48 
seems that the Inilk of the infection did not cojiie in the milk from this 
farm. 
The inspection of the dairy showed nothing immediate to account 
for the infection. Three of the men who worked at the dairy gave 
a history of having had typhoid fever within four to twenty years 
previous. Specimens of their stools and urine were examined at the 
Hygienic Laboratory, but all were negative for B. tyj^hosus. 
The sale of milk from this dairy was discontinued by order of the 
health officer on Augtist 6. 
One of us. conjointly with a representative of the health office, 
made an inspection of the other farm supplying this dairyman with 
milk, and the evidence obtained indicated quite strongly that this 
farm was the source of the infection for the majority of the cases. 
The owner of this farm did most of the handling of the milk. He 
Avas taken ill about July 1 with diarrhea and feA^er and confined to 
bed for a day or two. For about fiA^e Aveeks from that time he was 
comjtlaining, liaA’ing to lie doAvn for an hour or tAvo most eA’ery day ; 
had slight feA'er, Avhich he thought Avas malarial. He was engaged 
in handling the milk nearly eAxry day throughout his illness. 
In the neighborhood of this dairy farm were seA’en families Avhich 
obtained milk from the farm. In one of these families a child was 
taken ill about June 8 and continued ill with feA^er for about four 
Aveeks. Milk bottles from the dairy farm Avere deliA^ered to and 
collected from this house daily throughout the child's illness. 
In another of these families Avere three cases, clinically typical 
cases of typhoid feA^er. haA’ing the onset of illness in the early part 
of August. 
These fiAx cases all occurred in the State of ^laryland and are not 
included in our figures. 
The sale of milk from this farm was discontinued by order of the 
health officer on August 14. 
Besides this pronounced outbreak there Avere suggestive groups of 
cases on the routes of milk dealers as follows (see Chart Xo. 4) : 
Cases. 
Dealer No. 8 : Onset of cases from August 5 to September 7 15 
Dealer No. 46 : Onset of cases from August 14 to September 4 18 
Dealer No. 164 : Onset of cases from August 27 to September 5 4 
Dealer No. 44 ; Onset of cases from August 9 to 26 8 
Total 40 
Xo positive evidence could be obtained that these cases were due to 
milk infection, yet the grouping of the cases, etc., suggest so strongly 
that these were small milk outbreaks that it seems fair to estimate 
the chances of these 40 cases as haAung been due to milk infection at 
about 50 per cent ; and so, adding 20 of these cases to the 28 quite 
definitely attributable to milk infection, we haA*e 48, or about 7 per 
