334 TYPHOID FEVER. 



which in the intestine is sufficiently powerful to cause necrosis. 

 The affections of the other organs of the body suggest the cir- 

 culation in the blood of poisonous substances capable of depress- 

 ing cellular vitality, and producing histological changes. 



Suppurations occurring in connection with Typhoid Fever. — 

 With regard to the relation of the typhoid bacillus to such condi- 

 tions, statements as to its isolation from pus, etc., can be accepted 

 only when all the points available for the diagnosis of the organ- 

 ism have been attended to. On this understanding the following 

 summary may be given. In a small proportion of the cases ex- 

 amined the typhoid bacillus has been the only organism found. 

 This has been the case in subcutaneous abscesses, in suppurative 

 periostitis, suppuration in the parotid, submaxillary, and thyroid 

 glands, abscesses in the kidneys, etc., and probably also in one 

 or two cases of ulcerative endocarditis. But in the majority of 

 cases other organisms, especially the B. coli and the pyogenic 

 micrococci, have been obtained, the typhoid bacillus having been 

 searched for in vain. It has, moreover, been experimentally 

 shown, notably by Dmochowski and Janowski, that suppuration 

 can be experimentally produced by injection in animals, espe- 

 cially in rabbits, of pure cultures of the typhoid bacillus, the occur- 

 rence of suppuration being favoured by conditions of depressed 

 vitality, etc. These observers also found that when typhoid 

 bacilli were injected along with pyogenic staphylococci, the 

 former died out in the pus more quickly than the latter. Accord- 

 ingly, in clinical cases where the typhoid bacillus is present 

 alone, it is improbable that other organisms were present at an 

 earlier date. 



Pathogenic Effects produced in Animals by the Typhoid 

 Bacillus. — There is no disease known to veterinary science which 

 can be said to be identical with typhoid, nor is there any evidence 

 of the occurrence of the typhoid bacillus under ordinary patho- 

 logical conditions in the bodies of animals. All attempts to 

 communicate the disease to animals by feeding them on typhoid 

 dejecta have been unsuccessful, and though pathogenic effects 

 have been produced by introducing pure cultures in food, the 

 disease has borne no resemblance to human typhoid. The 

 most successful experiments have been those of Remlinger, who 

 continuously fed rabbits on vegetables soaked in water containing 

 typhoid bacilli. In a certain proportion of animals symptoms 



