Recent Developments in Pitblic Hygiene. xxiii 



have been formulated, and generally accepted as correct ; 

 and yet, from all that increase of knowledge, we seem to 

 have received no practical benefit. The reason is to be dis- 

 covered from a consideration of the causes by which the 

 spread of typhoid is chiefly favoured. One of these is a 

 contaminated water supply, and an interesting confirmation 

 has lately been supplied of the belief long held about its 

 importance. There is very satisfactory evidence that the 

 specific germ which produces the disease, has been discovered, 

 and this typhoid bacillus has been repeatedly discovered in 

 water, which had been used for drinking purposes, and 

 which had been suspected as the cause of local outbreaks. 

 But I greatly doubt, whether this cause plays any consider- 

 able part in bring about our high tj^phoid mortality. The 

 sources are now more carefully guarded than they were a 

 few years ago ; and besides, the circumstances which attend 

 its prevalence here are not those characteristic of epidemics 

 due to contaminated water, as they have been seen in many 

 places. Our outbreaks are not explosive ; the disease, year 

 after year, taking a decidedly epidemic character in 

 November or December, increasing steadily in prevalence 

 till about March, and then declining slowly till it almost 

 ceases in the early winter months. Our water supply is 

 certainly better than that of most European towns, and it is 

 not likely to be materially improved ; and so, unless there 

 is some other cause in operation, we can hardly expect to 

 see much lowering of our death rate. 



The use of contaminated milk has for a considerable time 

 been recognised as a mode by which typhoid is communi- 

 cated. It may be accidental contamination through the 

 medium of water, which has itself been polluted with 

 typhoid discharges, or by gross carelessness on the part of 

 those who handle milk after having been in contact Avith 

 a patient, or with soiled linen, &c., from his person. Quite 

 recently it has been alleged that cows suffer from a form of 

 disease, such that their milk may be capable of producing 

 typhoid in those who drink it. It has often been alleged. 



