560 Typhoid Fever 



broken-up bacillary bodies was then made, and allowed to 

 stand for from two to three days at 60 C. The extract 

 thus obtained, after removing the disintegrated and digested 

 remnants, was precipitated with alcohol, forming a fine coag- 

 ulum. This was subsequently dried and powdered and dis- 

 solved in sterile water in the proportion of 0.02 mg. to a 

 drop." * 



When one drop of this is placed upon the conjunctiva 

 of a patient in the early days of typhoid fever, diffuse 

 redness increases and becomes marked in two or three hours. 

 There is also some feeling of heat in the eye. Tears flow 

 freely, and there is a slight mucopurulent exudate in some 

 cases. The reaction persists about ten hours and then 

 declines, usually disappearing in twenty-four hours. Ham- 

 burger f confirmed the results of Chantemesse. It is too 

 early to say how useful the reaction is, but it seems to 

 promise aid in diagnosing difficult cases. 



Prophylactic Vaccination. Following the principle of 

 Haffkine's anticholera inoculations, Wright and Semple J 

 have used subcutaneous injections of sterilized cultures as 

 a prophylactic measure. One cubic centimeter of a bouillon 

 culture sterilized by heat was used. 



The "Indian Medical Gazette" gives the following im- 

 portant figures showing what was accomplished in 1899: 

 Among the British troops in India there were 1312 cases of 

 typhoid fever, with 348 deaths (25 per cent.)- The ratio of 

 admissions to the total strength was 20.6 per 1000. There 

 were 4502 inoculations and among them there were only 9 

 deaths from typhoid fever 0.2 per cent, of the strength. 

 There were 44 admissions, giving 0.98 per cent, of the 

 strength. Among the non-inoculated men of the same 

 corps and at the same stations, of 25,851 men there were 

 657 cases and 146 deaths, giving the relative percentages 

 of admissions and deaths as 2.54 and 0.56.$ 



In a later contribution, Wright || showed that this pro- 

 phylactic vaccination against typhoid fever reduced the 

 number of cases, and diminished the death-rate among the 



* See Hamburger, "Jour. Amer. Med. Assoc.," L. 17, p. 1344, April 25, 

 1908. 



t Loc. cit. 



I "Brit. Med. Jour.," 1897, i, p. 256. 



"Phila. Med. Jour.," Oct. 13, 1900, p. 688. 



|| "The Lancet," Sept. 6, 1902. 



