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characteristic Widal reaction has been obtained. This
reaction consists of the cessation of movement and the
agglutination (or clumping) of the Eberth-Gaffky bacilli of
Typhoid Fever (bacilli typhosus), when treated with a drop
of serum, or blood, taken from a patient actually suffering
at the time, or previously having suffered, from the disease.
The typhoid antitoxin (naturally formed in the blood of persons
infected with the disease) causes this reaction—a high
dilution of the blood serum to 1/60 to 1/100) being necessary. In
63 samples (i.e., 26.9 per cent.) the Widal reaction was but
slightly or feebly marked, but, in these instances, the afterhistories
of the cases shewed that the patients were, in all
probability, suffering from Para-Typhoid Fever, which
affects (chiefly) young adults, and the symptoms of which
resemble closely those of Typhoid Fever, though less severe,
as a rule. Para-Typhoid Fever is due to what is known as
the Para-Typhoid bacillus—a bacillus (with many varieties)
closely related to the bacillus typhosus.
The great value of this aid to diagnosis in Typhoid Fever
has been specially proved in connection with an outbreak of
Typhoid Fever that occurred on the Springfield Estate,
Wandsworth Road, in 1899—1900, many doubtful cases
having been discovered by this means, afterwards isolated
in hospital, and the further spread of the disease thereby
prevented. In several instances, the well-known clinical
symptoms of the disease were entirely absent, and the diagnosis
of the cases could only be made by means of the bacteriological
test.
Diphtheria.
3,188 samples of throat or nose membranes and secretions
from doubtful Diphtheria cases have been examined, and in
433 (i.e., 15 7 per cent.) Klebs-Loeffler Diphtheria bacilli
have been obtained. In this way, on the one hand, patients
suffering from true Diphtheria have been isolated in hospital,
as required, and the necessary precautions taken to
prevent the extension of the disease, whilst, on the other
hand, patients suffering from doubtful Diphtheria have not
been sent to the hospital and thereby run the risk (an actual
one at times) of contracting the true disease whilst there.
Again, there are infectious throats other than diphtheritic,
and by means of bacteriological examinations such throats
have been found at times to be associated with the pseudo-