334 TYPHOID FEVER. 



powerful to cause necrosis. The affections of the other 

 organs of the body suggest the circulation in the blood of 

 poisonous substances capable of depressing cellular vitality, 

 and producing histological changes. 



Suppurations occurring in connection with Typhoid 

 Fever. The relation of the typhoid bacillus to such 

 conditions has been the subject of much discussion, and 

 it must be observed at the outset that statements as to its 

 isolation from pus, etc., can be accepted only when all the 

 points available for the diagnosis of the organism have been 

 attended to. On this understanding the following summary 

 may be given. In a small proportion of the cases examined 

 the typhoid bacillus has been the only organism found. 

 This has been the case in subcutaneous abscesses, in suppura- 

 tive periostitis, suppuration in the parotid, abscesses in the 

 kidneys, etc., and probably also in one or two cases of 

 ulcerative endocarditis. But in the majority of cases, other 

 organisms, especially the B. coli and the pyogenic micro- 

 cocci, have been obtained, the typhoid bacillus having been 

 searched for in vain. It has, moreover, been experimentally 

 shown, notably by Dmochowski and Janowski, that suppura- 

 tion can be experimentally produced by injection in animals, 

 especially in rabbits, of pure cultures of the typhoid bacillus, 

 the occurrence of suppuration being favoured by conditions 

 of depressed vitality, etc. These observers also found that 

 when typhoid bacilli were injected along with pyogenic 

 staphylococci, they died out in the pus more quickly than 

 the latter. So that in clinical cases where the typhoid 

 bacillus is present alone, it is improbable that other or- 

 ganisms were present at an earlier date. 



Pathogenic Effects produced in Animals by the Typhoid 

 Bacillus. There is no disease known to veterinary science 

 which can be said to be identical with typhoid, nor is there 

 any evidence of the occurrence of the typhoid bacillus under 

 ordinary pathological conditions in the bodies of animals. 

 Even before any bacteriological investigation, unsuccessful 

 attempts had been made to communicate the disease to 

 animals by feeding them on typhoid dejecta, and we have 



