TYPHOID FEVEK IN DISTEICT OF COLUMBIA. 
21 
It should be remembered that the typhoid bacillus grows and 
multiplies in warm milk with great rapidity and that the milk 
may be teeming with these organisms without appreciably changing 
its appearance, odor, or taste. The danger is, therefore, hidden and 
insidious. 
Another source of danger is the small corner grocery where milk 
is retailed. At such places often as little as 1 or 2 cents’ worth of 
milk is sold at a time, from pint or quart bottles. 
In several instances^we found a close association between the 
family life of the patient and the business. The same hands that 
nurse the sick often purvey the milk. The patient is treated in a 
room adjoining the store. Flies swarm in and out. The chances of 
spreading the infection in this and many other ways must be great. 
The small retailers, while subject to inspection, are immune from 
the sanitary restrictions of the health department. This state of 
affairs evidently needs legislative correction. 
The milk supplied the citizens of the District is, for the most part, 
too old, too dirty, and too warm. Milk is not kept cold, especially 
in transit from the farm to the city dairy, and on the delivery wagons 
from the dairy to the householder. Of 172 samples tested during the 
warm months, only 16 were 10° C. (50° F.) or under. The average 
temperature of the 172 samples was 16.5° C. (61.7° F.). The dangers 
of warm milk in which bacteria and their toxic products develop to a 
dangerous degree are now well recognized. Of the 172 samples of 
milk tested only 29 contained less than 500,000 bacteria per cubic 
centimeter. The average of all the samples examined was 22,134,289 
per cubic centimeter. Hence the great bulk of the milk sold in Wash- 
ington during the summer months would have been considered 
adulterated and condemned in New York and prohibited from sale 
in Boston, on account of the temperature or the number of bacteria. 
Practically all of the samples examined contained gas-fermenting 
organisms, indicating contamination with cow-dung and other extra- 
neous matter. Most of the samples studied contained more visible 
foreign matter (dirt) than has a place in clean milk. 
So far as the city dairies themselves were concerned many defects 
were found. For instance, the location of many dairies is pernicious, 
in that they abut upon unkempt alleys and are in the neighborhood of 
squalid, insanitary settlements. The stables in the rear of practi- 
cally all the dairies visited provide breeding places for swarms of flies 
and are a source of foul odors. 
Flies are attracted by the milk and are abundant in nearly all the 
dairies. In some instances the water-closets are too near to the milk. 
Only one of the dairies visited was properly screened. In most 
instances no intelligent warfare is waged against the flies. At one 
dairy the milk from various sources is mixed in a large vat resembling 
