42 SEWAGE-POLLUTED OYSTERS AS CAUSE OF TYPHOID. 



of 1:200 with serum from the same lot previously mentioned, and 

 used on the culture isolated by Miss Greathouse from oysters exam- 

 ined on October 19, 1911. It should be said, in connection with the 

 isolation of these two strains of typhoid organisms, that no other 

 cultures of typhoid bacilli were being used in the laboratory at that 

 time. There was a pure culture in stock kept with other organisms 

 in the ice box, but there was no connection whatever between the 

 stock cultures and those isolated from the Jamaica Bay oysters. 



Inwood is a station located near the eastern end of Jamaica Bay, 

 while Indian Creek, near Canarsie, is a small stream flowing into the 

 northwestern portion of the same bay. Both sections are subject to 

 gross human pollution. The conditions prevailing at the two places 

 are somewhat similar, and the results obtained from an examination 

 of the shellfish collected from both are practically the same, being 

 highly polluted in each instance. 



PROBABLE CAUSE OF THE GASTROENTERITIS (DIARRHEA). 



From a study of the clinical symptoms, onset of illness, and dura- 

 tion of the disease, together with the presence of paratyphoid bacilli 

 in oysters taken from dealer A, the conclusion is reached that the 

 diarrhea or bowel trouble can probably be ascribed to the presence 

 of paratyphoid bacilli (said by some authors to be indistinguishable 

 from or closely allied to the Gaertner bacillus) in the oysters served at 

 the Minisink banquet. It is apparent that the disease was due to bacte- 

 rial infection, arising from the multiplication of the organisms in the 

 body after ingestion, and not to "ptomains," as suggested by some. 



Ptomains are formed most commonly during the decay of animal 

 matter. They are essentially the decomposed animal tissue, not 

 excretions of the bacteria, although the bacteria are responsible for 

 the decomposition. Such decomposition does not occur usually in 

 the body, even in animal matter taken as food. In abnormal con- 

 ditions, if food remains in the body until putrefied, ptomains may 

 be formed in the intestinal contents. When decomposed food con- 

 taining ptomains is received in the digestive tract, or originally 

 good food decomposes there, the mucous membrane and blood may 

 take up ptomains from this decomposed food, which ptomains affect 

 the tissues like other poisons. 



Substances of quite varied chemical constitution are classed under 

 the head of ptomains solely on account of their origin in proteid 

 decomposed by bacterial action. Bacterial toxins are to be distin- 

 guished from ptomains. Toxins are substances which are or have 

 been a part of the body of the bacteria; some are secretions from the 

 germ, others are liberated only in case of the death and breaking 

 down of the germ itself. In this latter class is the toxin of typhoid 

 fever, which is therefore particularly different in its origin and action 



