TYPHOID FEVER.

Globe, Volume XXII, Issue 1923, 23 April 1880, Page 4

TYPHOID FEVER.

Tho following letter appeared in this morning’s issue of the “ Press ” ; TO THE EDITOB OP THE PBESS. Sib, — As medical officer to tho Local Board of Health I felt bound in my report to notice the statement of the house surgeon to the Christchurch Hospital that “it was a moot point amongst the highest medical authorities whether typhoid fever was infectious.” _ I was constrained to say that such evidence was “altogether untrustworthy,” and that it was “difficult to realise what the house surgeon was thinking of when he made the statement.” Tho house surgeon has published a letter, in which ho gives certain quotations from “ Dr. Murchison on Continued Eevers,” which quotations he seems to think establish his position. However, in not one of the four passages quoted does Dr. Murchison deny that typhoid fever is infectious—they simply go to prove that, in his opinion, typhoid fevar may in certain cases arise de novo. Even this position, however, is strongly contested by most of the leading scientific men of the day. It thus appears that the real moot point is not “ whether typhoid fever is infectious,” but whether it can possibly also arise from decomposing filth, more especially decomposing human excreta. That I have rightly stated tho point at issue appears from the following extract from Dr. Bristowo (physician to Bt. Thomas’s Hospital) in his work on Medicine: —“The question then arises. Does the specific poison of this disease, which is certainly generated from the stools of patients suffering from it, also arise spontaneously, or rather independently of such stools ? The question is by no means easy to solve. _Dr. Murchison especially argues strongly in favor of its origin independently of the disease which it generates. Dr. Budd and others argue with equal vehemence in favor of the opposite hypothesis. We confess that wo incline strongly to the latter view.” But to remove any traces of doubt as to Dr. Murchison’s real views on the infectious nature of typhoid I fever it may be as well to give his own words:—“ Persons labouring under typhoid fever sometimes transport it into localities where it was before unknown, but where it then spreads from them as from a centre,” “It cannot bo doubted that there ore unequivocal instances of typhoid fever which appear to be propagated in the manner described. _ The following illustrations are to the point:— Ist. In 1826 an outbreak of typhoid fever occurred in the military school of La Fliiohe in France. It commenced in July, and did not cease until 109 boys were attacked. The school was broken up, and the boys who were not ill were sent to their own homes in distant parts of France ; twenty-nine were taken ill after reaching their homes, and eight communicated the disease to their families.” “ 2nd. In 1858 a servant ill of typhoid fever was removed from Windsor to her home at Chippenham, four miles distant. Three weeks after her father and sister took tho disease, although no other cases had occurred at Chippenham. Another girl ill of the fever was removed to Bray, some miles distant. Shortly after her two sisters took the fever, although it was stated that no other cases had occurred at Bray previously.” Dr. Murchison then goss on to state four other cases equally strong, and sums up as follows “In the face of such facta it is impossible to deny that typhoid fever is communicable by means of some poison emanating from the sick.”

The house surgeon asks in his letter how it is that, if tho disease is ”of this dangerous nature, patients suffering from it are distributed indiscriminately amongst the ordinary medical oases in St, Thomas’ Hospital, in the Edinburgh Infirmary, &o. This question can readily be answered by again quoting Dr. Bristowo. Speaking of the nature of the infection and its mode of communication, he says : —“ We have pointed out that it seems not to escape with the breath, or from the cutaneous surface; and, it must be added, that if it escapes with tho feces in an active form, it is difficult to understand how tho nurses, and other persons brought into relation with the sick, so constantly escape infection. It has been observed, however, over and over again, that the feces, which are probably at first wholly ineffectual, become, in the course of putrefaction, virulent in a high degree.” If, therefore, care be taken to disinfect the excreta of patients ill with typhoid fever, the danger of infection becomes almost nil. This entirely agrees with what is said by Mr John Simon (Medical Officer to the Privy Council of Great Britain) in his memorandum containing directions to be observed against the spread of infectious diseases. “ Among discharges or substances separated from the body which it is proper to treat as capable of communicating disease, are those which come in cases of small pox from the affected skin, in cases of cholera and typhoid fever from the intestinal canal, . . . Moreover in typhoid fever and cholera the evacuations should be regarded as capable of communicating a similar specific and infectious property to any night soil with which they may be mingled in privies, drains, or cesspools. This danger of multiplying the sources of communicating disease, must be guarded against by the chemical destruction, decomposition, or disinfection of all the intestinal evacuations as soon as they are passed from tho bowels, and certainly before they are thrown away, and so let loose on the world.” There being then no doubt whatever amongst scientific medical men that typhoid fever is infectious, it cannot be a matter of surprise that tho Government of New Zealand has proclaimed typhoid fever an infectious disease by “ Gazette ” of December 7th, 1876, and has issued an “Extract from ‘Public Health,’ No. 5, vol. 7, February 4th, 1875,” containing precautions against tho spread of typhoid fever, following in this respect the example of tho Privy Council of Groat Britain. Sir Thomas Watson, whose authority is undisputed, very justly remarks—“lf this fever bo really contagious it is not only erroneous but dangerous to hold the contrary opinion,” and Dr. Budd, writing before preventive medicine was so well understood in England as it is now, said “ To what extent it is dangerous may be best measured by the fact that in this country alone 20,000 persons die annually of this fever, and 140,000 more are laid prostrate by it.” Tours, &c., Couetney Ned wile, M.D., Health Officer.