Baltimore Evening Sun (8 June 1911): 6.

That typhoid fever constantly menaces Baltimore is known to everyone. Scarcely a year goes by without seeing a neighborhood epidemic of more or less seriousness. Last year it was Forest Park’s turn. Just how many cases developed out there I don’t know, but the number must have been fully 100. In the whole city the deaths from typhoid numbered 235, and the cases probably 3,000. In 1907, 1902, 1894, 1893 and 1890 there were other extensive epidemics, with more than 200 deaths each year. The average death rate for 20 years has been more than 190 a year. The lowest recorded since 1890 has been 139.

The unthinking Baltimorean, perhaps, is prone to look upon this annual assault as a sort of necessary evil, or, at least, as an inevitable one. People, he argues, must die of something, and so why not of typhoid? He, personally, will doubtless escape. When typhoid strikes it will strike the other fellow. Upon this platform of mingled indifference and hope he takes his stand, and it is difficult to move him. His attitude toward tuberculosis used to be the same. As a matter of fact, it is still the same, save on those rare occasions when a noisy and theatrical crusade arouses his temporary interest.

But every hygienist knows that typhoid is by no means a necessary evil—no more so, indeed, than smallpox, yellow fever or cholera. In many large cities it has been brought within bounds by energetic effort; in a few it has been stamped out altogether. That city in which it still rages is a city that lags behind in the march of progress—a city as certainly disgraced, though, perhaps, in less measure, as one in which smallpox and the other great plagues of the years gone by yet flourish. Baltimore has successfully combatted smallpox. In 1882 there were 551 deaths from that disease in the city, and in 1883 there were 633, but in all the years since 1884 there have been but 17. And just as smallpox has been stamped out, so typhoid should, will and must be stamped out.

But how? In the past, it appears, all effort—or at least all talk—has been directed toward improving the water supply. We have been told that our water supply is polluted and that typhoid will continue to rage until we build a filtration plant or bring water from some region more remote from inhabited places than the Gunpowder and Jones’ falls valleys. There is no doubt whatever that this pure-water campaign has done a lot of good, despite its failure to attain its chief ends. We still drink water from the Gunpowder and Jones’ falls and we yet lack a filtration plant, but, meanwhile, an alert and efficient health department has put an end to the old custom of emptying cesspools into Lake Roland. Baltimoreans have been taught to take thought of what they drink, and polluted wells and springs have been closed by the score.

There is, however, good reason to believe that the great majority of typhoid cases are not caused by impure water—for, after all, it is seldom that typhoid bacilli are found in our water—but by more direct infection You may boil your drinking water until its steam fills your house, and yet if there is a typhoid patient next door, undergoing home treatment in the customary unclean manner, and the house flies who inhabit his home afterward visit yours—in such event you will still run a very grave danger of falling ill of the fever yourself. In brief, it is quite possible, and even very probable, that home nursing and the open cesspool do more to keep typhoid alive in Baltimore than all the wrigglers (real and theoretical) in Lake Roland.

Practical experience bears out this theory. When, in 1903, the German Department of the Interior, advised by the late Dr. Robert Koch, undertook to grapple with typhoid in Alsace-Lorraine, it was quickly found that the purification of the water supply scarcely decreased the cases at all, but when each sufferer, as he was discovered, was put into quarantine and completely isolated from the well, then new cases began to be few, and before long the disease was stamped out altogether. Dr. Koch, in his report upon this experiment, pointed out its lessons. The first, he said, was the certainty that direct infection was responsible for practically all cases. The second was the certainty that, if typhoid were combatted like smallpox and cholera—that is, by the rigid seclusion of every patient and the careful disinfection of the sickroom and its debris—the disease would quickly disappear.

We of Baltimore, despite our surface indifference, move toward that end. The completion of the new sewerage system will see the disappearance of the open cesspool, and the disappearance of the open cesspool will vastly reduce the hazard that we now run. The closing in of Jones’ falls, in the waters of which typhoid bacilli have been found, will also help. And the growing custom of treating typhoid, not at home, where bacteriological cleanliness is next to impossible, but in hospitals, where it is not, will help still more. Perhaps the time will come when a typhoid patient will be forced, by law, to take thought of his neighbors, just as a smallpox patient is forced to do today. But before that day much sentimentality must be conquered.

Meanwhile, what to do? The obvious answer is to vaccinate. The new typhoid vaccine suffers a disadvantage in its newness, but that it is efficient to a fact which grows more certain every day. The United States soldiers now encamped in Texas have all been vaccinated. Result: Not a single case of typhoid among them. Every previous mobilization has been a staggering epidemic. During the Spanish-American War there were 30,730 cases and 1,?80 deaths among 120,000 men. Now we have no cases and no deaths among 12,000 men.

The new vaccine is no cure-all. _____ the smallpox vaccine, it sometimes fails. But reports from _______ 100,000 cases show that nine ________ out of ten, it succeeds. That is ______, it reduces the individual’s liability to typhoid by 90 per cent. Here in Baltimore, if all hands were vaccinated, we would have 300 cases a year instead of 3,000. And instead of ____ deaths we would have about 20.

The Voice of People, as the __________ breeze wafts it in:

After next September they won’t _______ no more foolishness in the public ________. My, but that Preston has got his _______ with him! Baltimore won’t seem like home ________ when the cobblestones has been _______. “Ed” Parrish got there before ________.

Boil your drinking water! Look ________ for automobiles! Send ________ money to the boomers! Keep ________ from the harbor! Root for old ____________ more! Glue an eye to the City ________!