DREYER, Georges; WALKER, E. W. Ainley; GIBSON, Alexander G.
The serious importance of paratyphoid infections is well shown in this paper. At the base hospital in Oxford to date only eight cases of typhoid fever were met with, and as many as six cases of paratyphoid infection with the B. paratyphosus B, of which two were apparently infected also with the paratyhosus A. Of these six three were in patients recently inoculated against typhoid, and they illustrate (1) the now established fact that such inoculation confers no protection against paratyphoid infection; (2) the manner in which inoculation statistics are vitiated when full examination is not carried out in every case; (3) the desirability of prophylactic inoculation with all three organisms, a point on which the authors insist, recommending the use of mixed vaccines. They point out that inoculated individuals may show a high agglutination titre, and state that the most practical way of determining whether such patients are suffering from active typhoid fever is repeated investigation of the maximum titre of the serum with standard suspensions of typhoid and the two paratyphoid bacilli. Agglutination due to inoculation remains at a constant level but in active fever the titre rises or falls according to the stage of the disease. The highest titre is obtained with the bacillus producing the fever; should agglutination occur with more than one of the three organisms, the repeated examination will show the agglutination curve of the second organism running parallel to that of the first, if it is an instance of co-agglutinin production, but not parallel, even perhaps crossing, if there is a mixed infection. [Some of these statements require a good deal of confirmatory evidence, which is at present held over.] Their method of preparing the standard stock suspensions necessary to make comparable the repeated observations on different days is described, macroscopic examination being used. J. H. S.
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