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more common than was generally believed from the returns of cases so designated. The usually recognised sources for the spread of the disease are, of course, water, food, flies and dust.
Regular analyses of the water supplies show that these are of good quality; furthermore, the number of cases is far smaller than a waterborne virus would produce.
Milk is very little used among the poorer Chinese population, but other food, such as sweetmeats, cakes, &c., are exposed in the streets and might easily be contaminated were the dust nuisance as prevalent here as in many tropical countries, but fortunately it is not. It would, however, be a wise precaution to compel the vendors to keep their wares under cover to protect them from the dust, flies, and the fingers of prospective buyers. The conditions under which, and the surroundings amongst which, these delicacies are prepared are not above reproach, and the purchasers take up one specimen after another before deciding which will give most value for their outlay.
Flies are troublesome at certain seasons, and especially in the poorer quarters, but these can only spread the disease by infecting themselves with the organism from some other source, and this source may be narrowed down to one, namely infected excreta. Very few houses in Hongkong are provided with water-carriage sewerage system, and so far as I am aware, the poorer quarters do not have it. If they do, the inhabitants do not avail themselves of it as much as they might; the usual method of disposal of excreta is on the lines of that of the Garden of Eden. But excreta cannot account for enteric fever unless they come from infected subjects.
(1) In order to test this I have made cultural examinations from the bile of a large number of subjects in the mortuary to ascertain whether any, and if so what proportion of persons over the age of ten years were harbouring the bacilli in their gall-bladders; for it is a well-known fact that this is the site of election of the bacilli in typhoid carriers. In other words I wish to refute or confirm the suspicion that "un-recognised carriers" were going about the streets.
The subjoined table (Table III) gives the results and these may be summarised by saying that of 295 examined by culture and serological tests (the details of these are of academic interest only and need not be stated here) there were 12 cases of death from enteric fever in some form. Of the remaining 283 there were 14 cases from which the bacilli were isolated and proved. This means that 14 or 4.94% of these patients dying of some disease other than enteric fever were actually carriers of the organism and had, therefore, been capable of, and probably had actually assisted in, spreading the disease.
(2) The above investigation, which I propose to continue, forms a good parallel with another undertaken at the desire of the manager of an important café in the town, to determine whether
M 67
more common than was generally believed from the returns of cases so designated. The usually recognised sources for the spread of the disease are, of course, water, food, flies and dust.
Regular analyses of the water supplies show that these are of good quality; furthermore, the number of cases is far smaller than a waterborne virus would produce.
Milk is very little used among the poorer Chinese population, but other food, such as sweetmeats, cakes, &c., are exposed in the streets and might easily be contaminated were the dust nuisance as prevalent here as in many tropical countries, but fortunately it is not. It would, however, be a wise precaution to compel the vendors to keep their wares under cover to protect them from the dust, flies, and the fingers of prospective buyers. The conditions under which, and the surroundings amongst which, these delicacies are prepared are not above reproach, and the purchasers take up one specimen after another before deciding which will give most value for their outlay.
Flies are troublesome at certain seasons, and especially in the poorer quarters, but these can only spread the disease by infecting themselves with the organism from some other source, and this source may be narrowed down to one, namely infected excreta. Very few houses in Hongkong are provided with water-carriage sewerage system, and so far as I am aware, the poorer quarters do not have it. If they do, the inhabitants do not avail themselves of it as much as they might; the usual method of disposal of excreta is on the lines of that of the Garden of Eden. But excreta cannot account for enteric fever unless they come from infected subjects.
(1) In order to test this I have made cultural examinations from the bile of a large number of subjects in the mortuary to ascertain whether any, and if so what proportion of persons over the age of ten years were harbouring the bacilli in their gall- bladders; for it is a well-known fact that this is the site of election of the bacilli in typhoid carriers. In other words I wish to refute or confirm the suspicion that "un-recognised carriers" were going. about the streets.
The subjoined table (Table III) gives the results and these may be summarised by saying that of 295 examined by culture and serological tests (the details of these are of academic interest only and need not be stated here) there were 12 cases of death from enteric fever in some form. Of the remaining 283 there were 14 cases from which the bacilli were isolated and proved. This means that 14 or 4.94% of these patients dying of some disease other than enteric fever were actually carriers of the organism and had, therefore, been capable of, and probably had actually assisted in, spreading the disease.
(2) The above investigation, which I propose to continue, forms a good parallel with another undertaken at the desire of the manager of an important café in the town, to determine whether
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