proceedings of section i. 595 



Form to be Filled in by Medical Practitioner Attending 

 Typhoid Case. 



Patient's name, age, and sex 



When did you first see case? 



What, in your opinion, was the probable date of onset? 



Here give a short summary of the chief symptoms and signs 



Was a Widal reaction done, if so, when and with what result? 



Was a blood culture done, if so, when and with what result? 



Are there any other cases in the family or vicinity? 



Have there been other cases in the household previously, if so, 



when ? 



How long has patient been in district, and has he been on visit 



lately, and, if so, where and when ? 



What is the water supply used by the patient? Has he drunk 

 water elsewhere? If so, when and where? 



What is the milk supply used by the patient? Has he had milk 

 elsewhere? If so, when and where? 



What is the method of excreta disposal ? 



Are there many flies in the house ? 



Further notes 



1. Finckh, A.M. Gazette, 27th July, 1912, p. 85. 



2. Tebbutt, A.M. Gazette, 20th April, 1911, p. 195. 



3. MacCoukey, Joiirnal of Hygiene, 1908, p. 322. 



4. Burton Bradley, A.M. Gazette, 20th January, 1911, p. 13. 



5. Dean, H. R., 'B.M.J., 1910, Vol. II., p. 1516. 



6. Tebbutt, loc. cit. 



7. Bulstrode, An. Rep. L.G.B., 1902-3, Supplement, p. 29. 



8. Osier's Medicine. 



9. Ledingham and Arkwright, The Carrier Prohlem and Infectious 



Diseases, Ed. Arnold, 1912, pp. 102 and 120. 



