1894-] LATTLMORE EPIDEMIC OF TYPHOID FEVER. 273 



the eastern shore, and, at least in theory, is not supposed to reach 

 the middle of the river where " the crib " is situated. The Bird 

 Island inlet, however, lies full in its way, but is kept closed. All 

 these facts bear upon the history of the case. 



The epidemic prevailed from the beginning to the end of March. 

 During these thirty days the total number of cases reported was four 

 hundred and fifty-three and considering the difficulty of obtaining 

 complete statistics in such cases I think we may reasonably conclude 

 that this epidemic produced a thousand cases of typhoid fever. 

 Happily the number of fatal cases was small. 



No sooner was the presence of an epidemic recognized than a 

 vigorous and intelligent search for the cause was instituted as the 

 necessary preliminary to any rational scheme for its abatement. 

 Guided by the bacterial theory of the origin of typhoid fever, atten- 

 tion was directed at once to the water-supply. The following facts 

 were discovered. During the latter part of February strong winds 

 from the north or northeast had been prevalent, setting back the 

 water in Lake Erie, and lowering the level of Niagara river so much 

 that the quantity entering the tunnel at "the crib" was greatly 

 diminished. Consequently the supply in the reservoir was being 

 rapidly exhausted on account of its small capacity, and the pressure 

 was being reduced to so low a point as to cause serious apprehension 

 in the event of a conflagration. Most unfortunately, and most unac- 

 countably, in this emergency, the gates of the unused inlet at Bird 

 Island, on the east side of the river, were opened and the sewage- 

 laden water was pumped into the mains of the city, and the requisite 

 fire-pressure secured. This event, it will be observed, preceded the 

 outbreak of the epidemic approximately by the ordinary period of 

 incubation for the typhoid bacillus. To transform the theory into a 

 demonstration, if, indeed, any were needed, and to render the chain 

 of evidence complete. Dr. William G. Bissell, Acting Bacteriologist to 

 the Department of Health, not only detected Eberth's Bacillus typho- 

 sus in water taken from the city mains March 7th, but successfully 

 cultivated it in various media. 



A significant fact was observed during the period of the epidemic, 

 that in those parts of the city to which the water mains had not been 

 extended, and where, in consequence, ordinary wells are in use, and 

 also in a section supplied from artesian wells, no case of typhoid 

 fever was reported. 



I call your attention to a map of Buffalo on which the location 

 of each reported case is accurately marked. A study of this map is 



