But our work was not yet finished. The vault, greatly neglected, was not far from the well; and so of the pigsty. Nor was it easy to resist the conviction that there was an underground communication between them. Then, finally, the house instead of standing on an elevation, greater or less,—a very common mode of building in New England,—stood in a sort of concavity, which contained also the barn and barnyard and woodpile;—connected with both of which was a large amount of decayed and decaying animal and vegetable matter.

Now after such a review as this, he who could remain in doubt with regard to the cause of existing disease, especially on its assuming the form of bowel complaint with typhoid tendencies, must be much more ignorant of the laws of health and disease than I was. In fact the signs were unmistakable.

We immediately made our report to the heads of the family, and recommended a most thorough cleansing, at once. It was easy to see that we gave great offence; indeed we had anticipated such a result. But we were not at all intimidated. We insisted on a work of immediate expurgation, which was finally effected, only we could not put pure water into the well. But we could and did require that the well water should not be used for any thing except washing clothes.

The result was a decided and almost immediate improvement in the condition of the family, except the two already spoken of, and a very young child. These three died. Some of the rest lingered for weeks, and one or two for months; but they finally recovered.

It is worthy of remark, moreover, that of the people of the neighborhood, though they had been excessively frightened and had not at first dared to come near the house, at least without holding their breath, not a person among them sickened. The disease began and ended over the foul cellar I have mentioned; nor has a similar disease ever since broken out there. The fair presumption is, that they have never since suffered such foul accumulations to remain through the hot season, on their premises.

My honest and truly honorable course of conduct, in this instance, cost me something. Though I was a means of saving their lives, the survivors never thanked me for the exposure I made of their slovenliness. Perhaps I was wrong in reporting it abroad; but it was next to impossible to conceal the facts; and I, for once, did not attempt it. Physicians sometimes thus stand between the living and the dead, and must expect to give offence. They are, however, in duty bound to keep the secrets of their patients' faults as long as they can, unless the greater good of the public demands an exposition.

But while I lost reputation in this particular family, I have not a doubt that I gained a strong hold, by this adventure, on the public mind and feelings. In truth, despite of even some trifling errors, I deserved it. I had, moreover, during the adventure, acquired a good deal of practical knowledge, of which, in the progress of my course as a medical man, I was glad to avail myself.

This was doubtless an extreme case of disease from filthiness; but cases of the same general character are quite numerous. I have sometimes wished the public could have a history of these cases. There is an immense amount of neglect in the departments of cleanliness and ventilation; and the consequent suffering in the various forms of disease, is in similar degree and proportion.

I will conclude this chapter with a single anecdote, which, were it necessary, could be substantiated by a very great number of living witnesses.

Some fifteen or twenty years ago, a severe disease was accustomed to visit one of our New England factory villages, and to carry off more or fewer of its inhabitants. So regular and certain were its yearly visits and ravages, that not a few were disposed to regard it as a sort of necessary evil, or, perhaps, as a divine infliction. At length a very shrewd old gentleman told the people that the troublesome visitor was of human and not of divine origin; and that if they would attend properly to their cellars, sleeping-rooms, wells, etc., it would no more be heard of. At first, they were disposed to laugh at him; but the matter was talked of and agitated, till a work of general purgation was actually attempted and finally accomplished. The disease has never re-appeared. Was all this the result of mere accident? Do our diseases spring out of the ground? Are they the result of chance or hap-hazard? or, are they not the heaven-appointed penalties of transgression?