intestine of a patient who had died of typhoid, bacilli. Socoloff,1 in 1876, investigated the spleens of nine cases of typhoid and found micrococci in three of them. Fischel,2 in twenty-nine cases, found micrococci in the spleen, in the remainder he could discover no micro-organism.

3

In 1880 Eberth made a noteworthy research. He very carefully investigated twenty-three cases of typhoid, paying special attention to the spleen and the lymph glands. The sections he cleared up with concentrated acetic acid. Out of the twenty-three cases twelve presented organisms; in each of the twelve these were found in the lymph glands, in six cases they were in the spleen. The colonies looked at first like heaps of cocci, but where they were less crowded could be seen to consist of bacilli. The rods were short with gently rounded ends; they had a soft outline and contained frequently very small, highly refractive, spore-like bodies. They were not easily stained with colouring agents. In 1881 Eberth returned with new experience to the subject, and by that date had altogether investigated forty cases of typhoid. Out of these he had found the above described bacillus eighteen times; in twenty-two the result was negative. Klebs published a few months after Eberth's first paper an account of a bacillus which he and his assistants had found in typhoid cases. Klebs devoted much time to the study of this bacillus and described it at length; he considered it a constant micro-organism in cases of typhoid. It is a matter of doubt whether Eberth's bacillus is the same as that of Klebs. Koch, it appears, independent of Eberth and Klebs, and about or before the same time, had discovered a special bacillus in typhoid, which did not agree with any other known microorganism.

Other researches followed, such as those of Meyer, Coats, and Crooke, these generally confirmed Eberth.s

The last noteworthy research is that of Gaffky.

Gaffky made

a most painstaking research on the bodies of twenty-eight patients

1 Virch Archiv. Bd. 66. 1876.

3 Virch Archiv. Bd. 83. 1881.

2 Präger med. Wochenschrift. 1878.

4 Arch. f. exper. Pathol. u. Pharmak. Bd. 12, Heft 2 u. 3.

5 Mittheilungen aus dem Kaiserl. Gesundheitsamte. Berlin, 1884.

6 Untersuchungen über den Bacillus des Abdominaltyphus. Inaug.-Diss. Berlin,

1881.

7 B. Med. Journal. 1882.

8 B. Med. Journal. 1882.

9 Mittheilungen aus dem Kaiserl. Gesundheitsamte. Berlin, 1884.

who had died of typhoid; he hardened the internal organs in alcohol, then cut hundreds of fine sections, these sections were treated as follows. They remained for from twenty to twenty-four hours in a methylene blue solution, made by adding a saturated alcoholic solution of methylene blue to distilled water until a very deeply coloured, non-transparent staining liquid was obtained, this was prepared fresh each time. The sections were next washed with water, dehydrated by absolute alcohol, cleared up by turpentine, and mounted in Canada balsam. Of the twenty-eight cases in one alone he failed to find Eberth's bacillus; this might be explained from the fact that the death took place at the end of the fourth week from peritonitis arising from a perforation. In twenty-two instances the colonies were found in the spleen; in thirteen cases in which the liver was examined, colonies were found in them all; in seven cases in which special attention was turned to the kidney, in three the bacilli were found; in four cases in which the mesenteric glands were investigated, in three the bacilli were found. Probably the failure to find the bacilli in other cases by other observers arises from the technical difficulty of the research, and also because the colonies are scattered in some cases at wide intervals; in such it is only by making a number of sections that success will be attained. In one of the twenty-eight cases Gaffky found micrococci, he follows Recklinghausen, Eberth, Koch, and others in considering their presence as secondary and not an essential of the disease. Gaffky was able to cultivate the colonies by the following process:-The spleen from the corpse of a typhoid patient, showing no trace of decomposition, was washed carefully with a one per thousand solution of corrosive sublimate, and then by means of a knife previously held in the flame to effectually sterilise it, cut into two halves.

Other slices were made by freshly sterilised knives, and platinum wires, which had been the moment before made red-hot so as to destroy any kind of organism infected from these surfaces. The platinum wires were then drawn over nutrient gelatin so as to make a streak. The cultivation of this miniature-sown furrow took place in a moist glass chamber at the ordinary temperature of the room. After twenty-four hours the streak showed a white. cloudiness which, after another twenty-four hours, had increased in intensity, but was still confined to the streak. The gelatin did

not become fluid. On examining with a low power the streak was found to consist of a large number of roundish, granular colonies of a light brown colour. On now taking minute portions from the streak and examining the colony thus removed in a drop of distilled water and highly magnifying the bacilli were found to be motile.

Pursuing his researches, Gaffky found that the bacillus grew in quite a characteristic way on slices of potato; the potato was prepared in the way familiar to bacteriologists and the surface seeded" with the bacillus. The slices were cultivated in the moist glass chamber at the ordinary room temperature. In fortyeight hours, if a particle of the surface be taken for microscopical examination, it seems as though the whole surface is covered with a connected resistant skin, and from whatever part a tiny sample is taken it is found to consist of incredible numbers of the motile bacillus; these are most of them of the ordinary size, but others are in the form of long glittering threads. There is no other bacillus known that is motile, does not liquefy the gelatin, and which grows on gelatin in the way described. The motile property is due as usual to motile threads at the ends of the rods. At the ordinary temperature of rooms no spore formation takes place, but it was found that spores could easily be produced by cultivating at from 30° to 40°. The spores are as usual long lived and resistant. Fig. 52 (a), represents the appearance of a stab culture in gelatin of the bacillus. Fig. 52 (b), is probably the same bacillus found by Klein in a fatal case of diarrhoea.1 Gaffky failed to raise the same bacillus from typhoid stools, because other organisms liquefied the gelatin. Chantemesse and Widal 2 have been more successful. They found that trichloride of iodine added to gelatin in the proportion of 1 to 500 prevented the growth of all ordinary microorganisms, but the typhoid bacillus was an exception. Using this medicated nutrient gelatin, the authors affirm that they have separated Eberth's bacillus from typhoid excretions. Gaffky was similarly unsuccessful in attempting to raise the bacillus from blood.

Recently there have been published improved methods; M. Rodets

1 Supplement, Seventeenth Annual Report, Local Government Board.

2 Gaz. hebd. et de Med. Chir. 1887. No. 9, 146.

3 Comptes rendus de la Societé de Biologie, T. ii., No. 8. Public Health, ii., 382.

has taken advantage of the fact that most micro-organisms will not grow at a high temperature, e.g. 44-5° C., but this temperature is not destructive of the typhoid bacillus. M. H. Vincent 1 modifies this process by sterilizing broth, and to every 2 c.c. adding a drop of carbolic acid and then testing, say drinking water, by

adding from five to fifteen drops to the broth. On now cultivating at 42° if the broth remains clear for twelve hours, the typhoid bacillus is not present; on the other hand, if it clouds, the turbidity is probably due to the bacillus, and by successive removes, that is, by taking minute quantities of the already clouded broth and transplanting into a fresh tube, and so on, an

1 Comptes rendus de la Societé de Biologie, T. ii., No. 5. Public Health, ii, 381.

K K

absolutely pure cultivation may be obtained and the characters of the suspected microbe studied. Rodet and Roux believe that there is an intimate relation between the bacillus coli communis and the bacillus of typhoid fever, the latter being indeed the bacilli in a state of attenuation or degeneration.

Eberth's bacillus has rather frequently been found in water which has produced typhoid. Beumer, for instance, found it at Greifswald, Rodet at Sous-Ville-Charmoux, Arloing at Cluny, Widal at Paris, and Chantemesse at Clermont-Ferrand and Pierrefonds. In the latter case Chantemesse found no less than 25,000 bacilli to the litre in a well-the water of which apparently communicated typhoid fever to twenty persons-chemical analysis in this case indicated no great pollution. To these examples may be added several in the United States. Dr. Prudden, of New York, found Eberth's bacillus in a filter in a household, some of the members of which suffered from typhoid, and filters from affected houses during the same outbreak were examined by Dr. Ernest of Boston and by Dr. Swartz, in a few cases with a positive result.

Numerous experiments by Klein, Murchison, Birch-Hirschfeld, Klebs, Gaffky, and many others, have been made as to the possi bility of infecting animals with true typhoid. For this purpose monkeys, guinea-pigs and various other animals have been fed with typhoid stools or artificial cultivations of Eberth's bacillus, products have been also injected subcutaneously or into the veins. Birch-Hirschfeld appears to have given a rabbit some disease similar to typhoid by feeding it for a long time with food infected with typhoid excreta. But considered as a whole the experiments are not altogether conclusive,

(370) Symptoms.

In a few cases which are specially dangerous to the public the only deviation from health is an almost painless looseness of the

1 Comptes rendus de la Societé de Biologie, T. ii., No. 7.

2 Fourth Annual Report of the State of Maine.

3 It is stated that Vaughan has inoculated successfully dogs and cats with Eberth's bacillus found in the Iron Mountain drinking water.-Sixteenth Report of the Michigan Board of Health.