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6
ever the occasion presents itself; as it does most favourably
now.
Twenty-three deaths in the year may not seem many
out of a population of 90,000, for a fever so universally
spread; but then we must remember that it is not a very
fatal fever, and that 23 deaths recognized, means (to say
nothing of those not recognized as from enteric fever) a
very great many cases of sickness, more or less severe;
means a very great deal of suffering, and a very great
deal of useful labour lost to the community. I remember
making an inquiry into an epidemic of this fever, during
which there was only one death among more than 150
cases; and during the course of a severe epidemic which
I had the advantage of observing at Lyons, the deaths
which occurred in the hospitals (where the worst cases
were taken), although numerous, were very few indeed in
proportion to the recoveries. So that the objection so
often made, that it is a disease which causes few deaths,
must be met by the reply that, for one death, it causes
many cases of illness, lasting for weeks, and perhaps
leaving effects for the rest of life; cases of illness, not
so much among children or old people, as among persons
in the prime of life, among young people, whose time is
so valuable; and when we come to consider that it is
prevented by the most simple precautionary measures,
that, in almost every case, one can demonstrate with
considerable certainty how it got, or at any rate, might
have got, into the premises, that one can go into a house,
look over it, and say with confidence, "there's very little
probability of your having typhoid fever here, unless it is
brought from outside, as by the water company or by the
milkman;" or, on the other hand, "if you don't alter
that pipe or this trap, you run a very good chance of