PATHOGENIC BACTERIA. 309 



satisfactor}'. With a few exceptions, possibly, anatomical 

 lesions resembling those of typhoid fever have not been pro- 

 duced by the inoculation of typhoid bacilli into animals. The 

 injection of cultures into animals may produce death, but it can 

 usually be shown to have resulted from the poisons contained 

 in the cultures. 



Typhoid fever is rare during the first two years of life. It 

 frequently attacks young and robust men. The causes that 

 bring about susceptibility to infection are not known. 



The principal lesion in typhoid fever Hes in the Peyer's 

 patches of the lower part of the small intestines; the mes- 

 enteric lymph-nodes and spleen also are swollen. The typhoid 

 bacillus may be demonstrated in sections of the walls of the 

 diseased portions of the intestines. Cases are recorded in 

 which no lesions were found -in the intestines, but where the 

 typhoid bacilli were widely spread through the organs of the 

 body, and which therefore represented typhoid septicemia. 



Periostitis and osteomyelitis, which are not uncommon 

 sequelae of typhoid fever, may be caused by typhoid baciUi. 

 Ordinary suppuration may be produced by the typhoid baciUus, 

 but most suppurative affections during or following typhoid 

 fever are mixed infections, or are due to the ordinary p}Ogenic 

 bacteria. 



Typhoid fever is transmitted chiefly through the medium of 

 water, according to present views. It is sometimes conveyed 

 by milk, green vegetables and oysters. Infection through the 

 medium of dust and by the hands and clothing probably occurs, 

 but not commonly. Under certain circumstances the bacilli 

 may be carried by flies.* In caring for cases of typhoid fever 

 the stools, urine, sputum and linen should be disinfected. Per- 

 sons handUng the patient should wash and disinfect their 

 hands: 



* Vaughan. Philadelphia Medical Journal. June 9, igoo. 



