Typhoid fever and typhus fever / by H. Curschmann ; edited with additions by William Osler ; authorized translation from the German, under the editorial supervision of Alfred Stengel.
- Heinrich Curschmann
- Date:
- 1901
Licence: Public Domain Mark
Credit: Typhoid fever and typhus fever / by H. Curschmann ; edited with additions by William Osler ; authorized translation from the German, under the editorial supervision of Alfred Stengel. Source: Wellcome Collection.
Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.
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![siderably fortified by the demonstration of the constancy and the abun- dance of the micro-organisms in the medullary infiltration of the intes- tine, in consequence of which opportunity for admixture with intestinal contents is continuously afforded from the earliest stages of the disease to the period of exfoliation and the completion of the process of ulcera- tion. If, in addition to the abundance of the bacilli in the portions of intestine the seat of the specific lesions, the relatively long duration of the latter and the number and' copiousness of the daily fecal dis- charges are taken into consideration, there can be no doubt that the stools constitute a prolific source for the contagium of typhoid fever. The bacteriologic examination of typhoid stools has also demonstrated indubitably and frequently the presence of living typhoid-bacilli.1 Recent observers have established this fact with certainty; as, for instance, Chantemesse,2 who in examination of the stools of 16 typhoid patients failed to find the bacilli only thrice. They are found most con- stantly, in accordance with the nature of anatomic lesions, from the beginning of the second week to the end of the third week and later, or from the period of medullary infiltration of the lymphatic structures, their exfoliation and ulceration, until the complete cicatrization of the ulcers. On account of the difficulty attending examination of the stools for typhoid-bacilli, a simple and reliable method for their isolation has long been wanting. That these difficulties are dependent especially upon the constant presence of numerous other micro-organisms is obvious. The most trouble- some of these is the colon bacillus, which resembles the typhoid-bacillus in so many respects. The efforts to isolate the typhoid-bacillus from the stools, and especially to differentiate it from the colon bacillus, have resulted in the publication of several hundred papers. Up to the time of the introduction by Eisner3 of the medium now known by his name, the isolation of typhoid-bacilli from the stools presented almost insurmountable difficulties. By the use of this medium Eisner,* Brieger,5 Richardson,6 and others were able to isolate the typhoid-bacilli from the feces of typhoid patients during the febrile stage in a large propor- tion of cases. In these cultures, however, the possibility of contamination by urine was not guarded against. Capaldi,7 Piorkowski,8 Remy,9 and others, by the use of special media, have also been able to demonstrate, with 1 Franke] and Simmonds, in their earliest publications. Pfeiffer, Deutsche med. Wochenschrift, 1885, No. 29. Merkel and Goldschmidt, Centralblatt f. Min. Med., 1887, No. 22. Cbantemesse and Widal, Gaz. hebd., 1887, No. 9. Karlinski, Central- blatt f. Bakteriologie u. Parasitenkunde, Bd. vii. Vilchour, Lancet, 1886, vol. ii., No. 3. 2 Soc. de Biol., Meeting Feh. 22, 1896. 3 Zeit. f. Hyg., Bd. xxi., 1895. 4 Loc. cit. 5 Deutsch, med. Woch., 1895. 6 Boston Med. and Surg. Jour., vol. cxxxvii., No. 18. 7 Zeit. f. Hyg., Bd. xxiii. 8 Berlin, klin. Woch., 1899, No. 7. 9 Ann. de l'Inst. Pasteur, T. xiv. ; also T. xv. 3](https://iiif.wellcomecollection.org/image/b21175251_0037.jp2/full/800%2C/0/default.jpg)
