Typhoid Fever

The reading that caught my attention, the most this week, was the reading about typhoid fever.  What it seems to me is that a doctor wrote it about the lack of science in public health.  William Budd writes about typhoid fever, which is a highly contagious disease cause by the Salmonella virus.  He describes his experience with typhoid fever in the introduction “How often have I seen in past days, in the single narrow chamber of the day labourer’s cottage, the father in the coffin, the mother in the sick bed in muttering delirium, and nothing to relieve the desolation of the children but the devotion of some poor neighbour who in too many cases paid the penalty of her kindness in becoming, herself, the victim of the same disorder!”  Everyone that came in contact with the disease seemed to be getting it.  After doing some research on typhoid fever, I learned that you can catch it even if symptoms have subsided, if it is not treated correctly.  So while people may have thought they beat the fever, it was still lurking.

William Budd then quotes what scientists think from the time ‘Much doubt prevails whether enteric (typhoid) fever be infectious or not, and the question really turns upon the existence of a distinct, specific poison.  Positive proof that it may be conveyed from one person to another is wanting, and certainly the majority of people affected with the disease derive it, upon the clearest evidence, from one and the same source.”  But this was clearly wrong as we now know that typhoid fever is highly contagious.  This reminds me of the previous reading dealing with the water pump, which stopped some outbreak of the disease but did not deal with the cause.

He then gives three reasons why contagion is widely ignored .

1. The first is, that medical writers, and especially those among them who exercise the widest influence, pass the greater part of their lives in great metropolitan cities -amid conditions, that is to say, under which, for reasons that will abundantly appear in the following pages, the operation of contagion in this particular fever is not only masked and obscured, but issues in a mode of distribution of the disease, which to the superficial observer would appear to exclude the idea of contagion altogether.

People living in crowded cities find reasons that are easier to explain than contagion.  Its easy to say that there is a common source, i.e. a water pump, then the esoteric idea of contagion.

2.  The great zeal with which during  the whole  period  of its existence,  the  General  Board  of  Health, backed by an  able and energetic staff and unlimited printing power, continued to urge anticontagionist doctrines.

This seems weird because in crowded cities contagion would run even more rampant but still it was overlooked.  Who knew how many lives could have been saved if we urged contagionist theories earlier.

3. The continued prevalence of very limited views as to what constitutes  evidence  of  contagion  or  self-propagation  in the case of disease.

The theory of what contagion was, wasn’t straightforward.

Budd constantly relates stories of how all the evidence pointed to contagion, the story of a dance/ball where everyone caught the fever but it was attributed to a water source that was contaminated.

Eventually we came to the conclusion that contagion does in fact exist and is a driving force in spread of disease.  However I think that, as science became more advanced, were able to develop the correct theories.