CARRIAGE OF DISEASE 133 



years after recovery, the excretion continued. Levy 

 and Kayser report that in the autumn of 1905 a num- 

 ber of cases of typhoid fever occurred in an insane 

 asylum, in which two years previously an inmate had 

 had the disease and had recovered. On the appear- 

 ance of these later cases, this person was examined and 

 was found to be excreting the bacilli in her f eces. Fur- 

 ther examinations were made at intervals of several 

 weeks, and the bacilli were found ten times. In Oc- 

 tober, 1906, she died of a typhoid bacillary septicemia, 

 due to auto-infection from the gall bladder; and on 

 autopsy the bacilli were isolated from the spleen, liver, 

 bile, wall of the gall bladder and from the interior of 

 a large gall-stone. 



"A somewhat similar case is reported by Nieter and 

 Liefmann, also from an insane asylum in which the 

 disease had been endemic for many months. A patient 

 dead of chronic dysentery was examined and typhoid 

 bacilli were found in the intestines and in pure culture 

 in the gall bladder, in which were gall-stones. Among 

 250 inmates were found seven typhoid carriers. 



"Klinger found, among 1,700 persons, twenty-three 

 typhoid carriers, ranging in age from eighteen months 

 to sixty years, eleven of whom had no typhoid history. 

 Of 842 convalescents from the disease, sixty-three, or 

 thirteen and one-tenth per cent, were found to be excret- 

 ing the bacilli, and eight were still doing so six weeks 

 after recovery. 



"Kayser, tracing outbreaks to their sources, found 

 a boy of twelve years, a member of a milkman's fam- 



