TYPHOID FEVER.—IS IT CONTAGIOUS?

New Zealand Times, Volume XXXI, Issue 4785, 24 July 1876, Page 3

TYPHOID FEVER.—IS IT CONTAGIOUS?

(From The Times, November 9,1874.) The position taken by Dr, Budd in reference to this question of typhoid fever is one which will render his name memorable in the history of medicine. In the work before us ho seeks to prove that there is no such thing as the spontaneous generation of typhoid fever ; that the malady is propagated, through a special virus, by contagion. He begins by developing his evidence on this head. Ho then fixes the principal seat of the contagious matter in the intestines j he examines the nature of the intestinal affection j the relation of typhoid fever to detective sewerage, the character of the contagious agent, the employment' of disinfectants, and disinfection. Ho discusses the so-called " pythogeuic” or putrescent theory, and winds up with some remarks on the spontaneous origin ■ of typhoid fever. The. book from beginning • to 'end 1 is one comprehensive argument, with Reference:to which it may be! said that'the facts alleged are of the most conclusive

character, while the -logic which binds them together is, so far as we can seej simply' irre-; sistible.

This is the question which is sure to occupy the attention of legislators as well as physicians, and it is , therefore desirable to place it in the clearest and most untechnical light. Dr. Budd takes his reader to the village of North Tawton, where he was himself born and brought up, and every inhabitant of which was personally known to him. In the village there was no general system of sewers. Hound the cottages of those who earned their bread with their hands, and who formed the great bulk of the population, were collected various offensive matters. Each cottage, or group of three or four cottages, had a common privy, to which a simple excavation in the ground served as a cesspool. In many cases : hard by the cottage door there was not only an open privy, but a dungheap, where pigs rooted and revelled. For a long period there was much offensive to the nose, but no fever. An inquiry, conducted with the most scrupulous care, showed that for fifteen years there had been no severe outbreak of the disorder, but that for nearly ten years there had been only a single case. For the development of this fever, adds Dr. Budd, “a more specific element was needed than the swine, the dungheaps, or the privies were able to furnish.” That element at length came, and formed a starting point from which its further progress might be securely followed. On July 11, 1839, a case of typhoid fever, doubtless imported from without, occurred in a poor and crowded dwelling, and before the end of November eighty of the inhabitants had suffered from it. The reader will, we trust, bear strictly in mind that the question now before us is whether the typhoid fever is contagious, and he is asked to weigh the answer which facts return to this question. Two sawyers living near the stricken house of North Tawton fell ill, and quitted the village for their own homes at Marchard, where no previous case of typhoid fever had been. In two days one of these men took to his bed, and at the end of five weeks he died. Ten days after his death his two' children were laid up with fever. The other sawyer also took to his bed, and when at the worst a friend from a distance came to see him, and assisted to raise him in bed. On the tenth day after this friend was seized with the fever. Before he became convalescent, two of his children were struck down, and his brother, who lived at a distance, but who came to see him, also fell a victim. Was this series of events the result of chance, or was it the work of contagion! Bet us pursue the inquiry further. On August 20, a Mrs. Bee began to droop at North Tawton, and, not knowing what was impending, she visited her brother at Chaff combe, some miles off. She was smitten with fever, and before she became convalescent her sister-in-law, Mrs. Snell, who nursed her, was attacked, and died subsequently. Then came Mr. Snell, then one of the farm apprentices, then a day laborer, then a Miss Snell, who had come to take charge of the house after Mrs. Snell’s death; and finally a group, consisting of a servant man, a servant girl, and another young person who had acted' as nurse.

The case here submitted is not one of medical practice, but of common evidence, which does not even require a trained scientific mind to weigh it. Bet us proceed:—A boy who had been smitten at Chaffcombe went to. his mother’s cottage between Bow and North Tawton. Before he recovered his mother, who had nursed him, sickened and died. Two children of the family next door were next attacked, then the sister of the boy, who had carried the infection from Chaffcombe. She, in her turn, removed to another place, and became a new focus for the propagation of the disease. Again, to lighten the list of invalids, a girl -named Mary Gibbins was sent from Chaffcombe to her home at Boosebeare, four miles off. Here she lay ill for several weeks. Before she recovered her father was seized. A farmer who lived across the road, and who visited Gibbins, was next struck down ; his case was followed by others under the same roof ; and the fever, spreading from this to other houses, became the centre of an epidemic, which gradually extended to the whale hamlet.

At the same time, scattered over the country side were some twenty or thirty other hamlets, in each of which were the usual manure yard, the inevitable pigsty, and the same primitive accommodation for human needs. The same sun shone upon all alike through month after month of the same fine, dry, autumnal weather. Prom the soil of all these hamlets human and other exuviae exhaled into the air the same putrescent compounds in about equal abundance. In some of them, indeed, to speak the exact truth, these compounds, if the nose might be trusted —and in this matter there is no better witness:—were much more ripe. And yet, while at Boosebeare a large proportion of the inhabitants were lying prostrate with fever, in not one out of the twenty or thirty similar hamlets was there a single case. There is no confusion of data here ; no blur or indistinctness in the observer’s vision ; no flaw,; ns far as I, can see, in his reasoning. He fellows the morbific agent from place to place, sees it planted, developed, shedding itsse‘eds,producingnewcrops ; growing up where it is sown, and there only. Ashpits fail to develope it; putrescence fails to develops it; stench fails to develope it; even the open privy is powerless as long as it is kept free from the discharges of those already attacked. The case of North Tawton is typical; numerous other cases equally conclusive are adduced—among them the foul condition of the Thames, in the hot weather of 1858 and 1859, when stench for the first time rose to the height of an historic event ; and when, nevertheless, Bondon, even along the river, enjoyed a singular immunity from fever. It is, I think, impossible for any intelligent reader, and I should say certainly impossible for any man trained to scientific reasoning, to quit Dr. Budd’s volume without closing with his conclusion, that the “ living body is the soil in which the specific poison of typhoid fever breeds and multiplies.” The strictest rules should be laid down with regard to cleanliness, and nothing should be allowed to remain a single moment that can possibly give off anything to the air, and even the walls should be impermeable.