PARATYPHOID FEVER 377 



ment of typhoid fever during the acute stage (Leishman and 

 Smallman). The method is to inject hypodermically 100 

 million dead typhoid bacilli, i.e., a, fifth of the first dose used for 

 the protective inoculation. If the temperature shows a tendency 

 to fall, this may be repeated about every four days. Experience 

 as to the success of the treatment varies, but the results obtained 

 are hopeful and justify the method being further applied. 



Antityphoid Serum. — Chantemesse immunised animals with dead 

 cultures of the typhoid bacillus, and, having found that their sera had 

 protective and curative effects in other animals, used such sera in human 

 cases of typhoid with apparent good result. In the hands of others, how- 

 ever, such a line of treatment has not been equally successful. 



Isolation of the Typhoid Bacillus from Water Supplies. — A great deal of 

 work has been done on this subject, and the b. typhosus has been isolated 

 from water during epidemics, though the difficulties are very great. The 

 b. coli is, as might be expected, the organism most commonly present in 

 such circumstances. In the case of both bacteria, the whole series of 

 culture reactions must 'be gone through before any.particular organism 

 isolated is identified as the one or the other ; probably there are saprophytes 

 existing in nature which only differ from them in, one or two reactions. 

 In examining waters, the MacConkey or similar. media may be employed 

 with advantage. Klein filtered a large quantity through a Berkefeld filter, 

 and, brushing off the bacteria retained on the porcelain, made cultures. 

 A much greater concentration of the bacteria was tli lis obtained. From time 

 to time vnrious substances have been used with the object of inhibiting 

 the growth of the b. coli without interfering with that of the b. typhosus. 

 Most of these have not.'stopd the test of experience.. Caffeine has been 

 used for this end. For use in examining waters the following is the 

 method employed: To 900 c.c. of the suspected water there are added 

 10 grms nutrose dissolved in 80 c.c. of sterile water, and 5 grms. of- 

 caffeine dissolved in sterile distilled water, heated to 80° C. and cooled 

 to 55° C. before addition. After mixing the ingredients, there is* added 

 10 c.c. of "1 per cent, crystal violet. The flask is incubated at 37° C. for 

 twelve hours, and then plates of Conradi-Drigalski medium are inoculated 

 from it. On the whole there is little to be gained from this attempt to 

 isolate the typhoid bacillus from water in any particular case, and it is much 

 more uselul for the bacteriologist to bend his energies toward the obtain- 

 ing of the indirect evidence of contamination of water by sewage, to the 

 nature of which attention has been called in Chapter V. 



Paratyphoid Fever. 



In 1898 Gwyn recorded a case clinically resembling typhoid 

 fever, from the blood of which he isolated an organism then 

 known as the paracolon bacillus and which is now denominated 

 the bacillus paratyphosus. Since that time numerous out- 

 breaks of intestinal disease have been described associated with 

 the occurrence in the stools and in the blood of organisms of 

 this variety. During the present war these have come into 



