TYPHOID 145 



Klein has very recently shown that the Eberth-Gaffky 

 bacillus may be inoculated into calves, and may grow and 

 multiply within the inguinal lymph glands. 



Enteric fever appears to be distributed fairly evenly 

 throughout the world. The influence of season is very con- 

 siderable, the greatest number of cases occurring in the 

 month of October. The case mortality is about 15 per 

 cent. In the Eegistrar-G-eneral's returns, enteric fever, 

 typhus, and iU-defined forms of fever, are classed together, 

 and the mortality due to them is about 1 per cent, of the 

 total death-rate. Typhoid fever is one of the diseases that 

 are subject to compulsory notification, and being in its 

 nature eminently amenable to sanitary control (that is to 

 say, the specifically infectious material is easily destroyed 

 or removed by proper means), the mortality due to it is 

 decreasing. 



The Conveyance of Typhoid Fever by Water. — It is now 

 universally acknowledged that polluted water is the most 

 important agent in the conveyance of enteric fever. 

 Although water contaminated with sewage has been, and is 

 still, drunk by a large number of people with impunity, so 

 far as the appearance of enteric fever is concerned, yet the 

 slightest contamination of a water-supply with the dejecta 

 from a case of typhoid has in many well-authenticated 

 cases caused widespread epidemics of the disease, which 

 generally was confined to those persons who had used the 

 particular polluted water-supply. 



In many of the recorded cases of water-borne typhoid, the 

 a,mount of organic matter accompanying the specific pollu- 

 tion was so extremely small that the water-supplies have 

 been repeatedly proved by chemical analysis to be of high 

 organic purity. Moreover, it has been shown that the 

 organism which is the cause of enteric fever may, when 

 introduced into potable water of good quality, not only 



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