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PRESIDENTIAL ADDRESg. \) 



suffered from typhoid fever, may have the germs of the 

 disease left in their bodies, e.g., in the intestines, the gall- 

 bladder, and the urine, for long periods after they are pro- 

 nounced convalescent, and, presumably, free from infection. 

 The gall-bladder theory is the explanation offered officially 

 in connection with a localized outbreak of typhoid fever, 

 consisting of 126 cases (8 deaths) in Glasgow and the 

 neighbourhood. Milk became infected, with the result 

 that the epidemic or outbreak occurred. Enquiries show 

 that 500 households were affected in that they consumed 

 the infected milk, that the 500 households consisted of 2,500 

 persons, that the attack rate was from 4 to 5°/°, whilst the 

 case fatality was 5*5°/°. Bacteriologically, the source of 

 the disease was traced to a woman milker, who had had 

 an attack of enteric fever sixteen years previously, and 

 had since been, on several occasions, associated more or 

 less clearly with outbreaks of illness which proved to be 

 enteric. The typhoid bacilli were found in her dejecta 

 (5,000 per cubic centimetre), and her blood gave a positive 

 Widal reaction. The chain of evidence was complete, 

 showing the outbreak of typhoid as caused in the first place 

 directly from the milker, and afterwards indirectly. Chronic 

 typhoid carriers have been found at periods varying from 

 a few weeks to as much as forty years after the attack of 

 the fever. In some cases there were no clinical symptoms 

 of typhoid fever, but, in this connection the typhoid was 

 simply regarded as influenza, pneumonia, meningitis, etc. 

 Of the chronic typhoid carriers, women form by far the 

 larger proportion (about 75f°), the bacilli finding a habitat 

 in the gall-bladder, passing down at intervals into the 

 intestines, to be voided with the stools. Another impor- 

 tant discovery, that T hope will be grasped by every civic 

 authority, shire council, and municipality throughout 

 Australia is that of Dr. Andrews of the Local Government 

 Board of England, and that is, the fact that pathogenic 



