PARATYPHOID 123 



clot in the Wright U-tube for culturing and the serum remaining after centrifugaliza- 

 tion for the Widal test (clot culture). B. typhosus appears in the blood in relapses. 

 Kayser considered that about 27% of cases of typhoid in Strasburg were caused by 

 raw milk, 17% by contaminated water, 17% by contact with typhoid, and 10% were 

 due to typhoid carriers. Other cases were due to infected food, and about 13% were 

 of origin impossible to determine. These latter may have been due to unrecognized 

 typhoid carriers. He does not attach the same importance to fly dissemination as 

 do American authors. 



Contact infection is the great factor in perpetuating typhoid fever 

 but this agency shows diminishing cases each year provided water and 

 milk supplies are safe. The leading European cities as a result of a 

 safe water supply rarely show more than about 3 typhoid deaths per 

 100,000 population per year. Edinburgh shows less than one per 

 200,000 for the year 1910. In American cities rates of 12 to 15 per 

 100,000 are common. 



The Gartner or Meat-poisoning Group. Under this designation 

 may be considered the organisms which cause gastrointestinal disorders 

 of varying degrees, infection with which is usually brought about by the 

 ingestion of meat obtained from diseased cattle. Unless the meat is 

 thoroughly cooked the bacilli in the interior may not be killed. 



In this group may be placed B. enteritidis, the typical meat-poisoning organism, 

 B. paratyphoid B, B. Danysz, B. Aertryck, B. typhi murium and B. suipestifer. 



B. suipestifer or the hog cholera bacillus was formally thought to be the cause of 

 this important epizootic. It is found in the intestines of quite a percentage of 

 healthy hogs. The cause is now known to be a filterable virus. 



These organisms are alike morphologically and culturally and show quite a 

 tendency to bipolar staining and reduction of neutral red with fluorescence in 

 forty-eight hours. B. paratyphoid B, B. Aertryck and B. suipestifer are alike from 

 an agglutination standpoint, while B. enteritidis and B. Danysz show similarity 

 in this respect. B. paratyphoid A stands by itself. 



Paratyphoid Bacilli (Achard and Bensaude, 1896; Schottmiiller, 

 1901). Cases resembling mild attacks of typhoid occasionally show 

 agglutination for paratyphoid bacilli. These organisms have also been 

 isolated from the blood, as with typhoid. Two types have been recog- 

 nized: the paratyphoid A. and the paratyphoid B. The latter occurs 

 in 80% of such cases. Culturally, paratyphoid B. cannot be separated 

 from Gartner's bacillus. In paratyphoid A. there is less gas produced 

 in glucose bouillon than with paratyphoid B., and the primary acidity 

 of litmus milk is not succeeded by a subsequent alkalinity. It does 

 not seem practical to draw a fine distinction between these two strains. 



