26 LOSS THROUGH INSECTS THAT CAREY DISEASE. 



extent. Box jn-ivies should be abolished in every commimity. The 

 depositing of excrement in the open within town or city limits should 

 be considered a punishable misdemeanor in communities Avhich have 

 not already such regulations, and it should be enforced more rigor- 

 ously in towais in which it is already a rule. Such offenses are gener- 

 ally committed after dark, and it is often difficult or even impossible 

 to trace the offender ; therefore, the regulation should be carried even 

 further and require the first responsible person who notices the de- 

 posit to immediately inform the police, so that it may be removed or 

 covered up. Dead animals are so reported ; but human excrement is 

 much more dangerous. Boards of health in all communities should 

 look after the proper treatment or disposal of horse manure, primarily 

 in order to reduce the number of house flies to a minimum, and all 

 regulations regarding the disposal of garbage and foul matter should 

 be made more stringent and should be more stringently enforced." 



In the opening sentence of the paragraph just quoted attention was 

 called to the activity of bacilli in excreta passed by individuals after 

 apparent recovery from typhoid. Since the paper in question was 

 published, more especial attention has been drawn b}^ medical men 

 to this point, and it has been shown that individuals who are chronic 

 spreaders of the typhoid germs are much more abundant than was 

 formerly supposed. Dr. George A. Soper recently discovered a strik- 

 ing case of this kind in the person of a cook employed successively 

 by several families in the vicinity of New York Citj^, with the result 

 that several cases of typhoid occurred in each of these families. In 

 a paper by Doctor Davids and Professor Walker, read before the 

 Koyal Sanitary Institute of London during the present season, the 

 history was given of four personal carriers of typhoid who had com- 

 municated the disease to a number of people. These four carriers 

 were detected in one city within a few months, and from this fact 

 it can be argued with justice that such cases are comparatively numer- 

 ous. This being true, the presence of unguarded miscellaneous 

 human excreta deposited in city suburbs, in vacant lots, and in low 

 alleyways intensifies to a very marked degree the danger that the food 

 will become contaminated with typhoid bacilli by means of the ty- 

 phoid or house fly. It is known, too, that the urine of persons who 

 have suffered from typhoid fever often contains active typhoid bacilli 

 for several weeks after the patients have recovered ; consequently this 

 also is a source of danger. 



The importance of the typhoid fly as a carrier of the disease in army 

 camps, as show^n in the Spanish war and in the Boer war and in the 

 camps of great armies of laborers engaged in gigantic enterprises like 

 the digging of the Panama canal, is obvious, but what has just been 

 stated indicates that even under city conditions the influence of this 

 fly in the spread of this disease has been greatly underestimated. It 

 is not claimed that under city conditions the house fly becomes by this 

 argument a prime factor in the transfer of the disease, but it must 

 obviously take a much higher relative rank among typhoid conveyers 



