G. D. Mavnard 
371 
the other tables contain for the most part the results of sporadic cases, that is, they 
represent the disease in its endemic form. Now it is well known that typhoid and 
para-typhoids are clinically indistinguishable, but the latter do not tend to occur 
in epidemic form so far as is known. We may therefore assume that the two 
epidemics mentioned were true typhoid, while in the other cases a certain number 
of para-typhoids are included, and probably in foreign stations many more than 
would be expected. 
Major Statham, R.A.M.C., has, I think, demonstrated beyond all question that 
in the Transvaal the para-typhoids are quite common. In a consecutive series of 
cases blood cultures were made from all the patients suffering from typhoidal 
diseases, and he found that approximately 20 (>f the supposed typhoids were in 
reality para- typhoids. Again out of a series of 196 cases examined by Widal's 
method at the Transvaal Government Laboratory, 102 or 52 were returned as 
typhoids, 72 or 37 7o as para- typhoids and 22 or 11 as mixed infections with 
both para- and true typhoid bacilli. That these latter figures represent the actual 
ratio of distribution is not likely, as it is chiefly in the mild cases that the blood 
is sent to the Laboratory for examination, and one would expect more "para" 
cases would be found in this class ; yet they serve to demonstrate that the disease 
is at any rate common in this Colony, and may occur elsewhei'e with sufiicient 
frequency to materially disturb the statistics bearing on anti-typhoid inoculation*. 
I have not been able to obtain any definite figures as to the number of cases of 
para-typhoid that occur in India, but the following sentence from Major Roberts' 
Enteric Fever, p. 122, is not without interest in this connection. "Out of 1397 
admissions to Hospital for enteric in 1904 only 749 were submitted to the ordinary 
serum test (against B. typhosus), of which .526 are declared to have been positive, 
198 negative and 25 doubtful. ****** c^n only suggest that 
taking these results as they stand, there is ample room for a large proportion of 
para-typhoid infections." 
If it is permissible to hazard a guess, it would seem likely, from the results 
found in this paper, that para-typhoids will be found to be relatively more common 
in South Africa than in India, and that the conflict in the results may be found to 
be largely due to this cause, although a much larger percentage than that found 
by Major Statham would be necessary to account for the entire difference. I 
calculated in Table V the probable error of the Group 5, and deducting this together 
with 20 7o of its original value the correlation remains negative but very 
slightly so. 
I regret that owing to lack of material I am only able to include two correlation 
tables showing the relation between inoculation and recovery from attack. They 
are both from the Indian stations and correspond to Tables II and VI. 
* [The ratio of B. paratypliosus to B. typhosus in the Hygienic Laboratory, Washington, for typhoid 
fever in the district of Cokimbia is given as 1 to 8 or 12°/ ,, but only 27 blood tests were made, and many 
of these gave no bacilli. Hypicnic Laboratory BuUctin, No. 44, p. 11, Washington, 1908. Editor.] 
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