TYPHOID FEVER. 



477 



being actually clouded by their presence. Petruschy ' 

 found that albuminuria sometimes occurred without the 

 presence of typhoid bacilli, that the presence of bacilli 

 in the urine is infrequent rather than otherwise, that the 

 bacilli never appear in the urine in the early part of the 

 disease, and hence are of little importance for diagnostic 

 purposes. GwynMias found as many as 50,000,000 per 

 can. of urine, and mentions a case of Cushing's in which 

 the bacilli persisted in the urine for six years after the 



Fig. 113. — Intestinal perforation in typhoid fever. Observe the threads of 

 tissue obstructing the opening. (Museum of the Pennsylvania Hospital.) 

 (Keen, Surgical Complications and Sequels of Typhoid Fever.) 



primary attack of typhoid fever. Their occurrence, no 

 doubt, depends primarily upon a typhoid bacteremia, by 

 which they are brought to the kidney. After recovery 

 from typhoid fever, their persistence in the urine prob- 

 ably depends upon growth in the bladder. It is of im- 



1 Centralbl.f. Bakt. u. Parasitenk., May 13, 1898, No. 13, p. 578. 

 1 Phila. Med. Jour., Mar. 3, 1900. 



