6 



ing sources: Contaminated country milk, the return of people in the 

 autumn from the less sanitar}^ countr}-, and lack of care in the disposal 

 of the discharges of persons who have contracted typhoid from either 

 of the first two sources. 



In the countr}^, however, conditions are difi'erent. Each country 

 house or each house in a small village has its own water supply, usually 

 in the shape of a well; the cattle get water from the streams; there 

 are no water-closets, and excreta are deposited in the open or in box 

 privies; drainage h'om these box privies or from the open deposits 

 containing virulent typhoid germs may enter the streams, be carried 

 for some distance and be taken into the stomachs of cattle all along 

 the course of the stream, or the germs may be carried by under- 

 ground drainage directly into the wells from which drinking water is 

 gained; or, exposed as these box privies or open deposits are, certain 

 flies may alight upon the excrement and carry the germs directly to 

 the food supply of the houses; or certain flies may breed in this excre- 

 ment and fly, fairly reeking with disease-bearing filth, to the kitchens 

 and tables of nearby houses. When we consider that active typhoid 

 germs ma}^ be given out for some time by persons who have not 

 developed typhoid fever sufficiently so that it may be recognized, and 

 that they may also be given out for some time after patients have been 

 apparently cured of the disease, it is perfectl}^ obvious that in the 

 country the lack of care with which excreta are deposited readily 

 accounts for outbreaks of typhoid fever from any of the causes men- 

 tioned. 



METHODS OF PROTECTION FROM TYPHOID AND MALARIA. 



Of course it will be said that the entire water supply of a city may 

 become contaminated at or immediately above its reservoir supply. 

 This contamination is from country sources and might be obviated 

 either in a general manner by the establishment of a reservoir filter- 

 ing plant, or in a special manner by individual householders by the 

 constant and thorough use of house filters. In cities possessing a 

 common water supply and modern sanitary plumbing there is no 

 excuse for the presence of typhoid in the household. Even the city 

 water must be filtered, which can be done by the use of any one of the 

 cheap filters now on the market; the milk which is drunk by children 

 must be sterilized, and the excreta of persons returning to the city, 

 after contracting typhoid fever in the country, must be disinfected 

 with the utmost care. These three measures, systematicall}' followed, 

 will result in the abolition of typhoid fever within the city boundaries. 



So much for cities. In the country the matter is somewhat more 

 difficult, and immunity from malaria and typhoid depends largely upon 

 the individual householder. Such immunity may be obtained, but only 

 as a result of intelligent care. 



