538 Typhoid Fever 



As the isolation of a pure culture of the typhoid bacillus 

 from the spleen is sometimes difficult because the groups of 

 bacilli are scattered throughout the organ, E. Frankel recom- 

 mends that as soon as the organ is removed from the body it 

 be wrapped in cloths wet with a solution of bichlorid of mer- 

 cury and kept for three days in a warm room, in order that 

 a considerable and massive development of the bacilli may 

 take place. 



Cultures of the typhoid bacillus may be obtained from 

 the blood, but it is necessary to bear in mind that con- 

 tamination may take place from the skin, that there are few 

 bacilli in any given quantity of blood, and that shed blood 

 is more germicidal than circulating blood. The technic of 

 this operation is simple ; the skin of the fold of the elbow is 

 thoroughly cleansed, a fillet put about the arm, and as the 

 veins become prominent, a sterile hypodermic needle is in- 

 troduced into one and about 10 c.c. of blood drawn into the 

 syringe. Before clotting can take place, this is discharged 

 into a small flask containing 100 c.c. of bouillon, mixed, and 

 stood away to incubate. After twenty-four hours the 

 bacilli can usually be found in pure culture or mixed with 

 skin cocci. 



The bacilli can also be secured, but with much more dif- 

 ficulty, from the alvine discharges of typhoid patients 

 during the second and third weeks of the disease. An ex- 

 cellent resume of the many methods employed for isolating 

 the bacillus from the stools has been published by Peabody 

 and Pratt,* and is appropriate reading for those interested 

 in this subject. 



These methods have been suggested one after the other, 

 in the hope that they could simplify the separation of the 

 typhoid bacillus from the other bacteria always present in 

 the feces. One of the first of these methods took advantage 

 of the resistance of the typhoid bacillus to carbolic acid, 

 which is greater than that of other organisms. It is now 

 of historic interest only, and is as follows: 



To each of several tubes of melted gelatin 0.05 per cent, of carbolic 

 acid is added. This addition is most easily calculated by supposing 

 the average quantity of gelatin contained in a tube to be 10 c.c., when 

 the addition of o.i c.c. of a 5 per cent, solution of carbolic acid gives 

 nearly the desired quantity. A minute portion of feces is broken up 

 with a platinum loop and stirred in the tube of melted carbolized gelatin; 



* "Boston Medical and Surgical Journal," 1907. 



