Vol. 60, 1909 - University of North Carolina at Chapel Hill

ORIGINAI, COMMUNICATIONS. 81
typhoid bacilli has been advocated by particularly in the rural districts, there is
Wrig-ht as a protective inoculatioji in per- often an absence of proper sanitation. Many
sons who are likely to be exposed to danger of our country districts have yet to learn
of infection. According to a recent report the A. B. C. of sanitation. With some of
of the board of ofScers of the U. S. Medical the conditions favoring; the persistence of
Reserve Corps, Dec. 7th, 1908, it was found typhoid infection we are not yet familiar,
that the practice had been used to vaccinate but the chief danger results from impure
about 1.5,000 men* in the English and Ger- water supply in the smaller towns, local
man colonial armies, and complete and house epidemics due to infected wells, and
carefully compiled statistics had been col- milk outbreaks due to the infection of dairy
lected, from a consideration of which the farms.
board was convinced that the vaccination The use of boiled water and of ice made
was quite harmless and that it would be of from distilled water, the systematic inspecgreat
service in diminishing the amount of tion of dairies, the scrupulous supervision
typhoid fever among troops, especially in of the sources from which the water is obtime
of war. It therefore recommended tained, an efficient system of sewage rethat
the practice of vaccination be intro- nioval, and, above all, the greatest possible
duced into the regular and volunteer armies care on the part of physicians and nurses
in time of war; and that in time of peace in the disinfection of the discharges of tyall
the men be given an opportunity to be phoid fever patients,—these are the measprolected
against the disease, and that ures necessary to reduce to a minimum the
special efforts be made to vaccinate as prevalence of typhoid fever,
many of the Hospital Corps and Nurse Typhus Fever.—Notwithstanding the fact
Corps and any others especially exposed as that nothing has yet been determined conpossible.
The immunity conferred lasts cerning the micro-organisms exciting this
from one to three years. disease, no one of the acute infections in
Another important practical application man seems to have been more dependent
of our knowledge of the specific substances upon filth and unsanitary conditions, and
developed in the lilood of persons sick with none has been more benefited by modern
typhoid fever, is the Widal or serum reac- hygiene or preventive medicine. Until the
tion as an aid to diagnosis. It is based middle of the last century this disease preupon
the fact that living and actively vailed widely in the larger cities,particularly
motile typhoid bacilli, if placed in the dilut- in luirope, and also in jails, ships, hospied
blood or serum of a patient suffering tals and camps. It was more generally
from typhoid fever, within a very short prevalent even than typhoid fever and much
time lose their motility and l)ecome aggluti- more fatal. With the gradual introduction,
nated into clumps. I-'roni an exi)erience of, however, of drainage and a good water suptwelve
years of this test, it may be said ply, and the relief of overcrowding, the disthat,
though not infallible, when performed ease has almost entirely disappeared, and
with due regard to the avoidance of every is now rarely mentioned in the lists of morpossible
source of error, it is as reliat)le as taiity, except occasionally in a few of the
any other bacteriological test at present in larger and more unsanitary cities or ports.
use, and is of the greatest value as an aid Asiatic Cholera.—This disease, also pecuto
the clinical diagnosis of irregular or ob- liar to man, is still one of the scourges of
scure cases of typhoid infection. the present times, having recently made in-
Although preventive medicine can rightly roads into Europe and America from India,
claim to have successfully controlled this its native home. It is caused by the
disease in certain localities and under proper "comma bacillus" or Spirillum Cholerae
hygienic conditions, especially where there Asiaticae, discovered by Koch in 1883. Its
h«s been a pure water supply and perfect mode of infection is through the mouth by
drainage, still typhoid fever is very preva- drinking contaminated water, also possibly
lent in this country. This depends mainly by eating food infected by flies, etc.
upon two facts: I'irst, )iot only is the ty- Not every one exposed to infection is atphoid
bacillus very resistent, but it may re- tacked by cholera; according to the greater
main for a long time in the body of a per- or less power of vital resistance of the body
son after recovery, and such persons in ap- the same infectious material may give rise
parent good health may act as carriers of to no disturbance whatever, a slight diarinfection
for months or even for years, ex- rhoea, or it may lead to serious results,
ceptionally; second, and doubtless this is I'urthermore, it may be accepted as an esthe
essential factor in the prevalence of tablished fact that recovery from one attack
typhoid fever in our section of country, of cholera produces individual immunity to
a second attack for a considerable length of
"Report.s had been received of about 100,000 men .;,„«
vaccinated, but in only 15,000 cases were statistics •
,,,'.,, • ... , . r 1 1 m
carefully collected. Within the last few years Ilaffkine, lu