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and some in both feces and urine. The large number suggested 
that they might be temporary or acute carriers. The woman origi- 
nally discovered to be a carrier was removed from the dairy. The 
milkers were required to wash their hands in a disinfectant solution 
before milking. Those who had typhoid bacilluria were treated with 
urotropin. Within a month after these precautions were taken the 
stools and urine of all the carriers were again examined bacterio- 
logically and all found negative except those of the original woman, 
whose excreta still contained typhoid bacilli in large numbers. 
The Strasbourg School has found, in a number of instances, such 
temporary or acute carriers among healthy persons living in close 
association with typhoid fever cases. 
The possibility of there being chronic or acute bacillus carriers 
among those concerned in handling the milk should be kept in mind 
in the investigation of a suspected milk supply. 
It is possible for persons in the early stage of the disease, and 
even before becoming ill enough to take to bed, to contaminate milk. 
The spread of infection from cases in the early stage has generally 
been considered of infrequent occurrence on the ground that the 
bacilli rarely appear in the urine before the end of the third week 
of illness and that few if any are discharged in the feces during the 
first week or two. On the contrary, H. Conradi,® who has made 
extensive studies on the conveyance of typhoid infection in Germany, 
states that he has reached the conviction that not only is the infection 
transmitted most often during the earliest stages of the disease, before 
its true nature has been recognized, but that it also frequently takes 
place during the incubation period. He bases this opinion on the 
observation that of 89 cases which he attributed to infection by con- 
tact, some 58 per cent of the secondary cases had onset of illness 
within a week after the onset of illness of the primary cases. 
Flies passing from infected excreta to the milk or the milk cans 
may readily convey the infection. 
The excreta of patients thrown into the privy or in the yard or field 
near by may be carried by drainage, seepage, on the feet of persons, 
etc., to the well, spring, or stream from which water is used for wash- 
ing cans, and so be conveyed to the milk. 
In country places there are frequent instances where chickens and 
other fowls have free access to the privy contents and may readily 
carry infection on their feet to the well or spring or to the dairy- 
house yard in which milk cans are set. The excreta of patients, care- 
lessly handled, may become dried and carried as dust into exposed 
milk or, more frequently perhaps, into exposed milk vessels. 
oDeut Med. Woch., Oct. 10, 1907. 
