PERSONAL HYGIENE AS TO FLUIDS DRANK.

BY GEORGE M. OCKFORD, M.D.

Fluids take such an important part in the operations of the human body that the hygienic consideration of those we drink demands our earnest attention. Their use is imperatively demanded in the alimentation of the constantly breaking down tissues, and to supply the waste occasioned by the exhalations of the different organs. If we consider the composition of the body as being twothirds water, and that the lungs, kidneys and skin are constantly throwing off the water already in the system, so that there is an annual loss of about 2,000 pounds, we can arrive at some idea of the amount required to be taken into the body, for, in order to maintain a state of health, it is necessary that the compensation be equal to the loss. To supply this demand, we have the oxidation of hydrogen in the system, that contained in food and the fluids drank. By far the greater portion comes from the latter source.

Of all the drinks used, water stands pre-eminent. It is the most universally used, and a drink that, used under proper restrictions, is healthful and devoid of injury. It can usually be tolerated in health and disease, and those who cannot drink water form a very small minority of the human race. Persons with healthy stomachs and nerves never have any trouble from the proper use of good water. The amount required by different individuals varies, habit and occupation modifying the thirst as well as seasons and diseased states. The use of ice water is frequently attended with injurious effects. It should be drank with great care by persons in an overheated condition, as the careless drinking of a large quantity of iced water or other excessively cold drinks is apt to be followed by severe gastric derangement or injury to the nervous system. Insanity sometimes follows as a sequence, the records of our asylums furnishing numerous instances wherein the careless use of ice water

was the exciting cause of the seizure. Modern physiologists agree that it is proper to drink freely during meals, and as often as thirst requires. The water we drink should be comparatively pure as well as palatable. We say comparatively pure, because pure, distilled water does not answer the purposes of a beverage. It is not palatable, and will not quench thirst. A moderate amount of earthy salts in drinking water is beneficial. Dirty water is not necessarily hurtful, or at least its use is not always attended with obvious bad results. The boatmen on the Mississippi drink the dirty water of that river freely with impunity. The presence of organic matter in water, renders the use of it dangerous. This kind of water is unfit for drinking purposes and should always be avoided. We can do this much better if we understand some of the means of pollution. Our water supply is derived from springs, wells, lakes, rivers or gathering grounds. All these sources of supply are liable to pollution. As a rule, springs and deep wells furnish much better water than shallow wells and are less liable to become impure. The Rivers Pollution Commissioners, of England, in their sixth report said that, "preference should always be given to spring and deep well water for purely domestic supply," and that "such waters are of inestimable value to communities." The quality, of course, varies according to the geological formation of the district where situated. The most efficient water bearing strata are: 1st. Chalk. 2d. Oolite (limestone). 3d. Green sand (containing silicate of iron). 4th. Hastings sand. 5th. New red and conglomerate sandstone. Springs and deep wells become polluted from surface drainage and through fissures in the rock in which located. Surface wells are either polluted or invariably liable to pollution. This is especially true of crowded localities. In such places shallow or surface wells are never safe, and the use of the water is attended with danger. The ground becomes saturated with filth, and its porous nature allows the sewage and decaying animal matters to soak into the wells and mingle with the water. Adjacent cesspools and privies may allow their contents to reach the water in the same manner, and from drains ramifying in all directions a similar result is obtained.

The water from rivers and lakes is generally furnished through

public water supplies. Water so furnished is liable to pollution at its source from defective storage, defective main pipes and defective house plumbing. At its source, the most common pollution is from the sewage of cities and towns, and any water supply containing sewage should be viewed with suspicion. Sewage is such a combination of filthy things that the mere mention of its presence in water should be sufficient to prevent its being used. The first report of the Rivers Pollution Commissioners, of England, described it. This report says sewage is "a very complex liquid; a large proportion of its offensive matters is, of course, human excrement discharged from water closets and privies, and also urine. But mixed with this is water from kitchens, containing vegetable, animal and other refuse; and that from wash houses, containing soap and the animal matters from soiled linen. There is also the drainage from stables and cow houses, and that from slaughter houses, containing animal and vegetable offal. In cases where cesspools and privies are used instead of water closets, or these are not connected with the sewers, there is still a larger proportion of human refuse in the form of chamber slops and urine. In fact, sewage cannot be looked upon as solely composed of human excrement diluted with water, but as water diluted with a vast variety of matters, some held in suspense, some in solution."

This description gives the general constituents of sewage. Of course, it varies in composition, but an average sample will give in 100,000 parts, 72.20 parts of solids in solution, and 44.69 parts in suspension. Those parts held in supension may settle, but the portion in solution are thoroughly incorporated with the water and will, under no circumstances, settle. These solids in solution are the most poisonous, being composed largely of organic carbon, organic nitrogen, chlorine and ammonia. These substances are deadly poisons and their presence in drinking water, to any great extent, renders it totally unfit for use. Large bodies of water lessen the amount of pollution in a given quantity of water, but even in them there is danger. The quantity of organic matters found in the public water supplies of cities on our great lakes shows that even procuring the water at a point several miles from the outlets of sewers, does not ensure uncontaminated water. Foul reservoirs

are a source of pollution, and where leaky mains are in close proximity to sewers, intercurrents may be set up, carrying the contents of the sewers directly into the water. In the houses supplied from public water works, the plumbing may be imperfect, or the presence of a reservoir with an overflow pipe leading direct to the sewer, may allow pollution by the sewer gases.

Rain water is healthy and palatable in its pure state. But it is only in exceptional cases that it can be procured in anything like a pure condition. The atmosphere is loaded with organic matter, and the roofs from which the water is collected are usually so dirty, that rain water is generally far less pure than the water procured from springs or deep wells.

The effects of drinking impure water differ according to the polluting material. That it is a potent cause of disease has long been recognized, but it is only within a comparative short time that minute investigation has succeeded in demonstrating the terrible effects upon the health of those who drink it. An excess of mineral substances may produce dyspepsia, visceral obstruction and constipation. Goitre has frequently been observed to follow the use of water containing magnesian limestone. Gravel and calculous disease has also been stated to bear a close relation to the amount of lime and magnesian salts contained in the drinking water of certain parts of the country. Water containing iron is apt to cause headache and general malaise. Lead poisoning is especially liable to occur if lead pipes are used for the conduction of soft water, and may ensue from drinking water containing as little as one-tenth of a grain of lead to the gallon. The worst pollution comes from the presence of animal organic matter; whether it has percolated into wells from cesspools or from soil pollution, or has been discharged from sewers into any source of supply, the presence of putrescent animal matter converts drinking water into a deadly poison, dangerous to health and life. It may be possible, under certain favorable circumstances, that these impurities might be rendered harmless by oxidation, yet so great is the danger from this form of contaminated water, that sound hygiene would contra-indicate its use for drinking. When discharges from persons suffering from specific diseases are mingled with these matters, the danger is much

greater. The principal diseases known to arise from drinking water containing animal organic matter, are diarrhoea and dysentery from non-specific; and cholera and enteric fever from specific pollution.

John Simon, the eminent sanitarian, says, "It is a It is a practical certainty in the districts which suffer high diarrhoeal death-rates, the population either breathes or drinks a large amount of putrefying animal refuse." The history of cholera epidemics, reports made to the English Parliament, the testimony taken before the Royal Commission on Water Supply in 1869, all connect the disease with impure water, and tend to show that cholera comes most often and stays the longest in the districts in which the inhabitants used polluted water. It is conceded on all hands that impure water is the most frequent promotive causation of this disease.

Typhoid or enteric fever is the household fever of our country. In some parts of the United States, it is always present. It has been shown to be a special product of putrefying human excrement, and whoever is affected with the disease has partaken of this stuff in some way. The most common mode of propagation is from drinking water polluted with the discharges of those affected with the disease. Indeed, so frequent has this method of infection been observed, that on the appearance of an epidemic of enteric fever the question of water-pollution instantly suggests itself.

These facts regarding the results of drinking impure water are sufficient to teach us the hygienic requirements concerning its use. Polluted water is always dangerous, and especially so during the prevalence of specific diseases. Hence it should always be avoided if possible, and if there is a possibility of pollution by the contagia of any disease it is totally unfit for use as a drink, and should be as sedulously shunned as other malignant poisons are.

Soda water and lemonade are popular drinks, and usually are innocent. The latter is healthful to most persons. Used to excess, they might prove hurtful, and if found to disagree in any instance, the dictates of prudence as well as hygiene would be to avoid their

use.

Mineral waters are used almost universally in this country. The summer pilgrims to the springs, those who remain at home,