336 TYPHOID FEVER. 



that the Payer's patches and solitary glands of the intestine 

 were enormously infiltrated, sometimes almost purulent, and 

 that they contained typhoid bacilli, as also did the mesenteric 

 lymphatics and glands, and the spleen. Sanarelli states that 

 by whatever path the bacilli were introduced into the body, the 

 brunt of the pathological effects thus always fell on the intes- 

 tine and abdominal organs. These results are interesting, but 

 are not conclusive of the etiological relationship of the typhoid 

 bacillus to human typhoid. In the latter it is probable that the 

 pathological changes are due on the one hand to the direct local 

 reactive effects of the tissues, and on the other to the absorption 

 of poisons, and therefore the artificial disease does not reproduce 

 all the incidents of that naturally arising. 



The Toxic Products of the Typhoid Bacillus. Here very 

 little light has been thrown on the pathology of the disease, but 

 the general results may be outlined. By alternately precipitat- 

 ing a filtered bouillon culture with alcohol, and redissolving in 

 water, a toxalbumin (vide Chapter V.) has been obtained which 

 has pathogenic effects of an indefinite kind. The toxic effects 

 of the bacterial protoplasm have been investigated by Sanarelli, 

 who killed glycerin bouillon cultures at 60 C, and allowed the 

 bodies of the bacteria to macerate. A clear toxic fluid could be 

 decanted, which, when injected subcutaneously, killed guinea- 

 pigs in twenty-four hours, with progressive fall of temperature, 

 abdominal pain, distention, and bloody stools. Post mortem 

 there were present peritoneal exudation, enlarged spleen, con- 

 gestion of the intestine, and, according to Sanarelli, a special 

 infiltration of the lymphoid patches. Sidney Martin found that 

 the bodies of bacteria killed by chloroform vapour were more 

 toxic (especially after being heated) than filtered cultures. 

 Diarrhoea was a constant symptom after injection, but no change 

 in the Peyerian patches was observed. Martin found that viru- 

 lent cultures of the B. coli gave similar results when similarly 

 treated, and the effects of both closely resemble those of ricin 

 and abrin. 



The general result of these and similar investigations is that 

 there exist in the bodies of typhoid bacilli toxic substances, that 

 in artificial cultures do not pass to any great degree out into 

 the surrounding medium, and that though they produce effects 

 on the intestine, there is evidence that such effects are not 



