread in America in 1893. With
measures to be adopted to keep out cholera,
this letter has nothing to do, but I desire to
say that the line of sanitation just indicated,
thoroughly and intelligently carried out,
while stamping out other tilth diseases, will
also place the oity in the best possible con
dition to prevent the spread of cholera
within its limits.
The want of a properly organized health
department ae a portion of the city gov
ernment has been the subject of so muoh
comment on the part of the citizens that aa
explanation of tho situation for the benefit
of tills generation may not be misplaced,
although it might be fairly argued that in
this respect the city is in advance of the
Btate.
Up to the 50s the necessity for a health
department did not exist, so well did the
Immense filter bed just alluded to do its
work. At the time alluded to three oitizens
in each ward were appointed by the mayor
to see that the yards were kept clean,
and that was all there was to do.
Nature did the rust. Closets were all on
the lanes, forty or more feet from the
houses. Hewers there were none, conse
quently there was no sewer gas laden with
a dozen or more varieties of disease germs.
There were no water wonts, and honoe
there was no plumbing to be defect
ive nor water mains to lay. The streets
were not yet cbveroi up with impervious
coating of different kinds, and as a conse
quence there was no pavements to repair.
Tbe legislature had not yet given private
corporations the right to dig up the streets
when and where they desired, nor had It
then begun to cut up the streets and disposo
of them to private oitizens or societies, and
the importance aud value of tbe shade
trees was appreciated, aud they were pre
served and cultivate i.
Savannah wai a village then compara
tively, and may have had what would now
be called primitive village ways, but they
suited admirably to keep out filth diseases.
Gradually, unoonsoiously this has been
changed. Water works came, bringing the
water closets into the houses with defective
plumbing. Sewers came with their at
tendant sewer gas and filth diseases.
Impervious pavements came, shutting
off tbe filter. The odorless excavating ma
chine came with oemented vaults, again
stopping filtration aud oouraug disease by
increasing the ohanoee of fermentation.
Tbe shade trees were cut down and the
hot sun allowed full play, and so on. The
band of improvement is upon us, aud the
modern city with its typhoid fever, scarlet
fever, diphtheria, membranous croup and
other filth diseases is here before we know
it, and, as a consequence, the organization
of the health department has not kept
pace with the increasing requirements of
tbe city.
The experienoeof 1593 will perhaps change
all this. Filth diseases have invaded the
houses of a class of oitizens who will make
themselves heard when they themselves are
touohed, but who have sat idly by for years
nor heeded the naming of the owning evil
until now it is beside them at tbeir own
hearths and firesides. Cassandra prohesied,
but none gave ear to her propheoy.
The fever of 1892 will surely eventuate in
good to the people. Such a result is not
uuusual; in faot, it is always so. It is the
law of compensation.
But the history of the outbreak of filth
diseases in 1892 has a still deeper lesson to
teach, which, if properly learned, may not
be too costly, even though it be at the ex
pense of many valuable citizens saorifloed
to typhoid fever, of time lost, of suffering
endured and of expense incurred by those
who recovered, of numbersof Innocent chil
dren made victims to scarlet fever, diph
theria and other filth diseases, of terrified
mothers, and families driven from their
homes, and business lost by rumors of dis
ease within our walls, which Is, that the
persistent negligence of sanitation on the
part of the authorities is gradually intensi
fying the Tiruie noe of filth diseases which
they tolerate, and is preparing tbe people
fora repetition of ihe experiences of 1876.
♦The bottom of the new Casey canal will
present an exceptionally cheap aud prac
ticable bed upou which to lay a pipe
through which the house drainage may
reach salt water six miles from the city,and
at the point of exit it may bo mixed with
all the fresh water coming from the drain
age of Ihe southeastern Bwamps, in which
It would be lost, so great would be the dilu
tion.
1 had hoped to he able to give the esti
mates of the cost of this and other routes,
besides other interesting data, but I have
been unable to obtain them in time for this
publication.
♦The number of dry wells is about 1,300
(1891], In October and November, 1891 .notices
were served on the owners of the properties
on which the dry wells exist and executions
were issued so that these dry well , could be
filled up before the summer of 1892. but in !
or about Deoemher, 1891, a petition from
the owners was presented to oouncll raking
that the ordinanoo be not enforced, and
council thereupon ordered that the ordl- j
nance should not be euforoed, and therefore
the drv wells remain. (Condensed from a
private letter which I am authorized to use.
R. J. N.) The records of the city show that
during tne last five years, 1889 to 1898 in
clusive, there ha? been appropriated for
house drainage 633,000, to which may be
added 35.000 worth of sower pipe on hand
In 1889. The municipal reports do not show
that any of this appropriation has been
used in tbe construction of the work for
which it was Intended.
tThat the pubiio may fully appreciate tbe
enormity of this danger 1 bug to su mit the
following calculation and comparison:
The number of vaults in tbe city proper is
about 4,400, and tbe average size is fully 5
feet long by 4 feet wide, giving an area of
twenty square feet. This will give a total
vault surface of 88,000 square feat.
Au acre contains 43,560 square feet, so
that the area of vault surface exposed to
aud coutaml: atiug the air of Savannah Is
over two acres, whioh again is about
equal in extent to one of our squares.
To this should be adaed another quarter
of no acre for those vaults in tle immediate
vicinity of the oity, aud which, while not
within its limits, ure contributing their
share of poisonous effluvia to vitiate the
atmosphere and to breed or Invite disease.
Surely this subjeot is important enough
to provoke serious dismission and a rapid
abatement of such a dangerous nuisanoe.
| Who are they who will then remap- to face
tie horrors of an epidemic? Who will then
restore to Savannah her lost commerce?
The experience of 1892 is but the distant
rumbling of tbe thunder warning us of the
' approaching storm. The "little cloud lize
a man's haud” is to be seen on the horizon.
I To the inexperienced these signs are mean
ingless, but to the educated seaman they
are warnings to trim bis sails to meet the
| coming storm.
j Typhoid fever, scarlet fever and diph
theria are but the skiroiish line of tbe ad
vancing army of flith diseases whole ad
vances have tieen coui ted and encouraged,
rather than opposed and repelled. By all
means let the responsibility for the death
and disaster which will accompany ita ad
vent be placed where it belongß. ft cannot
be laid to the charge of the medical profes
sion, whose warnings have always been un
heeded ; and I pray the present city admin
istration to so act that tbe blame may not
be laid at its door. Your obedient servant,
R. J. Nunn, M. D.
This letter has been submitted to Dr. J.
B. Read for his criticism. He, being a
native of this city, the oldest physician in
aotive practice, with a local medical expe
rience of nearly fifty yeais, is tbe test
qualified to express an opinion as to the sci
entific and practical value of the views just
given. Here is his reply:
Savannah, Ga , Jan. 30, 1593.
Dr. R. J. Sunn:
My Dear Doctor— l agree with you in all
that you have written la your statement in re
gard to the origin and increase of the typhoid
diseases that have prevailed iu this city disking
the last summer, and tLat still exist at his
time.
I hope the candid statement you have made
of three causes, and the method of avoiding
such diseases lor the future. wi!l be carefully
studied by the citizens ot savannah. Respect
fully. J. B. Read, M. D.
Brunswick. Ga.. Dec. 29, 1893.
Dr. R. J. .Vunn, Savannah. Ga.:
Dear Doctor -t must beg your indulgence for
my procrastination in responding to your letter
of the 15th inst.. but. In fact, my professional
duties have so absorbed my entire time, I Lave
not been able to make ou: a tabulated state
ment of the malignant fever prevailing here two
summers previous from my case book, and in
l eu of same wdl submit in this communication
the factors causing these summer fevers to as
sume such a fatal type from my observation
and experience.
We have, in common with other cities and
towns, the mild type of remittent fevers, run
ing their course, in many cases, without serious
complications, aud ending with convalescence
from fourteen to twenty-one and thirty days.
During tbe summer of 1890 there was an ex
cessive rainfall for two months (July and Au
gust), saturating the soil, and causing a rapid
and vigorous growth ot vegetation. This condi
tion was succeeded in September by a very
warm, dry period, causing decaying vegetable
matter to disseminate malaria; producing dis
tinct types of Intermittent fever.
Our municipal government very ignorantly
and unwisely permitted extensive upturning of
‘virgin soil ’ in Windsor park (the property of a
private company), “cooming” their real estate
interests here. The result of such excavations
here was cases of hemorrhagic and congestive
fevers, terminating fatally in my practice,
dearly and undoubtedly traced to this upturn
ing of saturated soil to the hot sun, eliminating
all its paludal causes.
This observation of cause and eff'-ct as to dis
turbing the soil during the hosted term was
continued by me in 1891 and tho present year
with the same unvarying results, clearly demon
strating to my mind tho great danger or’ ex
tensive and injudicious disturbing of soil in our
southern climate during the neated summer
months (May to Novemoer). Our city govern
ment, in their zeal for public improvements
(not seeing anything deleterious in disturbing
pure sand) ignored the ordinance governing the
turning of soil during the summer months, and
the board of health found it necessary to get
out a restraining order from the court forbid
ding the city from further excavation, etc., and
since that date our city iias been remarkably
exempt from severe forms of fever. In con
clusion I wish to say, in my close and personal
observation of our summer fevers that they
are intensified by extensive soil excavation and
dimisned by its cessation with as marked cer
tainty as the fall of a high temperature from
an untipyretic.
As to shelling streets, no ill effect, has been
experienced from that source, as all of the ex
tensive boulevards were done in winter months
I might add there was much cutting away of
chaparral and underbrush on tho peninsula
point of our suburbs in the summer of 1890.
This was allowed to remain on the ground for
some time before burning, and I observed cases
of intermittent fever about that period which
had not prevailed before.
This was in May, 1890, and the excavation or
grading of TVindsor park was continued through
the entire summer. The severe types of fever
occurred in August and September In locality
adjacent to park.
Not being a statistician, I regret my inability
to furnish you histories of these cases, which
would require much time to run through my
books, huut them out and write them up.
I hope these crude details may be of service
to you. I remain, very truly and sincerely,
Hugh Burford.
Office Health Offices. I
Brunswick. Ga., Doc, 17. 1892. (
Dr. R. J. iYunn. 119 York St., Savannah . Ga. :
My Dear Doctor —Yours of the 15th inst. to
hand this morning, and the contents noted.
I ll endeavor to answer your questions in order
in which you ask them, aud as fully as possible.
1, The fevers were of a distinctive form of
congestive malaria. The upturning of soil dur
ing the summer, with very heavy rains, I think
was the cause. There were no active steps
taken in the matter. Fortunately very shortly
after we had cold weather, which prevented, I
think, a great many cases.
The shelling of streets is not detrimental to
the pubiio health. I think the danger is in pre
paring and grading of the streets, which neces
sarily requires an immense area of new soil ex
posed, whioh gives off sufficient malaria to en
danger the public health.
1 say the shells themselves do not, I think,
occasion any trouble provided, of course, they
contain no organic matter. Most of ihe shell
that we have used have beeu dead shell.
During May and June of this year we had
several severe cases of malarial fever of a re
mittent form, and in some instances the bowels
would become involved, resembling typhoid
fever
All during the winter, spring and far into the
summer the city authorities continued to up
turn the soil, directly against an ordinance that
they themselves had made, and aeainst the
earnest recommendation of the board of health
and my writ'on opinion against it.
Finally, with the assistance of the board of
health, I succeeded in having a writ, or an in
junction. restraining them from further up
turning of the soil until the time set apart in
the ordinance allowed them so to do.
Almost immediately after this ceased the
forms of fever beoame milder and fewer, yield
ing more readily to treatment.
In my opinion, the upturning of soil in any
southern oity, especially during the spring and
summer, is one of the most potent causes of so
much malarial feTers.
I trust that I have furnished you the informa
tion that you desiro and will esteem it a privi
lege to serve you in anv manner that I can.
With great respect, I remain your obedient
servant, J. A. Dunwoody.
-~r - - --- 77T7 - —-'
: yfAST COAST L,Nr:
Nots3|No. +BI No. *' No.sool No. *23 No. ’ll No. *27 6TATIONS. |No *7o| No. *lB | No. *BO |N0.5600(N0. *7*No. *67iNo*3j
I 8:10 p 3:13 p 8:80 p 12:40 p 3:20 a Lv....Jack*onville Ar 1 0:40 a 1:25 p 8:83 p 10:30 a 6:48 p..
1 8:80 p 4:14 p. 3:60 p, 1:50 p 10:24 uAr I ILv 8:16 • 13:15 p- 8:25 p 8:50 a 4:25 p ■••••-
1:06 p. 9:35 a 2;00 p 10:30 aLv f " St Au S u,tme -■ iAr 12:!0p 6:80 p 18:45*5:45 0
8:05 p 10:40 3:05 p 11:28 aLv f • ■*“ t •lAr I 11:80aj 4:80 p 4^ p
8:85 pll 00* See No.l Sea N0.57 Ar [ p „... jLv i Sm No.sß|See No.Bo 11:84 a-4:P
■ 5:00 p 1:18 p Daytona 8:30a 1 2:58 p
• 7:O0 1 2:58 p Titusville 7:40 a 12:52
1 6:00 p 3:45 pAr ..Rockledge Lv 8:40a 11:53a ■ I
' TRAINS BETWEEN EAST PALATKA AND P ABATE A.
No*63 No. *6l;No. 453 No. *s7| No *sl I o. *56 No. *4o' No. *4? No. *56 No. *SB No. *OO No tß4|
4:48 p 3:10 p 2:05 p j 11:48a 10:40*1 l(T7o"a 1,r.... Kaat f’alatka ....Ar l 11:20a 11:45a 18:30 p 2:50 p 4:20 pi 440 pj
5:05 p 3:30 pi 2:26 p 1 12:06 p; 11:00 s| 10:30 aAr Palatka Lv I 11:00 *| 11:25a 12:10 p 2:30 p 4:00 pi 4:30 Pi
LOCAL TRAINS BETWEEN EAST PALATKA AND SAN MATEO. -
| No. +4l | No. *45 7 No. +4B j | No. +4O No. *42 |
| 9:15 a I
I 9:30 a | 5:65 p | 12:30 p| San Mateo I 9:45a l:00p|
•Dally Tbnraday and Saturday VMonday. Wednesday and Friday. + Dally except Sunday. , .
The ateamer Sweeney leavea Rockledge for Melbourne and intermediate points dally on arrival of train No. 11. Returning, arrive* Rock.eoge
in time to connect with train 68.
W. L. CRAWFORD, General Superintendent. JOSEPH C RICHARDSON, General Paasenger Agent.
RAILROAD’S.
Florida Central and Peninsular Rail man
FLORIDA TRUNK LIME-SHORT LIKE TO TAMPA-TL’E CARD IN EFKKfM-
GOING BOOTH—REAP DOWtL QOiNG MoRTH-REAt
| I Daily CALLAHAN i Daily | rn^T]
Cracker Daily Is the Point to Change S xc ® Dt Daily
; Pr. Sund<ty ' Going South. Sunday.
402 am 1:46 pm 5:66 are Lv... .Savannah Ar 8:82 pia 12 00 n'n -w
.922 am 7:11 pm 11:40 am Lv ..Callahan Ar pm ?150 m ‘
913 am 8:66 pm 11:30am Lv Jacksonville Ar 2:35 pm 5:30 am! 436 7^
|tl2oam 12:33 n’t 2:41 pm Ar Hawthorne .Lv 11:44 am 2-s<<imT*
1* >8 pm 6:44 pm Ar Silver Springs Lv J™ ? S
102 pm S:l3am 3:57 pm Ar Ocala Lv 10:12 am 1-12 am I2 At
15t pm 3:26 am 4:6opm Ar Wildwood .Lv D:loam 1130nmiiil? m
250 pm 4:55am 5:11 pm Ar Laoooohee ... Lv 804 am ’O“9 nm 10 * m
806 pm 6:15 am f:OT pm Ar... .Dade City... .Lv 7am ’fl'm E® jo * m
367 pm 5:30 am 7:00 Ar . Plant City .Lv i-v, ™
445 pm 7:50 am 7:50 Ar.... Tampa. Lv S:3O Im 7:pm 9mJS
tOOOpm 4:ooam s:oopm Lv . Wildwood. Ar ♦ 9:oßam Tl-lOnm
52 55 pm- 5:25 am 5:55 pm Ar Tavares Lv j sqg y. am
53 50 pm 7:2Bam 6:SopmAr Apopka Lv j 7 ; 28 am BS6 pm 950 tm
;4 26 pm 8:15 am 7:25 pm Ar Orlando Lv f 7-nn m 7:45 pm 915 £jjj
O .6:4oam) 6:55pm Lv....Lacoochee ..Ar B-in n.0.~
as* 7:t>Haml 9:10 pm Ar. Tarpon Springs.Lv 7| j>™ ™
nj I? 3 *; £.16 am! 9-25 pm Ar . Sutherland Lv . 7'090m ?
! K 8=32 am, 1 50:)pm Ar.. St. Petersburg. Lv """"i: 6*5 ££ £
2 ® *6:27 am *5:06 pm Ar ..Dunnellon Lv *8:50 am *4 35 pm icL
55 *6:36 pm Ar... Homosassa. . .Lv 7;10 am *u3 a
m -1 *
j Ar . .Cedar Key Lv 7.50 am!s 6:45 nm S
SAVANNAH AND FERNANDINA. :
CalJahn h (ha transfer statioa for all poiuts ia Sants
Florid.* reached fcj the F. C. 4 P. and it) craaeeiioai.
1 8:00 am! 6:20 amjLv . ..Savannah.. Ari 8:82pm! 12:35 n’tl T~
I ll’.oaml 4:14 pm|Ai Fernandloa. . Lv| 7:soam, 4:30
♦Daily except SuLday. tMeals. tSundars only. ~ ~ '
Solid trains Callahan to Tampa and Orlando. Close connection at Tampa with So n. D „
for Port Tampa. Key West and Havana. Close connection at Owensboro with So Fia
Luke.und and Bartow. Close connection at Tavares with J., T. and KW Rv for for
Titusville. Pullman Buffet sleeping cars on Dlght trains. Through short line JacksonvilleS 01 *
Orleans, Jacksonville to Thomaavllie, Montgomery and Cineinnati. Tickets soldTand Vew
checkeii through to all points in the United States, Canada and Mexico. aendfo r *h2s?f?f**S
Florida published, and for any information desired, to rw ®“
D. E. MAXWELL. U.M A. O. MACDONELL, G, P, A., Jacksonville
J A.CKSONVILLE, TAMPA and KEY WEST R’YCO
MASON YOUNG, Receiver.
timk tablb in bffkct jPTun. S. usm.
SOUTH. | __ NORTH. ~
No. 15. I No. 23. ; No. 27. No. 71. j STATIONS. Ne. 14. No. 78 No. 86 \\T-y,
Daily, j Daliv. j Daily. Ex. Sun.| Dolly. Ex. Sun. Daily. bail,
815 pm 12 30pm 955 am 8 25am Ly... Jacksonville... Ar 633 am 1 35pm 6 25pm TtiLZ
9 34pm 1 2.lpm 1C 41am 9 l.'am ArUreenCoreHpringsLv 5 20am 12 20pm 4 39pm na,?™
io44pm 2 09pm: 1121 am 10 10am Ar.. ..Palatka ... .Lv 4 2Sam 11 Slam 400nui 5
12 U3am 8 12pm 1211 pm 11 2.5 am Ar Seville I.v Bf3am 9 48ain 315 pm i
1241amj 340 pm l 12 03pm Ar. .DeLeon Springs. Lv 2 23am 910 am... ■>,?!?
i 325 pm 1150 am 11 50am Lv 1 • DeLand •f Ar 9 10am 300 pm 2
120 am 406 pm! .. .12 82pm Ar.. Orange City June. Lv 1 490 m 8 35am 2 52pU[
.. - j 6 10pm! 8 OOpm 3 00pm!Ar Titusville Lv 6 80am !2 25pm 1226 pin
2 05am; 4 40pm 132 pm 1 20pm Ar Sanford Lv 116 am 7 55am 158 pm T7<L*
| 345 pm tl24opm 12 40pn>iAr....Hawthorne La 9 E3am 2 34pm 23jnm
8 30pm t!2 30pm 12 30pm Lv 1’ ’ Gainesville.. f Ar , 0 osam 2 33pm a X
§ 9 00pm t 5 35pm 5 35pm Ar.... Pemberton .... Lv 9 10am ’l£m
§ 9 50pm t 6 80pm 6 30pm Ar ... Brooksville....Lv g 15am 6 15 m
8 45am 5 43pm 2 25pm 2 25pm Ar Orlando Lv 11 50pm 6 40am 1* 50pm 12 So D n
4 30am 6 12pm 252Dm 2 52pm Ar Kissimmee —Lv 11 OOpra 5 50am 12 20pro ‘2SOtim
7 45am 8 55pm 4 66pm 455 pm Ar Tampa Lv 8 00pm 10 25am 1(1 26ar
8 25am 9 40pm 6 35pm 5 35pui|Ar ..Port Tampa. ...Lv 7 20pm, 9-iOam !)atß
* 4 40pm 4 40pm Lv Bartow Lv 5 35pm |lO 50am 1050*^
+ 7 20pm 7 20pm Ar..... Arcadia. Lv jt 8 10am +8 19am
tDally exoept Sunday! — jj3unday only. ' ■
Traius 27 and 60 carry through Pullman parlor cars between Jacksonville and Titusville Punta
Gordo and Tampa.
Trains 23 and 78 carry through Pullman buffet sleeping oars between Louisville and Titusville.
Trains 23 ard 14 oarry through Pullman Buffet Sleepers daily between New York and Pert
Tarn pa, connecting at Port Tampa Mondays, Thursdays and Saturdays for Kev West and Havsaa
Traius 15 and i4 carry through Pullman sleeping cars between Cincinnati and Tampa.
Train No. 15 carries through Pullman sleeping car New York to Tampa. This sleapw is re
turned on No. 78, forming through service Orlando to New York.
From Gainesville, Ocala. Leesburg, etc.. connection is made by train No. 27 via Pemberton for
Dade City, lakeland, Bartow, Tampa, and Intermediate points
Steamers leave Punta Gorda daily, except Sunday, at 7 a. m. for St. James Oity, Punta iUa
and Fort Myers.
INDIAN RIVER STEAMKHB are appointed to perform the following service, south-bound:
Leave Titusville daily except Sunday at 3:20 p m for Melbourne, stopping at Cocoa and Rook
ledge (6:00 p in), and at principal landings south of Roekledge. The steamer leavin': Titusville
MONDAY. TUESDAY, THURSDAY and FRIDAY will run THROUGH TO JUPITER; due at
Jupiter 2:00 p m following day.
Ixtave Titusville daily except Sunday at 5:30 a m for Roekledge, Melbourne and Intermediate
landings; due Melbourne 11:40 a m.
Leave Titusville Mondays. Tuesdays, Thursdays and Fridays at 6:30 p m for Roekledge, Mel
bourne and Intermediate landings.
J. N. STROBHAR, Gen. Pass. Agent, Jacksonville, Fla.
W. B. DENHAM, Aotin* General Superintendent.
CANDIES
LIVINGSTON’S PHARMACY, Soie Agent
/ffkiCrs
-3T X 7ST B3 CATTDIES.
fi E3 V 3 iffil il ii Tbe original and only TENNEY, who established the reputation aid
I’fiEl i ■IB Ri bußineßß of the manufacture of TENNEY’S CANDIES, is A. Ilf. fSUr
|Jj | | V* NEY. None genuine unless countersigned with tho initials A. M. Tel-
Fresh Goods Every Steamer.,
&EB K?’ iT* 8 <5 1 KED letter DAY ON THURSDAYS.
r R*. Mb# B L f GOODS SOLD AT COST.
LIVINGSTON’S PHARMACY,
TELEPHONE 293. CONGRESS AND BULL.
/Pv I JOHN ROURKE & SON,^S
1 jSStfewtSk NOVELTY IRON WORKS, '-ifMw
msss2ssHH&iron and brass founders and
MACHINISTS, BLACKSMITHS AND BOILERMAKERS.
THE SAMSON SUGAR MILLS AND PANS.
DEALERS IN
STEAM ENGINES, INJECTORS, STEAM AND WATER FITTINGS
CORRESPONDENCE SOLICITED—ESTIMATES GIVEN.
Nos. S. 4 and 0 Bay and 1,3. 3, 4,, n and 0 River Streets.
SAV AIN NAH Gr A. _
J. St. A. & I. R. R’y
Time Table in Effect, February 6, 1893.
/Callahan isthe transferstation forall points inSoutht
Florida reached bythe F.C &P and its connections