338 TYPHOID FEVER. 



What remained in the dialyser was the toxic body. It gave 

 the reactions of the group of toxalbumins, and was ener- 

 getic in pathogenic effects. These, however, still did not 

 reproduce the appearances seen either in the natural or 

 artificial disease. 



In view of the uncertain results thus obtained in the 

 search for the toxines of typhoid in a pure condition, later 

 observers have been content to work with fluids containing 

 these toxines in mixture with other bodies. Sanarelli, who 

 has also investigated the toxic action of the typhoid bacillus, 

 thinks that various bodies may be concerned. He pre- 

 pared the toxine by growing the virulent bacillus on 2 per 

 cent glycerine bouillon for one month at 37 C. and eight 

 months at the room temperature. It was then kept for 

 some days at 60 C. to kill and macerate the bacilli. A 

 clear fluid could be decanted off which contained the 

 toxic substances, many being no doubt derived from the 

 bacterial bodies. When injected subcutaneously into guinea- 

 pigs in the proportion of 1.5 c.c.per 100 grms. of body-weight, 

 it caused death in twenty hours. There was progressive 

 fall of temperature, abdominal pains and distension, and 

 bloody stools. Post mortem there was peritoneal exudation 

 rich in leucocytes and an enlarged spleen. The intestine 

 was congested, especially the small intestine, and the lym- 

 phatic patches were infiltrated and congested. The other 

 organs were normal. Sidney Martin has found that 

 cultures (especially virulent cultures) in broth, when 

 filtered germ free, contain toxines causing lowering of 

 temperature, loss of weight and diarrhoea. Post mortem 

 the only changes were fatty degeneration of the heart. The 

 bodies of the bacilli killed by chloroform vapour were 

 much more toxic, similar effects, however, being pro- 

 duced, and here the toxicity could be further increased 

 by heating the bodies of the bacilli for a few minutes to 

 about 60 C. The latter result may be caused by the 

 poisons being liberated by the breaking up of the bodies of 

 the bacilli. No change in the Peyerian patches was ever 

 found, though diarrhoea was a constant symptom. The 



