TYPHOID FEVER. Causes of Its Existence and Methods of Dissemination.

Te Aroha News, Volume III, Issue 135, 2 January 1886, Page 4

TYPHOID FEVER. Causes of Its Existence and Methods of Dissemination.

The causation. of typKoid or enteric^ lever is^invdyed in 'great obscurity. JSome of the best authorities believe it may originate dti wowV in pother words,; as the great exponent of-thisttheory, Pr.'/Murchiaon,fltates it; "the poison of enteric fever is contained in the' emanations' from' -certain J forms of putrefying organic matter," and "is often generated byr faecal fermentation." Other authorities,- equally good, hold that^the appearance of typhoid-fever cases necessarily - presupposes the existence of a case which stands to the later ones in the relation of cause to effect, and that if this case is^ not discovered, it is simply because the "evidence is obscure, or the investigator inexperienced. Unfortunately, the identification of the typhoid germ has nofryetbeen satisfactorily determined, and until it ia we can hardly expect the mystery now surrounding the production of the disease to be cleared away, In regard to the means by which the fever spreads, there is more unanimity of opinion. The water of wells which has become impure from the leaking of vaults and cesspools has been shown over and over again to have caused typhoid epidemics. Notable instances of this have occurred in our own country, as in Syracuse in 1876, and the more recent epidemic at, Plymouth, Pa. Milk has also been the medium through which the typhoid poison has been disseminated. Impure water has been used to wash out the milk cans, if, indeed, it has not served other purposes, and the milk has thus become infected. A striking example of this medium of contagion was the outbreak of typhoid at Ma^ylebone, London. Within a few weeks 123 families were attacked. Mr Radcliffe "traced the cauee of this outbreak to milk which came from a particular farm on which "water used for dairy purposes contained excremental matters from a patient suffering from enteric fever immediately before and at the time of the outbreak." Epidemics occurring at Edinburgh, Glaßgow, Bristol and Dublin have also been traced to milk. These facts should stir up all health officials to the vital importance of the most rigid scrutiny of the milk supplied to the people under their charge, and should lead our judges to inflict the severest penalties upon those detected in the adulteration of this most essential food. That this disease may be contracted by those who nurse the sick is possible, but if this ever occurs it is extremely rare. The discharges from the intestine are believed to contain the infective material ; and, in the present state of our knowledge, to bury these discharges in the ground or to cast them into the sewer without previous disinfection must be looked upon as criminal. It is not difficult to understand that the infective material of such undisinfected discharges may cling to the interior of drain pipea and sewers, and through defective plumbing find admission to the dwelling and Bleeping rooms of the well. This is doubtless the explanation of the origin of cases ascribed to sewer gas. Typhoid fever is eminently a disease of the autumn, and its greater prevalance at this season of the year is attributed by some to the decay of vegetation ; others claim to have found, its prevalence to depend upon the rise and fall of the ground water. Just how far these conditions affect the prevalence of the fever is a matter of conjecture, and as they are entirely beyond our control we must in our endeavour toward prevention and restriction pay strict attention to cleanliness in all its forms, and especially to the thorough disinfection of discharges from patientß. For this purpose the commiLLeo uu Uif)infeotanta.of the American Public Health Association recommend solutions of chloride of lime, of chlorinated soda, or of bichloride of mercury. In our cities the typhoid patients are largely recruited from the ranks of those of ample means, who during the summer spend their time in the country, and often at the most fashionable watering places. It is notorious that these resorts are, as a rule, unsanitary in their appointments The crowding of human beings in such places, with the consequent accumulation of human waste, would, it would seem, help to account for the large representation of typhoid-fever victims in the ranks of their patrons. A study of typhoid cases with reference to this point would be an interesting and doubtless instructive. — " Science."