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large as the drain, to be removed for inspection and cleaning. In straight reaches of fifty feet or more in length, these Y-branches and clearing-holes should be introduced at intervals of not over forty feet.
(c) No T-branches should be allowed, except in vertical pipes.
(d) All pipes should be put together by a series of straight lines, and with a general direction as straight as possible.
(e) All pipes should have a fall of not less than two per cent. of their length, where no special apparatus is provided for flushing. All drains should be kept free from deposit; and, if this cannot be effected without flushing, special apparatus should be applied for this purpose.
(f) A trap should be placed on the main drain outside the house-walls, made of glazed earthenware, with a vent-hole as large as the pipe directly above the trap, communicating with the open air. This should be made accessible for cleaning out, and a rain-spout had best be discharged into it or into the drain at some point above it. This trap should be near the house, and can be alongside the grease-tank, if convenient.
(g) Every separate stack of soil or waste pipe within the house should extend out through the roof, at least four inches. in diameter: smaller pipes than this are liable to be choked with ice from condensation of steam in winter.
(h) Separate traps should be placed under all receptacles of drainage, as close to them as possible, and no other traps allowed to intervene between these and the outside or main trap described above (f). Each one of these separate traps should have an air-pipe of iron or lead connected just below the water-seal, as large as the waste-pipe, and either connecting at its upper end with the soil-pipe above all other branches, or passing through the roof independently, as found most convenient. Several traps can be served by the same vertical line of vent-pipe.
(i) No drain-pipe from any safe-pan under any tub, sink, bowl, or water-closet, should be connected below to the drainsystem, but should discharge over an open sink or cellarfloor.
() No waste-pipe from an ice-chest or refrigerator should be connected with the drains.
(k) Rain-water leaders should not be used as soil or drainpipes, nor should they be depended on to ventilate drains. If connected with the drains at all, care should be taken to so connect them below the water of some trap, otherwise supplied with water, unless their upper ends are remote from windows.
(1) A tank or small cistern should be provided in the upper part of the house, from which the kitchen-boiler should be supplied, together with the bowls and sinks; also any waterclosets that happen to be close by. The drinking-water should not be drawn from this tank, but from a separate tap on the supply-pipe direct from the street main. The overflow of this tank should not be connected with any drain, but discharge as directed for safe drains above (i). It is common in mild climates to discharge such pipes through the house-wall into the open air; but this plan would be worthless in frosty climates.
(m) All water-closets should be supplied by a small tank directly above them, and not by valves attached to the closets themselves, nor by pipes branched from those from which drinking-water is drawn.
(n) Concentrate the fixtures used for drainage-such as water-closets, bowls, sinks, tubs, etc.-as nearly as possible in vertical groups, to avoid waste-pipes passing across under floors, which are rarely satisfactory.
(0) Never locate a fixture, especially a water-closet, in a dark corner where a good ventilation cannot be had. If outer air cannot be got, seek to draw off the foul air from the closet by a pipe leading up through the kitchen-fire flue to the chimney-top, built into the chimney for the purpose, at least four inches in diameter. Small pipes branched into the fireflues for this purpose soon get choked with soot at their mouths, and become worthless, unless extending quite to the top of the chimney."
After securing as good house-drainage as possible, it is necessary to see that it is kept in order. Everyone knows that even the best-constructed houses need occasional repairs, as well as the heating apparatus and everything connected with them. No means have yet been found to render houses perfectly secure from sewer-gas, and only by vigilance in maintaining as good plumbing as possible can comparative safety be expected.
C. F. Wingate, an expert in sanitary engineering, says:
"It must always be remembered that no plumber's work, however complete it may be at first, can be relied upon to remain perfect. The best plumbing will not last forever, but needs attention. *
"Leaks may occur to permit the admission of sewer-gas from drain-pipes due to defective castings; or to walls settling in houses built on made ground, or from the strain of the alter
nate expansion and contraction from hot water, or even from the forcing of lead joints by the pressure of steam discharged from manufactories into public sewers.
"A no less serious evil is the corrosion of lead traps or lead waste-pipes, particularly into old houses which have unventilated drains. This may be caused by the action of sewer-gas, or from the use of certain popular disinfecting fluids. Lengths of pipe have been found completely honeycombed in this way. As such corrosions usually occur on the upper side of traps, or horizontal pipes, it is not easy to detect their presence, from the absence of leakage, and the only safeguard is to avoid carrying waste or soil pipes horizontally; also to extend their upper ends through the roof, and leave them open for ventilation. Lastly, to substitute iron pipes for lead wherever possible, which is now the general rule in all good plumbing practice.
"Corrosion sometimes occurs at the joints of lead pipes, contiguous to the line of solder, and is attributed to galvanic action created by the contact of the zinc and lead; but as these openings are apt to leak they are more liable to discovery. It is a good plan to overhaul all plumbing periodically— say every year or two-to guard against accidents.
And here it should be remarked that sewer-gas is not created in the sewers alone; but every inch of waste-pipe in a house, even though used to convey nothing but soapy water or the waste of melted ice from a refrigerator, can, and commonly does, produce foul gases. The worst odors are from such sources, and they are certainly unwholesome."
The danger from defective house-drainage, where there are cesspools and privy-vaults, is scarcely less than where there are sewer-connections, and yet as a general rule, much less attention is given to it, especially in regard to trapping. A prominent physician, in one of our neighboring cities, writing of the condition of houses in that city, where cesspools are used, says:
"House-drains are seldomed either trapped or ventilated. The ordinary dwellings have no traps to their kitchen-sink waste-pipes.
It is the usual custom to trap the soil-pipe with a half or full S bend, and then connect with this without separate traps, the waste-pipes of bath-tubs and wash-bowls on the same floor of the house." Late reports show that this state of affairs still exists to some extent, in every community.
A distinguished sanitary engineer, after speaking of the evils resulting from cesspools, said: "But cesspools, in the absence of sewers, become a necessity. Large numbers of our people are driven by the increase of population to live on quarter-acre lots, and even smaller ones, with their old privyvaults, cesspools and wells for drinking-water within one or two rods of one another." This picture is true, not only of villages and small cities where there are no sewers, but also of sections of cities throughout the country where sewers have been constructed.
We know this to be the case among some of the finest residences of Cambridge, Roxbury, Dorchester and various districts of Boston, as well as among tenement-houses. Within a week a physician in Cambridge reported attending several members of one family where the sickness was produced by just such a condition of their premises as that above described the privy-vault, cesspool and well all being in juxtaposition. The same physician reported a case of typhoid fever in a fine residence on one of the best streets of that city, where a cesspool and privy-vault were the cause of the disease. Many cases of this kind might be cited from the reports of physicians in all the cities mentioned, but as such experiences are common throughout the country it is unnecessary.
Before closing I wish to call attention to a condition of many city-houses that are left vacant every summer, where ordinary traps are used. The traps become dry and unsealed long before the summer is over; and the sewer-gas pervades the houses, infecting bedding, carpets, furniture, and sometimes the walls. This has frequently been the cause of sickness in families within a few weeks after their return from seashore or mountain resorts. One of the best safeguards against this evil is the Cudell trap, in which the pipe is closed by a ball in such a way that it cannot become unsealed, although the water in the trap may evaporate, when the pipe is left long unused. The Bower and Nicholas traps are also excellent.
In regard to the term "sewer-gas," about which there has been much dispute, I think the definition given by Dr. F. H.
Hamilton is a good one. He says: "What has been called. 'sewer-gas' is composed of air, vapor, and gases in constantly-varying proportions, together with living germs-vegetable and animal-and minute particles of putrescent matter. In short, it is composed of whatever is sufficiently volatile or buoyant to float in the atmosphere, and in consequence of which buoyancy it is permitted to escape through the various sewer-outlets."
By J. A. MUNK, M. D., Topeka, Kansas.
Medicine is, presumably, a science and an art. To perfect any system as extensive in design and scope as is embraced by medicine, requires time and labor. The facts necessary to build up a science are evolved slowly. It requires years of patient toil to gather and prove them. Hasty and superficial action in such work is worthless, since it accomplishes nothing. Facts alone, however, are not sufficient to give efficiency to science. To make knowledge serviceable, it must be skillfully handled. Science and art go hand in hand, and must ever be joined together to achieve success in any vocation. Facts furnish the material for the building, but skill molds. them into symmetry and beauty.
In the science of medicine many facts have been discovered and systematically arranged, yet much more is necessary to complete it. Valuable information has been acquired in anatomy, physiology, chemistry, surgery and therapeutics, enough at least to entitle them respectively to the name of science; but while this is true of each, in a general sense, they nevertheless lack much of being complete. In no department of medicine is there more instability and uncertainty than in therapeutics. Its means and methods are constantly changing, so that what is in vogue during one decade is obsolete in the next; yet nowhere is accuracy and certainty in greater *Introductory Address by the Secretary.