388 TYPHOID FEVER 







one hand protective inoculation diminishes the tendency for 

 the individual to contract typhoid fever, and, on the other, if the 

 disease be contracted, the likelihood of its having a fatal result 

 is diminished. Thus, in India, of 4502 soldiers inoculated, '98 

 per cent, contracted typhoid, while of 25,851 soldiers in the 

 same stations who were not inoculated, 2*54 per cent, took the 

 disease. In Lady smith during the siege there were 1705 

 soldiers inoculated, among whom 2 per cent, of cases occurred, 

 and 10,529 uninoculated, among whom 14 per cent, suffered 

 from typhoid. Wright collected statistics dealing in all with 

 49,600 individuals, of whom 8600 were inoculated, and showed 

 a case incidence of 2 '2 5 per cent, with a case mortality of 12 

 per cent. ; in the remaining 41,000 uninoculated the case 

 incidence was 5 '7 5 per cent, and the case mortality 21 per cent. 

 The best results seemed to be obtained when ten days after 

 the first inoculation, as recommended above, a second similar 

 inoculation was practised. Wright has found that in certain 

 cases immediately after inoculation there is a fall in the 

 bactericidal power of the blood (negative phase), and he is of 

 opinion that this indicates a temporary increased susceptibility 

 to the disease. He therefore recommends that when possible 

 the vaccination should be carried out some time previous to the 

 exposure to infection. There can be little doubt that in this 

 method an important prophylactic measure has been discovered. 

 Vaccine Treatment of Typhoid Fever. As in the case of 

 other acute infections, vaccines have been used in the treat- 

 ment of typhoid fever during the acute stage (Leishman and 

 Smallman). The method is to inject hypodermically 100 

 million dead typhoid bacilli, i.e., a fifth of the first dose used for 

 the protective inoculation. If the temperature shows a tendency 

 to fall, this may be repeated about every four days. Experience 

 as to the success of the treatment varies, but the results obtained 

 are hopeful and justify the method being further applied. 



Antityphoid Serum. Chantemesse has immunised animals with dead 

 cultures of the typhoid bacillus, and, having found that their sera had 

 protective and curative effects in other animals, has used such sera 

 in human cases of typhoid with apparent good result. In the hands 

 of others, however, such a line of treatment has not been equally 

 successful. 



Methods of Examination. The methods of microscopic 

 examination, and of isolation of typhoid bacilli from the spleen 

 post mortem, have already been described. They may be isolated 

 from the Peyer's patches, lymphatic glands, etc., by a similar 

 method. 



