PARATYPHOID. 451 



bacilli were cultivated from the muscles, spleen, 

 liver and intestines. De Feyfer cites an instance 

 in which the disease apparently was transmitted 

 through the water of a stream in which the cloth- 

 ing of the first patients had been washed. In 

 another instance, a regimental infection was traced 

 to the discharges of a single soldier, the water sup- 

 ply having become contaminated through a defec- 

 tive water closet. 



Paratyphoid, like typhoid fever, is accompanied cimracter- 



f Tin ^ A i istics of the 



by an enlarged spleen and many rose spots. Al- Disease. 

 though severe symptoms may be present for a time, 

 the course of the disease usually is mild and the 

 mortality is low. The incubation period approxi- 

 mates that of typhoid. In the few cases which 

 have come to autopsy the intestinal lesions have 

 varied from a mild ileocolitis with an intact mu- 

 cous surface to a condition of superficial ulcera- 

 tion. The involvement of Peyer's patches and the 

 solitary follicles which is so characteristic of ty- 

 phoid is absent, although these structures may be 

 moderately swollen. The mesenteric lymph glands 

 are not markedly involved and there is little pro- 

 liferation of the lymphoid or endothelial cells 

 (Wells and Scott). The disease has no specific 

 anatomic lesion. 



The organisms are found in the blood and vari- Excretion, 

 ous organs, in the rose spots, urine and f eces of the a t nd. i D?s 1 trf- 

 patients. Practically nothing is known of the oc- bution - 

 currence of the bacilli outside the body. Because 

 of their presence in the stools and urine of the pa- 

 tients, the methods of dissemination and infection 

 doubtless are similar to those concerned in typhoid. 

 The bacillus is said to have a marked resistance to 

 heat, withstanding 60 C. for 30 minutes and 



