THE BACILLUS OF TYPHOID FEVER. 433 



borhood of old ulcers and are supposed to have indicated a relapse 

 of the specific process. In the second case the negative result is 

 thought by Gaffky to have been not at all surprising, as the patient 

 died at the end of the fourth week of sickness, not directly from the 

 typhoid process, but as a result of perforation of the intestine. 



Gaffky has further shown that in those cases in which colonies 

 are not found in the spleen, or in which they are extremely rare, the 

 presence of the bacillus may be demonstrated by cultivation ; and 

 that, when proper precautions are taken, pure cultures of the bacil- 

 lus may always be obtained from the spleen of a typhoid case. 

 Hein has been able to demonstrate the presence of the bacillus and 

 to start pure cultures from material drawn from the spleen of a living 

 patient by means of a hypodermatic syringe. Philopowicz has re- 

 ported his success in obtaining cultures of the bacillus by the same 

 method. 



The fact that a failure to demonstrate the presence of microor- 

 ganisms by a microscopic examination cannot be taken as proof of 

 their absence from an organ, is well illustrated by a case (No. 18) in 

 which the bacillus was obtained by Gaffky from the spleen and also 

 from the liver, in pure cultures ; whereas in cover-glass preparations 

 made from the same spleen he failed to find a single rod, and more 

 than one hundred sections of the spleen were examined before he 

 found a colony. 



To obtain pure cultures from the spleen Gaffky first carefully 

 washes the organ with a solution of mercuric chloride, 1 : 1,000. A 

 long incision is then made through the capsule with a knife sterilized 

 by heat. A second incision is made in this with a second sterilized 

 knife, and a third knife is used to make a still deeper incision in the 

 same track. By this means the danger of conveying organisms from 

 the surface to the interior of the organ is avoided. From the bottom 

 of this incision a little of the soft splenic tissue is taken up on a ster- 

 ilized platinum needle, and this is plunged into the solid culture 

 medium, or drawn along the surface of the same, or added to lique- 

 fied gelatin and poured upon a glass plate. The colonies develop, in 

 an incubating oven, in the course of twenty-four to forty-eight hours. 



Gaffky has also shown that the bacillus is present in the liver, in 

 the mesenteric glands, and, in a certain proportion of cases at least, 

 in the kidneys, in which it was found in three cases out of seven. 



The appearance of the colonies in stained sections of the spleen 

 is shown in Figs. 104 and 105. Two colonies are seen in Fig. 104 

 (at a, a) as they appear under a low power about sixty diameters. 

 In Fig. 105 one of the colonies is seen more highly magnified about 

 five hundred diameters. 



Frankel and Simmonds have demonstrated that the bacilli multi- 



28 



