View report page

11
abundant supply of clean pure air, by which the poison may be
oxidized and destroyed or diluted until it ceases to be operative,
and which can only be obtained by plenty of cubic space and
effectual ventilation; secondly, the removal of the secretions of
the skin by frequent sponges of the surface, and by frequent
changes of bed and body clothing; thirdly, the passing of all
articles which have been in contact with the patient through some
chymical solution of a disinfecting character before being transmitted
to healthy persons to be washed or otherwise dealt with.
" Relapsing Fever" is a disease very different from Typhus in
its course and character, but appears to resemble it in the conditions
of its diffusion. It occurs in great cities as an occasional epidemic,
which is usually traceable to contagion derived from some foreign
country, but which once established is often obstinate. Relapsing
Fever rarely kills; and the principles of prevention which apply
to Typhus are those by which it must be controlled.
The third form, Typhoid, or " Enteric Fever," is the common
fever of this country, which destroys, on an average, about 12,000
people annually, and which sickens and endangers about 100,000
more. It is spread abroad chiefly, and probably exclusively, by
the discharges from the intestine. These, in the natural course of
things, find their way into cesspools and sewers, and when they do
so, render poisonous the solid or liquid contents of these receptacles,
and also the gas which is evolved from them.
The fever is reproduced, mainly in three ways,—first, by the
poisoned sewage obtaining direct access to drinking water, by
leakage or soaking, and so being swallowed; secondly, by the
poisoned gas escaping from sewers into water mains or cisterns, so
that it is absorbed or dissolved by the water, and so swallowed ;
thirdly, by the poisoned gas making its way through badly trapped
drains, or other channels, into dwelling or sleeping rooms, and so
being breathed by the occupants.
It follows that the form of cleanliness which can be effectual
against Typhoid has reference only to the intestinal discharges.
The Typhoid patient is harmless, except through this single
medium; and if the poisonous character of the discharges was in
all cases destroyed by chemical agency before they were cast away,
the disease would speedily, so far as our present knowledge of its
b 2