47^ PATHOGENIC BACTERIA. 



portance from a sanitary point of view to remember that 

 the urine as well as the feces is infectious. 



Occasionally the bacilli succeed in entering the general 

 circulation, and, finding a lodgement at some remote 

 part of the body, set up local inflammatory processes 

 sometimes terminating in suppuration. 



The pyogenic power of the typhoid bacillus was first 

 pointed out by A. Frankel, who observed it in a suppu- 

 ration that occurred four months after convalescence. 

 Low 1 found virulent typhoid bacilli in the pus of ab- 

 scesses occurring from one to six years after convales- 

 cence. 



Weichselbaum has seen general peritonitis from rupt- 

 ure of the spleen in typhoid fever with escape of the 

 bacilli. Otitis media, ostitis, periostitis, and osteomye- 

 litis are very common results of the lodgement of the 

 bacilli in bony tissue ; and Ohlmacher has found the ba- 

 cilli in suppurations of the membranes of the brain. The 

 bacilli are also encountered in other local suppurations 

 occurring in or following typhoid fever. Flexner and 

 Harris 2 have seen a case in which the distribution of 

 the bacilli was sufficiently widespread to constitute a real 

 septicemia, the bacillus being isolated from various or- 

 gans of the body. 



The bacilli are commonly found in the bile, where 

 they sometimes persist for a long time, as in the case 

 studied by Miller, 3 when they were found in this viscus 

 seven years after recovery from typhoid fever, dishing 4 

 invariably found the bacilli in the bile in clumps looking 

 like the agglutinations of theWidal reaction. He thinks 

 it probable that these clumps form nuclei upon which 

 bile-salts can be precipitated and calculus-formation 

 begin. The presence of gall-stones, together with the 

 long-lived infective agents, may at any subsequent time 



1 Sitz. der K. K. Gesellschaft d. Aerzt. in Wien. Aerztl. Central- Attz., 1898, 

 No. 3. 



2 Bull. Johns Hopkins Hospital, Dec, 1897. 



s Ibid., May, 1898. 4 Ibid., ix., No. 86. 



