608 ANAPHYLAXIS IN RELATION TO INFECTION AND IMMUNITY 



patients suffering from typhoid fever. Kraus 1 and his associates, re- 

 peating these experiments, could not convince themselves of the specific- 

 ity of this reaction, stating that healthy individuals also give it to some 

 extent, and that other bacterial extracts cause similar symptoms in 

 typhoid-fever patients. In addition he tried a cutaneous reaction, 

 but without result. Zupnik, 2 on the contrary, states that a cutaneous 

 reaction is useful, while the ophthalmic reaction is not useful. Deehan 3 

 obtained a weak to moderate reaction in 12 cases of typhoid fever, 

 whereas eight control cases showed none. Floyd and Barker 4 obtained 

 positive results in 19 out of 30 cases and none in 18 controls, including 

 two cases of paratyphoid fever. Chaufford and Trosier 5 reported 

 unfavorably on the reaction. 



Austrian 6 has reported very favorably upon an ophthalmic reaction 

 in typhoid fever following the installation of " typho-protein " prepared 

 by cultivating a large number of different strains of typhoid bacilli, 

 precipitating the protein with alcohol, drying the precipitate, and re- 

 dissolving in water so that from one-third to one-half milligram is 

 contained in each drop. In typhoid-fever patients reaction of the 

 palpebral conjunctiva of the lower lid and of the caruncle appears on 

 an average of two and a half hours later, reaching the maximum about 

 the sixth hour, and usually subsiding within forty-eight hours. In 75 

 cases of typhoid fever this test was found positive in 71 and negative 

 in four. In three cases the eye test antedated the Widal reaction, and 

 in only 23 per cent, was the Widal reaction positive at as early a date 

 as the eye test. A study of 190 persons normal or ill with diseases 

 other than typhoid has convinced Austrian of the specificity of the test, . 

 and he recommends it as an aid to diagnosis on account of its simplicity 

 and the absence of any discomfort to the patient. 



More recently, Gay and Force 7 have reported favorably upon a 

 cutaneous reaction indicative of immunity against typhoid fever. The 

 preparation which they used, "typhoidin," is prepared in the same man- 

 ner as Koch's old tuberculin: 250 c.c. of a 5 per cent, glycerin bouillon 

 is inoculated with Bacillus typhosus and cultivated at 37 C. for five 

 days. It is then reduced, without filtration, to one-tenth of its original 



1 Wien. klin. Wochenschr., 1907, 20, 1335. 



2 Munch, med. Wochenschr., 1908, 45, 148. 

 8 Univ. Penn. Med. Bull., 1909, 22, 6. 



4 Amer. Jour. Med. Sci., 1909, 38, 188. 



6 Compt. rend. Soc. de Biol., 1909, Ixvi, 519. 



6 Bull. Johns Hopkins Hosp., 1912, 23, 1. 



7 Archiv. Int. Med., 1914, 13, 471. 



