Tag Archives: typhoid fever

May 5, 1858: Birth of John L. Leal

May 5, 1858: 159th anniversary of the birth 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? Well, you will have to wait for the full story that has been published in my book, The Chlorine Revolution: Water Disinfection and the Fight to Save Lives which will be available for shipment on March 20, 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.

Commentary: On May 5, 2013, at Cedar Lawn Cemetery in Paterson, New Jersey, a grave monument was dedicated to Dr. Leal. For 98 years, his grave was unmarked. The granite obelisk has the names of John L. Leal and five members of his immediate family carved on the sides. Under John L. Leal’s name is the descriptor: Hero of Public Health.

Grave Monument for Dr. Leal

April 27, 1916: Typhoid Outbreak After Fire at Filtration Plant

April 27, 1916: Municipal Journal article. Typhoid Follows Burning of Filtration Plant. “South Fork, Pa.-South Fork has a typhoid fever epidemic. There are ten people ill with the disease now and a number of suspects are under observation. South Fork authorities say the sickness is the result of people not heeding the warning of the board of health to boil the water during the period in which the water was not treated because of fire destroying the filtration plant. The plant was burned several weeks ago. Circulars were distributed all over the town asking the people to boil all water used for domestic purposes. Ministers and school teachers announced the warning and the newspapers published it. Analysis of the water while the filtration plant was not working indicated possibilities of typhoid. The plant is again in operation and tests show the water free from pollution.”

Reference: “Typhoid Follows Burning of Filtration Plant.” 1916. Municipal Journal article 40:17(April 27, 1916): 590.

Commentary: Typhoid fever was still endemic in the U.S. in 1916. Any breakdown in the water treatment barriers caused spikes in disease such as the one described in this article. This also shows the problem with public notification. I guess that they did not have Twitter and Facebook back then.

April 20 1918: Tracing a Typhoid Carrier

April 20 1918: Municipal Journal article. Tracing of Typhoid Carrier Halts Epidemic. “Superior, Wis.-What threatened to be a serious epidemic of typhoid fever in this city has just been successfully averted. Nine cases of the malady broke out on one milk route, but it was successfully checked by Dr. D. R. Searle, city health commissioner; William Strasser, city bacteriologist, and Emil Haeske, milk inspector. This fight against typhoid is one of the most interesting in the city’s history. Two previous outbreaks of the disease had occurred on the same milk route, but the cause of the trouble has been removed at last. A dairyman’s wife and son have been discovered to have carried the disease for 16 years. Health commissioner Searle gave it as his opinion that if the epidemic had not been stopped when it was, it might easily have affected hundreds of persons. When a cousin of one of the dairy farmers who supplies Superior’s retail milk demand came over from Duluth sixteen years ago to recuperate from an illness with typhoid fever, this was the first link in the chain of infection, according to the authorities. Next the dairyman’s wife became ill with the disease, also one of his sons. Both recovered completely.

However, health department officials have found that the woman had been a carrier of typhoid for sixteen years and both herself and her son have been carriers of para-typhoid for that length of time. One case broke out on the milk route more than a month ago, but it was not reported immediately by the physician in charge. Then two more cases broke out and the health department began to investigate. The milk supply was immediately subjected to pasteurization. Blood and other tests were made on all members of the family and the premises were cleaned up on the dairy farm. Those who were found to be carriers of the disease were isolated.

Reference: “Tracing of Typhoid Carrier Halts Epidemic.” Municipal Journal article 44:16(April 20, 1918): 334.

Commentary: Even though this is a story about a typhoid epidemic that was spread by milk instead of water, it recounts the difficult time that health authorities had with identifying typhoid fever carriers—people who carried the bacterium in their gut but they did not have symptoms of the disease. Typhoid Mary was the most famous typhoid carrier in U.S. history.

April 4, 1912: Common Cup, Typhoid Warning and Electric Purification

April 4, 1912: Municipal Journal articles.

“Wage War on Public Drinking Cups. Topeka, Kan.-To prevent the spread of epidemic diseases the State Board of Health has issued an order that public drinking cups must be removed from all the cities of Kansas. City officials were notified the order must be enforced rigidly and business men were requested to remove common drinking cups from their places of business.” Commentary: Samuel J. Crumbine about whom I have often written over the last seven months was responsible for the ban in Kansas.

“Typhoid Warning at Logansport. Logansport, lnd.-The city’s supply of drinking water is practically cut off owing to the condition of the water following the flood in Eel river, which is the source of the city’s water supply. The high water swept away barns and outbuildings for miles above the city, and seeping back into the river was pumped into the mains. Dr. John Bradfield, secretary of the city health board, has issued a warning to citizens to refrain from drinking the water. The Cass County Medical Society has supplemented the action of the city health board by publishing a statement declaring that an epidemic of typhoid will follow the flood unless the use of city water for drinking purposes is stopped. The three artesian wells which were recently drilled by the city have been surrounded by crowds and water carts are supplying hundreds of homes with water from the wells.”

“Electric Purification To Be Tried. Eldorado, Kan.-Sewage at Eldorado will be disinfected by electricity. The engineers of the State university, are making a test of a system by which waste is disintegrated and all organic matter destroyed by an electric current.” Commentary: Everyone was fascinated by electric power at the turn of the 20th century. Unfortunately, destroying wastes by electrical current was not one of the successful applications.

Reference: Municipal Journal. 32:14(April 4, 1912): 525.

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.