THE New Zealand Times (PUBLISHED DAILY). TUESDAY, JULY 30, 1889.

New Zealand Times, Volume LI, Issue 8745, 30 July 1889, Page 4

THE New Zealand Times (PUBLISHED DAILY).

TUESDAY, JULY 30, 1889.

With which are incorporated the Wellinyt-u. Independent , eitablished 1845, and the Nev Zealander,

Reluctant as we all typhoid must be to admit a fact petee. so unwelcome in itself, and reflecting so unfavourably upon the sanitary condition of Wellington as the pre valence of typhoid fever in our midst, it would be idle to deny that such, unhappily, is the case. Two prominent citizens have already fallen victims to the fever, and the life 'of a third still hangs on the balance. We are informed by one of the leading medical practitioners of this city that at thepresenttimethere are no fewer than eight typhoid fever eases in one street, and others scattered about the place. It is notorious, however, that the fever prevails chiefly in one particular locality, and that not’ in any “ rookery,” or in the more crowded part of the city. Such an outbreak at midwinter has naturally excited a good deal of astonishment as well as consternation, and various theories have been broached to account for what at first sight seems phenomenal. Perhaps the favourite notion is that the infection is due to the distribution of fever germs in milk from uncleanly dairies. That milk is a very common vehicle of infection is well known, and it is quite possible that it may have played that part in the present case, but this still leaves the origin unaccounted for. The disease may have been spread to some extent by milk, but it must have existed in the first instance to be capable of diffusion in this way. The question is—How did the outbreak originate ? This is not easy te answer, but we may touch on a few points which seem to throw some little light on the matter generally. In the first place we may point out that the outbreak of typhoid fever at the present season is not so phenomenal an occurrence as it might appear at first sight. Every year, unfortunately, witnesses a greater or loss prevalence of typhoid at a particular period. That period is usually the beginning of autumn, sometimes earlier, sometimes later. But although the actual date is variable, the outbreak follows a very clearly-defined rule. It always comes after the first autumn rains. Such, at least, has been the local experience for some years past. If the dry weather breaks up earlier-than the calendar autumn begins, then we find typhoid prevalent in February or March. If the first autumn rains come at the normal period —at the end of March or beginning of April—we soon hear of typhoid cases. This year it was a subject of general congratulation that typhoid fever seemed almost unheard of in March and April. Bat on the other hand it must be remembered that we had virtually no rain at all of any consequence up to the latter half of last month. Some considerable rainfalls then took place, practically the first autumn rains, and now we have the customary sequel, only in a more severe form than usual. ¥e do not attempt to theorise on the matter. We do not even assert that this sequence of events represents cause and effect. We simply state the fact, which may be susceptible ©f various explanations.

Whether a certain degree of moisture is essential to the development of the typhoid germs, or whether the rains wash them out ot their hiding places in the soil—where it is known they may lie long dormant—we cannot pretend to say. We do not venture to pronounce on this question Some of the greatest medical authorities are at variance as to the nature and origin of typhoid fever, or “ enteric fever ” as it is more accurately named. There are two main theories on this head. The older one is that the typhoid poison may be generated by the fermentation of sewage and of other animal filth This view is supported by the almost invariable association of the disease with insanitary local conditions and by its frequent occurrence in circumstances which seem almost to preclude the possibility of its having arisen through infection from a previous case. But the later and more generally adopted theory is that the complaint is due to a specific bacillus, and that it is derived only from some pre-existing case of the disease. Indeed, the typhoid bacillus is said to have been authoritatively identified as found in the blood and in the tissues, According to this riew of the case the disease can only be communicaied through the evacuations and by the germs from these finding entrance in some way into the intestines of another person, when, if the conditions be favourable, they proceed to develop, and thus cause a fresh case of the, fever. The evidence in favour of this view is pronounced by one eminent authority to be “ overwhelming,” and searching investigations have established a connection in several instances which at first seemed explicable only on the alternative (or “ pythogenic ”) theory. It has been plainly proved that the germs may remain long dor tnenfc, yet still retain their full infective capability, and that they may be conveyed long distances by water : may be carried by drainage into the sources of springs; miiy be swallowed in drinking-water by human beings, and thus convey the poison direct to its mark; or, the water being drunk by cows, may thus find its way into their milk and thence to the intestines of the human recipient, where it at once begins its evil work. It may be asked bow, if the poison be so specific in its nature and in the mode of it« transmission, the occurrence of typhoid epidemics can be affected by ordinary sanitary conditions, inasmuch as the disease requires the direct communication of the germs from a previous case of the fever. To this there is a very clear and cogent answer. It is quite true that, in the opinion of most modern experts, the disease is transmitted only by infection from a former case. But such infec tion requires special conditions. The germs will not flourish in every human being. They require a soil suitable to their growth. And such a suitable soil, such specially favourable conditions are found in nearly all persons who have been exposed to insanitary influences, such as bad drainage, foul air, or unwholesome surroundings of any sort, or who are in poor health, or have suffered from any complaint of a weakening chaiacter. All these things tend to depress the strength and lower the vitality, and thus a fertile soil for tie propagation of typhoid germs is at once produced. There is no doubt that the typhoid poison may enter many healthy and well-nourished bodies, and pass harmlessly away. But let the vitality be lowered by the inhalation of sewer gas or other foal air, by exposure to any insanitary conditions, or by any other cause, and then the entrance of the poison into the system is almost certain to involve the communication of the actual disease.

These clearly demonstrated scientific facts point most forcibly to the urgent necessity of stringent precautions against the diffusion of the fever. Every fresh patient is a new source o! further danger. Yet the peril may be reduced to a minimum by the thorough disinfection of the evacuations before these are thrown away. This ought to be an invariable rule. Supposing, however, that some germs nevertheless escape, then the risk of contagion may further be minimised by good drainage, by rigid care as to drinking-water and milk, and by the observance of sanitary rules generally. All water and milk as to which the slightest suspicion can exist should be boiled before being used. A strict inspection of dairies is as imperative here as it has long been found to be in London and other large cities, and wo need hardly say that a better system of city sewerage is indispensable to the public safety. The present typhoid outbreak strikingly shows how unwarrantable and premature were the felicitations so generally indulged, in three months ago, upon the city’s freedom from this annual scourge. It is to be hoped that the lesson, sad and serious as it is, may bear speedy and salutary fruit in the shape of sanitary reform.