44 
The milker’s hands may have become soiled in acting as nurse 
for some case of typhoid in the family. He may be a convalescent 
from scarlet fever and be shedding particles of epidermis into the 
milk, or he may have diphtheria, or possibly tuberculosis, and with 
every act of sneezing and coughing spray tubercle or Ivlebs-Loffler 
bacilli with particles of sputum. If he does, as is not entirely 
unknown among careless milkers, and moistens his hands by spitting 
into the palms to facilitate the action of the fingers upon the teats., 
it is easily seen how infective material may find its way into the milk. 
(2) Air and dust of the stable . — The stable dust may contain 
organisms eliminated by those working in it, and as some of this 
dust and other stable refuse adhering to the flanks, buttocks, and 
udders of the cows and floating in the air finds its way into the milk, 
under the conditions sometimes employed, it may carry with it these 
organisms. 
(3) The milk pail— The milk pail may have been washed and 
taken care of by some person or member of the family suffering from 
a contagious or infectious disease and in the handling have received 
its quota of typhoid or other bacilli which thus find their way into 
the milk. 
(4) I Yater supply . — The water supply of the farm or dairy may be 
at fault. Farms are often very unfortunate in the location of their 
wells, which very frequently become polluted by cases of typihoid on 
the premises. The privy vaults are at times not far distant and are 
apt to be leaky and subject to seepage, and when a case of typhoid 
fever occurs on the place or a person eliminating the bacilli sojourns 
temporarily on the premises, the possibility of water contamination 
exists. In some cases the dejecta of typhoid patients are buried in 
shallow holes around the house and often unwittingly around the 
well, while at other times, as occurred in some of the epidemics 
reported later, the dejecta were simply thrown on the ground where 
they could easily find their way into the water supply. Pails washed 
in polluted water, if not afterwards scalded, may contain the infect- 
ive material and the more so if some of the last rinsing water still 
remains in them. The possibility of this water being added directly 
to the milk need not be considered, although it has undoubtedly 
played an important part in some epidemics. The water used may 
be a stream into which some household higher up empties its sewage. 
It has been supposed that cows wading into polluted streams might 
get upon the udders contaminated water, which in the act of milking 
would find its way into the pail. This at least is one of the rarer 
means of infecting milk. 
(5) Milk cooler . — If a milk cooler is used and not properly taken 
care of infectious material may reach the milk through it. 
