Epidemiology before Bacteriology


Meanwhile privies, pigstyes and dungheaps continued year after year to exhale
ill
odours, without any specific effect on the public health.
0  . 0  0   . .   0 . . . .  . .  . .  . . . . .          .. . . .0 0
  For the development of this fever a more specific element was needed than
either swine,
the dungheaps, or the privies were, in the common course of things, able
to furnish.
   This specific element was furnished in the excreta of the first case.
By excellent epidemiological studies, Budd traced the mode of spread
of many of his eighty cases together with others in neighboring villages.
   "The first thing to attract attention after the disorder had become
rife in North Tawton, was the strong tendency it showed, when once
introduced into a family, to spread through the household." By his
studies, Budd showed a high probability that the "specific element"
was in the intestinal discharges from fever patients and fresh cases
occurred through contact with the feces. In one town "the little stream,
laden with the fever poison cast off by the intestinal disease of the man
who had been stricken with the same fever some weeks before, was
the only bond between- the cases."
   In another series, "kept in strict separation from one another, as
far
as their persons were concerned, the common privy was almost the
only connecting link left between them." "Neither dirt nor rotting
manure cause the fever but some specific element breeding and multiply-
ing in the body and passing to well individuals by various routes."
It
was not the esthetically objectionable and disagreeable rotting feces
that were responsible for the spread of typhoid but some "specific ele-
ment" in the stools from a previous case.
  A clearer statement could hardly have been made until after the iso-
lation of the specific organism by Gaffky in 1884. Typhoid fever was
not reproducible in experimental animals, but numerous laboratory in-
fections with pure cultures have since then given ample proof of the
specific relationship of this microorganism to this disease.

Puerperal Fever
             OLIVER WENDELL HOLMES AND IGNAZ SEMMELWEIS
             If a pregnant woman be attacked
             by erysipelas of the womb, it is fatal.      HIPPOCRATES
  This bit of ancient wisdom, with stress on the modes of contagion,
was emphasized early by one of our most loved poet-physicians. "The
disease known as Puerperal Fever is so far contagious as to be fre-


35