MICROBIAL DISEASES OF MAN AND DOMESTIC ANIMALS 845 



While direct infection of one person from another has occurred, 

 cases of human tetanus are very rarely responsible for others. 



Horses and cattle are chiefly responsible for its distribution, the 

 tetanus bacillus being common in manure, which accounts for the 

 occurrence of tetanus in soil-contaminated injuries. 



Tetanus antitoxin, as a prophylactic measure, is widely and success- 

 fully used in all suspicious wounds in civil life, and was extremely 

 valuable during the war. Its administration should be combined dur- 

 ing the first twelve hours after injury, with thorough surgical treatment 

 aimed at the removal of damaged tissue and foreign bodies. The pas- 

 sive immunity begins to decline in about ten days. The serum is less 

 effective as a therapeutic measure, and must be given as soon as pos- 

 sible after the detection of symptoms in very large doses, intrathecally, 

 intravenously and subcutaneously. 



TYPHOID FEVER* 



Bacillus typhosus 



Typhoid fever is one of the most widespread of bacterial diseases 

 and is found endemic in practically all the countries of the world. 

 Epidemics frequently occur because of the infection of some local 

 public utility related to food or drink, particularly water or milk. 



Typhoid fever occurs naturally only in man. Intraperitoneal inocu- 

 lation of susceptible animals may result in death with acute peritonitis, 

 but lesions are in no way specific and can be produced by the colon 

 bacillus. 



The period of incubation varies ordinarily from five to twenty-one 

 days, with an average of fourteen days. 



The first week of the disease in man begins with a train of rather 

 indefinite symptoms such as headache, loss of appetite, digestive dis- 

 turbances, lassitude, and sleeplessness. Nose bleed is a peculiar and 

 rather constant feature. The temperature and pulse gradually rise 

 until by the end of five to seven days the former has become high, 

 io3F. to io4F. and constant. The temperature continues thus 

 through the second week during which a gradual stupor and occasional 

 delirium, diarrhoea, and enlargement of the spleen occur. The pulse is 

 often dicrotic and there is a rash consisting of isolated flattened rose- 



* Prepared by Edward Fidlar. 



