1394 THE ENTEROIDEA GROUP OF TROPICAL FEVERS 



higher base hne of inoculated persons, while there is little or no 

 rise in the agglutination titre iorB. paratyphosusB or ^, a diagnosis 

 of typhoid fever may be suggested with great probability. 



If there is a regular rise and subsequent fall in the agglutination 

 for B. paratyphosus B, while the agglutination titres for B. typhosus 

 andB. paratyphosus A show only a slight or no increase, the diagnosis 

 of paratyphoid B may be suggested. 



If there is a regular rise and later fall in the agglutination titre 

 for B. paratyphosus A, while the titre for B. typhosus and B, para- 

 typhosus B is only slightly raised or not at all, a diagnosis of para- 

 typhoid A fever may be made with a certain degree of probability. 



If there is a very distinct rise in the agglutination for all three 

 germs or any one of them, there is the possibility of the patient 

 suffering from one of the three fevers with non-specific agglutinins 

 for one or both the germs producing the other two, or there is the 



Tate 



r° 



10 3- - 



















26 27 28 



1 0 2»' — 

 1 0 1° — 





















10 0° — 

 03° - 



















m 



9 0° — 

 8 7" — 





















MARCH 



DATE 1 2 3 

 . M E M E M E 



14-5 6 7 8 9 







E M E H E 



M E M E M 



E M E M E M 



E M E ^f E Im 



E M E M 



E M E M E 























9 3° j-. . I 





















9 6° — i i i_ 



9 7° — i j. L 





















Fig. 662. — Temperature Chart of a Triple Infection: Typhoid and 

 Paratyphoid A and B Fever. 



possibility of the patient suffering from a mixed infection. In the 

 first case the agglutination curves are generally synchronous, 

 and the germ for which the agglutination is highest is often the 

 infective germ. 



In mixed infections, whether in inoculated or non-inoculated 

 subjects, the agglutination curves for the various infecting germs 

 are as a rule not synchronous, and follow their ordinary course 

 independently of each other. 



To carry out the above tests it is necessary to have recourse to 

 an accurate quantitative method, and we recommend, for the 

 purpose Dreyer's standard agglutination method, using standard 

 agglutinable emulsions. Details will be found in any modern 

 manual of bacteriology, such as Hewlett's seventh edition. 



Of course, in inoculated persons the search for the infecting organ- 

 isms in the blood, stools, and urine, as already described, is even of 



