109 



"were fatal, and several of the latter were from vessels coming from 

 New Orleans. Here we have evidence of the extraordinary mildness 

 of the epidemic, and its extremely mild type in its incipiency. 

 About Sept. 1st the disease began to spread rapidly, and during 

 that month there were 37 deaths. In October only 22, the deaths 

 probably not exceeding 1 in 15." 



But of all the forms of infectious diseases, the one from which the 

 greatest amount of mortality has occurred in most of the larger 

 Atlantic cities of the North-eastern and Middle States, during the 

 committee's term of service, is typhus, or, as it has been generally 

 called, ship fever. 



Though typhus is not perhaps as strictly entitled to the term epi- 

 demic as some other distempers, being never equally rife in the 

 different classes of society, but mostly confined to persons dwelling 

 in confined situations, in the midst of human filth, yet its prevalence 

 is sometimes so extensive, and its diffusion so clearly owing to the 

 agency of a peculiar atmospheric influence, that there is no sufficient 

 reason for not considering it as occurring epidemically. That it 

 conforms to the law of periodicity, which determines the recurrence 

 and spread of certain other maladies, is shown by its history in vari- 

 ous countries. Pursuant to that law, though it may never be absent 

 from a city or district, it increases at times, and after raging for a 

 season, declines like other epidemics. Dr. Alison says, in speaking 

 of the contagious fever of Edinburgh, that " there have been three 

 great epidemics of that disease in the last twenty-two years, begin- 

 ning in 1817, 1826, and 1836, (the last of which has now nearly 

 subsided,) each lasting nearly three years, and each of the last two 

 affecting, I believe, nearly ten thousand persons."* Of the typhus 

 of Glasgow, Dr. Davidson remarks "that a severe epidemic of one 

 or two years' duration, is never succeeded by another until several 

 years have elapsed, "f Similar facts illustrate the epidemic cha- 

 racter of typhus in other European cities. 



On examining the records of deaths from typhus| for the last 

 thirty-five years in the city of New York, it is found that the dis- 

 ease was epidemic in that period four times, viz. : in 1818, 1827-28, 

 1837, and 1846-47. In these years the increase of the disease was 

 so remarkable, that there is no hesitation in pronouncing them epi- 



* British and Foreign Medical Review, No. xxi. p. 27. 

 ■{■ Thackeray Prize Essay, p. 55. 



J In enumerating the deaths from typhus, we include the deaths from what is called 

 in the bills of mortality typlwid fever. 



