260 Dynamic Theory. 



upon the air. But it is extremely probable that in such places many kinds of microbes, 

 bacteria, &c., are developed, or rather perverted from the disintegrating tissues of or- 

 ganized materials. 



Typhoid Fever. The first effect of this disease is an altered state of 

 the blood, accompanied by a reduction of its fibrin and increase of its white globules, 

 which means failure to turn the white globules into red ones. This deterioration of the 

 blood soon communicates derangement and degeneration to many of the working parts 

 especially to the Peyers glands or " patches" and follicles of Lieberkiihn, situated in the 

 lo\ver part of the small intestine. These become inflamed and swollen, then congested 

 and perhaps ulcerated and sloughed off. The ulceration may extend to the outside coat 

 of the intestine and eat holes through it, the effect of which is speedily fatal. The ulcer- 

 ations may heal and the patient recover. The intestinal ulcerations are always accom- 

 panied by more or less enlargement of the mesenteric glands, especially those in most 

 immediate connection with the intestinal glands. This enlargement is due to an ab- 

 normal increase of cells like the normal ones of the glands. 



The spleen is generally enlarged to two or three times its normal size. There are de- 

 generations of the substance of various parts, as the liver, the kidneys, the glands of the 

 stomach, and some of the muscles. There are changes in the lungs, including conges- 

 tion and inflammation of the mucous membrane of the bronchial tubes, and ulcerations 

 of the larynx are not uncommon. There is generally an eruption over the body of iso- 

 lated pimples Ya of an inch long, of ovoid shape. Several observers have found in the 

 ulcerated organs in the intestine, colonies of the ovoid micrococci, while others have 

 found the rod-shaped bacilli in the laryngeal ulcerations. Emanations from the bodies 

 or breaths of typhoid patients thrown into the air do not, as a rule, communicate this 

 disease. If they contain a contagium it is not at first active. Flint suggests that " they 

 may become infecting agents after certain modifications or developments have taken 

 place under conditions which pertain to decomposing human excrement." The infec- 

 tion of the disease, at all events, in some way gets into drinking water and is commu- 

 nicated by that means in a vast number of cases. The disease frequently breaks out and 

 affects all in a neighborhood who use the water of a particular well, which, when exam- 

 ined, is found to be liable to contamination from some cess-pool, privy or drain. Flint 

 relates that a gentleman left his house in town shut up during the summer which he 

 and his family spent in the country. On the return of the family in September all the 

 members of the family between the ages of 7 and 22, iseven in number, became sick, one 

 child with a fever arid vomiting, not typhoid, and the other six with typhoid fever. 

 One died. " On examination of the premises the waste pipe in the cellar was found to 

 be defective, and at times a bad odor from it had been perceived." "The disease was 

 not prevailing in the neighborhood." This case appears to have arisen from the accu- 

 mulation of a miasm in the confined atmosphere of the cellar. And its infectiousness 

 depended upon its accumulation and density. Doubtless if the cellar had been venti- 

 lated the infection would have been so dissipated and attenuated as to be harmless. It 

 seems clearly not to have come from a typhoid patient directly or remotely. Many 

 cases might be cited in which the origin of the disease is free from any suspicion of the 

 agency of any previous typhoid disease, but none in which the agency of corrupt and 

 fermenting matters cannot be traced. 



Mountain Fever is a disease arising from the use of the water of mountain springs and 

 rivulets, which has been contaminated by the excretions of sheep, cattle, &c. It is the 

 same as typhoid, and occurs in the stock ranges of our western mountain districts. 



Typhoid fever is so called from its resemblance to Typhus fever.' 

 Typhus fever has been called also Ship fever, from its being landed in America from 

 emigrant ships. It closely resembles typhoid fever in most of its symptoms, the most 

 notable difference being its exemption from the intestinal lesions and ulcerations which 

 characterize typhoid fever. It is more contagious than typhoid. Patients, especially 

 when many are together, as in a hospital, are apt to give their disease to their nurses 

 and attendants, their emanations being sufficient without modification or development 

 to convey the infection. A single'patient in a large, well ventilated room does not often 

 give the disease to others, but many together in the wards of a hospital, if ill ventilated 

 and small, pack the air with the infectious miasm. The disease can also be carried in 

 the clothes, &c., when they have been well saturated with the miasm. " The disease 

 sometimes appears to be developed as a consequence of overcrowding and deficient ven- 

 tilation ; in other words, the concentrated emanations from the bodies of healthy persons, 

 apparently suffice for the generation of typhus germs. Outbreaks in jails, hospitals, 

 workhouses, ships, and unventilated tenement houses crammed with occupants are thus 



