68 TYPHOID FEVER 



the camps, small and large, north and south of the Mason and Dixon 

 line, and was recorded on sick reports under a multitude of names, 

 chiefly malaria, but often typho-malaria and many other designations 

 hitherto and subsequently unused. The board of medical officers 

 appointed to investigate, employing scientific methods of diagnosis, 

 soon showed that malaria was very infrequent and that more than 

 99 per cent, of the cases were typhoid. Among nearly 20,000 cases, 

 12 of coincident malarial and typhoid infection were found and even 

 in these the malarial manifestations were suppressed during the course 

 of the typhoid. A man already malarial is not immune to typhoid or 

 vice versa, but even in coincident infection there is no peculiar or 

 characteristic symptom complex. It follows that "typho-malaria" in 

 any sense is a misnomer and should not be used. 



Malaria is not the only infection which may be coincident with 

 typhoid. Cases, though few in number, have been reported in which 

 typhoid has been coincident with the following : Malta fever, recurrent 

 fever, anthrax, Asiatic cholera, diphtheria, miliary tuberculosis, scarlet 

 fever, and both amebic and bacterial dysentery. These facts simply 

 show that the above mentioned infections establish no immunity to 

 typhoid nor does this disease protect the individual against other bac- 

 terial invasions. Of more importance are the secondary infections 

 which may develop in typhoid. The intestinal lesions open ports of 

 entry especially for pus-producing bacteria, which may develop 

 abscesses in various parts of the body, and these are slow to heal and 

 difficult to reach. 



The Bacillus. In 1880 Eberth discovered short, motile bacilli in 

 the spleen and mesenteric glands of those dead from typhoid fever. 

 Four years later Gaffky isolated this organism and secured pure cul- 

 tures. An almost endless amount of research has been devoted to the 

 Bacillus typhosus with the hope of finding easy means of sure recog- 

 nition under all conditions. There is an extensive group of bacilli 

 with the typical typhoid at one extreme and the typical colon bacillus 

 at the other and with many intermediate varieties. It is easy enough 

 to distinguish the extremes, but it still remains quite impossible to 

 locate exactly every member of this group. The colon bacillus is a 

 normal dweller in the intestinal tract and causes trouble only when it 



