no MILK HYGIENE 



able to the growth of typhoid bacilli, may be infected in 

 this way. Water from open or thin walled springs or 

 wells may be directly infected by the entrance of water 

 which has been contaminated by the excretions of the 

 sick. [All surface streams are liable to become contam- 

 inated either directly or indirectly, through carelessness 

 or imperfect drainage systems. 



Typhoid bacilli may be blown about in dust, car- 

 ried on the boots of persons who walk over infected sur- 

 faces and they may also be carried by flies, as was 

 abundantly proven during the Spanish-American and 

 the South African wars. Cloths used for washing milk 

 cans may carry this infection. In one instance, in Phila- 

 delphia, it was found that a small milk dealer was in the 

 habit of washing his milk bottles in the family wash tub. 

 Milk has become contaminated during cooling, either by 

 a leak in the tubular cooler or by the entrance of water 

 into a submerged can. L. P.] 



Concerning direct or indirect infection from sick per- 

 sons or convalescents, emphasis should be laid upon the 

 fact that the disease often runs so light a course that the 

 diagnosis of typhoid fever is not established; further, 

 that faeces, and often urine, contain bacilli in great num- 

 ber and that convalescents often have bacteriurea for 

 months after typhoid fever and daily excrete number- 

 less bacilli with the urine. Neufeld ^^ has collected some 

 reports on this subject : of 210 typhoid patients not less 

 than 45 (more than 20% ) excreted bacilli with the urine, 

 and Petruschky ^^ found that the number of bacilli in the 

 urine exceeded 170,000,000 per c.c. It will be evident 

 to every one who is familiar with existing conditions and 

 customs, especially in the country, that under these 

 circumstances no extreme or unusual carelessness or 



2= Deutches med. Woclienschr., 1890, p. 824. 



20 Zentralbl. f. Bakteriologie, XXIII, 1898, No. 14. 



