THE RELATION THE HOUSE FLY BEARS TO

TYPHOID FEVER AND OTHER INFECTIOUS

DISEASES

J. W. Palmer, M.D., Ailey, Ga.

I have written on this subject again to show the new development, proofs, and progress made during the last twelve months relative to the dangers of the house fly, and also, in order that the general interest may be increased, the subject continually agitated and kept vividly before our minds. The history of the Association has been that these important subjects die out as soon as they cease to be interesting before the meetings. For instance, the hook worm subject was getting to be noninteresting to the meetings until the million-dollar gift gave it new life.

Scientists of all countries have agreed on one thing, namely, that flies are carriers of disease germs.

Typhoid Fever Physicians, scientists, and the laity in in all countries have agreed that the house fly carries Typhoid Bacilli to our food and drink. They differ only as to the extent, and this is because we have no scientific means of definitely estimating the number of cases infected by them.

In my paper last year, I stated that the house fly was responsible for 85% of the Typhoid Fever cases in the cities and 95% in the rural districts. Some thought this a very wild and radical statement, but during the last twelve months, the best authorities claim, the flies have been proven to be responsible for 30% more cases than thought last year. It is only a question of a few years until the researches, investigations, and experiments along this line will convince the entire world that the

eradication of the house fly will eliminate Typhoid Fever.

The reason so many are slow to accept the fly theory is that they have failed to devote any time to the subject and give it any serious thought. About one month ago I wrote a letter to practically all the State Boards of Health and some boards in the large cities, asking that they give me their opinion as to the extent the house fly is responsible for Typhoid Fever. I received a reply from all, I think, and they claim the fly to be a great factor in the dissemination of Typhoid Bacilli; some believed they were the principal cause and others thought other causes more important. There was one particularly noticeable and interesting feature in these replies: those who said they had not given the subject much thought, nor made any experiments or investigations, were those who thought flies were not the principal cause, while those who had given the subject thought, with experiments and investigation,claimed that the flies were the principal

cause.

Dr. J. N. Hurty. Secretary Indiana State Board of Health, states that with only a few investigations he believes that the greater portion of Typhoid Fever has been carried by flies. Dr. S. J. Crumbine, Secretary Kansas State Board of Health, says he has traced Typhoid epidemics to the fly so often, where water, milk, and other things were not the cause, that it is his positive conviction that the flies are responsible, at the very least, for 50% of the cases in his state. Dr. W. C. Hassler, San Francisco, says he installed 6,000 concrete horse-stable floors and that in so doing destroyed practically the entire breeding places of flies and, as a result, he finds a great reduction in all communicable diseases and that typhoid fever and summer bowel trouble is practically a thing of the past. He further states that typhoid fever had been the disease principally considered by the Board of Health and showed by experiments in his own laboratory that nearly every case of infection was fly-born.

The Board of Health in Chicago claims the fly is re

sponsible for the largest per cent. of typoid fever cases and has been giving it a close study since Dr. Alice Hamilton, of Chicago, showed, in 1902, that one of their largest epidemics was due to the spread of the bacilli by flies.

There was an epidemic of paratyphoid fever at Weyers Cave, Va., last summer. The epidemiological studies showed that it was not water, milk, shell fish, fresh vegetables, fruits or other foods that carried the infection, therefore it must have been flies.

Dr. G. M. Kober was one of the first to call attention to the danger of house flies in 1895, and he again called attention to it when he read his paper on Conservation of National Resources before the Governors' Convention, held at the White House in 1908. This Association has the honor of having as one of its members, a physician who was the first to show conclusively that the flies were responsible for typhoid fever. This is Dr. R. P. Izlar, of Waycross, who wrote a paper showing that the typhoid epidemic in Tampa, Fla., was due to the flies. This paper was read as part of his presidential address in Jacksonville, Fla., in 1898.

During the past typhoid season, I treated fever in several families and I took particular notice that the families which controlled the flies, as directed, had not new cases to develop, while the families which did not control the flies had any where from one to four cases to develop in each family.

Each year in this country typhoid fever claims fifty thousand victims out of the quarter of a million of subjects who are stricken with it annually and costs the country $50,000,000. It causes in one year more deaths than yellow fever in fifty years, however, the government protects us from yellow fever and leaves us unprotected from typhoid fever. There is more typhoid fever and house flies in the United States than in any other civilized country. Hence, Surgeon-General Wyman has named it the "National Disgrace."

The chronic typhoid bacillus carrier is the source of the cases of unknown infection carried by the fly, and it is these that make the flies so dangerous. These individuals are those who once had typhoid fever and continually and forever liberate these germs equal to the time when they were stricken with fever. These carriers have been proven without a doubt to the satisfaction of everybody. It is claimed that five out of a hundred who have typhoid fever become chronic typhoid bacillus carriers.

From observations, I certainly know that the house flies are practically responsible for the rural typhoid fever and I believe that experiments, close study of the subject, and keen observations will in a short time show that, if not directly, they are indirectly responsible for most of the city typhoid.

Most all cities have their sewage emptying into some body of water. Some cities claim, because their sewage empties into tidal water, it is innocuous, on the grounds that sewage discharges emptying into tidal waters are rendered innocuous by the natural action of moving tidal water.

This has all been proven to be erroneous because the floating excreta and the flies caught on it have been examined and the typhoid and dysentery bacilli found on them; besides typhoid fever and summer bowel diseases are so much more frequent in this section of these cities, and especially when the number of flies is at the greatest. This floating excreta is sought by the flies and after feasting on it they go to the nearest restaurants, homes and hotels to feast on food, milk and water, and infect the same with deadly germs, thereby producing numberless cases of typhoid fever which are attributed to the water. In the cities where the sewage discharges empty into rivers and other streams the swift current forces the suspended matter to the edges of the streams to lodge against the banks and eddy there, which furnishes infec

tion and breeding places for flies. And from these places the flies go to the various parts of the city to scatter the germs with which they are contaminated. The city says, "Poor sewage," overlooking the fact that the fly is the

cause.

In the cities you will find very few who keep the closets fly proof. You find the sinks, the underground or imperfectly drained cess pools, the back yards of homes, all good places to breed flies and to receive infection. The chronic typhoid bacillus carrier comes along and desseminates the typhoid bacilli in the non-flyproof closets swarming with flies. From these closets the flies go out all over the city, not only infecting the food and drink at places of eating, but infecting other closets, cess pools, sinks and back yards where other flies become contaminated and go out over the city infecting more food and drink, and so it goes ad infinitum, and we have a big city epidemic of typhoid fever due to flies and the city bacteriologist calls it impure water or milk.

The courts have passed upon the question of damages for a sufferer from typhoid fever who could trace his illness to flies feeding upon the filth of sewage. Sometime ago a man living in Germantown, Philadelphia, recovered heavy damages from the city for his illness which he proved was caused by a stream flowing through his yard which had been polluted by sewage from a house tenanted by a typhoid patient. The defense relied upon the proof that the plaintiff had neither drunk nor bathed in the stream, but an entomologist convinced the jury that he had contracted the disease through the medium of flies which had carried the infection from the stream to the food exposed to their visits in his house. About the only way I can see that the flies are not responsible for city typhoid is when the infection is due to leak in pipes and direct infection from contact. All the infected dairies that cause typhoid epidemics are infected through the flies.