The Goulstonian lectures on the typhoid bacillus and typhoid fever : delivered before the Royal College of Physicians of London on March 20th, 22nd, and 27th, 1900.

  • Hartley, Percival Horton-Smith, Sir, 1867-
Date:
1900
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Credit: The Goulstonian lectures on the typhoid bacillus and typhoid fever : delivered before the Royal College of Physicians of London on March 20th, 22nd, and 27th, 1900. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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    this is so, and though with care the typhoid bacillus can be accurately distinguished from the other members of the group, it is by no means a simple matter, and I propose to dwell for a short time on the methods which should be employed for making the diagnosis, more especially as no definite criteria have as yet been agreed upon by bacterio- logists, and consequently much valuable work has been vitiated by insufficient testing of the isolated micro- organisms. The Identification of the Typhoid Bacillus. In the first place, it may be said that there is not the smallest difficulty in distinguishing the typhoid bacillus from what may be called the classical bacillus coli communis. They resemble each other superficially, but differ essentially in that the typhoid bacillus does not, for example, form gas bubbles in dextrose gelatine, does not clot milk, nor form indol. The two can therefore be readily distinguished. The difficulty, however, in diagnosing the typhoid bacillus arises from the fact that the classical or typical bacillus coli communis is by no means the sole representative of this great group. Indeed, we now have to recognise the fact that the term “ bacillus coli” does not refer to a single bacillus but to a great group of microbes, some of which are identical with the classical bacillus coli while others very closely indeed resemble the typhoid bacillus. Innumerable intermediate forms also exist. The credit of first thoroughly bringing home this important point belongs to Dr. M. H. Gordon8 of St. Bartholomew’s Hospital who, in an admirable paper published in 1897, very clearly demonstrated its truth. Dr. Gordon obtained from various sources, such as stools, urine, sewage, milk, water, &c., over 100 micro-organisms which resembled the bacillus coli communis morphologically and in its growth on gelatine and agar. He then proceeded to investigate the attributes of each ; for example, their power of producing gas and indol, their capacity for acidifying and coagulating milk, the number of their flagella, &c. In this way he was able to demonstrate clearly what had been foreshadowed by Lawes and Andrewes,9 that the 100 or more microbes, apparently all similar, could really be divided into as many as 16 different and stable varieties, according as they had lost one or more of the properties characteristic of the typical bacillus coli communis. Large as the number may seem, it by no means includes all the varieties known ; indeed, to it we must now add several which resemble the typhoid bacillus most closely — for example, Petruchsky’s bacillus faacalis alkaligenes ; Gartner’s bacillus enteritidis, Nocard’s bacillus psittacosis, Gunther’s bacillus der fleisch- 8 Journal of Pathology and Bacteriology, 1897. 9 London County Council Reports, 1894.