The times. [volume] (Washington [D.C.]) 1897-1901, 1901-01-27

town. with population Of 5000 WIS In
part supplied with drinking water from a
reservoir. fed by mountain stream Dur
ing january. February. and March. In a
cottage by the side OF and at a distance OF
from sixty to eighty feet from this sfream.
a man was Ill with typhoid fever The at
tendants wers in the habit at night OF
throwing out the excavations on .the
ground toward the stream. During these
months the ground was frozen and COW
| cred with snow. In the latter part OF
March and early in April there was con-
siderable rainfall and thaw. in which
| large part of the three months accumu-
| iation of discharges was washed Into the
| brook not sixty feet distant. AT the very
time Of this thaw the patient had nu-
| merous and copious discharges. About
the 10th of April cases of typhoid fever
broke out in the town. appearing for a
| time at the rate of fifty day. In all
| about 1.2o0 were attacked An immense
| majority of the cases were in the part of
| the town which received water from the
infected reservoir
The use of boiled water and of ice made
| from distilled water the systematic in
spection of diaries. the scrupulous super
vision of the sources from which the
water is obtained. an efficient system OF
sewage removal and above all. the most
scrupulous care on the part of physicians
and of nurses in the disinfection of the
discharges of typhoid fever PATIENTS
these the factors necessary TO reduce
to minimum the incidence Of typhoid
\ fever.
! CHoLERA.-one Of the great scourges
Of he
| Europe and America from India. its ma
tive home. We have. however found out
! the germ, found out the conditions under
which it lives and it is not likely that 1t
will ever again gain foothold in this
country or Great Britain Since the last
| epidemic. 1878. the disease. though
| brought to this country on several oc-
| casiens. has always been held in check
| at the port OF entry. 1t is communicated
almost entirely through infected water.
| and the virulence of an epidemic In any
| city is in direct proportion to the imper-
| lection of the water supply. This was
| shown in a remarkable way in the Ham,
| burg epidemic of 1892. In Altoona. which
had a filtration plant. there were only 5ls
| cases. many of them refugees from Ham,
| burg. Hamburg. where the unfiltered
| water of the Elbe was used had soma
| 1890 cases with nearly SCn0 deaths
YELLOW FEvER--The cause of this
disease is still under discussion. 1t has an
! interest to us in this country from its
| continued prevalence in Cuba. and from
| the fact that at intervals 1t makes inroads
/ into the Southern States. causing serious
| commercial loss. The history OF the dis
ease in the other West India Islands. par
ticularly Jamaica, indicates the steps
which must be taken for its prevention.
| Formerly yellow fever was fatal a
| scourge in them as 1t is today in Cuba.
| By an efficient system of sanitation II has
been abolished. The same can be done
(and Eill be done) in Cuba within few
years General Wood has already pointed
out the way in the cleansing of Santiago.
THE PLAGUE.-One of the most re-
! markable facts in connection with modern
epidemics has been the revival of the bu-
bonic plague. the most dreaded of all the
great infections. During the present CEN
fury the disease in Europe has been con-
fined almost exclusively to Turkey and
southern Europe Since 1894. when it APP
peared at Hongkong. 1t has gradually
spread. and there have been outbreaks OF
ISrrlptS severity III fEuld 1t mas eAlcDtca
to certain of the Mediterranean ports. and
during the past summer 1t reached Glass
gov, where there has been a small out
break. On this hemisphere there have
been small outbreaks in certain of the
South American ports, cases have been
brought TO New York, and there have been
to November l twenty-one cases among
the Chinese in San Francisco. Judging
from the readiness with which 1t has been b.
checked and limited in Australia, and in
particular the facility with which the re-
cent outbreak in Glasgow has been stamp-
ed out. there is very little risk that
plague will ever assume the proportions
which gave to 1t its terrible reputation as
the black death" OF the Middle AgsA
As l have already mentioned. the germ
is known. and prophylactic inoculations
have been made on large scale in india
with a certain measure of success.
TUBERCULOSIS.-In all communities
the white plague, as Oliver Wendell
Holmes calls it. takes the first rank as a
killing disease. 1t has been estimated that
of it 10000 people die yearly in this coun-
try. In all mortality bills tuberculosis of
the lungs. or consumption, heads the list,
and when to this is added tuberculosis of
the other organs, the nLnber swells 10
such an extent that this disease equals
in fatality all the other acute infectivs
diseases combined If we leave out pneu-
monia. Less than twenty years ago we
knew little or nothing of the cause of the
disease. 1t was believed TO be largely
hereditary. Koch discovered the germ. and
with this have come the possibilities OF
limiting its ravages.
The following points with reference to
II may be stated. In u few very rare in
stances the disease is transmitted from
parent to child. In large proportion Of
all cases the disease is caught" The
germs are widely distributed through the
sputum, which, when dry, becomes dust,
and is blown about in all directions. Tu-
bercle bacilli have been found in the dust
of streets. houses. hospital wards. and
much-frequented places. a single indi-
vidual may discharge from the lungs
countless nyriads of germs in the twenty
four hours. DIR. Nuttall estimated from q
pa tient in the Johns Hopkins Hospital.
who had only moderately advanced cor
four and third billions of germs were
thrown off in the twenty-four hours. The
as has been well stated. Is
almost harmless, and only becomes harm
full through bad habits. The germs are
in the sputum which. when dry.