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39
The case illustrates many interesting points, and is of such
practical importance as to warrant a more extended notice.
The typhoid carrier has been the object of a great deal of
attention, both in this country and abroad, for several years
past, and last autumn Dr. Ledingham presented a report to the
Local Government Board upon the subject. In that report he
has pointed out the intimate connection between the "carrier"
state and the occurrence of gall stones. All the carriers who
have been examined either post mortem or at operations have
been found to suffer from gall stones.
•
Boutine examination of every case of Typhoid Fever to
determine the freedom or otherwise from the bacilli, is at present
impossible, but where a history of gall stone colic is obtained,
repeated examination of the dejecta should be made. The treatment
of the carrier case, so far has been disappointing. Drugs,
sour milk, X-rays, and even operations are known to have failed
in many cases. It has been shown, though, that thorough
washing with soap and water will remove the bacilli from the hands.
One thing certain is, that the worse the sanitary surroundings
of the carrier, the greater the danger to others.
Another fact proved in the report is that the campaign for
elaborate cleanliness in food preparation, so often urged by the
Medical Press, and so often derided by the general public as a
medical fad, is justified in every particular. " The fact that on
one occasion alone over 200 individuals were infected by typhoid
fever, owing to their milk being polluted with the excrement of
one milker, shows how perilously easy may be the path of the
bacillus from one man's bowel to another man's mouth.
Domestic and culinary cleanliness must be cultivated, and
possibly the public will take more interest in the disposal of
excreta when he learns that his neighbours intestinal floral is
dangerous and liable to reappear on his own tea table."