298 TEXT-BOOK OF BACTERIOLOGY. 



Sometimes this association becomes manifest in the symptoms of the 

 disease, inasmuch as typhoid in its course becomes complicated 

 with an erysipelas or similar process. On other occasions the true 

 state of things is not so evident, and only direct microscopical ex- 

 amination or cultivation will succeed in establishing- the existence 

 of such a mixed infection which is hardly ever absent, especially in 

 more severe cases of the disease. 



It is still a matter of doubt whether the demonstration of typhus 

 bacilli can be of any value in dubious cases for a quick recognition 

 of the disease. The proof of the existence of genuine typhus bacilli 

 depends every time on potato (or a similar) culture, and when we 

 have produced such a culture, so much time will usually have 

 elapsed that the clinician or even the pathologist has anticipated 

 the bacteriologist in his judgment. 



For this reason we cannot approve of the procedure in which 

 tissue is taken by puncture from the spleen of the patient, to be 

 examined as to the presence of bacteria. The presence of typhus 

 bacilli has, indeed, been ascertained in this way, but the result is 

 not proportionate to the severity of the means by which it was ob- 

 tained. This strange mode of investigation should not be permitted 

 for humane and other considerations. 



XIII. SPIRILLA OF RELAPSING FEVER. 



Typhoid fever was not differentiated from other diseases hav- 

 ing similar symptoms till about the middle of this century. 

 Henderson, of Edinburgh, in 1843 publicly declared that a par- 

 ticular affection, characterized by the lack of abdominal changes 

 and by the fact that it reappears in sudden relapses after apparent 

 recovery, should be differentiated from the complex of symptoms 

 hitherto known as " typhus." Henderson's view proved to be cor- 

 rect, and the disease was named relapsing fever (typhus or febris 

 recurrens). 



Relapsing fever appeared in Germany, in 1868, for the first time 

 in an epidemic form, and Obermeier, of Berlin, furnished in 1873 the 

 final proof of its peculiar nature by establishing, in all cases of re- 

 lapsing fever, the occurrence of a special form of micro-organism 

 met with in no other disease. 



They are long, undulating threads, with numerous convolutions, 

 resembling the cholera spirilla, though thinner and more delicate 

 than the latter. It is a genuine screw-bacterium and named " spi- 

 rillum Obermeieri." They are highly motile and rapidly glide and 

 turn about. They readily absorb the common staining solutions, 



