370 PHARMACEUTICAL BACTERIOLOGY 



of the Hamburg city Board of Health) noted that a reduction in deaths 

 from typhoid fever, due to improved water sanitation, coincided with 

 a reduction in mortality from causes other than typhoid. This is known 

 as the Mills-Reinke phenomenon and has received much attention on the 

 part of health officers everywhere. This observation is however not so 

 recent as is indicated by the date given. For many years, it has been 

 general knowledge among observing health officers and practicing physi- 

 cians, that an improvement of those conditions which reduce the mortality 

 rate due to any one of the more or less serious intestinal infections, reduces 

 the general mortaHty rate likewise, and it has been surmised for many 

 years that some kind of genetic relationship exists between all filth borne 

 pathogens and toxigens. It makes Uttle difEerence against which of the 

 many filth germs the sanitary activities of a city or community are pri- 

 marily directed, the end result will be a reduction in all filth borne diseases. 

 A thorough and complete sanitary cleanup of a city means a reduction in 

 the following diseases, naming them in the order of their more usual 

 pathogenetic filth relationship. The entire series of intestinal infections, 

 as the diarrheas, dysenteries, ententes, coUtis, cholera infantum, cholera 

 morbus, etc.; typhoid fever, tuberculosis (including both the bovine and 

 human types), diptheria, and incidentally also syphilis and gonorrhea. 

 The coincident reduction in the so-called social diseases is no doubt due 

 to the fact that a purely physical cleaning up, encourages or stimulates 

 moral cleanliness. To the list of essentially filth borne diseases must be 

 added Asiatic cholera, amebic dysentery, bubonic plague, and other 

 diseases endemic in certain countries. The exact causahty of some of the 

 supposedly water borne diseases, such as goiter, has as yet not been fully 

 worked out. 



As early as 1886-1887, the writer was stronly impressed by the high 

 rate of intestinal diseases in the city of Chicago and surmised so some 

 causal relationship between the dysenteries and typhoid. Since the 

 completion of the Chicago canal, the general health of that city has im- 

 proved wonderfully. Up to that time, the sewage of the city was dumped 

 into lake Michigan {via the Chicago river) and again pumped into the city 

 and the inhabitants were obliged to swallow the mixed human and animal 

 excreta. The accumulation of the sewage in the sluggish stream gave 

 rise to an undescribable stench, still fresh in the memories of the older 

 members of the present generation of the city. The digging of the sani- 

 tary canal and the proper diverting of the city sewage, is the grandest and 

 best thing ever done by the city of Chicago. 



A contagious disease is one which is readily communicable, from one 

 person or animal to another, either through direct contact or very close 

 proximity. An infectious disease is communicable through a considerable 



