Typhoid fever and typhus fever / by H. Curschmann ; edited with additions by William Osler ; authorized translation from the German, under the editorial supervision of Alfred Stengel.

  • Curschmann, H. (Heinrich), 1846-1910.
Date:
1901
Catalogue details

Licence: Public Domain Mark

Credit: Typhoid fever and typhus fever / by H. Curschmann ; edited with additions by William Osler ; authorized translation from the German, under the editorial supervision of Alfred Stengel. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    was thought that at least an increase in the mortality from typhoid fever could be demonstrated in association with unusual dryness. Although the supporters of the ground-water theory were unable to form anv definite conception of the nature of the typhoid poison, and even permitted interest in this to lapse further in the background the more they became involved in the ground-water theory, they adhered to two views still valid at the present day, namely, the specificity of the poison and its capability of germination and multiplication. Truth and error were, however, mixed in the further belief that the poison after passing through a necessary process of maturation in the earth passed from this into the human body, being most frequently transmitted through the air, rarely through water or through other media. The escape of the poison from the earth, its exhalation, was believed to be rendered difficult in damp weather and with a high level of the ground-water, for the reason that its breeding-point would be covered by this water, and thus be cut off from the surface of the earth ; while when the level of the ground-water was low the deleterious layer of earth would be in direct communication with the atmospheric air through the ground-air, and there would thus be no obstruction to the emanation of the poison. Apart from the fact that the theory of Pettenkofer ignored the nature of the typhoid poison and retarded its study, it was further attended with the not inconsiderable disadvantage that it brought strongly into the foreground, although as it now appears without suffi- cient ground, the dissemination of the poison through the ground-air and thence through the atmospheric air, and as a result greatly checked for a time the study of other etiologic possibilities. It is especially interesting to consider the effective objections of Lieber- meister ' and subsequently of Biermer2 to the ground-water theory and dis- semination through the air, and to note their discriminating support of another mode of dissemination, namely, that through water-infection. Their views also gained numerous adherents. The ground-water theory, however, remained for a time so firm that in not a few places epidemiologic investi- gations were adapted to it, instead, conversely, of deducing etiologic views from the facts. As late as the years 1886 and 1887 the author of this article had such an unfortunate experience.3 When he endeavored to trace the epidemic occurrence of typhoid fever in Hamburg at that time—more than 10,000 persons had been attacked—to specific infection of the water obtained from the river Elbe, and used for drinking and domestic purposes, it was found that certain circles did not consider it worth while to take this pos- sibility into consideration. The ground-water theory was believed to be 1 Gesammte Abhandlungen. 2 Volk?nann's Samml. klin. Vortr., 1873, No. 53. 3 Curschmann, Statistisches und Klinisches über den Unterleibstyphus in Ham' burg, Deutsche med. Wochenschrift, 1888.