Bad sewerage and grease-lined sink-pipes found to cause the disease. Malarial maladies in Harlem, recent work of the sanitary inspectors.

At this time of the year the number of cases of typhoid fever in this City always increases. This year is proving to be no exception to this rule. Every succeeding year, nevertheless, has brought a decreased number of cases, and this has been attributed by the Board of Health to the sanitary measures that have been so effectively enforced. It is only a few years ago, comparatively speaking, that there were a great many wells in this City.

This source of water supply was found to be a very prolific cause of typhoid fever, and the wells have gradually but surely been filled up and fallen into disuse. They became contaminated by organic matter and polluted by the washings from cesspools and insecure drains. The Sanitary Inspectors followed up cases of typhoid fever to these wells, and one after another they were rapidly closed.

Besides the contaminated wells, it was found that defective sewers and faulty plumbing were causing outbreaks of typhoid fever. As sanitary measures became better understood, traps began to be widely employed to protect the inmates of houses from noxious gases generated in the sewers. The principle of the trap is generally understood by the public. It has been found difficult for these gases to pass through water, and if they do they are deprived of their poisonous characteristics. Many devices have been invented to prevent the traps being emptied either by suction, siphoning, or any other means. The Board of Health reached the conclusion long ago that ventilation of traps alone was a preventive of their being emptied unintentionally. The policy of the department, therefore, has been thoroughly to accomplish this much-to-be desired end by extending the soil-pipe at full caliber to and through the roof of a house, and properly connect this pipe with every branch waste-pipe. The Sanitary Inspectors were instructed to make inspections from house to house, and order the plumbing to be properly trapped and ventilated. This course has led to a very great diminution in the number of cases of typhoid fever in this City.

As any accumulation of organic matter in the cellar, or near a dwelling or tenement, has been found to be a cause of typhoid fever, Commissioner Janeway has given a standing order that the premises in each case reported shall be thoroughly disinfected. This has often been the means of limiting the number of cases wherever an outbreak has occurred. A few weeks ago Inspector Tracy investigated the causes of an outbreak of typhoid fever in the lower part of West-street, and discovered several facts of exceeding interest to the medical profession and the public. The sewerage in this part of West-street is through open troughs, or gutters, leading along the sides of the street. One case was that of a saloon-keeper, who had been a very healthy man until this attack of disease. He had been in the habit of sitting on the edge of the sidewalk near the gutter. He would tilt his chair against a lamp-post and read the newspaper there for several hours at a time. He was attacked with a chill. Fever and great prostration followed, and he died in about three weeks, after exhibiting all the symptoms of typhoid fever.

A short distance further down this street there was an outbreak of typhoid fever under very similar circumstances. One after another was prostrated, until four persons became victims of that disease. On careful investigation it was found that the waste pipes leading from the sinks in all of these cases had become heavily coated with grease. This grease accumulated in considerable quantities. This decayed and sent forth a foul, noxious odor that pervaded the houses. As the gutters, which at first were thought to have been a factor in inducing these cases of typhoid fever, were found to be quite cleanly, it was believed that these cases were induced by the foul emanations from the grease-lined waste-pipes. Other cases were investigated with similar conditions, and it has seemed clear that the decaying grease adhering to waste-pipes from kitchen sinks, especially those of saloons and boarding-houses, may be a cause of an outbreak of typhoid fever. The remedy for this condition of things is exceedingly simple. If a strong solution of caustic potash or soda be made with hot water, and this be poured down the foul waste-pipe, it can be thoroughly cleansed of the accumulations of grease. This, to be effective in preventing disease, should be done several times every year, or as often as any foul odors are noticed escaping from the sink-hole.

On Friday a serious outbreak of typhoid fever was reported in the tall crowded tenement at No. 210 Avenue C. The first case was noticed about the 1st of the month. The disease spread rapidly through the family until five out of the six persons comprising it were prostrated. The family lived on the first floor of the tenement. They slept in two adjoining rooms, huddled together more like animals than human beings. The first patient attacked was convalescent when the outbreak was reported tot he Board of Health. Dr. Purcell, who visited the house, ordered that the four sickest patients be forthwith removed to the fever hospital on Blackwell's Island. Sanitary superintendent Day ordered Sanitary Inspector Wilder to investigate the case, and he has returned a full report of the circumstances, which present many points of especial interest. The report stated that the exact cause of this outbreak of typhoid fever was rather obscure, that is, although there was sufficient reason for the attack in the general surroundings, yet there was no particular cause that could be pointed out as directly the element of disease. The cellar was used by a butcher who had a shop on the ground floor. The waste-pipe from the ice-box was led through the floor, and the dripped into a barrel. It was stated that this barrel was emptied daily, and that every effort was made to keep the cellar clean and sweet. The floor of the cellar was found to be dry and the walls had been lime-washed recently. In the yard was found a possible cause of the recent outbreak. The water used in this house is all drawn from a hydrant in the yard. As a person stands at this hydrant to draw the water a sickening, over-powering odor is perceived, evidently arising from the cesspool and vault, which is almost directly beneath the hydrant sink. Between the vault and the cesspool is a gate so constructed that the fluid contents of the vault can run off through the cesspool, and thence on into the street sewer. Avenue C is unusually well sewered, and can easily carry away all the refuse and sewage that can pour into it from the tall tenements on its line. There is always a deposit of organic matter in the bottom of the cesspool, and if this is suffered to remain there and decay it must pollute the water drawn from the hydrant to some extent. A thorough and frequent use of disinfectants, and the careful cleansing of this vault and cesspool probably will remove this cause of typhoid fever.

Two of the members of this family were employed in a collar factory in East Fourteenth-street. The employees in that factory number over 100, and those two cases of sickness have been the only ones among them. The factory has water-closets on each of the seven floors, and they are well flushed by water pumped into a tank over each by the steam force-pump in the basement. The family in which this outbreak occurred moved from one of the very worst tenement districts on the west side of this City. It was, therefore, considered possible that the foundation for the present outbreak of typhoid fever may have been laid at their previous abode. This view was strengthened by the fact that the only cases of fever were in this one family, and some of the inmates of that tenement-house had lived there for over 20 years, during which the health of the tenants has been good. It was deemed wise, nevertheless or remove the sick persons to the hospital and employ thorough disinfection, and it is believed that prompt action of this kind has put an end to any further spread of the disease.

In most of the upper districts of the city the cases of typhoid fever this Fall have presented a decidedly malarial character. This has been attributed to the opening of the ground, both for building purposes and in repaving the streets. In One Hundred and Twenty-eighth-street the contract for tearing up the wooden pavement and replacing it with stone was given out last year. The contractor did not receive orders to proceed with the work until a week ago on Monday. The stone had been laid along the sidewalks, but there the work came to a stand. The wooden pavement had become sodden with water and was broken and depressed at frequent intervals, making driving through portions of that street very dangerous. As soon as the contractor received orders to proceed with his work he gave permission to everybody who desired to do so, to carry away as much of the old wooden pavement as was wished. Boys, armed with axes and picks, flocked to this street and began chopping and turning up the old pavement wherever they pleased. Sometimes as many as 20 licensed vendors' wagons could be counted in that street between Third and Fourth avenues. The licensed vendors purchased the rotten, foul-smelling wood torn up from the ground by the boys, and carried it away to be dried and used for fire-wood. Some of the boys made as much as $5 a day by the sale of this wood. They left the worst portion of the rotten wood lying in the street, and this gave off a miasma and steamed up toward nightfall like a fog. Complaints began to be made by the residents of the street that their families were being prostrated with malarial fevers, and the number of cases of that kind of sickness became so great that Sanitary Superintendent Day was obliged to interfere and stop this desultory tearing up of this old pavement. Dr. Wilder called upon Deputy Commissioner Hamlin, of the Department of Public Works, and explained to him the effect of this method of removing the old pavement. The Deputy Commissioner stated that he would attend to the matter, but the mischief had been done. He said that it was customary for contractors to permit any person who desired the old wood to remove it, but they simply followed close upon the pavers, and only such sections were torn up as could be repaved immediately. Thus the spread of malarial poison would be reduced to a minimum. The laying of the stone is now to be proceeded with vigorously, and it is believed that his will stop the further spread of malarial disease along this street.

A young man in One Hundred and Twenty-seventh-street is recovering from a severe attack of typhoid fever, contracted by sitting on a piazza evenings, exposed to the noxious gases arising from a large vault near by. This vault is almost directly beneath the windows of the Unitarian Church, and it was feared that extensive disease might be consequent upon permitting its continuance. Sanitary Inspector Comfort ordered this vault, which had not been emptied for two years, to be filled up forthwith. This order was made two months ago, but the property being in the hands of Trustees of an estate, they have not moved in the matter yet, and the danger still remains there. If the Trustees do not act very soon the Board of Health will be obliged to have the work performed.

The dumping ground on Fifth-avenue, between One Hundred and Thirty-seventh and One Hundred and Thirty-eighth streets, has recently been a great source of complaint on the part of persons living in that neighborhood. This is situated in Sanitary Inspector Comfort's district. He stated to a Times reporter that the Department of Police were accorded permission to dump at this spot by the Board of Health on the express condition that all the garbage should be carefully separated from the ashes and destroyed by being burned. The Dump Inspector failed to comply with this condition after a short time. Continued immunity rendered the employees more and more careless in regard to the destruction of the garbage deposited there. Dr. Joseph O. Farrington reported that he had under his professional care no less than eight persons suffering from malarial and typhoid fever who attributed their illness to the sickening odors coming from the heaps of garbage left to decay and rot under a Summer sun at this dump. Dr. John Shrady reported that he had three patients suffering from arial disease due to the condition of that dumping ground. Inspector Comfort accordingly reported the facts tot he Board of Health, and they revoked the permit. The Dump Inspector was ordered by Capt. Williams to rake out the garbage, burn it and cover the entire lot with a foot of cellar dirt. This was accordingly done. This has been a great improvement, and with the advent of cooler weather the nuisance has been abated to a great extent.

The Sanitary Inspectors are engaged in their annual house to house inspection in their several districts. This is to be completed so that the necessary improvements and repairs which they may feel called upon to recommend may be completed before the advent of cold weather. The general sanitary condition of this City is pronounced excellent, improved even over that of last year at this time. The Tenement-house law has been actively enforced by the Board of Health, and the condition of those who are obliged to live in this class of buildings has been perceptibly improved by the better sanitary surroundings that have been provided for them. This is shown by the decreased mortality among the tenement population, especially among the children under 5 years of age. Improved ventilation and 9increased facilities for light and water supply have already begun to bear fruit. The abolition of dark rooms has been one of the most important reforms of this year. The attention of the medical profession in this country and in Europe has been especially directed to the prevention of disease by improving the sanitary and hygienic surroundings. This, together with the proposed measures for isolating patients suffering from contagious disease, and the proper sanitary supervision of the large number of children attending the public schools, it is believed will make the record of disease in this City for the coming year very much less than that for the year that has passed.