DIAGNOSIS OF TYPHOID FEVER AND FOOD-POISONING INFECTIONS Iiy 



Some observers claim the addition of caffeine (6 cc. of sat. aqueous sol. to 

 too cc. of medium) inhibits colon growth without affecting the typhoid. 

 Crystal violet, Cong, red and brilliant green exert a similar effect. 

 Teague and Clurman recommend the following enriching medium: 



Meat infusion bouillon, 1000 cc. 



Gelatin, 100 Gm. 



Cong, red (2 per cent, aqueous sol.), 4 cc. 



Brilliant green 0.083 P er cent. 

 Tube, 10 cc. to each tube, and sterilize. 



Just before inoculation add i cc. of the following to each tube: 



Bromoform, 20 cc. 



Sterile distilled water, 100 cc. 



Shake and allow to stand over night. Avoid globules of bromoform on sur- 

 face and on bottom when removing fluid for addition to media. 



Hall in the Berliner klin. Wochenschrift, Dec. 27, 1915, reports excellent 

 results in the isolation of typhoid bacilli from f eces by mixing them with benzin 

 or with petroleum-ether and then plating. He states that this will kill all colon 

 bacilli without injuring the typhoid or interfering with their propagation. 



TECHNIQUE 



The evening before f eces are collected for examination the patient is given a 

 dose of salts. 



The patient defecates in a clean bed pan or sterile towel. 



Liquefy several tubes of Teague and Clurman's medium, add o.i cc. of 

 emulsified feces to one tube, shake tube to evenly distribute the feces, transfer 

 o.i cc. of the contents of this tube to a second tube, shake second tube to evenly 

 distribute bacteria and transfer o.i cc. of its contents to third tube which is also 

 shaken. 



Incubate at 37C. until growth is observed, then at once plate. 



Pour Conradi and Drigalski's or Endo's medium into a number of petri 

 dishes and when solidified plant several plates from each tube by removing a 

 loopful of fluid from a tube and drawing it over the surface of one plate after 

 another without recharging the loop. The loop should be drawn over the sur- 

 face of the agar in the form of the letter Z. 



Incubate at 37C. until growth appears. Examine plates showing discrete 

 colonies and any having the typical appearance of typhoid colonies are removed 

 and planted in plain bouillon ; after incubation transplants -from the bouillon 

 are made into differentiating media trypsinized peptone water (for indol), 

 litmus glucose broth, litmus lactose broth and litmus milk. 



The method of examining urine and feces for other members of the typhoid 

 colon group is exactly the same as when examining for the typhoid bacillus. 



