4The Atlantic Seaboard


State Board of Health and the presence of two medical schools in the
city, Baltimore long had had polluted water supplies, grossly defective
means of sewage disposal (Wynne, 185o; Ford, 19 1 1; Howard, 1920
and 1924), and high typhoid and enteric fever rates.13 Successive sew-
erage commissions were appointed and competent engineers were
employed who made adequate plans and recommendations; then the
whole matter was dropped because the people refused to approve a
bond issue to pay the cost of the work. Cesspools increased with fre-
quent connections with the storm sewers. While white marble or white
wooden front steps gleamed along miles of Baltimore streets, gray
smelly household wastes wandered slowly in the gutters even along
Monument Street by the Hopkins Hospital, and raw sewage flowed
into the bay not far from the oyster beds.
   In 1905 a third commission made recommendations. With pressure
from the oyster industry the plans were adopted, money was provided,
and at long last, a sewage-disposal plant and sanitary sewers to carry
both domestic wastes and human excreta were undertaken. Not until
1915 was the plant completed, and not until 1918 were the necessary
connections made. By this time also (1918-I 9) a single adequate source
of potable water (Gunpowder River) with an extensive filtration plant
near Lake Montebello was in use (saving Lake Roland for emergen-
cies) and "during these two years the percentage of B. coli determina-
tions in both laboratories (at the filtration plant and the city laboratory)
was relatively low." It is worth stressing that it was not until the
end
of World War I that the great city of Baltimore was forced to provide
safe potable water and adequate sewage disposal to its highly mixed
population. Salutations to the humble oyster! "Even as late as 1922,
the
system was not fully completed and over 2o,ooo houses remained un-
connected.""4
  As with other microorganisms, most of the early observations on
the Hyphomycetes (Fungi imperfecti) that cause disease were made in
Europe. Quite remarkably, however, three primary studies may be
credited largely to work done in the pathology department at Hopkins.
T. C. Gilchrist, who was trained in Great Britain, described in 1896 a
case of "blastomycetic dermatitis in man." He gave excellent details,
photomicrographs, and drawings of the lesions and the budding yeast-
like organisms that he named Blastomyces dermatitidis. In 1898 with
W. R. Stokes he published more completely the findings in a second
case from which pure cultures were grown on all ordinary media.


104