Annual report of the Sanitary Commissioner with the Government of India.

  • India. Sanitary Commissioner.
Date:
[1915]
Catalogue details

Licence: Public Domain Mark

Credit: Annual report of the Sanitary Commissioner with the Government of India. Source: Wellcome Collection.

    26/280 (page 16)
    TABLE No. 4. Summary of Table III showing change in diagnosis. Proved in our hands to be — Organisms received as Typhoid. Paratyphoid A. ” Paratyphoid <c B. ” Others. Fsecalis alkaligenes. B. Typhosus ... ... 61 5° 5 • • • 5 1 Paratyphoid “ A ” ... 63 1 56 2 3 1 Paratyphoid “ B ” ... ... 6 Ml 5 I Ml III No opinion ... 9 • •• 3 1 5 • • • Faecalis alkaligenes ... ... 2 • • • Ml M* 2 Total Hi 51 69 4 13 4 Examination of the fceces and the urine. — As has been the custom, each convalescent as soon as he arrives at the Dep6t is put on the “ First test n which consists of ten days’ consecutive examination of both the faeces and the urine. The second and third tests are carried out as soon as possible and each lasts for five consecutive days. Latterly owing to the large number of plates and the quantity of culture medium required the urine examination has been omitted from the second and third tests unless the first has proved positive. It is extremely unlikely that a “ carrier ” would be missed by this procedure. During the year the Endo medium has been used in preference to either Conradi-Drio-alski or McConkey. A series of tests proved that the growth of the typhoid group was more rapid, more abundant and not so steadily overgrown by eoli on the Endo, and confirmed the recent work of other observers. The number of specimens examined was 6,254 (faeces 3,198, urine 3,056). Agglutination reaction.—During the year 214 sera were tested against/?. typhosus, B. paratyphosus A and B. M. melitensis and others. With the advent of general prophylactic inoculation against enteric fever the agglutination reaction, as a test for typhoid infection, has lost a very great deal of its value. It is stated, however, that the difficulty may be overcome by estimating tne end-point 01 agglutination on several different occasions during the course of illness. If the end-point becomes higher a specific infection of B. typhosus is indicated. There is a fallacy, however, in coming to such a conclusion too hastily. If the infection be due to either B. paratyphosus11 A ” or “ B ” the end-point for B. typhosus may be increased (vide “ Carrier ” Jemmett). It is not an uncommon thing for a diagnosis of enteric to be made on the alteration of the end-point alone without a control for the paratyphoids. The reaction for the paratyphoids does not yet suffer from the complication introduced by prophylactic inoculation and as regards paratyphoid “ A ” fever there can be no doubt that a positive reaction to its specific organism is of the utmost diagnostic significance.