864 



SCIENCE 



[N. S. Vol. XXV. No. 648 



respect between typhoid and diplitlieria and 

 tuberculosis. A careful campaign is neces- 

 sary to discover bacilli-carriers once they 

 escape the physician's care. The rigorous 

 measures of isolation and disinfection adopted 

 in Germany are perhaps impracticable here at 

 the present time, except during epidemics. 



In the discussion which followed. Dr. W. C. 

 Woodward, health officer of the District of 

 Columbia, commended the accuracy and the 

 scientific spirit of Dr. Soper's work and spoke 

 of the desirability and the difficulty of pro- 

 curing such accuracy in the routine work of a 

 health department and in obtaining for such 

 routine work men imbued with the same scien- 

 tific interest as that displayed by Dr. Soper. 

 The extreme difficulty of detecting bacillus 

 carriers and of enforcing upon them proper 

 isolation would constitute a serious obstacle 

 in the way of preventing the spread of disease 

 through them. The public should guard, how- 

 ever, against forming exaggerated ideas of the 

 danger from this source. Among the many 

 hundreds of patients suffering from typhoid 

 fever who have come to the knowledge of the 

 Health Department during recent years, many 

 were housewives and other persons who, upon 

 convalescence, necessarily took an active part 

 in the ordinary affairs of the household. And 

 although many of such cases must have been 

 what are now termed bacillus carriers for 

 longer or shorter i>eriods after convalescence, 

 the Health Department had yet to find a case 

 in which there was an outbreak of typhoid 

 fever, or even a second case, in the household 

 after the convalescence of the first case. 



Dr. Woodward asked why it was that in the 

 families in which the bacillus carrier which 

 formed the subject of Dr. Soper's investiga- 

 tion, had been employed, the number of the 

 members of the families affected by the disease 

 was apparently relatively so small as compared 

 with the number of persona affected among the 

 persons employed about the household and 

 about the premises. 



Dr. M. J. Eosenau said that the typhoid 

 problem is now magnified and the difficulty of 

 dealing with it increased. Though complex 

 and intricate, the situation is not hopeless. 

 It is not necessary to imprison the bacillus 



carrier; it is sufficient to restrict the activi- 

 ties of such an individual. As for typhoid in 

 Washington, if largely transmitted by bacil- 

 lus carriers and contacts a different epidemio- 

 logical picture might be expected; the dis- 

 ease should increase progressively, whereas it 

 is epidemic in the summer, declining rapidly 

 in the fall; there is little typhoid fever here 

 in the winter and spring. Dr. Eosenau be- 

 lieves that when large quantities of virulent 

 cultures are ingested the disease is frequently 

 induced within the usual period of incubation. 

 Ordinarily, however, persons become infected 

 with dilute cultures or attenuated bacteria 

 which remain in the intestinal tract awaiting 

 lowered resistance before the disease mani- 

 fests itself. This lowered resistance is largely 

 brought about by the enervating effects of the 

 hot weather. This explains the seasonal 

 prevalence of typhoid fever and why it is a 

 summer disease in Washington and many 

 other places. 



Dr. L. O. Howard, while appreciating that 

 a charge of professional bias might lie, felt it 

 necessary to emphasize the role of the housefly 

 as a carrier. Whether its importance is 

 secondary, tertiary, or further removed in de- 

 gree, it is certainly known to transmit typhoid 

 even under city conditions. The housefly is 

 abundant in low quarters and near waste lots 

 in cities like Washington. To do away with 

 it is a simple matter. It is but necessary to 

 oblige stable keepers to dispose of horse 

 manure, since 99 per cent, of the houseflies in 

 cities are bred in it. Dr. Soper's paper has 

 emphasized the importance of this measure by 

 showing the possibilities of healthy human 

 subjects as carriers. Such persons of unclean 

 habits increase the opportunities of the house- 

 fly as a transmitter of infection. 



Dr. C. W. Stiles, referring to the question 

 why bacillus carriers did not infect more 

 widely, drew an analogy from parasitic 

 worms. Oxyuris (Oxyurias) vermicularis ia 

 transmitted by the hands. As with typhoid 

 distributors it might be expected to infect a 

 large number of persons. This is not the case. 

 For instance, in an orphan asylum of several 

 hundred, perhaps only eight or ten may be 

 infected, though the worm is transmissible 



