206 
TYPHOID FEYEE IX DISTEICT OF COLUMBIA. 
In considering Guiart’s theory, all authors Mill, I believe, admit 
that it is an exceedingly tempting one, and that the evidence which 
Guiart has submitted in its favor, while not convincing, is suggestive, 
and sufficient to demand an attentive consideration and an attempted 
confirmation. The claim that a wounded intestinal mucosa offers 
favorable points of attack for bacteria may also be admitted. 
The practical point to be considered here is whether whipworms or 
other intestinal worms are as common in typhoid cases in Was hin gton, 
D. C., as Guiart reports them for France, and as Yiraldi and Tonello 
report for Italy. Tins question is especially important in view of the 
fact that the European statistics are not very extensive and that 
it has not been shovm whether the high percentage of helminthiasis in 
these cases was not perhaps due to some special conditions. That 
this latter supposition is not excluded is seen from the fact that Stiles 
& Garrison (1906a, 50) have shown that whipworms were nearly 
twice as common (6.80 per cent.) among the sailors (Guiart’s patients 
were apparently sailors or soldiers) as among the civilians (3.78 per 
cent.) admitted to the Government hospital from the District of 
Columbia; further, also, by the fact that Stiles & Garrison (1906a, 
56-58) have shovm that whipworm infection may vary from 0 to 75 per 
cent in different wards of the Connecticut hospital among patients not 
suffering from typhoid. 
INVESTIGATIONS IN THE WASHINGTON EPIDEMIC. 
souECE OF :nl\teel\l. 
The 200 specimens of feces used were collected by the local board of 
health from cases of typhoid reported to the health officer during the 
months of July— September, 1906. Xot all cases which occurred were 
examined, but the 200 cases which were examined were taken at ran- 
dom from those which were reported; hence they were not subject to 
any selective process, and may therefore safely be taken as basis for 
studA^. 
«/ 
TECHNIQUE. 
The microscopic technique used was the same as that described in 
Stiles & Garrison (1906a, 10-11) except that because of the infec- 
tious nature of the material the specimens were collected in bottles 
instead of in paper, and trikresol was used instead of water. At least 
10 preparations were made of each specimen, and, in most cases, at 
least two men worked independently on the slides, so that there were 
very few cases in which either a positive or a negative diagnosis de- 
pended upon the observations of one man. For instance, I examined 
from 2 to 8 preparations of the majority of cases, and the remaining 
preparations were examined by Doctor Goldberger, ^Ir. TTillets, or 
l\lr. Paterson. 
