1364 THE ENTEROIDEA GROUP OF TROPICAL FEVERS 



largement of the mesenteric glands. Sydenham, in 1685, described 

 a fever lasting fourteen to thirty days, and associated with diarrhoea, 

 vomiting, epistaxis, etc., as distinct from febris pestilens. In 1715 

 Baglivi of Rome described the hemitritaeus of older writers under 

 the term ' febris mesent erica.' This fever was characterized by 

 being irregularly remittent, lasting from fourteen to twenty-one 

 days, and associated with inflammation of the intestines and 

 mesenteric glands. Lancisi thought that the enteric ulcers were 

 caused by round worms. Hoffman's febris petechizans vel spuria, 

 Strother's lent fever, Gilchrist's nervous fever, Huxham's slow 

 nervous fever, Riedel's febris intestinalis, and Manningham's 

 febricula, are all synonyms of enteric fever. In 1810 Hildenbrand 

 distinguished between contagious typhus and a non-contagious 

 nervous fever, which were respectively named typhus exanthemati- 

 cus and typhus abdominalis by German authors. 



In 1813 Bretonneau of Tours associated this fever with hyperplasia 

 of the solitary and agminated glands of the ileum, and gave it the name 

 ' dot hienent eric ' (from SoOirjv, a tumour, and evrepov, the intestine). 



In 1829 Louis gave the fever the name ' fievre typhoide,' and thie 

 work of Gerhard of Philadelphia in 1837, Shattuck of Boston in 

 1839, Barlow in 1840, Bartlett in 1842, Ritchie in 1846 (who intro- 

 duced the term ' enteric fever '), Jenner in 1849-51, completed the 

 clinical differentiation of enteric fever from typhus, from which 

 relapsing fever was also being separated. Thus arose the clinical 

 conception of enteric fever, but in the meanwhile many theories 

 had been promulgated as to its causation; thus Bretonneau held the 

 view that it was spread by means of contagion, but this opinion 

 was slow in gaining definite support. In 1847 Canstatt pointed out 

 ' that truly the exhalations of the sick man, his excrements, and possibly 

 the typhus eruption in the skin, are the carriers of the contagion.' 



In 1850 Riecke recorded outbreaks due to drinking-water be- 

 coming contaminated with sewage; Murchison implicated milk. 



In 1880 Eberth discovered the B. typhosus in the mesenteric 

 glands and spleens of persons dying from enteric fever, and in 1884 

 Gaffkey cultivated the bacillus so discovered. 



In 1885 Fraenkel and Simmonds obtained definite animal reac- 

 tions in guinea-pigs, mice, and rabbits; and more recently Griin- 

 baum, Metchnikoff , and Besredka reproduced the typical characters 

 of the disease in chimpanzees; and Bland-Sutton described deaths 

 of lemurs and monkeys in London which were associated with post ■ 

 mortem appearances resembling enteric fever. 



The diagnosis of the disease was greatly facilitated by Griiber 

 and Durham's, Widal and Griinbaum's, works on agglutinins and 

 specific agglutination reactions. Later, the cultivation of the 

 bacilli from blood obtained by splenic puncture, and by the 

 dilution method as devised by Castellani from the circulating blood, 

 assisted the diagnosis; while the bile enrichment method and the 

 Conradi-Drigalski's, MacConkey's, and other media generally aided 

 the investigation of the disease. Chantemesse has devised an 



