Medical Officers of the Army of India.
policy of compromise, resulting in the dissipation of practical effort, has had more
than a fair trial and that it has signally failed ? What in fact do all the strenuous
efforts in regard to enteric fever, summarised annually in Section II of the Report
of the Sanitary Commissioner with the Government of India amount to, but .a too
frequently futile endeavour to counteract radically defective conditions that are
largely of our own making, in the shape of a piecemeal policy of waste removal and
disposal, and of water-supply ? And, as a consequence, we have the demand for the
" perfect incinerator " that seems to present a problem as difficult to solve as that
of perpetual motion; and when we get it, will it not be further evidence of that
short-sighted policy that encourages the presence of disease causes and then sets
to work to destroy them in one direction only ? It is as if one encouraged
incendiarism, and established a costly method of putting out some of the sparks.
Again, as a consequence, we have often two alternative water-supplies, and then
embark on boiling and " permanganating," with the result that opinion and evidence
is as strong against these latter methods as for them, and, indeed, they seem to be
only maintained as a counsel of despair. Take the following brief epitome of the
opinions of medical officers with reference to the " causes " of enteric fever, as
given in the Sanitary Commissioner's (India) Report for 1899, Section II; first,
references to excretal pollution:—
123
Evidence of medi-
cal officers ;
I. Excretal pollution
of soil._
" Proximity to sewage irrigation, to filth pits, to an incinerator, to a latrine, to a
disused latrine ground, to an enteric ward, and to conveyance by flies and dust, to the
mouths of men, to food and to cooking water are the chief points mentioned."—" Dust
inhaled in pulling down an old latrine." In this connexion see the Report by Major Davies,
R. A. M. C., on Sanitation and Enteric Fever in Quetta: " the air over the filth trenches con
-tains large numbers of Proteus vulgarzs, universally associated with putrefaction and in all
probability derived from the night-soil; this organism was found in all the samples of soda-
Water and in the reservoir water; there is every probability that the enteric organism has also
been present in the air. The frequent occurrence of throat symptoms at the commence-
merit of the illness points strongly to the enteric infection having been (in these cases)
air-borne."—Contiguity of latrines to kitchens; cases in barracks near disused latrines just
before and just after the rains. Night-soil kept in carts until it could be mixed with refuse for
the incinerator.—Until recently night-soil deposited in pits 800 yards from barracks;
barrack refuse still collected in pits, 300 yards from barracks; flies accumulate thereon; bad
effluvia; " if the local factor be filth, it is universal in the cantonment."—The canton-
ment filth-pits are too close to windward of the British Infantry rifle-butts. " The munici-
-pality, not having funds to allow of the removal of some native latrines situated on the
border of the bazaar, 1,200
yards from the nearest barracks and from which the effluvia
are perceptible in barracks during the winds prevalent from October to March, they promise
to keep them clean" !—Contamination of latrines by ambulant (and convalescent ?)
cases, and reinfection by dust and flies.—" Though it is practised at many stations, only