164 INFECTIONS OF THE DIGESTIVE TRACT 



then be dealing with an eliminative process for bacteria, 

 such as pharmacologists have long known to exist for 

 poisons like carbolic acid, corrosive sublimate, and urea, 

 and such as Dr. Flexner has shown to exist for ricin 

 poisoning and for intoxications arising from the auto- 

 lyzed dysentery poison. 



That the blood contains typhoid bacilli early in the 

 course of the fever is now well established for a very 

 large proportion of all cases appropriately examined, and 

 is probably true of all cases of typhoidal type associated 

 with infection by typhoid bacilli. This bacillsemia 

 explains many of the complications and sequelae of the 

 disease, the passage of bacilli into the spleen with en- 

 largement of the organ, their passage into the liver and 

 hence into the gall-bladder (frequently with cholecystitis, 

 with or without gall-stone formation) and the entry 

 of the bacilli into the urine, where they may be found 

 for some weeks after the subsidence of the fever. That 

 these living bacilli should find their way abundantly 

 into the urine after convalescence has begun shows that 

 the microorganisms must still have a foothold in the 

 host, and points to unnumbered possibilities in respect to 

 relapses and the spread of the bacilli. It could hardly 

 have been predicted that convalescence is possible 

 while the living inciters of the disease still persist in the 

 body of the host. The explanation of this apparent 

 paradox must be sought in the development of protective 

 powers on the part of the host, powers which accrue to 

 the host in consequence of the specific excitation and 

 reaction of many different types of cells through sub- 



