168 
TYPHOID PEVER IN DISTRICT OF COLUMBIA. 
had had a severe attack of typhoid in 1896 was discharging typhoid 
bacilli in his urine and feces in almost pure culture. 
In the feces of those who have had typhoid fever the bacillus has 
been found to persist for even longer periods than in the urine, and 
such persons may continue to endanger the public health for many 
years. 
Kayser (1906), in investigating a small milk outbreak (5 cases) 
in Strassburg, traced the infected milk to a small dairy where was 
discovered a chronic bacillus carrier in the person of a 12-year old 
lad in whose stools typhoid bacilli were present in large numbers. 
This lad had had an unrecognized attack of typhoid six months 
before. 
This writer, in the same paper, mentions another milk outbreak 
(17 cases) which was also traced to a dairy, where there was found a 
chronic bacillus-carrier in the person of a woman in whose feces the 
bacilli were present. 
In another paper Kayser (1906) reports the case of a chronic 
bacillus-carrier which well illustrates the dangerous character of such 
persons. This one, a woman 40 years old, had had an attack of 
typhoid when she was about 10 years old, subsequent to which she 
suffered from jaundice, and for five years preceding the date of com- 
ing under observation had been suffering from attacks of gall-stone 
colic (it will be remembered that her attack of typhoid dated back 
thirty years). Fecal examination November 24, 1904, and repeat- 
edly since, has shovm the persistent presence of the typhoid bacillus. 
Her blood, tested January 11, 1905, gave a positive agglutination 
with typhoid bacilli in a dilution of 1:1,000. In 1904 two cases of 
typhoid fever occurred in members of her household in which no 
other source of infection could be found. Two other cases occurred 
in neighbors with whom she had business dealings. 
Lentz (1905) mentions a case in which the organisms were present 
in the feces forty- two years after an attack of typhoid. 
Of perhaps greater interest and not less importance is a group of 
persons who have been found to discharge typhoid bacilli in urine 
or feces for long periods, but have never experienced any clinical 
manifestations of the disease. Most, if not all, of the individuals 
belonging to this group have at some time been in a more or less 
close association with persons actually sick with the disease. 
The literature contains some interesting and instructive illustra- 
tions. 
Houston, in 1899, reported a case of cystitis of three years stand- 
ing in which the typhoid bacillus was found in the urine in pure cul- 
ture. The patient, a woman, had lived in the house where two 
children whom she had helped to nurse had died, one of bronchitis 
