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6
Looking back over a period of eleven years, I observe the
calendar includes about 600 cases occurring annually in the
Metropolis from this disease; 400 cases being usually
recorded between the months of September and March.
These figures relate only to persons who have died, and
do not include those who, having taken the disease, had
passed through the various stages towards recovery.
Estimated on a recognised statistical basis, the latter class
swell the total annual number of cases occurring in the
Metropolis to 3,600.
There is something remarkable about the conduct of
Typhoid, "when considered as a perennial disease, which
marks it especially as a subject for investigation, It appears
year after year in the Metropolis with unfailing regularity,
and distributes itself alike in the quarters of the rich and in
the quarters of the poor. It observes only a limited partiality
for seasons, as no month in the year is exempted from its
incidence. Yet it affects the autumn and winter months
rather than those of spring and early summer; moreover,
the cases do not especially select insanitary houses, where
the presence of sewer gas might offer a reasonable explanation
for their occurrence, but invade indiscriminately
houses sanitary and insanitary alike. Nor is district a
determining factor. To-day a case is notified at Kennington,
to-morrow at the Lower Marsh; after a few days a
third appears at Norwood, and again a fourth at Brixton,
and so on. Thus it is to be observed that they are not
aggregated together either in point of time or place; nay, if
any method may be recognised in their incidence, it is
that they do not fall in clusters, but singly and apart.
The disjointed order of incidence observed by cases of
this class is fundamentally opposed to any hypothesis of
local origin. If sewer gas be the vehicle of contagion