6 



SOURCES OF TYPHOID FEVER. 



Cities well supplied with water from a reservoir, especially a filter 

 reservoir, which possess a modern sewage system, and in Avhich 

 water-closets are universal, derive tj^Dhoid fever only from the follow- 

 ing sources: Country milk contaminated through vessels washed in 

 water infected with typhoid germs, the return of people in the au- 

 tumn from the less sanitary country, 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 country, however, conditions are different. Each country 

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

 ally in the shape of a well; there are few water-closets, and excreta 

 are deposited in the open or in box j)rivies; drainage from these box 

 privies or from the open deposits containing virulent typhoid germs 

 may enter the streams, or the germs may be carried by underground 

 drainage directly into the wells from which drinking water is gained ; 

 or, exposed as these box privies or oj^en deposits usually 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 excrement 

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

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

 may 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 appar- 

 ently cured of the disease, it is perfectly 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 mentioned. 



METHODS OF PROTECTION FROM TYPHOID AND MAIARIA. 



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 cit3\ 

 after contracting typhoid fever in the country, must be disinfected 

 with the utmost care. These three measures, systematically followed, 

 will result in the abolition of typhoid fever within the city bound- 

 aries. 



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