MAN'S FIGHT FOR SURVIVAL 



629 



patient in vaccination, and almost certain immunity against small- 

 pox is conferred. 



Nevertheless, smallpox is still with us. Frequent outbreaks still 

 occur and it is much to our shame that the United States has one fifth 

 of all the smallpox in 

 the civilized world. Dur- 

 ing the years 1921-1926 

 Massachusetts, with a 

 population of 4,197,000, 

 had 64 cases of smallpox, 

 though only 2 deaths, 

 while CaUfornia, with a 

 population of 400,000 

 less, had 26,985 cases and 

 392 deaths. This differ- 

 ence in smallpox rate was 

 not due to climate or 

 conditions of inhabitants. 



Deaths from smallpox occur almost entirely in 

 states that do not enforce compulsory vaccination 

 laws. 



but simply to the fact that in 1911, laws compelling vaccination as 

 a prerequisite for school attendance in California were repealed and 

 in 1921 all compulsory vaccination laws were repealed, while in 

 Massachusetts, vaccination is compulsory. In areas where vaccina- 

 tion is required the rate of smallpox is almost zero. 



In the case of typhoid we have a nearly conquered enemy. Pri- 

 marily a disease of the digestive tract, the bacilli enter the body with 

 raw foods and leave the body in the feces. Hence, any food or drink 

 that is contaminated with sewage becomes a potential source of infec- 

 tion. Prior to 1890, the death rate from typhoid was frequently as 

 high as 200 per 100,000 inhabitants, w^hile today in the country at 

 large the death rate from typhoid and paratyphoid is only a little over 

 3 per 100,000. This change has been brought about first through the 

 knowledge that epidemics are usually due to contaminated water or 

 milk. Filtration plus chlorination of water supplies has cut out the 

 offending bacillus from water. Pasteurization of milk has almost 

 eliminated this source of danger, although there are still epidemics 

 which are due to poor milk supplies. As late as 1927 Montreal, 

 Canada, had an epidemic of 4755 cases of typhoid which were dis- 

 tributed through milk. A report of the epidemic says that "surface 

 streams were commonly used as sources of water for the milk houses 

 (houses where the milk was prepared for shipment) and for the dis- 



