Spirillum fever : synonyms, famine or relapsing fever as seen in western India / by H. Vandyke Carter.

  • Henry Vandyke Carter
Date:
1882
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Credit: Spirillum fever : synonyms, famine or relapsing fever as seen in western India / by H. Vandyke Carter. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

    431/502 (page 409)
    to clothing and bedding, whilst retaining due activity, was conspicuous by its absence ; for on particular enquiry I found the washermen of the hospitals never were affected by fever, and only once did it seem that a habit of sleeping on empty ward-cots might have led to the illness of a servant. Besides, my experiments on man and the monkey showed that blood infective when fresh, when dried lost its power of infection, although the spirillar filaments remained quite distinct.* Hence, at Bombay (as elsewhere) the role of fomites was not clearly indicated. Diffusion of the contagium through water was not ascertained, nor its convection by currents of air. Comparative essays have shown that the blood at lirst and second relapse of man, is at least as infective as at invasion-attack (see Appendix A, No. I.); and supposing that the spirillum is here essentially concerned, it is possible on analogical grounds, that its matured germs are capable of a prolonged existence as 'lasting-spores.' Future experiment must determine this point, and also whether or not infectivity diminishes on artificial culture of the organism. Mode of Contagion.—Cutaneous transpiration and the breath of the sick are the probable channels of infection, the contagium passing inwards and outwards with equal facility. The critical sweat does not seem peculiarly infective. As the spirillum is absent from contents of the thoracic duct when abounding in the blood, the entry of its germs with the food appears unlikely. Men and women habitually handling the urinary and faecal excreta of fever patients, were not especially liable to fever. Spread of the disease by ' infection,' that is, through means of the more indirect channels, was neither indicated nor required upon theoretical grounds ; actual contact with the sick being invariably possible, and commonly inevitable. The less comprehensible side of experience is the comparative rarity of illness, after repeated contacts at all stages of spirillum fever ; for even the close and prolonged associa- tion of a suckling infant with its parent, may not eventuate in its illness until after the mother's relapse. Briefly, whilst the fact of this disease being communicable by contact is undoubted, little else is known except that its propagation is most certain where people are huddled together, and much less frequent in the absence of overcrowding. The records of family and ward infections show this. It is quite noteworthy that illnesses resulting from direct inoculation with contaminated blood, precisely resemble those acquired through ordinary channels ; as regards both time of advent and general character. Hsemorrhagic effusions {e.g. of epistaxis) may contain many spirilla, which are also present in the menses. Anomalies of Infection and their Explanation.—To account for seeming vagaries in the transmission of spirillum fever, under conditions ' Dr. Motschutkowsky [I.e.] found that blood kept at 60^ F. in a capillary tube (the spirillum still active), remained infective: when diluted with ci per cent, solution of Quinios Hydrochl. it was effective, though the organism became quiescent; the addition of alcohol rendered blood inoperative. Respecting infection through fames, it is proper to add that several observers from Cormack (1842) to Clark and Parry (U.S.A. 1869), have supposed that the clothing of fever-patients is a medium of contamination. Not all early original writers, however, mention this mode of transmission ; and, so far as I know, no late observer acquainted with the blood-spirillum has adduced valid evidence of infection through fomites.