380 MANUAL OF BACTERIOLOGY. 



Ordinary suppuration may be produced by the typhoid bacillus 

 but most suppurative affections during or following typhoid 

 fever are mixed infections, or are due to the ordinary pyogenic 

 bacteria. 



That typhoid fever is transmitted chiefly through the 

 medium of water, has long been held, though there are some 

 who now regard other modes of transmission of equal or 

 more importance. 



In Washington, D. C, there was a marked increase in the 

 number of cases of typhoid fever after the introduction of 

 the water filtration plant.* After the introduction of the filter 

 plant the purity of the water as shown by the number of 

 bacteria was in inverse proportion to the death-rate from 

 typhoid fever.f RosenauJ attributes the typhoid fever in the 

 District to three causes: To importation, to infected milk, and 

 to contact. He attributed 11 per cent, of cases during 1906 

 and 9 per cent, during the summer of 1907 to milk; 7 per cent, 

 during 1906, 19 per cent, during the summer of 1907 to con- 

 tact; 15 per cent, during 1906, 25 per cent, during the summer 

 of 1907 to importation. It is sometimes conveyed by milk, by 

 green vegetables and by oysters. Infection through the medium 

 of dust and by the hands and clothing probably occurs, but 

 not commonly. Under certain circumstances the bacilli 

 may be carried by flies, § and it is consequently of the 

 greatest importance in preventing the spread of the disease 

 to prevent flies from having access to the excreta of typhoid 

 fever patients. In caring for cases of typhoid fever the stools, 

 urine, sputum and linen should be disinfected. Persons 

 handling the patient should wash and disinfect their hands 

 after every contact with the patient. 



*Ed. Joum. Am. Med. Assn. Vol. XLVIII. No 17. April 27, 1907. p. 135. 

 tCosby. Wash. Med. Ann. Report of meetings of the Medical Society, 

 Washington, D. C, Feb. 19, and 26, 1908. p. 135. 

 % Ibid. 

 §Vaughan. Philadelphia Medical Journal. June 9, igoo. 



