120 THE ACUTE SELF-LIMITED INFECTIONS 



method of transmitting this disease. It is best not 

 to inculpate the ice itself, since freezing kills whatever 

 germs are not squeezed out in the contraction of the 

 water when becoming solid, but rather blame the dirty 

 methods of cutting, storing, and distributing. Ice 

 not infrequently becomes covered with manure and 

 earth in storing and lading for distribution. The 

 unwashed hands of the ice-man are only too familiar. 

 When ice is placed in the water cooler in public places 

 it is frequently washed under a spigot and then picked 

 up in the hands of the distributor. 



Typhoid bacilli do not multiply to any considerable 

 extent in water, but merely remain viable. Milk is 

 a prolific source of spread, since it is easy for the 

 dairyman with a case of typhoid on his farm to infect 

 this product. Fresh milk has a mild restraining effect 

 upon typhoid germ growth, but does not kill many. 

 The bacilli do not come from the cow, but are intro- 

 duced somewhere in the route from her to the con- 

 sumer. Vegetables grown in ground upon which 

 infected manure or water has been spread may carry 

 the disease; such as, for instance, water-cress, lettuce, 

 tomatoes, or others that are eaten raw. Oysters 

 fattened in water contaminated by sewage are said to 

 transmit the disease. 



House-flies may settle upon human excreta in out- 

 houses or toilets or in sick-rooms, and by walking on 

 articles intended for food, leave behind some of the 

 germs. 



The personal contact of nurse, physician, or a member 

 of the family must never be underestimated as a means 

 of direct transmission. Indeed, it is looked upon by 



