Am.  Jour.  Pharm. 
March,  1910. 
J      Philadelphia  College  of  Pharmacy.  143 
Abbott  said  that  in  order  to  ward  off  the  disease  it  is  necessary  to 
have  a  knowledge  of  the  manner  of  entrance  and  exit  of  the  germs. 
He  said  that  they  are  eliminated  both  in  the  faeces  and  urine,  and 
that  in  many  instances  the  urine  of  convalescents  will  show  the 
presence  of  the  bacilli,  and  that  in  a  few  well-authenticated  cases  the 
germs  continued  to  be  eliminated  by  the  bowels  throughout  the 
remainder  of  the  life  of  the  individual,  this  period  extending  to 
forty  years  in  one  instance.  The  control  of  such  cases  offers  con- 
siderable difficulty,  but  measures  are  being  considered  for  looking 
after  these  so-called  typhoid-carriers.  It  was  stated  that  in  order 
to  contract  typhoid  fever  the  living  germs  must  gain  access  to  the 
alimentary  canal,  and  in  this  connection  it  was  pointed  out  that  per- 
sonal contact,  such  as  handling  a  patient,  may  be  sufficient  to  com- 
municate the  disease,  and  that  the  number  of  so-called  personal- 
contact  cases  is  larger  than  is  usually  suspected.  As  is  well  known 
contaminated  drinking  water  and  foods  are  also  a  source  of  the  dis- 
ease. Dr.  Abbott  said  that  when  the  outbreak  of  the  disease  is  gen- 
eral, the  water  supply  is  usually  the  source  of  infection,  and  when  it  is 
restricted  to  certain  areas  or  districts,  as  of  a  city,  the  milk  supply 
may  be  suspected.  Oysters  were  likewise  mentioned  as  a  source  of 
the  disease,  and  garden  vegetables  grown  near  cities  on  land  fertilized 
with  soil  taken  from  the  city  were  also  considered  to  be  a  probable 
source  of  the  disease.  The  house  fly  as  one  of  the  carriers  of  the 
disease  received  a  share  of  attention.  In  all  these  instances  infection 
is  due  to  the  direct  or  indirect  transferral  of  the  germs  from  human 
excreta,  it  being  established  that  they  are  not  propagated  in  the 
bodies  of  any  of  the  lower  animals  mentioned.  Thus,  while  the 
fly  and  the  oyster  may  be  carriers  of  the  germs,  they  are  not  them- 
selves the  source  of  infection. 
Dr.  Abbott  said  that  knowing  the  manner  of  elimination  of  the 
germs  and  the  manner  in  which  they  are  communicated,  the  methods 
of  preventing  infection  readily  suggest  themselves.  He  said  that 
those  having  the  care  of  typhoid  patients  might  look  upon  it  as  a  safe 
rule  that  every  time  they  place  their  hands  upon  the  patient  the 
hands  became  infected,  and  should  be  washed  with  soap  and  water. 
Another  good  rule  is  to  cook  all  food,  including  milk,  the  statement 
being  made  that  in  many  other  countries  milk  is  invariably  cooked 
before  being  consumed.  The  necessity  of  thoroughly  investigating 
the  milk  supply  was  emphasized,  as  milk  is  a  good  culture  medium 
for  the  organism.    Municipal  cleanliness  and  a  good  water  supply 
