TYPHOID FEVER IN DISTRICT OF COLUMBIA. 
19 
Melted ice: 
Solely 1 
Principally 1 
SODA WATER. 
Three hundred and ten drank soda water within thirty days prior 
to illness, 392 drank no soda water within thirty days prior to illness, 
45 not stated. 
CONTACTS. 
Thirty- two of the 747 cases studied gave a history of direct and 
intimate contact with patients in the febrile stage of the disease. 
Nine gave a history of slight or occasional association with patients 
in the febrile stage. Twelve had free and intimate association with 
cases suspected of being typhoid fever, but which were not reported 
as such. In 21 cases the conveyance of the infection by persons or 
flies was strongly suggested. Therefore a certain percentage (about 
6 per cent) of the cases studied may reasonably be attributed to 
contact. 
No satisfactory information could be obtained upon the question 
of direct or indirect contact with persons recently (within three to 
four months) convalescent from the disease or with chronic bacillus- 
carriers. 
That some cases contracted their infection in this manner seems 
probable, and. therefore it may be argued that a larger percentage 
than above indicated were infected by contact. 
PROPHYLAXIS. 
Of the 866 cases, 374, or 43.18 per cent, were treated in hospitals. 
This naturally diminished the chances of dissemination of the infec- 
tion. As a further factor bearing on this same point, 119 of the cases 
treated at private homes were cared for by trained nurses. 
Of the 492 cases treated at home, the use of disinfectants in stools 
and urine was found to be efficient for 145 cases, inefficient for 286 
cases, of doubtful efficiency for 51 cases, not stated for 10 cases. 
Of other measures taken to prevent the spread of the infection, such 
as treatment of clothing, bedding, and dishes used by the patient, 
and care of the hands of the persons attending the patients, the pre- 
cautions carried out were: Fairly efficient, 212 cases; inefficient, 
270 cases; not stated, 10 cases. 
The destruction of the infection as it leaves the body is the most 
important measure to prevent tbe spread of typhoid fever. In our 
opinion it is the duty of the attending physician to see that these 
measures are effectively carried out. It is evident from the above 
figures that this important prophylactic measure is not carried out as 
it should be in the District of Columbia. If this condition of affairs 
