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logical method of prevention of typhoid fever was first advocated. This new method has been
but little practised in civil life, save by the campaigners of South-West Germany, but it has
been somewhat widely employed in the British, German, and French armies. It has been
assumed not only that this method has been productive of great results from a preventive
point of view in the case of those armies, but the corollary is apparently drawn that if it had
been adopted twenty years ago among civilians in this country there would have followed
not merely the huge decline in typhoid that has actually occurred, but an even greater decline.
To the epidemiologist this is very hard of acceptance ; he inclines to think that more benefit,
as regards further reduction of typhoid fever in this country, is likely to result from pursuing
the older epidemiological methods than from giving effect to the new principles advocated by
Koch and his followers. In particular, further care for the purity of shell-fish layings and entire
prohibition of the sale of ungutted flat fish are to be looked upon as the main lines upon which
further advance can be made."
In 1917 the behaviour of typhoid remained much as in 1915 and 1916. A small oyster outbreak,
however, affected a few Londoners.
In 1918 typhoid was still at a low ebb and the continued smoothing out of the autumnal rise was
again observed ; in 1919 the number of cases in the last quarter of the year showed a very slight increase.
The diagram on p. 17 has been prepared to illustrate the behaviour of typhoid fever since 1911
in—(i.) London and four east coast ports engaged in trawling in the North Sea; and in certain large
towns and counties mainly supplied with flat fish by those ports; (ii.) west coast towns and counties ;
and (iii.) south coast towns and counties. It will be seen that there is a close family likeness in the curves
for the east coast fishing ports; and traces of the same likeness are to be discovered in some of the large
towns and counties mainly supplied from these ports. Towns like Birmingham, however, at some
distance by railway, show a more marked fall in typhoid in recent years than towns more easily accessible ;
this might be held to accord with the probability that freight charges discourage the despatch of comparatively
worthless fish from a port to a distant town, whereas if the port were near the town the fish
might find a market there. On turning to the curves for south and west coast towns and counties,
some of the towns and counties present family likenesses inter se, but they show as a rule little or no
resemblance to the curves of the five east coast ports. It now remains to allude to some further important
evidence concerning the relation of fish and shell-fish to typhoid fever.
The Departmental Report of 1914.
In the year 1914 there appeared an important Report of a Departmental Committee on Inshore
Fisheries, in which many questions of very great industrial and epidemiological interest are touched
upon. The references therein made to the fish nurseries and shell-fish layings in shallow and estuarial
waters, and to the pollution of the same by sewage, throw further light upon typhoid fever prevention.
They may be grouped under the following heads:—
(a) The sources, mainly estuarial waters, from which the smaller flat fish are obtained.
Q. 525 elicits the answer: "We know the important grounds where plaice occur on either side
of the North Sea in a small condition, and we know too that the strip along the English coast generally
is an important area for small plaice and small flat fish."(In an earlier Blue Book it is stated that—" The
Lowestoft vessels fish about the Gabbard and Kentish Knock, which is practically a part of the estuary
of the Thames." "I believe it is a fishing nursery all in that estuary." "For flat fish?"—
"Yes, the same as the estuary of the Tees and the same as the estuary of the Ilumber.")
Q. 4539: "Do you find that, owing to the eastern current, the ova of deep sea fish drifted to
the eastern side of the North Sea, and that there were miles of ground suitable for nurseries for these
small flat fish, and the fishermen pursued the fish until they saw they were going to destroy the golden
egg and appealed to the Government to prohibit the sale of smallundersized flat fish?""I am
speaking of the coast of Denmark of the Bight of Heligoland and the Dutch coast . . . and the German
coast."
Q. 5687: "Are immature fish used for anything else besides baiting lobsters ?"—"No, only
what we say, sir, some people eat the little fish; no doubt little plaice are sold for these fried fish shops
very small fish are to-day." Q. 5688: "But practically their only value is for bait ?"—"That is
all,'really."
Q. 5750: "In every district, according to local knowledge, where there is shallow water and
where plaice and flounders and dabs pass the stage when they are the size of sixpence to five shillings
or upwards, and it may be until they are 1 lb. in weight, I should protect, not all of them, but I should
protect certain selected areas and appropriate areas in every district."
Q. 6326: "Do you find that there are many undersized flat fish come through Parkeston; from
the Continent ? "—" Yes, from Parkeston."
Q. 6329: "Do you find there are many undersized flat fish come in that way, more particularly
plaice?"—"More particularly from Parkeston, there is a lot. Across on the other side there is a limit,
I think, of ten inches; it is perhaps eight inches, but, anyhow, I think many a time they take the large
out and we get the small."
Q. 6573 (el infra): "They catch a lot of small flat fish from Ramsgate, do they not?"—"Yes,
they catch a good many" ''Pegwell Bay is a case in point; it has been a very difficult thing
to get a regulation made with regard to it" ''They come into the shallow water at Pegwell Bay to
escape from their enemy the larger fish."
Q. 6719: "Being so close to the coast of France we have a considerable number of these French
trawlers which slip in on moonless nights Last year there has been less poaching, but still a considerable
quantity goes on, and there is a very bad feeling existing between the men at Boulogne and