THE MILK SITUATION IN THE DISTRICT OF COLUMBIA. 329 



day or two millions of bacteria in a teaspoonful of milk not properly collected 

 and cooled. As the milk must often be kept in the house for 12 hours or more 

 after it is delivered and before it is consumed, it naturally becomes still more 

 unwholesome before being used, and it therefore becomes important that all of 

 the milk sold in the city should reach the consumer in good condition and be 

 kept cold after it is delivered. 



The number of bacteria in milk should be as low as is possible under the 

 conditions under which practical dairy farming must at present be carried 

 on. All milk dealers can easily produce and sell milk which has less than 

 500,000 bacteria in a cubic centimeter, or about one-fifth of a teaspoonful, 

 which is the limit set by this department for clean milk. To keep within this 

 limit the cattle, stables, and the milker's hands should be kept clean, and the 

 pails and cans should be always scrupulously clean and properly sterilized. 

 The milk should be immediately cooled at the farm and transported to the city 

 with the least possible delay. So far as practicable, each day's milk supply 

 should reach the city on the same day or not later than the following morning, 

 and the temperature of the milk should be continuously maintained at 50 F. 

 or less. 



The department of milk inspection, With the cooperation of farmers and all 

 milk dealers, hope to improve the character of the milk sold in this city, so 

 far as the number of bacteria in it is concerned. It is a matter of great impor- 

 tance to the health of everyone that our milk supply be clean and pure. This 

 department will test samples of milk for the number of bacteria which they 

 contain; and where the number is found to be so great as to show that the 

 milk has not been properly produced and handled, the dealers to whom such 

 milk is shipped will be cautioned to notify the farmers who supply them to 

 improve their methods. If then the milk is still found to contain dangerous 

 numbers of organisms, the sale of the milk will be prohibited, and the board 

 of aldermen will be requested to revoke the license of the dealer if necessary. 

 Very respectfully, 



WALTER O. SCOTT, Inspector of Milk. 



HOW TYPHOID FEVER IS CAUSED. 



[This circular is based on one prepared by Dr. H. W. Hill, for the Minnesota State Board 



of Health.] 



Typhoid fever is an infectious disease. The infection is in the excrement and 

 urine of the patient, and sometimes in the saliva. The patient after recovery 

 often remains infectious for some weeks or months. 



No one ever catches typhoid fever except by getting into his mouth some of 

 the excrement, urine, or saliva of one who already has, or has recently recov- 

 ered from typhoid fever or is infected with the germs of the disease. At first 

 sight it might seem that this can not be true, for no one would ever take will- 

 ingly or knowingly any of these things into the mouth. But, as a matter of 

 fact, people are continually catching typhoid fever from others, always in just 

 this way never in any other way. 



If one will stop and think carefully about it, he will see that this disgusting 

 way of " catching " typhoid fever is not only possible, but can and must happen 

 all the time ; and is in fact the only way the disease is carried. For instance, 

 the discharges of a patient thrown out or buried in gravelly soil near a well 

 may soak through the soil into the well, or the discharges may be thrown or 

 washed into a stream. The persons who drink water from such a well or 

 stream drink the discharges also, much diluted it is true, and of those who 

 drink such water some become infected. 



But the water route is only one of the many ways in which excrement, urine, 

 and saliva pass from the patient into other people's mouths. The most common 

 of the routes other than water is by way of the hands, and a few of the 

 ways that infection travels by the hands are given here in detail. One may 

 never have thought of these, but once thought of they can never be forgotten 

 again because the whole thing is so plain, and so disgusting. There is nothing 

 mysterious about the transmission of typhoid fever. 



The patient. To begin at the beginning. A typhoid patient is usually help- 

 less, and everything must be done for him he must be washed, his nose and 

 month wiped, and his bedclothes changed by some one else. He must be fed 

 and given medicines by an attendant; he must have a bedpan or urinal placed 



