A NEW PATHOGENIC BACILLUS 391 
III. Report of an Additional Case 
A case recently admitted to the Liverpool Royal Infirmary, as one of typhoid 
fever, but which gave a negative serum reaction with B. typhosus, affords the basis 
for the present paper. The clinical history is reported by kind permission of 
Dr. Caton. 
T.R., Male, age twenty-nine, bricklayer, admitted to the Royal Infirmary on 
September 24, 1901, complaining of ' typhoid.' 
Familv history and personal history : unimportant. 
Present illness : — 
September 1 5. Seized with headache, chiefly occipital ; felt sick. 
,, 18. Headache became much worse, and there was pain in the back 
and legs. Went to bed thinking he had influenza. 
,, 19. Went for a short walk, but had to go back to bed on returning 
home. Had several severe attacks of vomiting and 
diarrhoea. 
,, 21. Headache ceased. 
On admission, September 24 : Patient is well developed ; lies in dorsal decubitus ; 
clear mentally ; cheeks flushed ; skin is warm and moist. 
Temperature: ioi'4°F. (38*5° C.) No jaundice. 
Tongue: coated with white fur. 
Appetite : poor ; is very thirsty ; no diarrhoea or vomiting within first 
few hours. 
Circulatory System : pulse 80 ; regular ; low tension ; large volume ; 
artery wall normal. Heart : not enlarged. Faint systolic mur- 
mur at apex ; no other murmurs. 
Respiratory System: chest rather emphysematous ; no bronchitis; lungs 
clear. 
Nervous System : no headache ; sleeps poorly ; reflexes sluggish ; mind 
clear. 
Urinary System : micturition normal ; urine normal ; no albumin. 
Roseola : there are numerous rose spots on chest and abdomen ; these 
disappear on pressure. 
Spleen : palpable on deep inspiration. 
Abdomen not distended. 
September 30. Evening temperature still above 102 0 (39 0 C.) ; slight cough ; 
considerable muco-purulent expectoration ; roseola still 
present. 
