PROCEEDINGS OF SECTION I. 593 



In many parts sewerage should be insisted upon, and it is 

 really cheaper for any country to build sewers than to face typhoid 

 epidemics. In the absence of this, in certain coastal districts and 

 other parts where drinking water cannot be contaminated by their 

 leakage, cess-pits, as advocated by my colleague. Dr. Cleland, are 

 the proper thing for the climate. Generally, they are remarkably 

 free from flies, and built with discretion, under the supervision of 

 a medical man, and with due regard to the position of drinking 

 water supiDlies, they are very harmless. They are, in fact, primi- 

 tive septic tanks, and in many scattered districts they should be 

 installed instead of earth closets. They are fool proof, fly proof, 

 and their almost universal condemnation in favour of pan closets 

 is surely a relic of the days preceding the fly theory of infection. 

 In closely-populated England, with every stream a water supply, 

 they are justly condemned, but we surely need not follow blindly 

 without taking the trouble to see that in very many districts in 

 Australia cess-pits are not undesirable. I call to mind a scene in 

 a small coastal village, built on the edge of the cliffs close to the 

 ocean. Groups of earth closets, all open-doored, hot and sunny and 

 filled with flies, and in all the fseces uncovered and typhoid in the 

 district. Deeply sunk cess-pits, which would have drained through 

 some hundreds of feet only into the sea, would have been quite 

 harmless, and would seem quite obviously the solution of the 

 preblem. 



The second desideratum is an efficient S3''stem of having all cases 

 notified and kept under the observation of the health authorities. 

 Each case should be studied bacteriologically, and at least two 

 examinations of the faeces should prove negative before the patient 

 is allowed to pass out of the observation and control of the authori- 

 ties. If the case becomes a carrier, or if a carrier be detected other- 

 wise, methods of education are probably the most practical solu- 

 tion of the difficulty, for legislative methods are at present almost 

 impracticable. 



The third measure required, and I think amply justified by the 

 results to date, is compulsory typhoid vaccination. Its simplicity, 

 painlessness, and the extremely beneficial results shown by figures 

 to date, recommend it, and in a semi-tropical country such as ours 

 where typhoid is always present, I am convinced it should be given 

 the benefit of a fair trial. 



In the actual handling of any particular epidemic methods of 

 isolation and, when circumstances demand, removals to hospital, 

 disinfection of fseces, urine, &c., are called for. 



Destruction of property is practically a useless piece of absurdity, 

 and my last word in this paper is to condemn the policy of form- 

 alinising and disinfection and destruction in the case of a disease 

 in the vast number of instances only spread by an excreta — mouth 

 chain. 



