258 BACTERIA PATHOGENIC TO MAN 



Besides the epidemic at Seal Harbor, numerous cases of moderately 

 severe or slight dysentery due to the first type were met with in the 

 extensive epidemic which has been already alluded to in the towns 

 north of New York City. A few characteristics in many slightly 

 developed cases of dysentery in New York City during the past two 

 summers were caused by this type of bacillus. A great many cases 

 are also due to the Philippine type. A number of rather severe cases 

 of dysentery developed in Orange, N. J. Cultures from two cases were 

 made, and this type alone obtained. The folloAving is a typical case. 

 Eighteen out of thirty colonies, selected from the plates, when tested 

 proved to be dysentery bacilli of the Philippine type. 



Dorothy D., aged two years and three months. Seen first July 29th, 

 a day after the child had eaten green apples. Previous to this the 

 child had had an attack of vomiting and diarrhoea, the sickness lasting 

 two weeks; the diarrhoea had subsided only two days before present 

 illness. No blood was seen during this first attack. When first seen, 

 the child had a temperature of 104.6, with vomiting and diarrhoea. 

 After a calomel purge the patient was better; the following day, how- 

 ever, the diarrhoea started up again and the temperature rose. The 

 stools were numerous, small, containing mucus and blood, preceded 

 by pain and accompanied by tenesmus. Many of the stools consisted 

 of nothing but blood and mucus. Sixteen movements were the greatest 

 number recorded in a day. On August 2d ten cubic centimetres of 

 dysenteric serum were injected. There seemed to be some improvement 

 in the character of the stools following the injection. On August 4th 

 and 6th the injections were repeated, being followed each time, appar- 

 ently, by some improvement in the child's condition. The blood dis- 

 appeared in eight or nine days, and the child had then five movements 

 daily, consisting largely of mucus. 



At Hiker's Island a number of men were filling in new land. Dysen- 

 tery broke out and spread to a number of the men, as well as to the 

 physician in charge. Those infected had usually a short, sharp attack 

 with a quick recovery. Very large amounts of blood were passed by 

 some of the sick. 



In some a large proportion of the bacteria isolated were bacilli of 

 the Philippine type. No other type of dysentery bacilli was found in 

 any of the cases in this epidemic. 



Charlton and Jehle report a series of cases occurring in St. Ann's 

 Hospital, Vienna, in which mannite fermenting types were the only 

 dysenteric-like organisms present. The cases on the average ran a 

 much milder course than those in whichtbe- true dysentery bacilli were 

 present. 



When the agglutinating characteristics of these bacilli and their 

 susceptibility to immune sera are studied carefully, we find that each 

 of the three types differs from the others. The mannite and the 

 maltose types, since in animals they stimulate abundant common 

 agglutinins and immune bodies, seem more closely allied to each other 

 than to the Shiga type. 



