THE TYPHOID BACILLI S 283 



The Cupaldi medium lias the objection that some of the typhoid 

 and some of the colon colonies frequently look much alike. If one, 

 however, will always pick out the colonies which look most like the 

 typhoid, it will usually turn out that typhoid bacilli have been obtained 

 if any were present. Personally, for general use, I prefer the Capaldi 

 or Drigalski medium for the plate cultures and the Hiss tube medium 

 for identifying the bacilli obtained. Through these media and specific 

 agglutinating serum we are now in a position to obtain and identify 

 typhoid bacilli from feces, urine, etc., within forty-eight hours. 



Typhoid Bacilli in Feces. Recently numerous investigations have 

 been carried out to discover how frequently and at what period in 

 typhoid fever bacilli were present in the feces and urine. Hiss some 

 time ago examined the feces in 43 consecutive cases, 37 of which were 

 in the febrile stage and 6 convalescent. In a number of instances 

 only one stool was examined, but even under these adverse conditions 

 the average of positive results in the febrile stage was 66.6 per cent. 

 Out of 26 cases of typhoid fever examined in hospitals, 21 were in 

 the febrile stage and 5 convalescent. In the febrile cases in 17 the 

 presence of typhoid bacilli, often in great numbers, was demonstrated. 

 Thus in these carefully followed cases the statistics show over 80 per 

 cent, of the febrile cases positive. The bacilli were isolated from these 

 cases as early as the sixth day, and as late as the thirtieth day, and in 

 a case of relapse on the forty-seventh day of the disease. The con- 

 valescent cases gave uniformly negative results, the earliest examination 

 having been made on the third day after the disappearance of the fever. 

 The bacilli seemed to be more numerous in the stools from about the 

 tenth or twelfth day on. These observations, with regard to the appear- 

 ance of the bacilli in the stools during the febrile stage and their usually 

 quick disappearance after the defervescence, have been confirmed by 

 others. The bacilli were isolated in several cases in which no Widal 

 reaction was demonstrated. Between the seventh and twenty-first days 

 of the disease, experience seems to indicate that the bacilli may be 

 obtained from about 25 per cent, of all cases on the first examination 

 and from about 75 per cent, after repeated examinations. In some 

 samples of feces typhoid bacilli die out within twenty-four hours; in 

 others they remain alive for days or even weeks. This seems to depend 

 on the bacteria present in the feces and upon its chemical character. 

 Probably the presence of typhoid bacilli in some stools and their 

 absence in others must be explained largely by the characteristics of 

 the intestinal contents. The short life of the typhoid bacillus in many 

 specimens of feces suggests that stools be examined as quickly as pos- 

 sible. In fact, unless the physician wishes to take the trouble to have 

 the sample of feces sent immediately to the laboratory, it is hardly 

 worth while for the bacteriologist to take the trouble to make the 

 test. 



Typhoid Bacilli in the Urine. Of even more interest than the pres- 

 ence of the bacilli in feces is their frequent occurrence in great 

 numbers in the urine. The results of the examinations of others as 



