TYPHOID FEVER 301 



capable of a saprophytic existence in soil, dust, water, milk, and other 

 natural media. It can survive in ordinary earth for two months, 

 on sterilised linen for sixty days, on woollen cloth for eighty days, in 

 sterilised water one hundred and ninety-six days, in particular soils 

 four hundred days (Martin, Firth and Horrocks, etc.). Therefore it 

 follows that the organism may remain in the body for long periods, 

 may pass from the body in urine or in faeces, and find its way into 

 natural media, and from such media, sooner or later, back to man. 

 The line of infection may be direct or indirect ; but that it occurs 

 there can be no doubt. 



The Bacillus of Typhoid Fever (Eberth-Gaffky).— The evidence 

 that Eberth's bacillus is the cause of typhoid fever consists in the 

 main of three parts : — (1) The bacillus is found with almost invariable 

 regularity in the spleen of persons dying of typhoid fever, when an 

 adequate bacteriological examination is made. (2) Eberth's bacillus 

 elaborates specific toxins. Tliese toxins are for the most part intra- 

 cellular, contained within the bacillus itself, and are chiefly set free 

 when the latter is destroyed; and they are comparatively feeble 

 compared with those of other pathogenic organisms ; and to account 

 for the clinical conditions of the disease the number of bacilli 

 present in the infected body would have to be exceptionally large. 

 This fact, coupled with the varying virulence of the bacillus, is all 

 the more remarkable when it is remembered that not a few of the 

 epidemics of the disease have arisen from a dose of poison, so 

 excessively minute in itself, and so enormously diluted, as to appear 

 out of all proportion to the number of persons attacked. It is 

 possible that a few organisms introduced into the human body are 

 able, under certain conditions, to multiply rapidly, and so bring 

 about the same results as large dosage. Again and again it has been 

 shown that considerable epidemics have arisen from a pollution of 

 water so slight as to escape detection by any methods of chemical 

 or bacteriological analysis at present known. (3) The blood serum 

 of individuals suffering from typhoid fever has a specific agglutinative 

 action upon the Eberth bacillus, similar to that observed in the 

 blood serum of animals, rendered immune to this germ (compare 

 also PfeifPer's reaction). And whilst there is no evidence to suppose 

 that animals suffer from typhoid fever as the disease occurs in man, 

 there is evidence to show that under certain conditions, a disease, 

 not unlike enteric fever, can be produced by inoculation of the B. 

 typhosus into guinea-pigs, mice, rabbits, etc. (Frankel and Simmonds). 

 Klein has also recently demonstrated by inoculation, that the bacillus 

 is able to multiply and develop in the lymph-glands of the calf. 

 For all practical purposes, therefore, the B. typhosus of Eberth is 

 now generally accepted as the causal agent in typhoid fever. 



The channels of infection in typhoid fever are almost entirely 



