CARRIAGE OF DISEASE 141 



sewered city the cases of typhoid infection due to 

 direct fly transmission are relatively very few com- 

 pared with the number due to water, to milk and to 

 contact (including contact with carriers). As one 

 writer has said, in discussing this question, 'We 

 need more scientific knowledge and less repetitious 

 babble of sentiment in dealing with flies or any other 

 nuisance/ " 



Such ideas as this are likely to do harm. From 

 every point of view it is desirable to rid communities 

 from flies, and the only danger of over-emphasizing the 

 importance of the typhoid fly in its relation to typhoid 

 fever is that it may be accepted as the principal cause 

 of the spread of the disease in certain cases where care- 

 ful investigation would indicate other and perhaps eas- 

 ily controllable causes. Therefore, while we are in- 

 clined to agree with the writer of the editorial that 

 statements should be cautious to a reasonable extent, 

 the general tone of the editorial undoubtedly far too 

 greatly minimizes the importance of flies from the dis- 

 ease point of view in modern cities. 



Reference is made to "any reasonably clean and well- 

 sewered city." The city of Washington has the repu- 

 tation of being perhaps the cleanest and best-sewered 

 city in the United States, and yet it is possible any 

 summer morning to find human dejecta in alleyways 

 and vacant lots deposited there over night by irrespon- 

 sible persons, and in the light of day swarming with 

 flies. In the poor quarters of the city uncared-for chil- 

 dren of the indigent ease themselves almost wherever 



