476 PATHOGENIC BACTERIA. 



longer to be a saprophyte, but now to be a virulent pus- 

 producer, and in many cases of typhoid we find suppura- 

 tions and other milder inflammations due to this microbe. 

 This is also a stumbling-block, for the typhoid bacillus 

 when distributed through the blood may act in exactly 

 the same manner. 



The typhoid bacillus may enter the body, at times, 

 through dust (Klemperer and Levy), but no doubt, in the 

 great majority of cases, enters the digestive tract at once 

 through the mouth. It may possibly enter through the 

 rectum at times. Eichhorst mentions the infection of 

 soldiers in military barracks through the wearing of 

 drawers previously worn by comrades who had suffered 

 from typhoid. 



When ingested the resisting power of the bacillus per- 

 mits it to pass uninjured through the acid secretions of 

 the stomach and to enter the intestine, where the chief 

 local disturbances are set up. 



The bacilli enter the solitary glands and Peyer's patches, 

 and multiply slowly during the one to three weeks of the 

 incubation of the disease. The immediate result of their 

 residence in these lymphatic structures is increase in the 

 number of cells, and ultimately the necrosis and slough- 

 ing which cause the typical post-mortem lesion (Fig. 113). 

 From the intestinal lymphatics the bacilli pass, in all 

 probability, to the mesenteric glands, which become en- 

 larged and 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 dis- 

 ease, and the bacilli are found in the urine in about 25 

 per cent, of the cases. Smith l found the bacilli in the 

 urine in three out of seven cases which he investigated, 

 Richardson 2 in nine out of thirty-eight cases. They did 

 not occur before the third week, and remained in one 

 case twenty-two days after cessation of the fever. Some- 

 times they were present in immense numbers, the urine 



1 Brit. Med. Jour., Feb. 13, 1897. 



2 Journal of Experimental Medicine, May, 1 898. 



