CHARLES B. BALL

Chief Sanitary Inspector, Health Department, Chicago

It has been well said that the amount of soap used in any community affords a ready index to the kind of civilization which that community enjoys. A far better test of community attainment is the degree of care used in the disposal of excrementitious wastes. The bodily refuse from any animal if not promptly removed from about the animal comes speedily to endanger the health, development and life of that animal. The higher the type of organism the greater the offense and the greater the danger caused by the presence of the wastes cast out by that organism, until in man we find the extreme of disgust and repulsion and menace from surroundings in which nuisance of this nature is present.

That feelings of repugnance are not, however, based upon real apprehension of the dangers which come from the exposure of fecal waste is, alas, too true. When the waste from a single human body is not removed and properly disposed of, it may happen that purity of the air, water and food supplies of an entire community are endangered and that disease may be transmitted to some members of that community.

The primitive methods of disposal of such refuse which still prevail in many well-built-up towns and cities in the United States constitute a serious indictment of our progressive civilization. Accumulations of offensive matter in crude excavations in the ground, with only rough shelter houses above them, invite the spread of contagion and render ineffective the most careful labors of the sanitarian and the physician. In our largest and most prosperous cities far too little attention is paid to the protection of privy vaults against fly invasion. Even where sewer facilities are available, few of our cities rigidly insist that [end page21] water closets be built to replace the abominable vaults. The day before yesterday I rode across the state of Pennsylvania; I saw hundreds of privy vaults from the train. That is a situation we ought not to have in a state like Pennsylvania.

While the results of this neglect are not fully known, and statistics of the number of privy vaults and of the mortality due to the diseases which they affect are lacking over a large part of the United States, sufficient facts are known to say that we have relatively eight or ten times the number of cases of typhoid fever and deaths therefrom which prevail in the German Empire.

I presume all of you know how defective are our mortality statistics in the United States, how small an area makes any report which is worthy of the name. I remember speaking in a town in Wisconsin not long ago, and we had taken pains to procure from the health officer a statement of the number of deaths; they were reported as 289 for the year. At the end of my talk a gray-haired old gentleman tapped me on the shoulder and said: "I am the principal undertaker here, and I buried 397 last year and there are two other undertakers here that make a living somehow in this town." That is a city within the registration area whose statistics are supposed to be worth while.

THE PREVALENCE OF PRIVY VAULTS

In attempting to ascertain the extent to which privy vaults are found, we are at once confronted with a lack of statistical information. Although it is possible to ascertain with reasonable accuracy what cities and towns are provided with sewerage facilities, it is impossible to determine to what extent these sewerage systems afford facilities to the outskirts of the various cities or to what extent privy vaults are found where sewers are available in these cities. In addition to the localities having sewers there are large areas in the United States, including many villages of considerable size, in which it is known that no sewers exist. It is impossible, however, from present data to determine the proportion of our population which depends upon the use of privies or the proportion of these privies which could by rigid provisions of law be required to be replaced by water closets.

In Chicago we lately made a canvass of our privy-vault situ- [end page 22] ation. It is not yet completed; it will show, however, that we have about 8,250 privy vaults in Chicago, and that there are about 5,000 of that number for which no sewers are available. Of that 5,000 at present unprovided for about 1,000 will be provided for this year by extension of the sewer system. I am sure that these statistics are bad enough without going into any account of the details. I spent some time trying to see if there were not enough data to give us an idea of the prevalence of privy vaults throughout the United States, but I gave it up. I do not believe anybody can make even an approximate guess.

The only general statistics regarding privy vaults of which I have knowledge were collected by Mr. Burton J. Ashley, of Chicago, from about forty cities. Mr. Ashley obtained authoritative replies usually from the inspector of plumbing of each city. Some of the most noteworthy of these statements were as follows, identifying the city only by its population:

Population Number of Privy Vaults Number of vaults for which sewers are available

350,000 60,000 50,000

240,000 29,000 7,000

490,000 27,000 20,000

300,000 25,000 0

96,000 15,000 10,000

50,000 13,000 500

46,000 6,200 3,000

THE CONSTRUCTION OF PRIVIES

In locations where public sewers are not available, it is practicable to provide for the disposal of sewage from ordinary plumbing by the construction of individual septic tanks and small disposal fields. Many such installations, in satisfactory use at the present time, have been designed by Mr. Burton H. Ashley, of Chicago, an engineer who has given much attention to small plants for the service of a single dwelling. There are doubtless other engineers who have had favorable experience in the design of various means of sewer disposal for single buildings. [end page 23]

Granting, however, that it is still necessary to construct privies in many localities, such appliances may be classified by their location with relation to the surface level, as:

First: Vaults under ground.

Second: Boxes or pails placed above ground.

Privy vaults below the surface of the ground should be made of masonry, either brick or concrete. The masonry wall and floor must be constructed so as to be water-tight, and should also be well plastered on the inside to secure a smooth surface which can be readily washed and cleaned. In form, they should be rectangular, if built of brick. They may be round or oval or with plane sides having rounded corners, if made of concrete. Every underground vault should have its walls built above the surrounding ground surface to a height of at least eight inches in order to prevent the entrance of surface water.

In size, underground vaults should be small rather than large so as to require relatively frequent cleaning. The form and location with respect to the shelter house should allow of cleaning without taking up the floor of the house or, indeed, entering it.

It is thought desirable by some of our most careful sanitarians to guard against soil pollution by prohibiting the construction of privy vaults under ground. A number of cities, foremost of which is Washington, D. C., require that the privy vault should be provided with a platform either of cement, concrete, or wood covered with metal, and having its surface at least six inches above the adjacent level of the ground. Upon this surface is placed a metallic box or pail or a wooden box lined with metal so as to be impervious. These receptacles are necessarily relatively small in size and it is claimed that the frequent cleaning thus imposed is an advantage rather than a disadvantage. The ease with which the condition of such appurtenances may be determined is a strong argument in favor of their use.

THE SHELTER HOUSE

The building placed above either an underground or an aboveground privy should be tightly and well built, should be made [end page 24] of smooth boards, should have its seats provided with self-closing covers and should have a number of screened, slatted openings for ventilation. There is no precaution which can be observed in the design and construction of such buildings and in their use to which greater importance should be attached than their being properly screened and kept closed so as to prevent the access of flies and mosquitoes. The remarkable results attained by Col. Gorgas in the sanitation of the Canal Zone, resulting in a reduction of the hospitalization for malaria to one-twentieth of its original amount, could never have been attained without large expenditure for screening the barracks and privies of the workmen. More than three-quarters of a million dollars have been thus used since the beginning of the canal work by the American forces, but this large expenditure is amply justified as having made available the services of thousands of workmen who would otherwise have been attacked by disease.

It was my privilege to take a winter vacation in the Canal Zone and I assure you that you would have had your interest stimulated in sanitary matters if you could have seen some of the things done there. I made a field inspection with the chief inspector one day, visiting first the row of barracks, in each of which seventy-two men had been housed the night previous. As we entered the first building the chief inspector inquired: "Has my inspector been here this morning? " The janitor replied: "Yes, he has been here, and he caught two mosquitoes." That merely illustrates the care with which they have attacked malaria on the Zone. When they started in 1904 the hospitalization per week from malaria was one man in twenty of that force, and it is now one in four hundred. The expenditure for screening was three-quarters of a million dollars, which means that they have effectively screened the houses and kitchens and privy vaults. You will agree with me that it is worth while to note the cleanliness of the tropical cities they have there. I saw three tropical cities, Colon, Panama and Port Limon, Costa Rica, the streets of which were cleaner than any ward in the city of Chicago. It is disgraceful that we do not realize the significance of the results obtained down there, but I am sure we are learning from them. [end page 25]

THE REPLACEMENT OF PRIVIES BY WATER CLOSETS

Where sewers are available, every effort should be made to secure the replacement of existing privy vaults with proper water closets. It is in the highest degree desirable that such water closets should be provided within the building instead of in any outside location. This will often mean considerable study to determine the best place for the water closet and will sometimes require an extension of the house to provide suitable compartments.

The three principal reasons why water closets should be placed inside the house are:

First: A proper water closet within the house will have a trap above the floor and thus the main disadvantage of the long hopper fixture is overcome.

Second: An indoor location secures protection of the water supply from freezing, and thus avoids the periods of disuse due to this cause.

Third: The convenience of the users of the fixture is greatly facilitated, unquestionably resulting in their improved health.

If the obstacles to the passage of a law securing indoor locations are too great, the next alternative is to locate a long hopper water closet close to the building with the floor of the compartment on the ground, so as to remove the trap of the closet as short a distance as possible from the bowl, and to arrange for the flushing from a tank placed within the house. The advantages of securing a tank gush combined with the opportunity of using a water closet rim which flushes entirely around the bowl are material as compared with the use of an iron hopper closet into which the water enters tangentially so that the flushing effect is greatly dissipated. This arrangement of closet is common in Washington, D. C., but not elsewhere.

The reason for its existence in new buildings in Washington is that there are so many colored domestics about the house, and there is a feeling of dislike to have the colored servants use the same facilities as the members of the household. That is the reason for the outside water closet having its tank within the house, a tank filled with warm water which may be brought to the outside closet without freezing. [end page 26]

The next type of fixture in point of desirability is a closet of the frost-proof or non-freezing type, so called, having an underground closed tank, or a tank located above the fixture, into which the water enters only when the fixture is used. The objection to this kind of water closet, which has not yet, so far as I am aware, been overcome in any design, is the fact that freezing occurs when the flushing water comes in contact with those parts of the fixture which are necessarily exposed to a low temperature. An additional disadvantage is the fact that it is found necessary in the case of an underground valve to provide a cross connection from the soil pipe to the water supply in order to allow the wasting of the water from the exposed portions of the apparatus. There is no doubt that such a connection is an element of danger whenever a loss of pressure or, as is sometimes the case, a positive vacuum occurs in the water supply mains, thus allowing the possible entrance of sewage matter into the domestic water-supply system.

THE CLEANING OF PRIVIES

Greater diversity is shown in the methods in vogue for the cleaning of privies than in almost any other line of municipal administration. In some cases the municipality makes no provision whatever for rendering this service. It is most common to limit the cleaning operations to licensed scavengers and to require that permits be taken out for each vault. In other jurisdictions the service is performed entirely by a municipal force of laborers. It is well recognized at the present time that such work should not be performed at night, but in the day time, in order that greater care may be exercised and that responsibility may be readily determined if nuisance is created. The method in vogue in Chicago of allowing the work to be done by licensed scavengers under close supervision of sanitary inspectors is a relatively expensive method, as it involves the presence of a man who renders supervisory service only and does not perform any part of the work. It seems the best method to have the work performed by day labor employed directly by the city and to provide for the owner's meeting the expense by a deposit of the cost before the work is done. In emergency cases requiring [end page 27] immediate attention, privy vaults should be cleaned by the city and the expenses assessed upon the property as are other taxes. In the absence of such powers it is impossible to secure prompt action in cases where the owner is unwilling or possibly unable to meet the expense involved.

SUMMARY

We recommend, then:

First, that attention be directed to the nuisance and danger of maintaining privy vaults.

Second, that statistics of the existence of privy vaults be collected, including:

(a) Those where sewer facilities are available.

(b) Those where sewers are not provided.

Third, that the practicability of providing individual septic tanks and small disposal fields be urged.

Fourth, that comparisons be made of the relative advantages and disadvantages of underground vaults and receptacles placed above ground.

Fifth, that the screening of vaults and privy houses be considered necessary.

Sixth, that privy vaults be replaced by indoor water closets wherever this can be accomplished.

Seventh, that the cleaning of privy vaults be performed by municipal day-labor forces.