31 



long coufusod with (.v[)lius IVvor ; very I'ecently nnotlier disease has-been 

 differentiated, kunwn as i)aratyp]ioid. Thus tiner and finer distinctions are 

 being made. In this oonnection I might refer to the analogous case of 

 the plants Scrophnlaria nodosa, Scn)i)hnlaria Marylandica, and Scx'oph- 

 ularia leporella. and how the latter, a native Indiana plant, was for a long 

 time confounded with the other, jnst as that in turn had been confused 

 with the Kuropean form — a liotanist will ri'adily understand this simple 

 allusion. 



Malari:i and tyi»hoid fever both tlonrish under simple and primitive 

 conditions, that is. uiuler a neglect of sanitation. Malaria flourishes 

 where the Anopheles mosquito breeds and is transferred from one iudi- 

 vidual to another by its bite. The drainage of wet places and the use of 

 • luinine are the chief factors that account for the subsidence of malaria 

 and its present r.irity. Typhoid fever differs markedly from malarial 

 fever in that one attack protects the individual. The weak are killed off 

 and those who survive are innnune (second attacks of the disease being 

 rare) and this fact has an important bearing. Typhoid fever is chiefly a 

 water-borne disease, especially w^ell water. Where wells and closets are 

 close together or where the subsoil is porous, diffusion takes place. In a 

 fannly where typhoid fever occurred there may be no further ditticulty 

 from the use of the well w^ater, but any stranger or visitor using it may 

 fall a victim. In cities dependent on w^ells there may be nuich typhoid 

 fever, while on the other hand a city with a good nniniciiial water supply, 

 especially where the Abater is properly filtered, may have little of it. Cities 

 dependent on a river supply without previous filtration may fare very well 

 so long as the water is clear, but with the nuuldying of the river after a 

 rain and witli a resort of the citizens to the old wells, there may be a 

 constant recurrence of the disease. In this connection we nuist not forget 

 that many of our rivers are today nothing but oi)en sewers full of infee- 

 tioiis germs. 



Malaria has disappeared from the cities (the Anopheles mosquito does 

 not live in cities) but it still nourishes in backward, undrained, communi- 

 ties — conununities that are still in the Dog fennel days. On the other 

 hand, typhoid fever is all too connnon in some of our cities and tow'us — 

 another indication of the survival of Dog fennel days. 



Not so very long ago the chief diagnostic character for distinguishing 

 between the two diseases was the fever, that is the elevation of tempera- 

 ture, but every now and then so-called atypical cases occurred which left 



