262 PATHOGENIC BACTERIA. 



softened, and finally extend to the spleen and liver, and 

 sometimes to the kidneys. The growth of the bacilli 

 in the kidneys causes the albuminuria of the disease. 

 Sometimes under these conditions the bacilli can be found 

 in the urine. Occasionally the bacilli succeed in entering 

 the general circulation, and, finding a lodgement at some 

 remote part of the body, set up local inflammatory pro- 

 cesses sometimes terminating in suppuration. 



The bacilli can be found in the intestinal lesions, in 

 the mesenteric glands, in the spleen, in the liver, in the 

 kidneys, and in any local lesions which may be present. 

 Their scattered distribution and their occurrence in 

 minute clumps have already been alluded to. They 

 should always be sought for at first with a low power 

 of the microscope. 



Ordinarily no bacilli can be found in the blood, but 

 it has been shown that the blood in the roseolse some- 

 times contains them, so that the eruption may be regarded 

 as one of the local irritative manifestations of the bacillus. 



The amount of local disturbance, in proportion to the 

 constitutional disturbance, is, in the majority of cases, 

 slight, and almost always partakes of a necrotic charac- 

 ter, which suggests that in typhoid we have to do with a 

 toxic bacterium whose disease-producing capacity resides 

 in the elaboration of a toxic substance. This, indeed, 

 is true, for Brieger and Frankel have separated from 

 bouillon cultures a toxalbumin which seems to be the 

 specific poison. Klemperer and L,evy also point out 

 further clinical proof in certain exceptional cases dying 

 with the typical picture of typhoid, yet without charac- 

 teristic post-rnortem lesions, the only confirmation of the 

 diagnosis being the discovery of the bacilli in the spleen. 



As the discovery of the bacilli in the spleen, and espe- 

 cially the securing of a pure culture of the bacilli from 

 the spleen, are sometimes attended with considerable dif- 

 ficulty because of the dissemination of the colonies 

 throughout the organ, E. Frankel recommends that as 

 soon as the organ is removed from the body it be wrapped 



