644 Typhoid Fever 



eruption may be regarded as one of the local irritative 

 manifestations of the bacillus. 



Particularly careful work upon this subject has been 

 done by Richardson,* who found that by carefully disin- 

 fecting the skin, freezing it with chlorid of ethyl, making 

 a crucial incision, and cultivating from the blood thus 

 obtained, he was able to secure the typhoid bacillus in 

 13 out of 14 cases examined. It was, however, necessary to 

 examine a number of spots in each case. 



As a means of diagnosis the matter is of some importance, 

 as the rose spots may precede the occurrence of the Widal 

 reaction by a number of days. 



In rare instances the bacillus may be found in the expec- 

 toration, especially when pulmonary complications arise in 

 the course of the disease. Cases of this kind have been re- 

 ported by Chantemesse and Widal f 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. Low 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 very 

 common results of the lodgment of the bacilli in bony tis- 

 sue. Ohlmacherll has found the bacilli in suppurations of 

 the membranes of the brain. The bacilli are also encoun- 

 tered 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 wide- 

 spread to constitute a real septicemia, the bacillus being 

 isolated from various organs of the body. 



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 



"Phila. Med. Jour.," March 3, 1900. 

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

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

 "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. 



