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14
it was probable that she would occasionally assist the nurse who nursed
him.
Dr. Wilson had made exhaustive enquiries as to the cause of infection
of the nurse, but had not been able to trace it to a previous case. In view of
the probability of her having come in contact with the boy, the mystery was
cleared up. On the following day the Bacteriologist reported that the Widal
Reaction was positive, 1 in 20. There is therefore no doubt in my mind that
he had recently suffered from Typhoid Fever. The next question that arose
was, whether he was the cause of the illness of the other customers, or was
he infected like the others from some still undiscovered cause.
I was informed that he was taken suddenly ill on January 4th, and
taking into consideration the fact that he had a few spots on him on
January 11th, I came to the conclusion that he was not the cause, although
he had been at the dairy on many occasions previous to January 4th. He
had not been there between January 4th and February 3rd, when some of
the others were infected.
In spite of the denial of the rest of the family, I had the blood examined
of the dairyman, his wife, daughter and the assistant. The latter two gave
negative results, but that of the dairyman was positive I in 25 and slight
I in 50. Curiously enough, the blood of the dairyman's wife was positive
for Paratyphoid B 1 in 25, and partial in 1 in 50. We had no cases of
Paratyphoid fever. I have not the slightest doubt that the dairyman was
the cause, probably an innocent cause, of the outbreak. His stools were
examined bacteriologically and were found to be positive. The stools of the
boy (the dairyman's grandson) gave negative results. The dairyman's wife
admitted afterwards that her husband complained about three months previously
of a severe headache and that he would like to take two or three
days' rest, but did not do so.
The dairyman was removed to the North Western Fever Hospital, and
after he had been there a month the bacteriological examinations of his stools
showed that he was an intestinal carrier of typhoid bacilli. The man's general
condition was good, and he could not be kept in the hospital indefinitely.
The only active measure of treatment which was likely to terminate his
"carrier" state was an operation on the gall bladder. Rather than be
operated upon at his age (63) the dairyman preferred to give up his trade
and sell his business. A Notice was therefore served upon him under Section
19 of the Milk and Dairies Order, 1926, prohibiting him from handling vessels