TYPHOID “ BACILLUS-CARRIERS.” 
By Joseph Goldberger, 
Passed Assistant Surgeon, Public Health and Marine- Hospital Service. 
The great importance of contact, direct and indirect, in the epi- 
demiology of t^’phoid fever has been receiving increasing attention 
in recent years. One of the most interesting and important facts 
developed as a result of this relates to the part played in the trans- 
mission of the disease by persons apparently in perfect health. 
The fact that persons in average health might harbor the cholera 
vibrio in their intestinal tracts or the diphtheria bacillus in their 
throats has been knoAvn, and its importance in prophylaxis appre- 
ciated for some years; but it is only a few years since the suspicion, 
that a similar relationship might exist in the case of man and the 
typhoid bacillus, has actually been confirmed. 
It has been found that persons apparently well may discharge 
tA'^hoid bacilli in the urine or feces for months and even years after 
passing through an attack of the disease. It has been knovm since 
1881 that typhoid bacilli may be present in the urine during an 
attack of typhoid fever, but the knowledge of their persistence 
therein long into convalescence and even for years after is compara- 
tively very recent. In 1899 a remarkable case was reported by 
Richardson. The patient, a man, returned to the Johns Hopkins 
Hospital five years after having been treated there for typhoid fever. 
Investigation showed him to be suffering from a cystitis, and the 
typhoid bacillus was obtained in pure culture from his urine. 
Busing (1902) reported finding the bacillus in the urine of a trooper 
returned from China four months after an attack of typhoid. This 
man, except for a slight tendency to frequent micturition, presented 
no sAunptoms that would attract attention to his condition. 
Liebetrau (1906) has reported a very interesting and instructive 
case. On and oft' smce 1896 there had occurred cases of typhoid 
fever in newcomers to a mill in the toAvn of W . A fatal case in 
a servant in October, 1905, caused an investigation to be made, 
which led to the discovery that the brother of the mistress of the 
place, a man who had lived at the mill a great many years, and who 
167 
