It is not just to place the whole blame for typhoid on the water supply. In the city of Washington the typhoid rate remained quite high several years after the completion of the sand filters. Bad milk, the fly and the mosquito are enthusiastic allies of bad water in increasing the typhoid death rate. A higher death rate from typhoid during the summer and autumn months is probably due largely to the above causes. Fuller has shown1 that the typhoid rates in Richmond and in Washington have followed practically the same curves, and that therefore the conditions in the two cities are similar. Better sanitary inspection of milk, a more eager campaign against the fly, the filling up of swamps and low places and thus combating the mosquito, have done a great deal in both Washington and Richmond, according to Fuller, in curbing the death rate from typhoid.

1Journal of the Franklin Institute, July, 1915, page 55.