102 AIDS TO BACTERIOLOGY 



necrosis of the Peyer's patches is set up, forming ulcers, 

 which may become so deep as to lead to perforation. The 

 bacillus may rarely be detected in the faeces and urine 

 during the early stages of the disease, but appears in the 

 former after the eighth or ninth day, and from urine 

 enormous numbers can sometimes be found after the 

 third week. The organism may be found in the spleen, 

 sweat, mesenteric glands, liver, kidneys, bone-marrow, 

 and in some cases of pneumo-typhoid in the sputum. 

 From its presence in the kidneys, rose spots, and urine, 

 Wright and Semple consider the disease to be a septi- 

 caemia. The dorsi-lumbar region is not a very uncommon 

 site for the late activity of the bacillus (' typhoid spine '). 

 Such complications as cystitis (from infection by urine) 

 and inflammations of the gall-bladder are common. 

 Typhoid bacilli persist in the gall-bladder for a long time 

 and are suggested to be a frequent nucleus of gallstone. 

 Typhoid pleurisy is rare and typhoid meningitis rarer 

 still. Osteomyelitis may develop six or seven years 

 after recovery from typhoid (Jordan). Injected into 

 animals, the typhoid bacillus produces a general septi- 

 caemia. Animals, with the exception of chimpanzees and 

 young suckling rabbits, are immune to the bacillus 

 administered per os. In young rabbits a febrile affection 

 is produced, with diarrhoea and inflammation and ulcera- 

 tion of the lymphoid (Peyer's) patches and solitary 

 glands. The organism is most readily demonstrated in, 

 and isolated from, the spleen of a cadaver, in which it is 

 found in the form of small aggregates or colonies. 



The view that the first lesion necessarily takes place 

 in the ileum is giving way before the idea that an entrance 

 into the blood-stream is effected through the tonsil or 

 other alimentary lymphoid area. 



Typhoid Carriers. After cessation of the fever, the 

 bacillus disappears from the faeces and urine fairly soon 

 as a rule, but a certain proportion (Semplo gives it as 

 11*6 per cent.) of cases are infectious for more than six 

 weeks after infection (chronic carriers). It is estimated 

 that three or four persons in every thousand are carriers. 

 Cammidge records a case where the bacilli wore still being 

 excreted in the faeces ten years after recovery from the 

 disease. The gall-bladder and the urinary passages are 

 the sources from which the faeces and urine are infected. 



