ALKALI TOLERANCE IN PELLAGRA
Journal of the American Medical Association (JAMA)
but the evidence is fairly conclusive: 1. He had been employed by the school for a period of only three years, and typhoid fever outbreaks had occurred in two of these years and not previously. 2. In his duties he must have handled foodstuffs which were served in the cafeteria uncooked. 3. While he denies having had typhoid fever, it was stated by others that during a previous epidemic he had a mild case of "walking typhoid." The dairyman claimed that the man in question had never handled milk,
... never handled milk, but it was well known that the men of the farm interchanged work frequently. The character of the outbreaks pointed either to an intermittent carrier or to a carrier who only occasionally had opportunity to infect food, as would be the case with the present carrier. It must also be kept in mind that at least half the school had received antityphoid inoculations within a year, and that all the cases in the second series occurred in the uninoculated. summary In investigation of two small intermittent outbreaks of typhoid fever, a carrier was found who could have been responsible for both. A method of obtaining satisfactory specimens of stools for examination some distance from the labora¬ tory was used with success. In work with urine 1 in 1917 it was found that a considerable number of patients showed a tendency to an increase in the output of ammonia either relative to the total nitrogen or absolutely. The urinary findings suggested that in. some cases, at least, there might be a greater or less depletion of the alkali reserve.