394 
THOMPSON YATES LABORATORIES REPORT 
The points of interest in the case are : — 
(a) The presence of typical typhoid onset and symptoms ; roseola, enlarged 
spleen, and a fairly typical temperature curve. 
(Ji) The profuse and long continued diarrhoea, for a time with bloody 
stools, and for a week or more with involuntary movements. The 
diarrhoea continued for more than a month after the temperature 
became normal. 
(J) A well-marked relapse. 
(</) The occurrence of a cystitis during the convalescence. 
Isolation of Bacillus ' L ' from Faeces and Urine 
On November 28, three weeks after the temperature became normal, cultures 
were first made from the stools, a small quantity being collected in a sterile jar. 
Plates were made on MacConkeyV 6 taurocholate agar, and loopfuls of the faeces 
were inoculated into each of several tubes made according- to a modification of 
Gabritschewsky's" pattern. The latter are designed to facilitate isolation from 
stools, of organisms like B. typhosus, whose motility is usually greater than that of 
B. coli. Within twenty-four hours pure cultures were obtained trom the distal end 
of the tubes, of a motile bacillus in form like B. typhosus. Sub-cultures on 
various media soon indicated that the organism was evidently a member of the 
B. enteritidis group. A few days after the first isolation of the bacillus, the patient 
developed a cystitis. Cultures were made as before, from a portion of catheterized 
urine ; on the plates were found, in addition to organisms identified as B. coli, a 
large number of colonies of a bacillus soon proved to be the same as that isolated 
from the stools. 
A full comparative study ot the organism thus isolated from both faeces and 
urine was undertaken, the results of which are appended. The bacillus will be 
spoken of throughout this paper as Bacillus ' L.' 
Agglutination Tests with Patient's Serum 
The patient's serum-reaction was, unfortunately, not tried during the acute stage 
of his illness ; and yet the results recorded below were so positive as to lead one to 
the conclusion that the typhoid-like illness was due to an infection, not with 
B. typhosus, but with Bacillus ' L.' The serum was tested on November 28, seventy- 
five days after the onset of the symptoms and twenty-one days after the temperature 
became normal. The results of the test, made with six available cultures ot the 
B. enteritidis group, as well as with cultures of B. typhosus and B. coli are recorded 
in Table III ; while in Table IV is shown the action of the sera of two typhoid 
patients and two normal persons on some of the bacilli recorded in Table III. 
