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25
In considering this question it is desirable first to point out
briefly some of the more important characters of the disease
before us. Typhus fever is an infectious fever, but though infectious
is far less so than either scarlet fever or small pox;
and hence it happens that, although it spreads rapidly and with
virulence in the presence of the overcrowding, ill-ventilation and
want of cleanliness, which characterize the dwellings of many of
the poorer classes, solitary cases have been known over and over
again to occur in the houses of the better classes without the
extension of the disease to any other member of the household.
Typhus fever again, like small pox and scarlet fever, is one of
those affections which as a rule happen only once in a life time;
and hence those who have once had it may be regarded as safe
from future attacks; hence too when the disease has been sbsent
for some years from any locality, and but few of those who have
had the disease remain, the population becomes susceptible of
its contagion, and the disease, if by any accident introduced,
tends to assume among them an epidemic and virulent character,
and to prevail, unless precautionary measures be adopted, until
it has invaded the whole of the unprotected portion of the
population.
These considerations serve to shew that, among the better
classes, the disease may be left with propriety to be dealt with
by those who are personally interested in the welfare of the
sick; but that among the poorer classes, both in the interests
of those who who are attacked with the disease and in the interests
of those among whom they dwell, the sick should
be removed from their residences and treated away from their
families in appropriate institutions.
It will, perhaps, at once suggest itself that we already possess
these institutions in our general hospitals and in the London
Fever Hospital. And no doubt these places, in years when there