TYPHOID FEVER 930 



dividuals were laid up with typhoid fever, the only feature common 

 to them all being that each one of them had partaken of the water 

 from the polluted well. Other wells from the same village were 

 analysed and found to contain sewage, but no case of typhoid fever 

 resulted from the use of the water of these wells. No other 

 possible source was found for the pollution of the infected well 

 except the returned trooper. The sanitary conditions were such 

 as to render the well liable to pollution from the soil pipe.^ 



We have entered into matters which may at first sight appear 

 to belong rather especially to clinical medicine for the reason that 

 they bear, as we shall see, a very important relation to the 

 epidemiology of the disease. Moreover, there are several other 

 characteristics of the bacillus which may be mentioned as having 

 some importance in the spread of the disease. Two points respect- 

 ing the toxins of the typhoid bacillus must be named, one, that 

 the toxins are for the most part intracellular, contained within 

 the bacillus itself, and are chiefly set free when the latter is 

 destroyed ; and the other, that the toxin is a comparatively feeble 

 one as compared with that of other pathogenic organisms, and that 

 to account for the clinical conditions of the disease the number of 

 bacilli present in the infected body would have to be exceptionally 

 large. This fact, coupled with the varying virulence of the bacillus, 

 is all the more remarkable when it is remembered that not a few 

 of the epidemics of the disease have arisen from a dose of poison, 

 so excessively minute in itself, and so enormously diluted, as to 

 appear out of all proportion to the number of persons attacked. 

 It is possible that a few organisms introduced into the human 

 body are able, under certain conditions, to multiply rapidly, and so 

 bring about the same results as large dosage. Again and again it 

 has been shown that considerable epidemics have arisen from a 

 pollution of water so slight as to escape detection by any methods 

 of chemical or bacteriological analysis at present known.- Precisely 

 the same condition of things applies to pollution of milk, though 

 possibly in an even more marked degree. It is not unlikely that 

 when specific typhoid matter is introduced into water or milk, 

 under ordinary circumstances, that a rapid multiplication at once 

 takes place, whereby large volumes of such water and milk become 



' Brit. Med. Jour.., 1900, vol. ii., p. 1494. (Dr Walker, Senior Surgeon, 

 Peterborough Infirmar>'.) For a general review of the question of the typhoid 

 bacillus in faeces and urine as it affects hygiene see the New York Medical 

 News nth May 1901 (Hiss). 



- See also Report of the Medical Officer to the Local Government Board., 1881. 



