An Address on Typhoid Fever in Paris during the Years 1875-1882
Authors: P. d. P. Santa
Journal: BMJ (1883)

invited me to take part in the proceedings of this splendid assembly, which will form an epoch in the history of the British Medical Association, I have thought that it would be suitable to direct your attention to-day to one of the questions which, thankstothe researches of physicians and sanitarians in Great Britain, has received the greatest and most successful amount of study.If I do not absolutely agree with the ideas and doctrines of the English school respecting the etiology of typhoid fever, I have too much confidence in the liberality of your sentiments and the impar- tiality of your opinions to refrain from submitting both my doubts and my reservations to your impartial consideration.It is especially with regard to the complex problems of public hygiene, that the necessity appears of promoting the progress of knowledge, not only by the discovery of positive but also by the establishment of carefully observed negative facts, so as to restrain the excessive tendency to generalisation which may attend an ac- cepted doctrine.The scientific history of typhoid fever does not extend further back than forty years; but, among the eminent authors who have built it up, you must be, with good right, proud to reckon the names of William Budd, Murchison, Corfield, Carpenter, and Strange.Before entering on the immediate subject of this paper-namely, typhoid fever in Paris during the period 1875;-1882-allow me to give a general outline of the subject in three preliminary chapters; viz.: I.The present state of the question; II.The conditions of this morbid entity in the French army; II.Its general manifestation in Europe dnring, for example, the year 1876.These preliminary considerations will, I hope, facilitate the expo- sition of the new facts; and, if they do not entirely justify the con- clusions to which careful statistical researches have led me, they will, no doubt, inspire some of you with the thought of verifying and controlling, in the case of London or some other great centre of population, the results which I believe have obtained in the case of Paris.Let us not forget, moreover, that similar researches entered into the programme traced out by Dr. Strange at the meet- ing last year in the Isle of Wight.I.No one in the present day could doubt the existence, in the great centres of population, of a fever which, notwithstanding the various denominations which it receives in different countries of the world, possesses a special and characteristic physiognomy, consti- tuting synthetically the typhic or typhoid condition.In England, as you know quite well, three theories have been proposed, to explain the assemblage of phenomena which constitute the disease.According to Drs.Budd and Corfield, typhoid fever is an exnthematic pyrexia, which is propagated by specific germs from the intestines of diseased persons, and enters the system by the air water, and food.Drs.Murchison and Carpenter, partisans of the phytogenic theory, maintain that the transmission of the disease is effected by microzymes, by fungi (microgerms of vegetable nature), or by chemical matters.An intermediate theory admits, for the production of virulence in these germs, a force capable of trans- forming them and increasing their activity and power.Dr. Strange regards as an established fact in science the feecal origin of typhoid fever (which on the Continent is called the "I English theory"), whether there be direct contagion by the patient's intestines, or whether the morbific material be elaborated in sewers, Read In the Section of Public Medicine at theAnnual Meeting of theBritish Medical Association in Worceater, August1880. in latrines, in privies, in water and soil impregnated with faeces, and