The Goulstonian lectures on the typhoid bacillus and typhoid fever : delivered before the Royal College of Physicians of London on March 20th, 22nd, and 27th, 1900 / by P. Horton-Smith.
- Date:
- 1900
Licence: Public Domain Mark
Credit: The Goulstonian lectures on the typhoid bacillus and typhoid fever : delivered before the Royal College of Physicians of London on March 20th, 22nd, and 27th, 1900 / by P. Horton-Smith. 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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![seemed undoubtedly one of typhoid fever, yet post mortem there were no intestinal lesions. It is true that he himself refused to believe that this and similar cases were really typhoid fever, but such was not the opinion of all his contemporaries. Since the time of Louis, also, many similar cases have been reported from time to time, and of late years a certain number with bacteriological examina- tions. In all some 18 of the latter have now been described. Of these a considerable number, especially those of earlier date, have to be excluded for our present purpose, since the tests- applied to the isolated bacilli were not sufficiently stringent. But even if we thus eliminate the cases of Vaillard,^ Karlinski,° Vincent,' Beatty,^^ Pick,'^ Chiari and Kraus,^^ we are still left with others, which are almost certainly representatives of this group, such as, for example, those described by Du Cazal,^* by Dr. Cheadle,^^' by Dr. Bryant,'^ by Flexner and Harris, and finally by Lartigau.^® In these cases the patients, after having suffered during life from a disease resembling typhoid fever, presented no in- testinal lesions post mortem, but the typhoid bacillus was recovered from many of their organs and often from the blood of the heart as well. It is true that in none of these cases was the reaction of the isolated bacillus to high dilutions of typhoid serum investigated. Dilutions of 1 in 20, of 1 in 50, and of 1 in 100 have been made by different observers, bat not higher, and a possible source of error has thereby been introduced. Still, remem- bering that we are not dealing with a single case but with a series of cases all of which present more or less similar characters, remembering, too, that during life these patients have often presented the typical symptoms of typhoid fever, including the presence of rose spots, and bearing in mind that some at least of them have evidently been exposed to typhoid infection, other members of the family being ill with typhoid fever at the same time, there cannot be any moral doubt that the bacilli found were in truth the typhoid bacilli and that this variety of typhoid fever does really exist. That it is uncommon is proved by the fact that at St. Bartholo- mew's Hospital no case has occurred during the last three years, though Widal examinations have been made in all suspicious cases as a matter of routine, and therefore such a case if it had occurred could not have been overlooked. 8 La Semaine Medieale, March, 1890, p. 94 ; Bulletins et Memoires de la Societe Medieale des Hopitaux de Paris, 1890, p. 201. y Wiener Medicinische Wochensehrift, 1891, pp. 470 and 511. 10 Annales de I'lnstitut Pasteur. 1893. 11 Brit. Med. Jour., January, 1897, p. 148. lis Wiener Klinische Wochensehrift, ]897, No. 4., pp. 82 to 86. 13 Zeitschrift fiir Heilkunde, xviii., p. 471. 1* Bulletins et Memoires de la Societe Medieale des Hopitaux de Paris, 1893. 15 The LATfCET, July 31st, 1897, p. 254. le Brit. Med. Jour., April 1st, 1899. 1' Johns Hopkins Hospital Bulletin, 1897, p. 259. 18 Ibid., April, 1899, p. 55.](https://iiif.wellcomecollection.org/image/b21059718_0043.jp2/full/800%2C/0/default.jpg)
