592 PROCEEDINGS OF SECTION I. 



is made to divulge its train of connexions by the replies of the 

 practitioners to the questions on the circulated sheets referred to. 

 But bacteriological research as an aid to the inquiry as to the 

 primary focus as contrasted with its use in precise diagnosis should 

 not be entered upon until the epidemiological considerations 

 begin to point in a particular direction, or when it is thought 

 likely to definitely settle some moot point such as the possibility 

 of some person being a carrier, &c. Though I am anxious to 

 «xpress my views as to the great importance of a bacteriological 

 investigation being made into each and every epidemic, and even 

 if possible into every case of enteric, and am sure that it is only 

 through bacteriological methods that it is possible to com- 

 plete the proof of any particular theory as to the primary cause 

 of an outbreak, yet I am also anxious to protest against the 

 indiscriminate examination of samples of water, milk, &c., often 

 leading to a great waste of time and material, and in the big 

 bulk of cases quite a useless proceeding. Unless evidence points 

 very strongly to the infectivity of such substances it is little use 

 examining them. To repeat this in a different way — first, all the 

 epidemiological data should be most carefully considered, and in 

 the majority of cases the outcome of logical reasoning, based on 

 well-collected and considered data, will point the way in one 

 ■direction, and narrow the field, and show where the bacteriologist 

 is likely to find a really useful occupation — thus we shall save time 

 and much material. 



Having, I believe, now, even thoiigh in a somewhat tabloid 

 form, indicated the lines along which investigations as to the origin 

 and spread of an epidemic should be pursued, I wish to indicate 

 in a still more tabloid form the means needed to prevent them. 



First and foremost, is an efficient sanitary disposal system, 

 preventing the 'pollution of water and the spread of infection hy 

 flies. For this country it is not possible to dispense with conser- 

 vation systems of excretal removal, but we should be able to do a 

 great deal by education, and possibly by penalising legislative 

 Baeasures to make people keep their closets dark to prevent the 

 ^-ntrance of flies, and to cover the excreta thoroughly, and to close 

 the lid of the excreta receptacle and the door. It would be, one 

 would imagine, possible to do a great deal by local health com- 

 mittees, or some such means, and the framing of regulations as to 

 the construction of closets in all towns, villages, &c. 



Much has been said of fly infection, and it is a deadly enough 

 menace in this country, but the means to prevent fly infection is 

 not, as has been said, to kill the flies. Virtually that is im- 

 possible. We must break the other link in the chain, stop the flies 

 having access to the fgpces. 



