en it would attack only those few whose constitutional vigor was
impaired, and in the course of a generation or two the number of these
would be so decidedly diminished that pneumonia would find no one
susceptible.

_Infection of pneumonia._

It must not be forgotten that a pneumonia patient is a source of
infection quite as much as is a tuberculous patient, and the same
precautions against infection should be followed. The nurse should be
particularly careful not to infect herself. She should be careful to
exercise enough self-control always to get daily exercise and fresh air
and must, as a matter of self-protection, avoid overfatigue. The eating
utensils, food refuse, and soiled clothing may all be infectious and
must be sterilized by boiling as soon as removed from the sick room. The
severe epidemics which have occurred from pneumonia have occurred in
camps where sanitary conditions are grossly violated. Under such
conditions pneumonia has become a most alarming epidemic, sometimes
called the black death. In a single house, however, disinfection of the
wastes of the patient and a proper care of the personal hygiene of the
rest of the family will avoid the spread of the disease, and if the
patient has sufficient vitality, sustained by good food and fresh air,
he will recover without serious after affects.

CHAPTER XVII

_TYPHOID FEVER_

The two diseases already described, tuberculosis and pneumonia, are by
far the most serious of all the infectious diseases, being responsible
in New York State alone, in 1908, as already stated, for 5727 deaths. No
other infectious disease even approximates the virulence and deadliness
of these two, and while some of the constitutional disorders, such as
Bright's disease, diarrhoea, and irregularity of the circulation, each
result in from 2000 to 3000 deaths, the cause and prevention of these
are so little understood as to baffle the hygienist. There are a number
of contagious diseases which, while comparatively unimportant in the
number of deaths, yet are of concern because the cause of the disease is
so well known that the means of prevention is quite within our power. Of
these, typhoid fever, in New York State in 1908, among the rural
population alone resulted in 437 deaths, a rate of 18.7 per 100,000
population. The facts substantiate the assumption that for every person
dying with typhoid fever there are ten cases of it, so it is a fair
statement that in the rural p