Prophylaxis 599 



disease. Cases of this kind have been reported by Chantemesse and 

 Widal* and Frankel.f 



The pyogenic power of the typhoid bacillus was first pointed 

 out by A. Frankel, who observed it in a suppuration that occurred 

 four months after convalescence. Lowf found virulent typhoid 

 bacilli in the pus of abscesses occurring from one to six years after 

 convalescence. 



Weichselbaum has seen general peritonitis from rupture of the 

 spleen in typhoid fever, with escape of the bacilli. Otitis media, 

 ostitis, periostitis, and osteomyelitis are common results of the 

 lodgment of the bacilli in bony tissue. Ohlmacher has found the 

 bacilli in suppurations of the membranes of the brain. The bacilli 

 are also encountered in other local suppurations occurring in or 

 following typhoid fever. Flexner and Harris || have seen a case in 

 which the distribution of the bacilli was sufficiently widespread to 

 constitute a real septicemia. 



Lower Animals. Typhoid fever is communicable to animals with 

 difficulty. They are not infected by bacilli contained in fecal matter 

 or by the pure cultures mixed with the food, and are not injured 

 by the injection of blood from typhoid patients. Gaffky failed 

 completely to produce any symptoms suggestive of typhoid fever 

 in rabbits, guinea-pigs, white rats, mice, pigeons, chickens, and 

 calves, and found that Java apes could feed daily upon food pol- 

 luted with typhoid bacilli for a considerable time, yet without 

 symptoms. Griinbaum** produced typhoid fever in chimpanzees 

 by inoculating them with the bacillus. The introduction of viru- 

 lent cultures into the abdominal cavity of animals is followed by 

 peritonitis. 



Germano and Maureaff found that mice succumbed in from one to 

 three days after intraperitoneal injection of i or 2 cc. of a twenty- 

 four-hour-old bouillon culture. Subcutaneous injections in rabbits 

 and dogs caused abscesses. 



Losener found the introduction of 3 mg. of an agar-agar culture 

 into the abdominal cavity of guinea-pigs to be fatal. 



PetruschkyJt found that mice convalescent from subcutaneous 

 injections of typhoid cultures frequently suffered from a more or less 

 widespread necrosis of the skin at the point of injection. 



Prophylaxis. One of the most important and practical points 

 for the physician to grasp in relation to the subject of typhoid fever 

 is the highly infective character of the discharges, bothfeces and urine. 



* "Archiv. de physiol. norm. et. path.," 1887. 



t "Deutsche med. Wochenschrift," 1899, xv, xvi. 



j"Sitz. der k. k. Gesellschaft d. Aerzt. in Wien," "Aerztl. Central-Anz.," 

 1898, No. 3. 



"Jour. Amer. Med. Assoc.," Aug. 28, 1897. 



|| "Bull. Johns Hopkins Hospital," Dec., 1897. 

 "* "Brit. Med. Jour.," April 9, 1904. 

 ft "Ziegler's Beitrage," Bd. xn, Heft 3, p. 494. 

 ifZeitschrift fur Hygiene," 1892, Bd. xn, p. 261. 



