The etiology of typhoid fever and its prevention : being the Milroy lectures delivered at the Royal College of Physicians in 1902 / by W.H. Corfield.

  • Corfield, W. H. (William Henry), 1843-1903.
Date:
1902
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Licence: In copyright

Credit: The etiology of typhoid fever and its prevention : being the Milroy lectures delivered at the Royal College of Physicians in 1902 / by W.H. Corfield. Source: Wellcome Collection.

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    of excretal refuse, but especially by pollution of drinking- water by such foul matters. In the early times in the investigation of the causes of this disease it was considered sufficient to show that a place where it prevailed had its water, air, or soil or any or all of them contaminated with excremental filth. Thus, in the third report of the medical officer of the Privy Council, published in 1860, outbreaks in Bedford, Bath, and Kingston-Deveril (Wilts), and Dronfield (Derbyshire), are reported on, and in all of them it is con- sidered sufficient to show the state of things just mentioned. But the inspectors of the Privy Council, headed by Dr. Buchanan, and under the guidance of Mr. Simon, were very soon not satisfied with such investigations and adopted the plan of, as far as possible, tracking each outbreak to the special circumstances more particularly associated with it. We will now consider a number of instances in which cases of outbreaks have been caused in this and other coun- tries, beginning with those which have been connected with general insanitary conditions, and I shall, as far as possible, quote the actual words of the reporters, as that will make the information much more valuable than if I summarised the reports myself. In the sixth report (1863) of the medical officer of the Privy Council is a report by Dr. J. S. Bristowe on fever at Whitehaven. He satisfied himself that the cases were undoubtedly cases of typhoid fever. He came to the conclusion that the fever was spread by means of general filthy conditions. He says : “I have no hesitation in assert- ing that there is no English town with which I am acquainted where the sanitary circumstances (with one or two exceptions) of the inhabitants, and especially of the poor, are in a more disgraceful and degrading condition. The houses of the labouring population (more particularly in the central parts of the town) are crowded together in a way which is scarcely conceivable ; the houses are for the most part dirty, dilapidated, and imperfectly (if at all) ventilated ; they are overcrowded and the cellars are habitually let out as tenements ; houses, courts, and even streets are without any privy accommodation and where privies are provided they are of the most objectionable kind and generally most objec- tionable as regards their situation ; drainage scarcely exists. ” And it must be remembered that this is the opinion of a metropolitan medical officer of health. Under the heading “ Causes of Pever ” he says that the condition of things dis- closed in the statement just made “amply accounts for the present epidemic of fever ; indeed, it is difficult to suggest any measures for producing typhoid fever so likely to be efficient as those which have allowed Whitehaven to be degraded into its present filthy state. ” In the seventh report of the medical officer of the Privy Council (1864) is a report by Dr. Bristowe on fever at Grant- ham. He states that it was “true typhoid or enteric fever.” He shows that it was not caused by the water-supply because it was distributed amongst persons supplied from various