10 
TYPHOID FEVEK IN DISTRICT OF COLUMBIA. 
ing winter and early spring months there was comparatively little 
typhoid fever in the District of Columbia; but suddenly, in July, 1906 , 
there occurred such a great increase in the number of cases that the 
disease was properly regarded as prevailing in epidemic form. This 
corresponds with the history of the disease in many previous years. 
The recurrence of the disease under the greatly improved condi- 
tions of the water supply was a matter of keen disappointment both 
to the medical profession and to the general public, inasmuch as 
assurance had been given, and indeed it had been confidently expected, 
that the introduction of sand filtration would largely diminish the 
disease, as it had done in Lawrence, Lowell, Albany, London and 
Hamburg, and other American and European cities. The health 
officer of the District, Dr. William C. Woodward, found himself con- 
fronted with a difficult and unusual situation, and at his instance the 
Commissioners of the District of Columbia requested the Surgeon- 
General of the Public Health and Marine-Hospital Service to cooperate 
with the health officer in making a study of this subject, as may be 
seen by the following letter : 
Executive Office, Commissioners of the District of Columbia, 
Washington, June 21, 1906. 
Dear Sir: The number of reported cases of typhoid fever in the city of Washington 
has increased instead of diminished within the year, notwithstanding the opening 
of the filtration plant and the official tests showing that it is in successful operation. 
The health department of the District of Columbia has been unable thus far to account 
for the general prevalence of typhoid fever, as shown by the reports, in view of the 
official statement as to the working of the filtration plant and the efficiency of the milk- 
supply inspection, and especially in view of the fact that the cases appear in uniform 
numbers throughout the community and seem to have no particular foci. 
As the facilities of the health department for making a complete investigation of 
the causes of typhoid fever are limited, I have the honor, on behalf of the Commissioners, 
to ask for the cooperation of your Department in order that this important and, at 
present, mysterious matter may have a thorough and comprehensive treatment in the 
interests of the health of the national capital. Besides such assistance as your De- 
partment can give in the general investigation, I have to ask that you will cause an 
early and simultaneous bacteriological examination of the water from each of the 
public pumps, which are also a possible source of danger. The health department 
has not the means to make such an analysis, although from time to time it has made 
a chemical analysis of all the public pumps, so that each is inspected at least once a 
year and closed if found to be contaminated. As a possible source of typhoid fever 
germs, the public pumps, of which there are over ninety in constant use by large num- 
bers of people — transients as well as residents — in their neighborhoods, seem to require 
our special attention. 
The Commissioners will be grateful for the cooperation of your Department and for 
the suggestions of any additional measures which they may take to safeguard the health 
of the community in this relation. 
Sincerely, yours, 
H. B. F. Macfarland, 
President Board of Commissioners of the District of Columbia. 
Surg. Gen. Walter Wyman, 
Public Health and Marine^ Hospital Service. 
