Epidemiology before Bacteriology


43 persons. All persons who became ill partook of the well water of
the tavern whereas no cases occurred in three families that used their
own wells. Flint attributed the difference to the better diet and living
conditions of these wealthier families. In 1843 morbific emanations or
mineral poisons introduced into the well could be suspect, but it was
too early and the influence of anticontagionism was still too strong to
permit the idea of living microbic agents transmitted through drinking
water. In 187311 after reading the papers of Canstatt (1847), Riecke
(1852), and Budd (1856), Flint realized his error and made out an
excellent case for the contamination of the tavern well from a privy
attached to the inn. On his behalf, we must state that he spent only one
day at North Boston during which he performed one autopsy and ques-
tioned nine cases, while William Budd had spent years in the epidemic
area.
  Austin Flint came to our attention again the next year (i 874), in an
analytical paper in the New York Medical Journal on the "Logical Proof
of the Contagiousness and of the Non-catagiousness of Diseases." He
distinguished between "logical proof" and the "demonstrative
proof"
of the contagiousness in syphilis and gonorrhea, in smallpox, and in
several cutaneous diseases. He again referred to the writings of Budd,
and of Snow and of Simon "which seem to point to the presence of a
contagium   in drinking-water" during the cholera epidemics of
Britain. From a review of the literature and from his own experience,
he concluded that this disease is not spread by "fresh cholera-dis-
charges." "Although not contagious, cholera is, however, portable."
He declined to consider whether the special cause is a chemical prod-
uct, a living organism, or dead organic matter.
   In 1875 an excellent review article, "Bacteria and their Septic In-
fluences," by L. A. Stimson appeared in the same journal. (This paper
was abbreviated in the Popular Science Monthly.) Beginning with
Leeuwenhoek, the author quoted liberally, giving the then recognized
classification by Ehrenberg and some of his published pictures of mor-
phological types of bacteria. Stimson especially emphasized the im-
portance of the demonstration by Davaine of large bacilli in the blood
of anthrax cases, probably the causative agent. Articles on Lister's
methods appeared here and there, for example two were published in
the Boston Medical and Surgical Journal in i877, one of them by Robert
White who had had personal instruction by Lister in Scotland.
   Three decades after the Erie County epidemic, a paper by L. Woods


41