594 Typhoid Fever 



injected into guinea-pigs the typhotoxin of Brieger causes salivation, 

 accelerated respiration, diarrhea, mydriasis, and death in from 

 twenty-four to forty-eight hours. Klemperer and Levy also point 

 out, as affording clinical proof of the presence of toxin, the occasional 

 fatal cases in which the typical picture of typhoid has been without 

 the characteristic postmortem lesions, the diagnosis being made by 

 the discovery of the bacilli in the spleen. 



Pfeiffer and Kolle* found toxic substance in the bodies of the 

 bacilli only. It was not, like the toxins of diphtheria and tetanus, 

 dissolved in the culture-medium. This was an obstacle to the immu- 

 nization experiments of both Pfeiffer and Kolle andLofiler and Abel,t 

 for the only method of immunizing animals was to make massive 

 agar-agar cultures, scrape the bacilli from the surface, and distribute 

 them through an indifferent fluid before injecting them into animals. 



If the bacilli grown upon ordinary culture-media are several times 

 washed in distilled water, and then allowed to macerate in normal 

 salt solution, autolysis takes place and a toxin is liberated, showing 

 that the toxin is intracellular. Macfadyen and Rowland J liberated 

 an intracellular toxin from cultures of the typhoid bacilU by freezing 

 them with liquid air and grinding them in an agate mortar. Animals 

 immunized with this poison produced an antiserum active against it, 

 but useless against infection with typhoid bacilli. Wright, of Net- 

 ley§, observes that Macfadyen's method of securing this intracel- 

 lular toxin was unnecessarily cumbersome, as the body juices of 

 animals injected with dead cultures of the bacilli dissolve them at 

 once and thus liberate the same toxic product. 



Besredka|| and Macfadyen** think that exotoxin is also formed. 

 Vaughanft has obtained poisonous and non-poisonous fractions by 

 extracting massive cultures of typhoid bacilli with 2 per cent, solu- 

 tions of sodium hydrate in absolute alcohol at 78°C. 



Mode of Infection. — The typhoid bacillus enters the body by 

 Way of the alimentary tract with infected foods and water. 



Rosenau, Lumsden, and Kastle J J were able to connect 10 per cent, 

 of the cases of typhoid fever occurring in the District of Columbia 

 with infection through milk. Interesting additional facts upon the 

 subject can be found in Bulletin No. 41 of the Hygienic Laboratory 

 upon "Milk in its Relation to the Public Health." The bacillus 

 occasionally enters milk in water used to dilute it or to wash the cans. 



The occurrence of typhoid fever among the soldiers of the United 

 States Army during the Spanish- American War in 1898 was shown by 



* "Deutsche med. Wochenschrift," Nov. 12, 1896. 



t "Centralbl. f. Bakt. u. Parasitenk.," Jan. 23, 1806, Bd. xix. No. 2^, d. qi. 



f'Brit. Med. Jour.," 1903. 



§ Ibid., April, 4, 1903, i, p. 786. 



II "Ann. de I'Inst. Pasteur," 1895, x, 1896, xi. 



** "Centralbl. f. Bakt," etc., 1906, i. 



ft "Amer. Jour. Med. Sci.," 1908, cxxxvi. 



it "Hygienic Laboratory Bulletin No. 33," Washington, D. C, 1907. 



