TYPHOID AND PARATYPHOID FEVER 163 



with a colloidal gold preparation and Labbe and Moussaud have also 

 made use of the latter agent. 



Svestka and Marek used "Typhin," the nucleohiston prepared 

 from typhoid bacilli. In 60 cases so treated they grouped the clini- 

 cal results as follows: In one case the temperature increased for 

 the day following the injection, then fell and remained normal. In 

 14 cases remissions began, the temperature coming down with the, 

 usual remissions normally observed in the late stages of typhoid. 

 In the balance of the cases the remissions became greater but the 

 disease continued the usual length of time. In 21 cases 2 injections 

 were made; in 11, 3 injections. They observed no increase in the 

 agglutinin titer of the serum after the injections. 



Neustadt and Marcovici treated 25 cases of typhoid with "Typhin" 

 and as a routine measure gave digitalin 2 days before the injection to 

 counteract any tendency of collapse on the part of the vascular sys- 

 tem. In 21 cases the injection was made intravenously. In 11 of 

 these cases there was apparent a decided influence on the disease 

 process in 5 of these 11 the fever terminated by crisis; 4 cases gave 

 evidence of some alteration and apparent shortening of the course 

 of the disease; 3 cases were much less toxic after the injections; 3 

 patients died, one in collapse. Of four cases injected intramuscularly, 

 2 were influenced favorably, but the effect was not as marked as with 

 the intravenous injections. 



Svestka and Marek consider that the method can be used with- 

 out harm to the patient and is of decided value when given early 

 in the disease, but they did not hesitate to give it even late in the 

 disease if the cardiovascular tone was good. They consider the state 

 of the circulatory apparatus the chief factor in judging whether or 

 not the patient is a suitable risk, although they excluded markedly 

 cachectic patients as well. After the injection improvement in the 

 general condition of the patient was apparent in practically every 

 case. 



Slaymaker reported on a few cases treated with typhoid vaccine 

 given intravenously, the dosage varying from 25 million to 100 mil- 

 lion. While only 9 cases were treated there were no marked re- 

 sults, apart from some evidence of reaction and improvement in two 

 of the cases. One patient died. From his experience Slaymaker was 

 not inclined to continue the use of the method. Silvestri, using milk 

 injections, found that this treatment seemed to increase the tendency 

 to shock and hemorrhage in the twelve cases that he observed. 



In judging the relative safety or danger in the method of therapy 

 it may be well to present briefly the statistics recently gathered by 

 Vaughan in the American Army and others from military sources. 

 These represent the results in vaccinated troops and may be considered 

 quite satisfactory under military conditions. 



