232 RAVENEL— THE CONTROL OF [April i8, 



In Watertown vaccination was advised for the husband of a 

 woman suffering from typhoid, and two trained nurses who were 

 in attendance. One of the nurses refused to be vaccinated, saying 

 that she was immune. About three weeks after leaving the case she 

 went down with a severe case of typhoid fever, and was ill for sev- 

 eral weeks. The husband and other nurse remained well. 



The vaccination has been carried out also to a large extent in the 

 National Guard of Wisconsin. This is still on a voluntary basis. 

 In 1912 a large number of troops submitted to the inoculations, but 

 many refused them. Some of those who declined were taken sick 

 with typhoid fever soon after reaching home. We have not been 

 able to trace any case among those who received the full vaccination. 



Another condition in which the use of anti-typhoid vaccine is 

 likely to prove of great service is in the treatment of typhoid bacillus 

 carriers. During the last few years many cases have come to light 

 in which individuals have been carrying the typhoid fever germ, and 

 have been discharging it from their bodies for longer or shorter 

 periods of time ; such persons are known as " carriers." The most 

 noted of these cases, " Typhoid Mary " in New York, is well known 

 to the general public. Another striking example came to light on 

 the steamship Acme sailing from San Francisco. So many cases of 

 typhoid fever occurred among the sailors on this vessel that she 

 obtained a bad name as the " fever ship," and it was difficult to 

 secure good crews. The treatment of such cases has been a puzzle 

 to the medical profession, and it seemed impossible to keep these 

 persons in hospitals or under quarantine indefinitely. It has been 

 found, however, in a number of cases such as those reported by 

 Brem, and by Currie and McKeon, that the bacilli rapidly disap- 

 peared from the discharges of the body after administration of a 

 vaccine made from the particular strain of typhoid germs recovered 

 from the patient — what is known as an autogenous vaccine. 



There are nineteen cases of carriers recorded in literature that 

 have been treated with typhoid vaccine. Fourteen of these were 

 successful ; five were failures, though two of the latter were helped 

 for a time. 



