borne
epidemics. Such persons are known as "typhoid carriers" and
constitute one of the gravest problems the public official has to
contend with in his struggle to prevent the spread of typhoid fever.

Where outbreaks are caused by milk, they can readily be traced by
means of the milk route, as there are always a sufficient number of
susceptible persons, so that outbreaks of epidemic proportions
develop. In the Stamford, Conn., outbreak in 1895, 386 cases
developed on one milk route. In this case it was shown that the
carrying cans were thoroughly washed, but were later rinsed out with
_cold_ water from a polluted shallow well.

The mode of infection of milk varies, but in general, the original
pollution is occasioned by the use of infected water in washing the
utensils, or a case of "walking typhoid" or bacillus carrier, who
directly infects the milk. In case of sickness in rural families,
some member of the household may serve in the dual capacity of nurse
and milkmaid, thus establishing the necessary connection. Busey and
Kober report twenty-one outbreaks, in which dairy employees also
acted in the capacity of nurses. The fact that the urine of a
convalescent may retain the typhoid germ in large numbers for some
weeks renders the danger from this source in reality greater than
from feces, as, naturally, much less care is exercised in the
disposition of the urine.

The house fly is now regarded as one of the important means of
spreading typhoid fever, indeed it is often called the "typhoid
fly." The infectious material deposited in an open vault may serve
as a source from which the fly carries the organisms to milk and
other foods in the house or elsewhere. The protection of vaults and
the screening of every place where human food is handled or prepared
is the only protection.

It should be emphasized that in the case of the tubercle organism,
no growth ever occurs in milk, but with the typhoid bacillus growth
is possible. It thus needs but the contamination of the milk with
the smallest particle of material containing them to seed the
milk. By the time it is consumed it may contain myriads of the
disease-producing organisms.

=Diphtheria.= This is a highly infectious disease, affecting children
primarily and is characterized by the formation of membranous
exudates in the throat and air passages, which are teeming with the
causal organism, the diphtheria bacillus. This organism is capable
of forming highly to