Tag Archives: typhoid fever

March 13, 1914: Death of John L. Leal

Grave Monument for Dr. Leal

March 13, 1914: Death (in Paterson, NJ) of John L. Leal, physician and water treatment expert who pioneered chlorine disinfection in the U.S. There are many unsung heroes who contributed significantly to public health at the turn of the 20th century. John L. Leal is one of them and after reading this, I think you will agree that he did more than most to save people’s lives.

John L. Leal was born in the small town of Andes, New York on May 5, 1858. His father, John Rose Leal was a physician who joined the 144th Regiment, New York Volunteers and fought in the Civil War. During the siege of Charleston, South Carolina, John Rose Leal contracted what was most likely a case of amoebic dysentery from contaminated drinking water. He suffered from the disease for more than 17 years before he finally died of it in 1882.

John L. Leal attended Princeton College and graduated in 1880. He went on to Columbia College of Physicians and Surgeons finishing his medical education in 1883. He opened a medical practice in Paterson, New Jersey and went to work for the Paterson Board of Health where he remained until 1899. He left City employment and became the sanitary adviser to private water companies including the East Jersey Water Company and the Jersey City Water Supply Company. In 1888, he married Amy L. Arrowsmith and they had one son, Graham, later that year. So far, his life was well spent but not exemplary.

In the field of water supply, there were big moves afoot in the state of New Jersey at the turn of the 20th century. Jersey City had suffered with a contaminated water supply for decades causing tens of thousands of deaths from typhoid fever and diarrheal diseases. In 1899, the City contracted with Jersey City Water Supply Company to build a dam on the Rockaway River and provide a new water supply. The dam created Boonton Reservoir, which had a storage capacity of over seven billion gallons. Leal’s job with the company was to remove sources of contamination in the Rockaway River watershed above the reservoir. Water from the project was served to the City beginning on May 23, 1904.

When it came time for Jersey City to pay the company for the new water supply, they balked. The price tag was steep—over $175 million in current dollars. Using newly developed bacteriological methods, consultants for the City claimed that the water was not “pure and wholesome,” and they filed suit against the company to get a reduced purchase price. The trial that resulted pitted the water quality experts of the day against one another in a battle of expert witnesses. The opinion of the judge was published on May 1, 1909. In that opinion, Vice Chancellor Frederic W. Stevens said that Boonton Reservoir did a good job on average of reducing the bacteria concentrations in the water provided. However, he noted that two to three times per year, especially after intense rainstorms, the reservoir short-circuited and relatively high bacteria levels resulted.

Rather than build expensive sewers that would deal with only part of the bacteria contamination problem (an early recognition of non-point source pollution) Leal and the company attorney argued to install “other plans or devices” that would do a better job. The judge agreed and gave them a little over three months to prove their idea. Leal had decided in May 1909 that it was time to add a chemical disinfectant to drinking water. He was all too familiar with the suffering and death caused by typhoid fever and diarrheal diseases. He knew of some successful instances of using forms of chlorine in Europe, but nothing had been attempted in the U.S. on a large-scale basis or over any continuous time period.

But, there was a problem. The public feared chemicals in their food, medicines and water. Adulteration of food and medicines was rampant during this period, which was faithfully catalogued in Upton Sinclair’s The Jungle.

“How could they know that the pale-blue milk that they bought around the corner was watered, and doctored with formaldehyde besides?. . .How could they find out that their tea and coffee, their sugar and flour, had been doctored; that their canned peas had been colored with copper salts, and their fruit jams with aniline dyes?”(1)

At any conference of water professionals in the late 19th and early 20th centuries, strong language was used to oppose chemical disinfection. Even George W. Fuller early in his career was not supportive of chemical disinfectants.

1893, George Warren Fuller: “While chemicals have been of much aid in surgery by bringing about antisepsis and asepsis, it is very improbable that people would allow their drinking water to be drugged with chemicals, even with the view of removing dangerous bacteria–indeed, such a method might prove very dangerous in many cases.”(2)

1894, Thomas M. Drown: “…the idea itself of chemical disinfection is repellent.”(3)

1904, George C. Whipple: “Thus in St. Louis the popular prejudice against the use of alum in clarifying the water is said to be so intense that a local engineer has said ‘it is very doubtful if alum could be used, no matter how excellent the results which might be obtained.’. . .‘We don’t want to drink puckered water.’”(4)

1906, George C. Whipple: “The idea of adding poisonous chemicals [like chlorine] to water for the purpose of improving its quality for drinking purposes has generally been considered as illogical and unsafe. . .”(5)

1906, William P. Mason: “I very much question if the public at large would be willing to disinfect water to-day. We are scarcely driven that far yet.”(6)

1906, P.A. Maignen: “Among the so-called ‘disinfectants’ tried may be cited copper, chlorine and oxalic acid. . .Such poisonous materials should not be permitted to be used on water intended for public supplies.”(7)

Nonetheless, Leal was convinced that adding a disinfectant to the Jersey City water supply was the best course. He had done laboratory studies that convinced him that a fraction of a ppm of chlorine would kill disease-causing bacteria. In the face of the certain disapproval of his peers and possible condemnation by the public, he moved forward. Where he found the courage to follow the path of chemical disinfection when all of the experts railed against it is not known for certain. His father’s gruesome illness and death and the unnecessary deaths he personally observed as Health Officer for Paterson must have contributed to his decision.

However, no chlorine feed system treating 40 million gallons per day had ever been designed or built and if the feed system failed to operate reliably, all of the courage of his convictions would not have amounted to much. He needed the best engineer in the country to do the work. He needed George Warren Fuller. In 1908, Fuller was famous for his work in filtration. He had designed an aluminum sulfate feed system treating 30 million gallons per day for the Little Falls treatment plant. On July 19, 1908, Leal left his attorney’s office in Jersey City and took the ferry to Manhattan. In Fuller’s office at 170 Broadway, he hired the famous engineer (undoubtedly on the basis of a handshake) and told him that the bad news was that he needed the work done in a little over three months.

Ninety-nine days later, the chlorine feed system was built and operational. Calcium hypochlorite (known then as chloride of lime or bleaching powder) was made into a concentrated solution, diluted with water and fed through a calibrated orifice to the water before it traveled by gravity to Jersey City. The feed system worked flawlessly from day one and continued to operate successfully for all of the following days. Liquid chlorine eventually replaced chloride of lime, but September 26, 2012, marks the 104th anniversary of the first continuous use of chlorine on a water supply—the longest period of water disinfection anywhere in the world.

In a second trial, the court vindicated Leal’s decision. Afterwards, the use of chlorine spread like wildfire throughout the U.S. Typhoid fever death rates plummeted and children under one year of age stopped dying by the hundreds of thousands.

John L. Leal was not a physically imposing figure. Photographs of him show a man of average height and build with a kind face. Nothing in his appearance hinted at the steel spine and dogged courage that he possessed. One definition of the word hero reads: “a man of distinguished courage or ability, admired for his brave deeds and noble qualities.” These days, many people feel that the word hero has been overused in this country. I think that promoting a water treatment process that saves millions of lives qualifies Leal to be known as a Hero of Public Health.

Why doesn’t everyone know about Leal? Another man, George A. Johnson was wrongly given the credit for the idea of chlorinating the water supply for Jersey City. Johnson was able to get away with his charade, in part, because John L. Leal died on March 13, 1914, and Johnson lived for another 20 years.

Still not convinced? Read The Chlorine Revolution: Water Disinfection and the Fight to Save Lives which was published in April 2013.(8)

References

(1) Sinclair, Upton. The Jungle: With an Afterword by Emory Elliott. New York:Signet Classic, 1990, original copyright 1905, originally published in 1904.

(2) Fuller, George W. “Sand Filtration of Water, with Special Reference to Results Obtained, at Lawrence, Massachusetts.” In American Public Health Association, Public Health Papers and Reports. Vol. 20, Columbus, OH:APHA, 64-71. 1895.

(3) Drown, Thomas M. “The Electrical Purification of Water.” Journal NEWWA. 8 (1894): 183-7.

(4) Whipple, George C. Discussion of “Purification of Water for Domestic Use.” Transactions ASCE. 54:Part D (1905): 192-206.

(5) Whipple, George C. “Disinfection as a Means of Water Purification.” Proceedings AWWA. (1906): 266-80.

(6) Mason, William P. “Discussion.” Proceedings AWWA. (1906): 282-3.

(7) Maignen, P.A. “Discussion.” Proceedings AWWA. (1906): 285-6.

(8) McGuire, Michael J. The Chlorine Revolution: Water Disinfection and the Fight to Save Lives. Denver, Colorado:American Water Works Association. 2013.

Dr. John L. Leal

March 9, 1973: Miami Water Tainted by Waste

1973 Vintage Postcard

1973 Vintage Postcard

March 9, 1973: New York Times headline–Drinking Water Is Tainted By Waste in Miami Beach. “Miami Beach’s supply of drinking water is contaminated with organisms from human waste, Dr. Milton Saslaw, Dade County health director, told the County Commission today. He said that residents should boil all water used for drinking, making ice and brushing teeth. Dr. Saslaw said that the problem, apparently confined to Miami Beach, was not related the recent outbreak of typhoid in the town of Homestead, 25 miles south of here. He said that the unsanitary conditions would last for several days until the chlorine level of the water supply could be raised to combat the organisms. Hotels in this resort town immediately began boiling water before serving it to guests.”

Commentary: The contamination problem was linked to a drop in the chlorine residual. Chlorine equipment was flown to Miami Beach from Alabama to alleviate the problem. Wait a minute. There was typhoid fever in Homestead, FL? Look at the year—1973. That sure sounds like a story worth telling.

#TDIWH—February 25, 1910: Chlorine Disinfection in Minneapolis

The East Side Pumping Station was built on Hennepin Island in 1885 and efficiently delivered sewage-contaminated drinking water to Minneapolis

The East Side Pumping Station was built on Hennepin Island in 1885 and efficiently delivered sewage-contaminated drinking water to Minneapolis

February 25, 1910: The first use of chlorine as a drinking water disinfectant in Minneapolis, MN. “The water source for Minneapolis, Minnesota, in 1910 was the Mississippi River. At that time, the city had a population of about 380,000, and average daily water use was about 20 mgd. Water was pumped from the river into two rectangular basins with a total capacity of 97 million gallons. Plagued with outbreaks of typhoid fever, the city had considered several treatment options including the installation of slow sand filters. However, none of these plans came to fruition because of the resistance of the electorate and the costs of the projects. On February 25, 1910, a chloride of lime treatment system was put into operation after an alarming increase in typhoid cases and deaths in the city.”

References:

Jensen, J.A. “A 20,000,000-Gal. Hypochlorite Water-Disinfecting Plant at Minneapolis, Minn.” Engineering News. 63:14 (April 7, 1910): 391-2.

McGuire, Michael J. 2013. The Chlorine Revolution: Water Disinfection and the Fight to Save Lives. Denver, CO:American Water Works Association, Chapter 12.

Commentary: The chlorination of the water supply for Minneapolis was part of the explosion of chlorine use after the first use on the Jersey City water supply planned and executed by Dr. John L. Leal in 1908.

#TDIWH—February 20, 1862: Willie Lincoln Dies of Typhoid

250px-WILLIEFebruary 20, 1862: President Abraham Lincoln and Mary Todd Lincoln were grief stricken when their eleven-year-old son, Willie, died from typhoid fever, which may have been due to polluted drinking water delivered to the White House. His full name was William Wallace Lincoln but his parents called him Willie.

“Willie and his younger brother Tad were considered “notorious hellions” during the period they lived in Springfield. They’re recorded by Abraham’s law partner William Herndon for turning their law office upside down; pulling the books off the shelves while their father appeared oblivious to their behavior.

Upon their father’s election as President both Willie and Tad moved into the White House and it became their new playground. At the request of Mrs. Lincoln, Julia Taft brought her younger brothers, 12-year-old “Bud” and 8-year-old “Holly” to the White House and they became playmates of Willie and Tad.

Willie and Tad both became ill in early 1862, and although Tad recovered, Willie’s condition fluctuated from day to day. The most likely cause of the illness was typhoid fever, which was usually contracted by consumption of fecally contaminated food/water. The White House drew its water from the Potomac River, along which thousands of soldiers and horses were camped. Gradually Willie weakened, and both parents spent much time at his bedside. Finally, on Thursday, February 20, 1862, at 5:00 p.m., Willie died. Abraham said, ‘My poor boy. He was too good for this earth. God has called him home. I know that he is much better off in heaven, but then we loved him so. It is hard, hard to have him die!’”

Willie was only 11 years old when he died.

Commentary: Typhoid fever caused by contaminated water killed by the hundreds of thousands every year. The suffering of the parents of children was great and avoidable. It would take Louis Pasteur, the germ theory of disease, Dr. John Snow, public health professionals and the sanitary engineers of the late 19th and early 20th centuries to eventually break the death spiral of sewage contaminated drinking water.

#TDIWH—February 14, 1884: Teddy Roosevelt’s Mother Dies of Typhoid

Mittie Roosevelt

Mittie Roosevelt

February 14, 1884: 1884, Martha Bullock (“Mittie”) Roosevelt, mother of Theodore Roosevelt, died of typhoid fever. “Roosevelt was at work in the New York state legislature attempting to get a government reform bill passed when he was summoned home by his family. He returned home to find his mother, Mittie, had succumbed to typhoid fever. On the same day, his wife of four years, Alice Lee, died of Bright’s disease, a severe kidney ailment. Only two days before her death, Alice Lee had given birth to the couple’s daughter, Alice.

The double tragedy devastated Roosevelt. He ordered those around him not to mention his wife’s name. Burdened by grief, he abandoned politics, left the infant Alice with his sister Bamie, and, at the end of 1884, struck out for the Dakota territories, where he lived as a rancher and worked as a sheriff for two years. When not engrossed in raising cattle or acting as the local lawman, Roosevelt found time to indulge his passion for reading and writing history. After a blizzard wiped out his prized herd of cattle in 1885, Roosevelt decided to return to eastern society. Once back in New York in 1886, he again took up politics and took over raising his precocious daughter, Alice, who later became a national celebrity.”

#TDIWH—February 9, 1918: Water and Energy Waste in Chicago

0209 Coal pump plantsFebruary 9, 1918: Municipal Journal article. 100,000 Tons of Coal Wasted by Chicago. “The Chicago Waterworks pumps and sterilizes two and a half times as much water as the consumers actually use, the balance-waste and leakage-amounting to more than the combined consumption of Milwaukee, Boston, Cleveland and St. Louis.

The coal required for pumping this waste during one year amounts to about 100,000 tons-more than enough to heat all the public schools during the present coal-famine winter. This useless pumping adds about half a million dollars a year to the operating expenses.

In addition, three and a half million dollars is spent annually in an attempt to keep the plant adequate for the extravagantly excessive service, and even this amount is not sufficient. If the waste could be stopped, no more such additions need be made for more than thirty years to come.

The wasteful consumption of water so reduces the pressure in the mains that over more than three-fourths of the area of the city it is less than half of that recommended by the National Board of Fire Underwriters; and in only one of the 35 wards does it equal the recommended pressure.

The above startling facts are derived from a report entitled ‘The Waterworks System of the City of Chicago’ that has just been published by the Chicago Bureau of Public Efficiency. This report contains 207 pages, 28 of which are occupied by diagrams, photographs and other illustrations. A considerable part of the report is devoted to a description of the waterworks system of the city, but the purpose of the entire report is to make public and emphasize the enormous amount of unnecessary waste, and the undoubted increase in this which will occur, with the consequent waste of public funds involved, unless radical methods are carried out for greatly reducing it. The main points brought out in the report we will endeavor to give in a brief synopsis.

With approximately two-and-one-half million population, Chicago is pumping into its water mains 14 per cent more water than New York receives by gravity (with no pumping costs) for the use of a population of five and one-half million. It supplies more water than any other waterworks system in the world.

Commentary: Many of the large cities in the U.S. were battling with water waste due to the enormous costs. Universal metering and an aggressive rate structure eventually reduced water waste dramatically in most cities. The figure below showing the dramatic drop in the typhoid death rate is similar to the one I included in The Chlorine Revolution: Water Disinfection and the Fight to Save Lives. Chicago was an excellent example of how water disinfection saved lives.

Reference: Municipal Journal. 1918. “100,000 Tons of Coal Wasted by Chicago.” 44:6(February 9, 1918): 105-6.

0209 Chicago Typhoid death rate decline

#TDIWH—February 5, 1914: Low Typhoid Death Rate in Providence, RI and Sale of Treatment Plant in New Jersey

Charles V. Chapin

Charles V. Chapin

February 5, 1914: Municipal Journal article. Reduce Death Rate from Typhoid. “Providence, R. I.-The death rate from typhoid fever in Providence in 1913 was 10 per 100,000 in an estimated population of 241,000, the lowest rate for ·the disease ever recorded in this city, according to figures compiled for City Registrar C. V. Chapin. Since 1884 the typhoid death rate here has been reduced from 42.62 to its 1913 mark of 10. The average death rate from the disease for the entire period is 24.10. The best previous record was 11.02, attained in 1911. The 1912 rate was 11.65.”

Commentary: Charles V. Chapin was one of the leaders of the public health movement in the U.S. and he spent great energy improving the death rates for waterborne illnesses in his city.

0205 pvwcFebruary 5, 1914: Municipal Journal article. Offers to Sell Plant to New Jersey. “Passaic N. J.-Since the issuance of the State Water Supply Commission’s report, the East Jersey Water Company has accepted the value placed upon its property by the state’s appraisers. Moreover, the property may be acquired without the investment of any cash, for the state can assume the outstanding bonds of the company, amounting to $7,500,000, and give the present owners additional bonds in the sum of $1,300,000 for their equity. These terms were offered, notwithstanding the difference in the inventories of the state’s and company’s appraisers, the East Jersey company estimating the value of their property at $1,171,700 above the commission’s figures. The bonds can be directly assumed by the State Water Supply Commission for the municipalities, and the plan of the commission, if the property is bought, is to lease the plant to the municipalities for the exact sum of the carrying charges. The acquisition of the company system would mean a water supply of 50,000,000 gallons daily.”

Reference: Municipal Journal. 1914. 36:6(February 5, 1914): 181.