A text-book of medicine : for students and practitioners / by Adolf Strümpell.

  • Adolph Strümpell
Date:
1894
Catalogue details

Licence: Public Domain Mark

Credit: A text-book of medicine : for students and practitioners / by Adolf Strümpell. Source: Wellcome Collection.

    28/1106 (page 2)
    surface of boiled potatoes is also very characteristic. The bacilli cover the entire surface with a very thin though tough pellicle scarcely recognizable to the naked eye. Examined in water, the typhoid bacilli exhibit quite an active individual motion. The formation of spores takes place only when the temperature is between 86° and 108° (30°-42° C), ceasing at lower temperatures. Numerous attempts have been made to produce tyi^hoid fever artificially by introducing pure cultures of the typhoid bacilli into the bodies of animals, but the results of these efforts have not yet proved perfectly harmonious. The main cause of the discrepancy is probably that animals are in general very slightly susceptible to the disease. At any rate, the attempts at artificial infection up to this date have proved successful only in cases when the animals subjected to the expei'iment (rabbits, guinea-pigs) have received large amounts of the typhoid bacilli directly into a vein or into the abdominal cavity (E. Fränkel, Simmonds), or when the bacilli have been introduced into the duodenum (A. Fränkel). Probably, how- ever, we have here to do rather with the intoxication of the animals caused by the poisonous matters generated in the cultures of bacilli than with an actual in- fection, for the pathological changes of typhoid fever are but little develojied in the animals, and the injected bacilli themselves appear to be for the most part destroyed within the body of the animal experimented upon (Flügge and Sirotinin, and others). Attempts to produce the disease by mixing the dejecta of typhoid patients with the animal's food have thus far proved invariably un- successful. Probably the bacilli are immediately destroyed by the hydrochloric acid in the stomach. Investigation of the aetiology of typhoid fever must consequently be directed to ascertaining in what manner and through what channels the specific typhoid bacilli'penetrate* into the human body, and what circumstances are then essen- tial to their further development and to the display of their pathogenic properties. It must be confessed that the ability to answer these questions accurately is a goal from which we are quite distant. It is almost universally believed that, as a rule, typhoid bacilli do not have any permanent, independent existence outside the human body. Often, however, the conditions essential to an abundant development of the bacilli arise in pertain places, and thus make it possible for a greater or less number of persons to absorb the pathogenetic poison, and, as a result, to be attacked by typhoid fever. In this way occur the numerous greater or smaller epidemics of typhoid fever in contrast to the sporadic cases, which are likewise possible, and are not infrequent. If an epidemic of typhoid appears in a place till then entii'ely free from the disease, we must always refer it to an importation of the disease-germs, and seek their, source in some previous case of typhoid. We must, therefore, take for granted that the poison of typhoid can in some way escape from the body of the patient into the outer world. If we believe this, we shall be sure to think, first of all, of the intestinal discharges as the source of infection. These discharges, as already stated, are known to contain the typhoid bacilli or their spores. As to the exact manner of infection, views are still widely different. Up to the present time there are chiefly two contrasted theories, called, respectively, the ground-soil and the drinking-water f theories. According to the former, which is maintained principally by Pettenkofer and his pupils, the ground-soil is * Perhaps it is not useless once more to call attention expressly to the fact that typhoid fever can result only from an infection of the body with actual typhoid bacilli, and never through any other bacteria, through the products of decay and decomposition, tainted food, and the like; nor does there yet exist the slightest proof that typhoid bacilli can be developed from any other micro-organisms. f Compare with wliat follows the statements concerning the a;tiology of cholera, where the same disputed points are considered.