22 
TYPHOID FEVEK IH DTSTEICT OF COLHMBIA. 
a bath tub. This vat was open at the time of the inspection^ and from 
10 to 15 flies were being mixed up with the milk. 
At most of the dairies the hands of the employees who come into 
contact with the milk were dirty and their clothing not changed or 
covered with a clean apron. Employees who handle milk should be 
required to wear clean laundered clothing, or at least a clean apron 
or gown. Their hands should be thoroughly washed before beginning 
work. 
The milk passes through too many hands and is exposed too many 
times before it reaches the consumer. The general rule with the milk 
business in the District of Columbia appears to be that the farmer 
sends his milk either directly to the railroad station or to a neighbor- 
ing collecting depot ; from this point it passes into the care of the rail- 
roads and is shipped to town without ice. The milk is received at 
the city railroad depot and carted to the city dairies, where it is some- 
times mixed, aerated, separated, reassembled, cooled, and filtered 
before it is bottled. It would evidently be much better if the milk 
could be cooled and bottled at once on the farm or at the near-by col- 
lecting depots, thereby avoiding much handling and consequent 
chances of contamination. 
The milk is kept too long before reaching the consumer; the loss of 
about a day being common at most of the dairies. 
While the present outbreak of typhoid fever is by no means wholly 
attributable to milk, the wonder is, judging from our observations of 
the milk business in the District of Columbia, that more sickness and 
disease is not spread through this medium. 
ICE. 
Ice can not be a frequent vehicle by which the infection of typhoid 
is spread owing to the fact that the great majority of bacteria are killed 
in the process of freezing. 
Our studies indicate that ice plays little, if any, part in spreading 
the infection of typhoid in the District of Columbia. The possibility, 
however, of typhoid infection being occasionally present in manu- 
factured ice sold in Washington is indicated by the unclean methods 
used at the factories. Urine and excrement are carried on the shoes 
of the workmen to the tops of the cans or tanks, from there dropping 
into the freezing water. This is confirmed by our bacteriological 
examinations, which disclose a greater number of organisms in the ice 
than in the water from which the ice is made. The contrary should 
be the case. 
'^Can” ice in the District is made mostly from distilled water and 
should be safe. Plate” and block” ice is made largely from tap 
water, and if not subsequently contaminated should also be reason- 
ably free from injurious pollution. 
