46 
long as certain classes of people persist in using them for various 
other purposes such as urinals and receptacles for sputum. Dr. 
Herbert Fox, chief of the laboratories of the Pennsylvania State 
department of health states: 
The attention of the commissioner of health, Dr. Samuel G. Dixon, was 
called to a slimy mass of material on the under surface of a milk-bottle cap. 
He sent this to the laboratory and it was received in a very dry condition. 
Upon softening down and smears made from it we were able to obtain suffi- 
cient proof that it was sputum. Doctor Dixon informs me that he has known 
of milk bottles used for cuspidors on more than one occasion. 
The practice of drinking directly from the bottles is a habit that 
must also be borne in mind as a possible means of contamination 
with tubercle and Klebs-Lofller bacilli. An example of apparent 
bottle infection is found in the typhoid outbreak at Montclair, X. J., 
in 1902. 
Montclair epidemic . — During the summer and autumn of 1902 
there was only an occasional case of typhoid in Montclair.® The 
1st of December several cases occurred, apparently having milk from 
one dairy as the only factor in connnon. Investigation of the farms 
producing this milk failed to reveal any cases of disease which could 
be the source of the infection. All persons coming in contact with 
the milk were apparently in good health. More careful examination 
of the invaded houses showed that cases of typhoid existed only in 
those houses receiving milk in pint bottles. There were no cases 
among the quart-bottle customers. Cases continued to be reported 
on this route and the sale of milk from the dairy was therefore 
stopped. After two weeks new cases ceased to develop. It was then 
found that a man from Xew York City had come to Montclair ill 
with typhoid fever and had remained for a few days at a house sup- 
plied with milk from this dairy until he could be removed to a hos- 
pital. This house had during the patient’s stay been supplied daily 
with 3 pint bottles of milk. The empty bottles were removed daily 
and, without sterilization, refilled and delivered to other houses. It 
seemed that this was the means of spreading the disease. Eighteen 
cases occurred in Montclair and 10 in Bloomfield, all in houses 
supplied with milk in pint bottles from this dairy. 
Pathogenic organisms may possibly reach the milk through dust 
while in the care of the vendor, but most likely the vendor himself is 
the more important and that, while organisms floating in the air can 
undoubtedly settle into milk, yet the chief danger is from contact 
with diseased persons or those having an intimate relation with the 
sick. 
a Ninth Annual Report, Board of Health, Town of Montclair, N. J., 1903. 
