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CHAPTER XI
SANITARY AND SOCIAL PROBLEMS
The health of the population of Russia was much
lowered even before the famine in 1921, which in
spite of the measures taken by the Government
and foreign relief organisations, caused the death
of at least three million people.
The Great War and the Russian civil war
had in reality not only cost the lives of 2 2
millions directly, but had in addition encouraged
an unusual outcrop of pests 1 typhus, cholera,
typhoid, intestinal inflammation and dysentery,
which assumed an epidemic character and were
spread far and wide by the movement of troops,
refugees, and prisoners.* Tuberculosis and digestive
diseases had become widely diffused among the
under-nourished population, living under the most
unhygienic conditions, and the cases of premature
ageing were innumerable.
The famine brought to light a whole series of
illnesses, often caused by the use of harmful sub
stitutes, and it led to a dangerous new outbreak
of the epidemics ,. It is calculated that from 1 9 1 8
to 1922 there were between twenty to thirty million
cases of typhus. That means that during recent
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