BACILLI OF THE COLON-TYPHOID-DYSENTERY GROUP G97 



stool culture and in a few cases by blood culture. A large number of 

 the men of these regiments turned out to be paratyphoid "A" carriers. 



Paratyphoid "B" is probably a more common disease than para- 

 typhoid "A," and is more apt to be typhoid-like and severe. From the 

 very distinct differences between the clinical manifestations of this dis- 

 ease and the ordinary case of so-called meat poisoning, it would appear 

 that there must be a very definite human paratyphoid "B" organism 

 which is conveyed by the same agencies and subject to the same epidem- 

 iological laws as typhoid fever. It is difficult to base this on bac- 

 teriological evidence since it is often impossible to find any cultural 

 or agglutinative distinctions between organisms isolated from the 

 human blood or bowel, and other bacilli which, from their sources and 

 general reactions, would fall into the groups of hog cholera, enteritidis, 

 etc. Numerous attempts have been made to classify these organisms 

 according to source; one of the last attempts to correlate group with 

 host-origin being that made by Krumwiede, Pratt and Kohn. 44 Their 

 results seem to indicate that reduction of fuchsin and quantitative dif- 

 ferences in the fermentation of dulcite and arabinose may to some extent 

 bring about a tentative correlation. But it cannot be said in any sense 

 at the present time that we can sharply differentiate between ' those 

 "B "' types which invade human beings and produce the typical typhoid- 

 like disease, and those which may originate in a disease of animals and 

 be secondarily transferred to man. 



Paratyphoid "B," then, occurs in man in exactly the same way and 

 by the same agencies as typhoid fever, and produces a disease indis- 

 tinguishable from typhoid, except by bacteriological methods. 



In contradistinction to true typhoid the temperature reaction of this 

 case may set in more abruptly and remain more irregular throughout 

 the disease. Gastric symptoms, vomiting, and nausea are often more 

 prominent than in typhoid fever and enlargement of the spleen is less 

 regularly present. Owing to the low mortality of paratyphoid fever (in 

 120 cases observed by Lentz 45 less than 4 per cent, and in many other 

 smaller epidemics no deaths have occurred), we have remained relatively 

 ignorant concerning the pathologic anatomy of the disease. Long- 

 cope 4G observed a case, fatal after two weeks of illness, in which there 

 was no enlargement of Peyer's patches and no sign of even beginning 

 ulceration. Most other observers have also found less involvement of 



44 To be supplied. 



45 Lentz, Klin. Jahrb., xiv, 1914. 



46 Longcope, Amer. Jour, of Med. Sciences, cxxiv, 1902. 



