"This is a direct, and at the same time an indirect cause. The infection is carried to the ship by the emigrants from a country where hunger typhus prevails; besides, the previous exhaustion predisposes to be attacked by miasma. In connection with this branch of the subject, another source of the development of ship-fever demands notice. In the cabins and hovels the homes of these famine-stricken people typhus fever raged a long time, and doubtless prevails extensively yet, produced by the same general and specific causes as have been described. The emigrants leave for the seaboard, and straightway enter the ships, unpurified and unwashed, reeking with the fever miasma of their habitations. Into the crowded and confined steerage they hasten for rest and escape from starvation and death. But unconsciously they bring the enemy with them; the fatal seeds are but sown in a fresh soil, and, as though from a hot-bed, they sprout even more vigorously. One such case on board a crowded and badly ventilated ship may cause the death of numbers.
"The food with which these people are supplied on shipboard, Improper foodeven if sufficient in quantity (which it is not always), is very often so badly cooked as to operate injuriously upon them. So great is often the difficulty, among from 300 to 1,000 people, of finding a proper time and opportunity for cooking, that it is a common occurrence for them to swallow their flour or meal only half cooked, or even mixed simply with warm water, if indeed warm water can be had. The effect of this kind of diet is but to add other evils, such as dysentery and diarrhoea, to the typhus miasma with which the steerage becomes infected, the debility of the inmates rendering them more susceptible to its influence than they would be if well fed.
"For the prevention as well as the cure of typhus, it is Prevention and cure of Typhusnecessary that the physical stamina be well maintained by appropriate food, in sufficient quantity. With ordinary strength of body and elasticity of spirit, few persons can be induced to remain below deck for many hours together, and, while the pure air of the ocean directly increases animal vigor, it is also the surest preventive of typhus. Even the half-starved emigrant would find his energy and spirits revive, if compelled by a rigid sanitary police to make frequent visits to the ship's deck.
