PREVIOUS REPORTS UPON TYPHOID FEVER. 
223 
into the river; hence the low counts. There is, however, an increase 
in the quantity of house sewage at this time of the year; hence a rel- 
ative increase in the number of dangerous bacteria. 
Taking all these circumstances into consideration, it will be readily 
understood that instead of the coincidence of the highest typhoid 
rate with the lowest bacterial counts being a contradictory condition, 
it is exactly what it is to be expected. 
The authors draw this final conclusion: 
That the typhoid death rate, the presence of colon bacilli, the fermentation changes 
in the media, and the temperature should coincide with one another is perfectly log- 
ical, and there is but one conclusion that can be drawn therefi’om — the increased mor- 
tality from typhoid and diarrheal diseases is due to the increase in the quantity of 
bacteria from the intestines of man, which our citizens are compelled to digest at that 
time. 
vSand filtration was recommended as the most practical method of 
purifying the water. 
NECESSITIES FOR THE PREVENTION OF POLLUTION.® 
[By G. M. Kober (1898).] 
In this valuable paper Doctor Kober considers the typhoid-fever 
epidemic at Gumberland, Md., and its effects upon the city of 
Washington. 
In reference to our Potomac River, which is by no means a type of the most polluted 
American rivers, we know that it receives the sewage of Frederick, Cumberland, and 
Harper’s Ferry, besides that of about 25,000 people living in smaller towns and settle- 
ments along the watershed. 
My suspicions that the typhoid germs may travel all the way from Cumberland and 
infect susceptible persons in Washington were confirmed as early as the winter of 1889- 
90 by studying the effects of the typhoid epidemic at Cumberland upon the prevalence 
of the disease in this city. 
The records of the health office show that during this epidemic, from December, 
1889, to April, 1890, the deaths from typhoid fever amounted to 74, as compared with 
42 for the corresponding months of the previous year. Indeed we had almost double 
the number of typhoid deaths during these months than for any similar period either 
before or since this epidemic. 
Cumberland had about 45 deaths and 485 cases; this city had 74 deaths and about 
740 cases, and yet the starting point of all was the excreta of one patient washed into a 
little run which empties into the Potomac about 300 feet above the pumping station at 
Cumberland. In the face of this fact I have no hesitation in declaring that our exces- 
sive typhoid rate is largely due to contaminated Potomac water. 
Doctor Kober further considers the sources of river water, the char- 
acter and extent of pollution, the significance of intestinal bacteria 
in the water, the self-purification of rivers, why all persons are not 
infected with typhoid fever, remedial legislation by Congress, and 
“Report on the pollution of rivers, by Henry Talbott, chairman of Committee on 
River Pollution, to the Game and Fish Protective Association of the District of Colum- 
bia. Washington, Government Printing Office, 1898, p. 32. 
