442 BACTERIOLOGY. 



to the laboratory, it is hardly worth while for the bac- 

 teriologist to take the trouble to make the test. 



Typhoid Bacilli in the Urine. Of even more interest 

 than the presence of the bacilli in feces is their frequent 

 occurrence in great numbers in the urine. The results 

 of the examinations of others as well as those of our 

 own indicate that the typhoid bacilli are not apt to be 

 found in the urine until the beginning of the third week 

 of the fever, and may not appear until much later. 

 From this on to convalescence they appear in about 25 

 per cent, of the cases, and usually in pure culture and in 

 enormous numbers. Of nine positive cases examined 

 by Richardson 1 two died and seven were discharged. 

 At the time of their discharge their urine was loaded 

 with typhoid bacilli. We have noted similar cases. In 

 one the bacilli persisted for five weeks. Undoubtedly 

 in some cases they persist for months. When we think 

 of the chances such cases have to spread infection as 

 they pass from place to place, we begin to realize 

 how epidemics can start without apparent cause. The 

 more we investigate the persistence of bacteria in con- 

 valescent cases of disease the more difficult the preven- 

 tion of their dissemination is seen to be. The disin- 

 fection of the urine should always be looked after in 

 typhoid fever, and convalescents should not be allowed 

 to go to places where contamination of the water-supply 

 is possible without at least warning them of the neces- 

 sity of great care in disinfecting their urine and feces 

 for some weeks. Richardson made the interesting dis- 

 covery that after washing out the bladder with a very 

 weak solution of bichloride of mercury the typhoid 

 bacilli no longer appeared in the urine. 



1 Journal of Experimental Medicine, May, 1898. 



