The Johns Hopkins Hospital Reports (Volume 4)

This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1895. Excerpt: ... VIII.--TYPHOID FEVER IX BALTIMORE. BY WILLIAM OSLER, M.D. Among the cities which still pay an unnecessary Delian tribute of young lives to the Minotaur of infectious diseases, Baltimore holds a high rank. The pity of it is, too, that this annual sacrifice of thousands of lives (2281 for 1892, not including consumption), is not due to ignorance. For more than fifty years this gospel of preventive medicine has been preached--whether they would hear or whether they would forbear--in the ears of councils and corporations: that three measures, efficiently designed and effectually carried out, reduce to a minimum the incidence of infectious diseases; viz., pure water, good drainage, and a proper isolation of the sick. Of sanitary essentials in a modern town, Baltimore has a well-arranged water supply; still, however, with unprotected sources and constant liability to contamination. It has nothing else--no sewage system, no system of isolation of the sick, no hospital for infectious diseases, no compulsory notification of such a disease as typhoid fever, no disinfecting station, no system of street-watering, no inspection of dairies, no inspection of meat. The streets are cleaned, but so carelessly that for a large part of the year the citizens breathe a mixture of air with horse-dung and filth of all sorts. Perhaps the best gauge of the sanitary condition of a city is to be found in the mortality returns from typhoid fever. The Incidence Of Typhoid Fever During The Five Years 1888-92. To the deaths from typhoid fever have been added the cases returned as typho-malarial fever, since no reason now remains for separate classification. We may speak for this latitude with some confidence upon this point, after a study of some 300 cases of typhoid fever, in not one ...