The follow in g conclusions seem to be
warranted by the f a c t s contained in the foregoing
#1. That the chief source of Typhoid Never
and the sole cause of i t s remaining
endemic in a rural area is the
presence of carriers in that area.
#2. That almost all these carriers are faecal.
#3. That when the carrier condition becomes
chronic, recovery seldom, if ever,
#4. That treatment of Typhoid carriers with
detoxicated vaccine seems to offer
some prospect of success.
#5.That treatment with detoxicated vaccine
in the case of three chronic nasal
Diphtheria carriers proved
#6. That the Law dealing with Typhoid carriers
seems to require alteration in certain
#7. That proper provision should be made for
the maintenance of chronic Typhoid
carriers where their means of living
has been interfered with and who are
not able to maintain themselves, and
that this should be done mainly by the
If vaccine treatment should prove a
means of cure for Typhoid carriers,
this burden would be removed, and
the Law dealing with carriers could
be strengthened without inflicting
upon them too great hardship.
In conclusion, I take leave to say that the
more my experience of administrative work in a rural
county has been, the more am I convinced that rural
areas offer opportunities for the elucidation of
epidemiological problems such as can not be got in
crowded cities, and this holds more particularly in the
case of Typhoid Fever and Diphtheria.
The problem of the cure of carriers is
perhaps the most important of all Public Health problems
of the present time. As the Lancet puts i t in a Leader
of November 13th, 1920:- "The "carrier" problem in
infectious disease is one of the most difficult, and. at
the same time, one of the most urgent questions from the
point of view of the hygienist, the bacteriologist, and
the medical practitioner. It is incidentally one of
great interest to the Public, although it may be doubted
whether that interest has yet been sufficiently aroused.
Nor is the time quite ripe for insisting upon public
education, since it must be confessed that efficient
methods of discovering the carriers and of rendering them
innocuous have yet to be evolved'.