3o8 PATHOGENIC BACTERIA IN MILK 



In London, Horton-Smith found typhoid bacilli present in the 

 urine in 25 per cent, of all cases examined. Working in Boston, 

 Richardson obtained a positive result in 22-5 per cent, of the cases 

 examined. Both investigators found the bacilli present, in certain 

 cases, in such large numbers that the urine was rendered turbid 

 by their presence. Nor are such cases rare. Out of the cases in 

 which the specific bacillus was present in the urine, in as many 

 as 12 it was present to the degree of turbidity, and in only 2 

 was the urine described as "clear" (Horton-Smith). Referring to 

 the stage of the disease in which the bacilli appear in the urine, 

 they have been found as early as the thirteenth day from the 

 commencement, and as late as the fourteenth day of convalescence 

 (Horton-Smith), Karlinski is reported to have found them as 

 early as the third day of the fever. Speaking generally, the con- 

 dition is rare before the third week of the disease. The duration 

 of this specific bacilluria also varies. The shortest duration 

 recorded by Horton-Smith was eight days, but in four other 

 cases it had not disappeared until after the lapse of twenty-one 

 days, twenty-five days, thirty days, and seventy days. But even 

 that is not the limit, for the presence of the bacilli in the urine 

 may persist, not for months, but even for so long as five years 

 (Gwynn). Various explanations have been suggested for this 

 phenomenon of typhoid bacilli in the urine, but that which seems 

 most adequate to the facts is that which assumes that one or more 

 bacilli, but probably extremely few, find their way into the bladder 

 and there commence rapid growth in the urine within the bladder, 

 which medium is by no means unfavourable to the multiplication 

 of the bacillus (Horton-Smith). This question of typhoid bacil- 

 luria is in our judgment one of such importance, when it is 

 considered that the urine of typhoid patients may so remain 

 infective for weeks or even months, that we make no apology for 

 inserting here the record of a small epidemic of typhoid fever 

 apparently traced to such infection. In the village of Long Orton 

 in Huntingdonshire, there were, in 1900, two houses obtaining their 

 water supply from the same well. The water was highly con- 

 taminated with sewage. No one, however, suffered in consequence 

 until after the arrival of a trooper invalided home from South 

 Africa, convalescent from typhoid fever. He had been in 

 hospital from 23rd May to ist August and arrived home at Long 

 Orton on 19th August. Immediately after his arrival the well 

 became infected with the typhoid fever bacillus, as shown by the 

 fact that between 4th September and 17th September, twelve in- 



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