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480 Proceedings of the Royal Physical Society. 
Eberth’s bacillus, and I have only a few words to say with 
regard to the prevention of the disease. 
Typhoid fever is most prevalent during the hottest months 
in Africa, and it should be remembered that sandy soil 
favours its spread, as the dried excreta of patients may be 
conveyed by the wind unless care be taken. The utmost 
care should be taken to ensure the fullest sanitary pre- 
cautions. The excreta must be properly disinfected, and the 
water-supply should not only be carefully selected, but all 
water should be filtered and boiled. Milk, too, deserves 
special attention. The meat-supply should also be investi- 
gated, and all tainted supplies rigorously rejected. It is 
necessary also to pay attention to the vegetables, as un- 
doubtedly they may carry the infection. All patients should 
be thoroughly isolated, and their bedding and linen destroyed. 
It is very necessary, in my opinion, to get rid of the idea that 
typho-malarial fever exists, and in cases of doubt a bacterio- 
logical investigation should be made, which failing, the 
disease should be treated by quinine, and if it does not 
succeed in reducing the temperature, then the case should be 
treated as one of typhoid fever. The eases which have been 
designated typho-malarial fever are in reality severe cases of 
remittent fever lapsing into a typhoid state, or else enteric 
fever modified by its occurrence in a patient who has previ- 
ously suffered much from malaria, or occurring simultaneously 
with an attack of malarial fever (Duncan). 
Tropical Dysentery and Diarrhea. 
Dysentery has practically the same distribution as malaria 
in Africa, and there are only some minor differences met 
with in the distribution of the two diseases. It does not 
always follow that the maximum intensity of the diseases 
coincides. : 
In referring to the etiology and prevention of dysentery, I 
may, to economise space, include diarrhcea as well, for, 
although | believe true tropical dysentery to be due to the 
amceba discovered by Cartulis of Alexandria, which dis- 
covery has been confirmed by American observers (see 
