Prophylaxis 557 



neal cavity, and the bacilli introduced through an esophageal 

 catheter, Klemperer, Levy, and others found that an intes- 

 tinal condition which very much resembled typhoid as it 

 occurs in man was produced. The virulence of the bacillus 

 can be very greatly increased by rapid passage from guinea- 

 pig to guinea-pig. 



Virulent cultures of the typhoid bacillus, when injected 

 subcutaneously into guinea-pigs and some other laboratory 

 animals, produce a fatal septic infection. 



In the experiments of Chantemesse and Widal the symp- 

 toms following the injection of virulent culture into guinea- 

 pigs were briefly as follows: 



"Very shortly after the inoculation there is a rise of temperature, 

 that continues from one to four hours, and is succeeded by a depression 

 of the temperature, which continues to the fatal issue. Meteorism 

 and great tenderness of the abdomen are observed. At the autopsy 

 a sero-fibrinous or sero-purulent peritonitis is observed sometimes 

 hemorrhagic. There is also generally a pleurisy, either serous or 

 hemorrhagic. All the abdominal viscera are congested. The intes- 

 , tine is congested contains an abundant mucous secretion. The Peyer 

 patches are enlarged. The spleen is enlarged, blackish, and often 

 hemorrhagic. In cases which are prolonged the liver is discolored. 

 The kidneys are congested, the adrenals filled with blood. 



"In such cases the bacillus can be found upon the inflamed serous 

 membranes, in the inflammatory exudates, in the spleen in large num- 

 bers, in the adrenals, the liver, the kidneys, and sometimes in the 

 lungs. The blood is also infected, but to a rather less degree. 



"In cases described as chronic, the bacillus disappears completely 

 in from five to twenty-four hours, and produces but one lesion, a small 

 abscess at the point of inoculation. 



"Sanarelli has observed that if some of the poisonous products of 

 the colon bacillus or Proteus vulgaris be injected into the abdominal 

 cavity of an animal recovering from a chronic case, it speedily suc- 

 cumbs to typical typhoid fever." 



Petruschky * found that mice convalescent from sub- 

 cutaneous injections of typhoid cultures frequently suffered 

 from a more or less widespread necrosis of the skin at the 

 point of injection. 



Prophylaxis. One of the most important and practical 

 points for the physician to grasp in relation to the subject of 

 typhoid fever is the highly virulent character of the dis- 

 charges, both feces and urine. In every case the greatest 

 care should be taken for their proper disinfection, a rigid 

 attention paid to all the details of cleanliness in the sick- 

 room, and the careful sterilization of all articles which are 

 soiled by the patient. If country practitioners were as 

 * "Zeitschrift fur Hygiene," 1892, Bd. xn, p. 261. 



