YELLOW FEVER. 523 



The proofs of the specificity of the Bacillus icteroides 

 are not limited to the animal experiments quoted. Sana- 

 relli also adduces five experimental inoculations upon 

 men. These inoculations were not made with the bac- 

 teria — /. e. were not infection experiments — but were 

 made with the filtered sterile toxin, whose action could 

 be more easily controlled. " The injection of the filtered 

 cultures in relatively small doses reproduced in man 

 typical yellow fever, accompanied by all its imposing 

 anatomical and symptomatological retinue. The fever, 

 congestions, hemorrhages, vomiting, steatosis of the liver, 

 cephalalgia, collapse — in short, all that complex of symp- 

 tomatic and anatomical elements which in their combina- 

 tion constitute the indivisible basis of the diagnosis of 

 yellow fever. This fact is not only striking evidence in 

 favor of the specific nature of the Bacillus icteroides, but 

 it places the etiological and pathologic conception of yel- 

 low fever on an altogether new basis." 



The discovery of the Bacillus icteroides, and especially 

 of its toxin, entirely changes our view of the pathology 

 of the disease. Instead of being a disease of the gastro- 

 intestinal tract, as one would conclude from the symp- 

 toms, "all the symptomatic phenomena, all the functional 

 alterations, all the anatomical lesions of yellow fever, are 

 only the consequence of an eminently steatogenous, 

 emetic, and hemolytic action of the toxic substances 

 manufactured by the Bacillus icteroides." 



Readers interested in the study of yellow fever and the 

 relationship of the Bacillus icteroides to the disease 

 should not fail to read the critical papers upon the sub- 

 ject by Novy. 1 



The mode by which the Bacillus icteroides enters the 

 body to produce the disease has not been made out. 

 The digestive and respiratory tracts are the most likely 

 routes. 



Sanarelli points out that when it happens that a mould 

 develops near the Bacillus icteroides, the products of 



1 Medical News, Sept., 1898, pp. 331 and 360. 



