s evidently suffering from mild typhoid
fever, the symptoms of the disease being carefully detailed by Dr.
Thorne. The laborer at the time of his going to work had a severe
diarrhoea, and while in the tunnel was obliged to make use of the
bucket, in which the excavated chalk was hauled to the top. He admitted
that at times the bucket, in being hauled up, would oscillate in such a
way as to spill part of its contents and thereby pollute the water of
the well below. Two weeks from this accidental pollution the epidemic
began, and there can be little doubt of the relation of this mild case
of typhoid to the epidemic which followed.

A second illustration may be cited at Butler, Pennsylvania, which
occurred in 1903. The water-supply of Butler, a borough of 16,000
people, comes from a reservoir on the creek which flows through the
phase. On account of the gross pollution of the water at the
pumping-station, a long supply pipe has been laid from the reservoir
directly to the pumps. The water also was filtered through a filter of
the mechanical type. Through some accident the filter was thrown out of
service for eleven days, between October 20 and 31, 1903, and
unfortunately, on account of the failure of the reservoir dam, the water
was at that time being taken directly from the creek at the pump well,
and had been since August 27. Only ten days after the filter was shut
down, the epidemic broke out in all parts of the town. Between November
10 and December 19 there were 1270 cases and 56 deaths. In the
subsequent investigation it developed that not only was the stream
generally polluted by the sewage at various points above the intake, but
that there had been several cases of typhoid fever on the watershed,
some on a brook that enters the creek within one hundred feet of the
filter plant. As at Caterham, the inference is patent that the
introduction of some specific infection into the drinking water was the
direct cause of the general epidemic.

The occasional outbreaks of typhoid fever which occur in single families
are not so easy to explain, particularly since the small number of
persons affected does not usually call for a widespread interest on the
part of those experienced in such epidemics. In the Twenty-seventh
Annual Report of the New York State Department of Health, the following
description of an outbreak in a small hamlet, where the cause seems to
have been the use of a pond for a wash tub by some Italian laborer