TYPHOID CARRIERS 421 



stools by simple plating. Firth's statistics give an idea 

 of the frequency of the development of the carrier state. 

 Of 1,229 cases of enteric fever among the British troops 

 in India bacteriologically examined, thirteen cases of 

 chronic carriers and thirteen cases of temporary carriers 

 were detected. Obviously the typhoid carrier is a source 

 of serious risk to the community, and mysterious outbreaks 

 of enteric fever, ascribed by some in the past to a " de 

 novO " origin of the specific organism, become explicable. 

 Typhoid convalescents should be bacteriologically ex- 

 amined three or four times at weekly intervals before 

 discharge from hospital, and the negative cases may 

 with reasonable safety be allowed to resume their civil 

 life (Ledingham). Once the carrier state is established, 

 no treatment seems to be of any use, and the condition 

 probably continues for the remainder of life. The typhoid 

 bacillus may occur in the contents of ovarian cysts, 

 usually causing suppuration, and may survive for months 

 twelve in a case recorded by Taylor 1 after the attack 

 of typhoid. 



Survival of the typhoid bacillus outside the body, The 

 Bacillus typhosus has been isolated in a few instances from 

 WATER SUPPLIES which have become infected, and have 

 given rise to epidemics, as in the case of the Lincoln 

 epidemic in 1905. 2 This is the exception, however, and 

 the isolation of the typhoid bacillus from an infected water 

 is a difficult matter on account of the fact that the bacillus 

 may have died out before the investigation is commenced, 

 that it is generally in a small minority and admixed 

 with numbers of coliform organisms, and that until 

 within the last few years no medium was available which 

 inhibited the growth of the coliform organisms without 

 at the same time inhibiting the growth of the B. typhosus. 



1 Journ. Obstet. and Gyn. Brit. Empire, Nov., 1907. 



2 Rep. Med. Off. Loc. Gov. Board for 1905-06. 



