CARRIAGE OF DISEASE 
141 
sewered city the cases of typhoid infection due to 
direct fly transmission are relatively very few com¬ 
pared with the number due to water, to milk and to 
contact (including contact with carriers). As one 
writer has said, in discussing this question, ‘We 
need more scientific knowledge and less repetitious 
babble of sentiment in dealing with flies or any other 
nuisance.’ ” 
Such ideas as this are likely to do harm. From 
every point of view it is desirable to rid communities 
from flies, and the only danger of over-emphasizing the 
importance of the typhoid fly in its relation to typhoid 
fever is that it may be accepted as the principal cause 
of the spread of the disease in certain cases where care¬ 
ful investigation would indicate other and perhaps eas¬ 
ily controllable causes. Therefore, while we are in¬ 
clined to agree with the writer of the editorial that 
statements should be cautious to a reasonable extent, 
the general tone of the editorial undoubtedly far too 
greatly minimizes the importance of flies from the dis¬ 
ease point of view in modern cities. 
Reference is made to “any reasonably clean and well- 
sewered city.” The city of Washington has the repu¬ 
tation of being perhaps the cleanest and best-sewered 
city in the United States, and yet it is possible any 
summer morning to find human dejecta in alleyways 
and vacant lots deposited there over night by irrespon¬ 
sible persons, and in the light of day swarming with 
flies. In the poor quarters of the city uncared-for chil¬ 
dren of the indigent ease .themselves almost wherever 
