Infectious diseases / edited by J.C. Wilson ; an authorized translation from "Die deutsche Klinik" under the general editorial supervision of Julius L. Salinger.

Date:
1910
Catalogue details

Licence: In copyright

Credit: Infectious diseases / edited by J.C. Wilson ; an authorized translation from "Die deutsche Klinik" under the general editorial supervision of Julius L. Salinger. Source: Wellcome Collection.

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    well known ice may also become dangerous. Alcoholic drinks are less dan- gerous as alcohol shows a certain disinfecting power towards the typhoid bacillus. Vegetables and fruit which are cleansed with infected water should also be mentioned and, finally, a food substance which on several occasions has been the source of enteric fever, oysters. Fattening them in contaminated water must be looked upon as the source of the infection, and thus we find, in all these infections by food substances, the actual point of origin of the disease proves to be almost constantly the water. Infections Through Air and Ground.—In comparison with the enormous importance of water for the distribution of enteric fever, the two other factors which formerly played a part in the supposed causation of the disease, ground and air, are almost insignificant. Especially air as the carrier of the virus, is scarcely of importance; all the former experiences regarding the transmission of the infection by the air will not stand criticism. Liebermeister 1 in 1870 still quotes a case of Gietl as an example of infection by the air as “ very instructive ”: The evacuations of a typhoid patient were thrown upon a dung heap; among 5 persons who a few weeks later were occupied in carting this dung heap away, 4 were taken ill of enteric fever and I with gastric symptoms, with enlargement of the spleen. Unquestionably the assumption of the typical infection per os, transmitted by contamination of the hands, the clothes or food material of the work- men, would be much nearer the truth than that which Liebermeister assumed at the time as “ completely justified,” believing that the typhoid fever arose “ by the inhalation of the exhalations of the typhoid stools.” Naturally, the further distribution of the dried germs by the air is not to be denied; this is certainly possible, and the inhalation of the bacilli with dust occurs, though very rarely, in fact. But these air infections are by no means pulmonary infections, the usual course being that the inspired bacilli remain in the upper parts of the respiratory tract until they are swallowed and taken into the digestive tract with saliva or food particles. The ground may contain the typhoid germs in a living condition for a long time, as has been previously remarked. Repeatedly in excavations of the earth, in carrying out large enterprises which require turning the earth, enteric fever has been seen to originate in the workmen thus engaged and to distribute itself rapidly. This is readily explained by a previous contamination of the earth with typhoid stools and stirring up the quiescent germs by turning the earth. This may naturally give rise to the occasional inhalation of germs, but it is certainly much more common that the germs are taken into the sus- ceptible organism by unclean hands, contaminated food, etc. [The common house-fly plays an important role in the dissemination of the germs of enteric fever. This mode of conveyance from the improperly con- structed latrines to the improperly protected food of the soldiers was com- mon in the Spanish-American and in the South-African wars. Without doubt, many of the instances of supposed aerial transmission are to be explained in this way. Vaughn’s studies of the subject are most convincing.—Ed.] The ground-water may be active in the distribution of the infection, in that it floods out the germs which have remained upon the bottom, thus reaching wells or the source
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