The St. Louis Republic. [volume] (St. Louis, Mo.) 1888-1919, 1901-01-27
Explaining the Prevalence
of Typhoid Fever.


Of Typhoid Fever.
Typhoid Fever-Whils preventive msdi-
cine can claim a great victory In this dis
case also. II IL less brilliant, since the con-
ditions which favor its prevalence are not
those specially relating to overcrowding az
much as to imperfect water supply and the
contamination of certain essential foods. as
mix. 1t has been repeatedly demonstrated
that with a pure water supply and perfect
drainsg sc. typhoid fever almost disappears
from a city. In Vienna after the introduc-
tion Of good water, the rate Of mortality
from typhoid fever fell from Il per 1000 OF
the Inhabitants to about L In Munich the
fall was still more remarkable. From above
70 per 1000 Inhabitants In 1857 It fell to
about 1 per 1000 In 1887. That typhoid fe-
yer in this country Is still a very prevalent
disease depends mainly upon two facts:
First, not only Is the typhoid bacillus very
resistant. but It may remain for a long
time in the body of a person after recoy-
cry from typhoid fever, and such persons in
apparent good health may be a source of
contamination. With many OF the condi-
tons favoring the persistence and growth
Of the bacillus outside the body We are not
yet familiar. The experience In the Span
ish-Amerlcan War illustrates how danger
Gus is the concentration together Of large
numbers OF individuals. But, second, the
essential factor In the widespread preva-
lepce OF typhoid fever In the United States,
particularly IN country districts. is the abb
sence of anything like efficient rural SANTA
ton Many counties have yet TO learn the
alphabet of sanitation. The chief danger
results from the impure water supplies of
the smsller towns. the local house epidem-
les due to infected wells and the milk out
breaks due to the infection Of dairy farms.
The Importance Of scrupulously guarding
the sources of supply was never better
illustrated than IN the weli-known and oft
quoted epidemic In Plymouth, Pa The
town. with a population of 5000. was In part
supplied with drinking water from a reser-
voir fed by a mountain stream During
January. February and March. in a cottage
by the side of and at a distance of from
sixty to eighty feet from this stream. a man
was I'll with typhoid fever. The attendants
were in the habit at night of throwing out
the excavations on the ground toward the
stream. During these months the ground
was frozen and covered with snow. In
the latter part of March and early in April
there were considerable rainfall and a thaw.
III WHICH q AG4Sc part u NHS "a OA~f
accumulation Of discharges was washed
into the brook not sixty feet distant. AT
the very time Of this thaw the patient had
numerous and copioas discharges About
the 10th OF April cases of typhoid fever
broke out in the town. appearing for a time
at the rate of fifty a day In ali about
1.2o were attacked. An Immense majority
Of the cases were In the part Of the town
A. la - o- AZ f-faofo Il
reservoir.
The use Of boiled water and Of Ice made
from distilled water. the systematic inspec-
tion Of diaries, the s~crupulous supervision
of the sources from which the water IS OBJ
tained. an efficient system of sewage re-
movaI. and. above all. the most scrupulous
care on the par Of physicians and of nurses
IN the disinfsction OF the discharges Of
typhoid fever patients-these are the fac
tors necessary to reduce to a minimum
the incidence Of typhoid fever.
Cholera-One Of the great scourge Of the
present century made inroads into Europe
and America from India. Its native home
We have. however. found out the germ.
found out the conditions under which IL
lives. and It is not likely that it will ever
again gain a feothold In this country or
Great Britain. Since the last epidemic.
1873. the disease. though brought TO this
on several occasions. has always
been held In check az the port Of entry.
II Is communicated almost entirely through
water. and the viruience Of an
epidemic in any city is In direct proportion
to the imperfection Of the water supply.
This was shown in q remarkable way In
the Hamburg epidemic Of 1892 In Altoona.
had a filtration plant. there were
only SIG cases. many of them refugees from
Hamburg. Hamburg, where the unfltered
of the Elbe was used. had some 1900
cases. with nearly $500 deaths.