TYPHOID FtN 543 



times it was less prevalent than now. For many years it was confounded with 

 typhus fever, and this accounts for our ignorance ot r history. Typhus and 



typhoid are two totally distinct diseases; in ivulity, there is very little relationship 

 between them. Typhus fever is far more closely allied to small-pox, measles, and 

 scarlet fever, than to typhoid ; and typhoid, in its mode of causation and propag; 

 bears a greater resemblance to cholera and dysentery than to typhus. 



Typhus fever is contagious, typhoid is not. Whoever touches a person suffering 

 from typhus fever runs a certain amount of risk of catching it. Doctors and nurses 

 frequently suffer from this disease, when brought in contact with typhus patients. 

 In Ireland, in the year 1847, no less than 500 medical men, or about one-fifth of 

 the entire number, suffered from typhus, and of these 127 died. During the 

 Crimean War, it is said that more than 80 surgeons died from this Hfao T In 

 hospitals, unless those suffering from the fever are strictly isolated, it spreads 

 rapidly. In the case of typhoid all this is exactly the reverse. You may Hjx-nd your 

 whole day by the bedside without running any risk of catching it. Physicians and 

 nurses do not suffer from it more frequently than other people. In our hospital 

 typhoid patients are placed in the general wards, and no steps are taken to isolate 

 them, and yet it never spreads from bed to bed. At the London Fever Hospital, 

 in 14 J years, 2,506 patients with typhoid fever were treated, and yet in that time 

 only 8 cases originated in the hospital. 



Sometimes typhoid fever may break out in a hospital, but that does not prove 

 that it is contagious. Residence in a hospital does not make you disease-proof. 

 Some ten years ago a number of cases originated in the hospital at Basle. The 

 disease was contracted there, and many people said that it must have been caught 

 from the typhoid patients in the wards. But curiously enough the majority of the 

 cases occurred in people who had nothing to do with the wards, and who had no 

 communication, direct or indirect, with the typhoid patients. For instance, there 

 was a man who had just recovered from small-pox in a ward which had been 

 strictly isolated. He was attacked with typhoid fever immediately on his discharge, 

 and he died from it. It was obvious that it must have been contracted in the 

 hospital. Then, again, the apothecary and the engineer, and several washerwomen 

 and kitchenmaids, who never, by any chance, entered the wards, were attacked in 

 the same way. An examination disclosed the fact that in one portion of the 

 building there was a defect in the drainage, and this, there is no doubt, was the 

 cause of a good deal of the mischief. It was found that there was a wooden pipe 

 running from the roof to the sewer, and this passed close by two of the rooms in 

 which typhoid had most frequently occurred. In the sewer just where the pipe 

 entered there was a fault in its construction. It turned suddenly at a right angle, 

 so that all the refuse matters accumulated at this spot, and the foul gas which they 

 gave off passed up the wooden pipe. Steps were taken to remove the accumulation, 

 and to have the pipes thoroughly and frequently flushed, and from that time there 

 was a considerable decrease in the number of typhoid cases which broke out in the 

 hospital. 



Such instances are by 110 means uncommon. Only a year or two ago one of 

 the largest and most popular colleges in Cambridge was almost decimated by 



