The Dawson news. (Dawson, Ga.) 1889-current, 1914-06-26

rately as possible in order that suit
able means shall be taken to prevent
further dissemination of the typhoid
bacilli from the sick person.
At present the physician can avail
himself of two valuable diagnostic
procedures in addition to study OF
the symptoms. One of these is ex-
animation of the blood by means OF
cultures. The typhoid bacillus is
present in the circulating blood early
in the course of the disease, so that
from 20 to 40 drops of blood, drawn
from the ear or finger or, better,
from a vein in the arm by means OF
sterile syringe and subjected to ex-
pert bacterial cultivation and exam
nation, will reveal the presence OF
the typhoid bacillus usually in the
| first week of the disease. II the
blood is examined later than the first
week or ten days, even in pronounced
cases the bicilli may not be found.
When the typhoid bacillus is actually
obtained from the blood in this way
there can be no further doubt as to
the presence of typhoid fever. A Ger
tain degree of technical experience
and suitable laboratory facilities are
necessary for the proper application
of this method.
The other method of bacterial di-
agnosis is the agglutination or Cru
er-Widal test. This is based on the
discovery that the blood of persons
who are infected with the typhoid
| bacillus possesses the power of
dumping or agglutinating the bacilli.
For this test there is needed only a
small amount of blood, which may be
collected in small tubes or allowed to
dry on mica slips. When the serum
| from a drop of coagulated blood is
mixed in dilutiOn of $50 or, better,
I1:1O0, with culture of typhoid
bacilli suspended in salt solution, the
bacilli will gather in clumps if the
blood is taken from a typhoid fever
patient, but will remain separate ii
the blood comes from a normal per-
son or from one affected with dis
ease which is not typhoid fever. This
dumping property in the blood does
not develop as a rule until the sec
ond week of the disease, and may not
appear until later, or may be absent
altogether in exceptional cases. 1t
is so often positive, however, even
in cases in which other symptoms
are obscure, that it has proved
very valuable aid in typhoid diagno-
sis. The presence or absence of ag-
glutinatiVe power cannot be regarded
as final, but taken along with the
clinical symptoms and other circum-
stances it makes it possible for ply
sicians to recognize the existence of
typhoid infection in practically all
cases. If the first agglutination test
is negative, and the symptoms of ty-
phoid persist, a second and even
third test should be made. In the
Interpretation of positive agglutina-
ton tests, careful inquiry should be
made as to previous typhoid infec-
ton Or previous typhoid vaccination,
since in either of these instances a
positive agglutination may be OBJ
tanned although the disease from
which the patient is suffering may
be due to other infection. Moreover,
either typhoid vaccination or a pre-
vious attack makes the subsequent
occurrence of typhoid extremely un-
likely.
The importance of recognizing as
many cases of typhoid fever as pos
sible and recognizing them early is
very great. The typhoid germ multi
plies almost exclusively in the living
human body and cannot as a rule
retain it's vitality very long apart
from its human host. The disease is
kept alive, therefore, mainly by the
transfer of the living germ from the
person in whom it has grown, usually
typhoid patient, convalescent, or
carrier. to a healthy person who gives
it shelter, becomes a breeding ground
for it and in his turn passes it on
to one or to hundreds of others. 1t
is one of the urgent tasks of public
hygiene to break this chain of ty-
phoid germs at as many points as
possible.
Report Typhoid Cases.
To this end it is necessary to es-
tablish in each community or group
of communities some central health
office to which the physicians shall
report every case or suspected case
of typhoid fever coming under their
observation. Only in this way can
the beginnings of an epidemic be de-
tected and measures taken to pre-
vent further spread. One or two ty-
phoid cases in the practice of a busy
Dbvcician naturally do not aDDpar to