A manual of practical hygiene / by the late Edmund A. Parkes.

  • Edmund Alexander Parkes
Date:
1891
Catalogue details

Licence: Public Domain Mark

Credit: A manual of practical hygiene / by the late Edmund A. Parkes. Source: Wellcome Collection.

    33/844 (page 9)
    Pettenkofer has repeated and extended the inquiry with the same results. The point has been also numerically investigated by Seidel ^ in Munich and Leipzig for the years 1856-64 and 1865-73, and from a mathematical consideration of the numbers he concludes that, according to the theory of probabilities, it is 36,000 to 1 that there is, in each period, a connection between the two occurrences.^ Other observations in Germany are con- firmatory,^ but in this country the connection has not been traced. In some outbreaks of enteric fever the ground water has been rising and not falling. Fodor^ says that at Buda-Pesth the rise of enteric fever mortality accompanies the rising ground water, and the two fall together. In other instances the attacks have been traced to impure drinking water or milk, to sewer emanations, or to personal contagion, and the agency of the ground water has appeared to be quite negative. Dr Buchanan ^ has quoted a case in which the sinking of the ground water and the outbreak of fever were coincident, and yet the connection was, so to speak, accidental, for the efficient cause of the outbreak was the poisoning of the drinking water with enteric evacuations. And he also points out that when the ground water has actually been lowered in certain English toAvns by drainage operations, enteric fever has not increased as it should do, according to theory, but has diminished, owing to the introduction of pure water from a distance. He thus thinks that, while a connection between the prevalence of enteric fever and sinking of the ground water must be admitted to exist, it is indirect, and the true cause of the fever is impurity of the drinking water. Petten- kofer has replied to this view,® and denies, from actual analysis, the fact of the contamination of the drinking water in enteric outbreaks. The observations of Pettenkofer, and the case of the barracks at Heustift, recorded by Buxbaum, are certainly in favour of the opinion that a direct connection may exist in some cases between the sinking of the ground water and outbreaks of enteric fever; but the frequency and extent of the connec- tion remains to be determined, and in this country, at any rate, the other conditions of spread of enteric fever appear to be far more common. Assuming the truth of the connection, the other conditions which Pettenkofer considers necessary, besides a rapid sinking of ground water 1 Zeitsch. fur Biologie, Baud i. p. 221, and Band ii. p. 145. 2 Ranke, however, pointed out that no enteric fever existed in the neighbourhood of Munich biat what was imported from Munich, although soil and ground water were the same. Munich has a soil consisting of fine sand, with a peculiar power of holding nitrogenous substances ; it was provided with cesspools, from which more than 90 per cent, of the contents soaked into the surrounding soil, and, as the streets were well paved, the houses were the only outlets for the foul soil-air. Virchow, in his Report on the Sewerage of Berlin, showed that the mortality was greatest in July and August, the curve corresponding accurately with the variation of the ground water, the death-rate being greatest at the lowest level; this was chiefly due to deaths under one year. At the lowest level there was every year a little epidemic of enteric fever. At Zurich in 1872 the results were directly opposed to Pettenkofer’s views (see Lectures on State Medi- cine, p. 101). Geissler considers the influence of the rise and fall of the ground water a local matter, and agrees with Rudolph Rath in attributing the enteric fever of Berlin to contami- nated water. The case of water transmission (which he quotes from Hagler) in the village of Lausen is a very conclusive one. {Schmidt’s Jahrhuch, 1874, No. 2, 185 ; also Archiv fur Klin. Medicin, 1873, p. 237; see also an abstract in the Report on Hygiene, Army Med. Reports, vol. xv. p. 197.) Vogt of Bern {Trinkwasser oder Bodengase) strongly supports Pettenkofer’s views, and considers the propagation by drinking water as illusory. 3 Buxbaum, “ Der Typhus in der Kaserne zu Neustift,” Zeitsch., fur Biologie, Band vi. p. 1. This seems strong evidence in favour of Petteukofer’s view. Op. cit- 5 Medical Times and Gazette, March 1870. 3 Medical Times and Gazette, June 1870; and Vierteljahrschrift fur dffentliche Gesunds- heitspfege, 1870, Band ii. pp. 176, 197.