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May 3, 1884


JAMA. 1884;II(18):499-501. doi:10.1001/jama.1884.02390410023015

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To the Editor of the Journal of the American Medical Association. 

Sir:  —Infectious disease is the only foreign enemy which threatens, and may one day invade and decimate the United States.The danger is not visionary. Small-pox and other zymotic fevers are practically endemic in many of the larger European cities, but being usually confined within narrow bounds, seldom excite public attention, yet there are times when, even in England, the pestilence stalks forth from the slums to scatter disfiguration and death among the wealthiest and the highest.Why may it not do so here? New York sanitation is notoriously far from perfect. Lesser outbreaks are of frequent occurrence throughout the country, and since the conditions, atmospheric or otherwise, which occasionally break down all limitations of infection are more or less undetermined, who can question the possibility of our being brought face to face with the national disaster of an

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