BACILLUS TYPHOSUS. 411 



these bacteria are found side by side with the typhoid 

 bacilli; in such cases it is difficult to say which was the 

 primary and which was the secondary infection. 



The peculiar arrangement of the typhoid bacilli in the 

 body can only be explained by their passage through 

 the circulation; and this is proved by the bacilli being 

 found in the spleen almost constantly and in smaller 

 numbers in the blood itself. Thus, Neuhauss has had 

 nine positive results out of fifteen in cultures from vein 

 blood. 



The typhoid bacillus can be transmitted also from 

 the blood of the mother to the foetus (E berth, Fraenkel, 

 etc.). In one case reported by Ernst a living child, 

 four days after birth, showed evidences of general 

 typhoid infection, icterus and rose-spots. Frascani 

 reports that in animal experiments he has frequently 

 found typhoid bacilli in the foetus. 



Not infrequently typhoid bacilli are found in the 

 secretions. They are present in the urine in about 20 

 per cent, of the cases in the third and fourth week of 

 typhoid fever. Slight pathological lesions in the kid- 

 neys almost always occur in typhoid fever, but severe 

 lesions also sometimes occur. In a case under our ob- 

 servation the urine was distinctly purulent and crowded 

 with typhoid bacilli. The bacillus typhosus is not 

 commonly found in the sweat, but Geisler observed it 

 once. It has also been detected, though rarely, in the 

 sputum and secretions of the throat. 



In cases of pneumonia due to the typhoid bacillus it 

 is abundantly present in the sputa, and care should be 

 taken to disinfect the expectoration of typhoid patients. 

 According to Chiari, in typhoid fever the bacilli are 

 almost always present in the gall-bladder. The bacilli 



