CARRIAGE OF DISEASE 131 



in the body and be found in the feces and gall blad- 

 der long after all clinical symptoms have ceased; it 

 appears that women form a large percentage of chronic 

 bacilli carriers; sixteen out of twenty-two cases (Lutz) 

 and nine out of twelve cases (Klinger). (3) Typhoid 

 bacilli may be found in the excreta of healthy persons 

 who have apparently never suffered from typhoid 

 fever; they have been in contact with cases of typhoid 

 and are analogous to the contact cases of diphtheria 

 outbreaks. 



Nature, in a review of scientific memoirs by officers 

 of the Medical and Sanitary Departments of the Gov- 

 ernment in India, No. 32, Calcutta, 1908 (Review, Na- 

 ture, November 5, 1908, p. 21), shows, as a result of 

 this Indian work, that the typhoid bacillus continues 

 to be excreted for long periods in the urine and feces 

 of a certain percentage of patients convalescent from 

 enteric fever, the number in the urine being very large 

 and the excretion being markedly intermittent. The 

 general conclusion arrived at was that the problem of 

 the prevention of enteric fever among the British troops 

 in India is the detection and isolation of the individual 

 harboring the Bacillus typhosus. 



As a matter of course, the typhoid patient himself 

 is a much more frequent cause of infection than the 

 healthy typhoid carrier. Klinger, in the report of the 

 anti-typhoid campaign in Southwest Germany, pre- 

 viously referred to, found that the typhoid patient was 

 the source of infection in 1,272 cases and the healthy 

 typhoid carrier in 125 cases. He concluded therefore 



