10 



viz., that in the contents of the ileum and in the fluid and semi- 

 fluid (typical pea soup) typhoid stools the typhoid bacillus does 

 occur in great numbers. In several instances of cultivation 

 by the Drigalski-Conradi medium it was possible to show that 

 in the fluid typhoid stools the B. typhosus was present to 

 the number of one to three millions per one cubic centimetre, 

 that is to say, about one to two hundred thousand per drop 

 (minim) of the stool. As regards the mesenteric glands and 

 the spleen of a case of typhoid fever, the demonstration by the 

 microscope and particularly by culture of the B. typhosus can 

 be demonstrated readily, and in culture made with a trace of 

 a particle of these organs crowds of typhoid bacilli generally 

 in pure culture can be obtained. It has been further 

 shown that in some cases even several months after con- 

 valescence has set in, typhoid bacilli are still present in the 

 stools of the patient, although as a rule a few weeks after 

 convalescence has commenced they have practically dis- 

 appeared from the bowels. It has further been shown that 

 in localised inflammations following upon the acute stages 

 of the disease particularly in the lung the typhoid bacilli 

 may be, and sometimes are, present in large numbers. One 

 of the most important results of research that has been 

 brought to light is this, that typhoid bacilli pass out of the 

 body by way of the kidney and urine in enormous numbers 

 during convalescence, so much so that it has been calculated 

 that in at least 25 per cent, of cases (according to more 

 recent observations over 25 per cent.) the convalescent voids 

 typhoid bacilli by way of the urine (Bacilluria), this fluid being 

 in some marked instances turbid by the number of typhoid 

 bacilli up to 6000 millions per one cubic centimetre (Dr. 

 Horton Smith, Gulstonian lectures before the Eoyal College 

 of Physicians, 1900). It must be obvious that these results 

 are of the utmost importance to public health, and I will for 

 the sake of illustrating this importance take the following 

 into consideration : Up to the time and before the above fact 

 concerning the copious presence of B. typhosus in the urine 

 of a large percentage of convalescents was elucidated, the 

 attention of sanitarians, physicians, and nurses was chiefly 



