Typhoid

an acute infectious fever. It is due to a poison produced in the system, particularly in the alimentary canal, by a horde of one-celled, microscopic plants known as bacteria or bacilli. The typhoid bacillus was discovered by the German Eberth in 1880. The bacilli are so small that from 8,000 to 25,000 placed end to end measure only an inch. The length is about twice the width. Seen under a powerful microscope, the typhoid bacilli are said to look like links of sausage, furnished each with a dozen twisted arms or hairs. These arms, called flagella, because they whip about, enable the bacillus to move rapidly in a liquid. The natural home of these typhoid germs is in man. They pass by the million in the body wastes of every typhoid patient; they are capable of living for a time and of multiplying in water, milk, many kinds of food, and in certain soils. They gain access to new victims only through the mouth. A person may be in the midst of typhoid and wait on typhoid patients without danger, so long as he neither eats nor drinks, or so long as he can be sure that his food and drink contain no typhoid germs. There are a thousand avenues by which the typhoid germ may approach, but all pass through the mouth.

Milk is a carrier of germs. A case is cited of a dairyman's wife who nursed a neighbor through an attack of typhoid, but conveyed the germs on her hands to her husband's milk cans and sent the fever to thirty-nine of his customers. A dairyman at Stamford, Connecticut, washed his milk cans at a contaminated well and carried fever to 378 customers. A gentleman who had the typhoid visited a friend for a day or two. Some milk bottles, emptied in the house during his visit, were returned without proper scalding, and carried the disease to twenty-eight customers. Once the typhoid bacillus gets into milk, it multiplies with rapidity. An English scientist devised a method of noting the increase. He started with a small colony of 78 germs; in twenty-four hours they had increased to 6,000 and in another twenty-four hours they numbered 10,000,000. In a week he computed the number on hand at 440,000,000. Milk may be frozen and churned without seeming injury to the typhoid bacillus. The only way to exterminate it in milk is to boil the milk and then seal it up to prevent new germs from getting in by means of dust or flies. It is thought that a bacillus colony is capable of living in milk and milk products for a month or six weeks before dying out.

Drinking water is a carrier of typhoid. It may be clear, sparkling, and icy cold, and yet be infested by the germs of typhoid. One spring the disease broke out in the mining town of Plymouth, Pennsylvania. Out of 8,000 people, over 1,000 were down with the fever; business came to a standstill; 114 lives were lost; in direct expense and wages the miners suffered a loss of $100,000.

The town was supplied with water from a clear mountain stream. Nobody suspected the drinking water. Investigation revealed the fact, however, that a lone camper in a cabin on the banks of the stream among the hills had fought with typhoid for his life during the dreary weeks of winter. He had thrown the wastes out on the snow. When the spring thaws came the germs had been washed into the stream where they multiplied, with the result stated. A privy used by persons having typhoid fever overhung a brook in Lowell, Massachusetts. The use of water thus contaminated caused a thousand deaths. For the reasons named, city authorities pay attention to the shores of the reservoirs from which water is obtained. The bacilli flourish in running or open water from six to ten days. If they do not reach a human host by the end of that time they die out. Well water is a frequent source of infection. If a well be situated near a privy or place where wastes are thrown, the germs are likely to seep through the ground into the well and contaminate the water. Many a neighborhood epidemic has been traced to the use of water from a contaminated well. If there is the slightest reason to doubt the purity of water, it should be boiled before it is used for drinking purposes. In 1891 the death rate from typhoid in the city of Chicago was 160 per 100,000 people. In 1895, after the completion of the drainage canal, the typhoid rate sank to 16 per 100,000 people.

Physicians have traced typhoid to the use of celery and lettuce raised in a garden where the soil has been contaminated. They have shown that, while the germs die in about four hours if exposed to sunlight, they live for months in the upper inch of moist soil. Oysters taken from river beds into which the discharge from sewers finds the way, are a dangerous source of typhoid. English army physicians traced an outbreak of typhoid on board a training ship in the Thames River to a bale of blankets that had been used in a typhoid camp in the Boer War six months before.

Fingers, dust, and unwashed utensils are the means of carrying the typhoid germ to our food, but the common domestic fly is said to be the worst agency of all. Let the house flies gain access to the germs from a typhoid patient and they will spread them all over a camp or town. The pests walk in filth, eat filth, fly everywhere, tramp over food, dip their polluted mouths into food, and drop flyspecks on food everywhere. An examination of a single flyspeck has revealed the presence of thousands of germs. Authorities are emphatic in saying that all litter, manure, filth, or refuse in which flies can lay their eggs and rear young should be cleaned up to prevent the appearance of midsummer swarms; that screens should be used to prevent flies from approaching the patient, and that the wastes of a fever patient should on no account be exposed to flies. A neglect of these precautions subjected 22,000 American soldiers to typhoid during the Spanish-American War and cost the lives of 2,000 men. Inasmuch as a person cannot have typhoid except he take germs into his system that have come recently, directly or indirectly, from a typhoid patient, the case is one for the application of the old proverb, an ounce of prevention is worth a pound of cure.

If, then, the typhoid germ multiplies so rapidly and is communicated so readily to food and drink the wonder is that anyone escapes. Fortunately the body is not helpless. The white corpuscles of the blood are the scavengers, the health patrol, of the body. The white corpuscle and the typhoid bacillus are enemies. The typhoid germs either attach themselves to the white corpuscle and begin to feed on it, to transmute its material into a host of bacilli or bacteria by which other corpuscles are absorbed, or else they produce a poison or toxin which destroys the white corpuscles. On the other hand, the white corpuscle in some way has the power of destroying bacilli. A battle goes on; if the corpuscles win the fight, as they generally do, the person knows nothing of the danger he has escaped. If, for any reason, the bacilli win, the patient comes down with fever; his blood becomes thin, his temperature rises, the flesh wastes away, and the germs run riot in the body, pervading even the spittle and the perspiration. If outbreaks of bleeding, or of ulcers that eat holes in the intestines, do not cause death, the system rallies and in a way not understood, seeing that the white corpuscles have been destroyed, begins to produce a toxin that destroys the bacilli. In from four to six weeks, if no relapse takes place, the patient may hope to be on foot again. The anti-bacillus toxins appear to remain in the system and to render the person immune for a time. Strangely enough, young, strong people, persons whose blood dances through the veins in the exuberance of health, suffer most from typhoid. According to the census bureau of the United States the number of deaths from typhoid in 1907, within the registration area, was 12,670, or 30.2 for each 100,000 people. The registration area comprises those states and cities in which the death record is kept with care. It includes 42,000,000 people.

To summarize, the home of the typhoid bacillus is the intestinal canal of man. It lives and multiplies for a time,--hours, days, weeks, and even months,--in milk, water, soil, or cesspools, and it may exist for a long time in dust, but, except in man, it finally loses its vitality. If new cases of typhoid could be prevented for a few short months the scourge would disappear. All cases are due to eating or drinking or possibly to breathing germs. Typhoid fever is due, to speak plainly, to eating or drinking human filth in microscopic quantities. Sanitation--keeping body wastes out of our food and drink--is the cure. The prevalence of typhoid in lumber camps, military camps, and in new settlements, is due to filthy conditions and want of sanitation,--nothing else.