OPINIONS ON SEWAGE CONTAMINATION. 41 



oysters in the mouths of rivers in the vicinity of sewers is dangerous to the public 

 health is beyond question shown by I lie combination of conditions which have made 

 it possible to trace the \Yeslcyun typhoid outbreak to the eating of a lot of infected 

 raw oysters. 



In reporting the typhoid epidemics of the mayoralty banquets at 

 Winchester and Southampton, England, November 10, 1902, Dr. 

 Bulstrode 11 cites 21 cases of typhoid and 118 cases of gastroenteritis 

 from a total number of 267 guests who ate raw oysters. The oysters 

 in question were imported from France and "laid down" for a few 

 days in sewage-polluted "drinking" grounds at Emsworth. One 

 patient who developed a fatal case of typhoid only ate one infected 

 oyster, while certain of the guests ate only two of their three oysters. 



The health officials of New York City, 51 in making a study of 1,786 

 cases of typhoid fever reported during 1904, in the Borough of Man- 

 hattan, obtained data on 1,322 cases. Of this number 22 cases, or 

 1.6 per cent, were habitual consumers of raw oysters, while 44 cases, 

 or 3.3 per cent, habitually consumed both raw oysters and raw milk. 



Dr. Fraser, 22 in speaking of the public health of Portsmouth, 

 England, for 1907, where there was reported 233 cases of typhoid 

 fever, says: 



The one article of diet which in this town has a special relationship to typhoid 

 fever is shellfish, and during last year no fewer than 80 persons, or 34 per cent of the 

 total number attacked, contracted typhoid from this source. * * * 



It seems that the only thing that can be depended upon to stop this loss of life is 

 legislation, making it illegal to collect shellfish from any places certified by local 

 medical officers to'be subject to sewage pollution. Otherwise men are sure to collect 

 and hawk the fish from such places, and the public purchases them not knowing, nor 

 apparently caring, what their previous history has been. 



In summarizing his work on shellfish pollution Fuller 25 concludes 

 by saying: 



There are those who still believe that polluted shellfish cut very little figure, gen- 

 erally speaking, as regards the public health. Some of these persons appear to have 

 formulated their views without knowledge as to general experiences or the evidence 

 upon the subject. Others for commercial reasons attempt to minimize the evidence, 

 and class it as a whole with some statements and conclusions which are obviously of 

 questionable accuracy. There has been a substantial harmony in the conclusions 

 reached by all who have investigated the subject carefully. 



The evidence already presented leaves no room for reasonable doubt that to a lim- 

 ited degree typhoid fever is transmitted by oysters, clams, and some other shellfish 

 which become infected in sewage-polluted waters. 



While scientific or medical literature contains little or no evidence 

 to disprove the theory of disease transmission through the agency 

 of infected sea food, it is true that sometimes disease and death are 

 attributed to this source without just cause. For example, in April, 

 1908, there appeared in many of the New York papers notices of 

 death from typhoid occurring in a family named Bendt residing in 

 Newark, N. J., and the infection was attributed to eating bad oysters. 

 The Department of Public Health of Newark, N. J., stated that the 



