43 
man and a woman. But still cases developed, and all evidence con- 
tinued to point to the milk. It was therefore concluded that infec- 
tious material reached the milk after sterilization, and it was decided 
to find whether one of the two persons handling it was a bacillus 
carrier. The woman milk handler was removed from the dairy and 
her feces examined. Pure cultures of the typhoid bacillus were 
isolated from her stools. She was permanently removed from the 
dairj^, and, after a lapse of the usual incubation period of two weeks, 
no new cases had developed up to the time of the report, three months 
later. 
Dr. A. K. Chalmers, medical officer of health of Glasgow, Scot- 
land, reported an outbreak in Glasgow in December, 1907, and 
January, 1908. This outbreak is of interest because of the parts 
played by a bacillus carrier and an acute case of typhoid fever in the 
production of the epidemic. There were 126 cases of typhoid, in all 
of which the patients obtained milk from one dairy. Eight of the 
patients sickened between December 5 and 14. One of these 8 cases 
developed at Parkhouse dairy farm, which supplied milk to the dis- 
tributing dairy from which all the other patients obtained their milk. 
Then for four days there were no cases. Following this, between 
December 19 and January 13, 93 cases developed. The result of 
much careful work in studying the relationship of the milk distri- 
bution to the incidence of the disease showed that the Parkhouse 
farm was the undoubted source of infection, and while the acute 
case which developed there could, from a standpoint of time and 
opportunity, have been the direct cause of the 93 and more cases 
which formed a typical milk epidemic, and undoubtedly was the 
cause, yet there remained to be found. the source of infection of the 
first 8 cases, of which this patient was one. The water suppl}^ of 
the farm could not be found at fault, and so an investigation was 
made of the dairy hands. There was found an elderly woman milker 
who gave a history of having been previously associated with out- 
breaks of typhoid fever. She had had the disease sixteen years 
before. Her stools were examined and the typhoid bacillus isolated. 
Her blood gave a positive Widal reaction with the laboratory strain 
of the typhoid bacillus.” The conclusions drawn were that this 
woman was the source of infection of the first 8 cases occurring be- 
tween December 5 and 14, one of which developed on this same farm 
in a woman who was ill from December T to 24, when her case was 
diagnosed as typhoid fever, and that this latter case was the source 
of infection causing the typical milk outbreak between December 19 
and January 13. 
