Wheeler's handbook of medicine / by William R. Jack.

  • Wheeler, Alexander, -1903.
Date:
1920
Catalogue details

Licence: Public Domain Mark

Credit: Wheeler's handbook of medicine / by William R. Jack. Source: Wellcome Collection.

    40/592 (page 20)
    It is accompanied by characteristic ulcerations of the small intestine, and by enlargement of the spleen and mesenteric glands. Etiology,—The disease is most prevalent in the autumn months. It attacks both sexes, principally between fifteen and twenty-five years of age. It is rare in infancy or over the age of sixty. Second attacks are uncommon. The poison is conveyed principally by— 1. Contaminated water (or ice). 2. Milk ; uncooked vegetables grown on infected soils ; food contaminated by flies. 3. Shell fish, especially oysters, grown on river-beds polluted by sewage. 4. Direct contact wuth stools of patients. 5. Soiled linen of patients in public laundries (stools or urine). 6. Contamination of the soil through defective drains or cesspools. 7. “ Typhoid carriers.” The possibility of air-borne typhoid must be remembered, especially in hot countries. The organism may be drawn into the mouth in dust, and afterwards sw^allow^ed. The stools or urine when freshly passed are said to be less virulent than after some time has elapsed. In certain cases, after recovery, the bacilli may persist for years in the intestine or gall bladder, and sometimes in the kidney or bladder, whence they pass out in the urine. The dejecta of such subjects, who are known as “ typhoid carriers,” may be constant sources of infection. Sewer gas, filth, etc., do not of themselves cause typhoid fever, but form a suitable soil for the multiplication of the organisms. The Specific derm, known as the bacillus of Eberth or bacillus typhosus, is a Gram-negative organism, shortt thick, and with rounded ends. It is highly mobile, and possesses numerous flagella. It does not form spores. Cultures are easily destroyed by corrosive sublimate 1-2500. During life the bacilli may be found in the rose-spots, the stools, and the urine, and are discoverable with some difficulty in the peripheral blood, from which they can usuaMy be isolated by culture. Post mortem they are found in the intestinal and mesenteric glands, the spleen, the blood, the gall bladder, and frequently in other parts of the body.