THE BACILLUS OF TYPHOID FEVER. 433 
borhood of old ulcers and are supposed to have indicated a relapse 
of the specific process. In the second case the negative result is 
thought by Gaffky to have been not at all surprising, as the patient 
died at the end of the fourth week of sickness, not directly from the 
typhoid process, but as a result of perforation of the intestine. 
Gaftky has further shown that in those cases in which colonies 
are not found in the spleen, or in which they are extremely rare, the 
presence of the bacillus may be demonstrated by cultivation ; and 
that, when proper precautions are taken, pure cultures of the bacil- 
lus may always be obtained from the spleen of a typhoid case. 
Hein has been able to demonstrate the presence of the bacillus and 
to start pure cultures from material drawn from the spleen of a living 
patient by means of a hypodermatic syringe. Philopowicz has re- 
ported his success in obtaining cultures of the bacillus by the same 
method. 
The fact that a failure to demonstrate the presence of microdér- 
ganisms by a microscopic examination cannot be taken as proof of 
their absence from an organ, is well illustrated by a case (No. 18) in 
which the bacillus was obtained by Gaffky from the spleen and also 
from the liver, in pure cultures ; whereas in cover-glass preparations 
made from the same spleen he failed to find a single rod, and more 
than one hundred sections of the spleen were examined before he 
found a colony. 
To obtain pure cultures from the spleen Gaffky first carefully 
washes the organ with a solution of mercuric chloride, 1:1,000, A 
long incision is then made through the capsule with a knife sterilized 
by heat. A second incision is made in this with a second sterilized 
knife, and a third knife is used to make a still deeper incision in the 
same track. By this means the danger of conveying organisms from 
the surface to the interior of the organ isavoided. From the bottom 
of this incision a little of the soft splenic tissue is taken up on a, ster- 
ilized platinum needle, and this is plunged into the solid culture 
medium, or drawn along the surface of the same, or added to lique- 
fied gelatin and poured upon a glass plate. The colonies develop, in 
an incubating oven, in the course of twenty-four to forty-eight hours. 
Gaffky has also shown that the bacillus is present in the liver, in 
the mesenteric glands, and, in a certain proportion of cases at least, 
in the kidneys, in which it was found in three cases out of seven. 
The appearance of the colonies in stained sections of the spleen 
is shown in Figs. 104 and 105. Two colonies are seen in Fig. 104 
(at a, a) as they appear under a low power—about sixty diameters. 
In Fig. 105 one of the colonies is seen more highly magnified—about 
five hundred diameters. 
Frankel and Simmonds have demonstrated that the bacilli multi- 
28 
