^, "-> IMAGE EVALUATION TEST TARGET (MT-3) £.^ y 4" << 1.0 1.1 I^|2j8 |25 £ LS. 12.0 iIse l'-2^ r u^ ^ 6" » Hiotographic Sciences Corporation 23 WEST MAIN STREET WEBSTER, N.Y. USSO (716)872-4503 CIHM/ICMH Microfiche Series. CIHIVI/ICiy/IH Collection de microfiches. Canadian Institute for Historical Microreproductions / Institut Canadian de microreproductions historiques Technical and Bibliographic Notas/Notas tachniquaa at bibliographiquaa Tha Inatituta haa anamptad to obtain tha boat original copy avaiiabia for filming. Faaturaa of thia copy which may ba bibllographicaily uniqua, which may altar ary of tha imagaa in tha raproduction. or wnich may aignificantly changa tha uaual mathod of filming, ara chackad balow. 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Maps, plates, charta. etc.. mey to filmed at different reduction ratios. Those too large to be entirely included In one expoauta ara filmed beginning in the upper left hand comer, left to right and top to bottom, aa many frames aa required. The following diagrama illustrate the method: Lea cartae. planches, taMeeux, etc., peuvent Atre filmAe A dee taux da rAductlon diff Arents. Lorsque le document eet trop grend pour Atre reproduit en un seul clichA, 11 est fHmA A partir da Tangle supArieur gauche, do gauche A droite, et do haut en baa. en prenant ie nombre d'images nAcessaire. Lee diagrammea suivanta illuatrent la mAthode. 1 2 3 1 2 3 4 5 6 I An Experiment with the Serum Reaction as a Test for Typhoid Infection in Water, etc. BT WYATT JOHNSTON, M. D., xoNnueAL, IWloloita* to th* BmM of Haaltb ibr the IWtooo of Qnobw) J FMholofbt to tho lIontrMl Oonml HoqtIW , AMiitMit ProftHor of HyglMM, MeCMU UoiTtnltr. 3feto i'-orit ittetrfcal Soutnal /or Jim« 5, 1897. 'i.^<'-^.*V' ■' Mmmmmm Jvy^s*. «'.* ■.■■..'.•I .■■/ .^. v/ E!.«' ( > 'r c i KviilV'^ ■-—-'■■■•- -^ -'■ -^^^- TiTi rirrilii ttfi ' keprinted from the New York Medieat Journal for June 5, 1897. AN EXPERIMENT WITH THE SERUM EE ACTION AS A TEST FOR TYPHOID INFECTION IN WATER, ETC.* By WYATT JOHNSTON, M. D., HONTRBAL, BA0TEBIOI.OOI8T TO THE BOARD O? HEALTH FOR THE PROVINCB Or QUEBXC ; PATHOLOGIC>T TO THE MONTREAL GENERAL HOSPITAL ; ASSISTANT PROFESSOR OF HTQIENE, MCGILL UNIVEB8ITT. To say that the injection of a suitable quantity of living or dead typhoid bacilli into a suitable animal will produce a typhoid reaction in the blood of the animal is to state a well-known fact. So far as I am aware, how- ever, no one has attempted to utilize this as a means of demonstrating typhoid infection of drinking water, milk, etc. Wishing to test this point practically, I introduced one cubic centimetre of a typhoid bouillon culture into a flask containing two litres of tap-water from which eleven thousand colonies to the cubic centimetre grew on gelatin at room temperature. After shaking the flask, one cubic centimetre of the water thus infected was introduced into a second flask containing two litres of the same water. From this second flask, which thus represented a dilution « * Read before the Montreal Medico-chirurgical Society, May 4 1897. Copyright, 1897, bt D. Appleton and Company. IK,' ^ 'a wun ay ega gBi iax bwP i' '' » '«■ * ■ j«6«iiS,-wra:*a»«»r:r^ ^- A TEST FOR TYPHOID INFECTION IN WATER. of one to four millions of the original bouillon culture, one cubic centimetre was placed in five cubic centimetres of ordinary peptone bouillon and grown at 37° C. for twen- ty-four hours. The bouillon was then sterilized for one hour at 65° C, and injected into the peritoneal cavity of a rabbit. The animal's health remained good, except for a slight loss in weight. Its blood, examined after an in- terval of eight days, gave a perfectly typical reaction when tested with a typhoid culture. The blood had been tested before inoculation with negative results. The blood of a control animal inoculated with five cubic centimetres of a bouillon cultiire made from the same water without adding typhoid gave no reaction, nor did that of another control animal kept with the others and not inoculated. ' It had occurred to me some months previously that by testing in this manner samples of suspected water and milk, typhoid infection might be demonstrated more readily than by making cultures. I tried it in the case of two samples of suspected milk in December, 1896, with negative results, but in both of these the circum- stances of the case made typhoid infection seem im- probable, and I thought it better to apply the test under more definite conditions. It will be remembered that Vaughan * inoculated white rats with mixed cultures from water sediments for the purpose of demonstrating in a general way whether infective or toxic substances were present. Now that we have a definite means of recognizing the effects of the typhoid bacillus this method of investigation offers more prospect of being of permanent utility. * Transactions of the Society of American Phy^cians, 1892. ^km A TEST FOR TYPHOID INFECTION IN WATER. 8 I am now, with the aid of Dr. D. D. McTaggort, making studies as to the conditions under which a posi- tive result may be looked for. The above experiment is cited only as an illustration of the method, possibly an exceptional one. Whether it will prove of practical use in laboratory work I am not at present able to say. Concentration of the suspected substance by collect- ing the bacteria in a porcelain filter naturally renders the test more delicate, as does also the employment of specialized media for the cultures. I have found that rabbits show the reaction at an earlier stage than guinea- pigs, in some cases in two or three days after inoculation. They also have the advantage of being less susceptible than guinea-pigs to septic influences. The preliminary sterilization of the culture is not essential. It lessens to some extent the chances of obtaining a reaction from typhoid infection, but, on the other hand, it permits a larger dose to be given. By averting the danger of concurrent septic ir faction by other bacteria it increases the animal's chance oi surviving long enough to give the reaction time to develop. Small repeated doses we know to be safer than large initial ones. With proper care a typhoid reaction can be induced without the ani- mal's health being seriously impaired. Capacity to produce a blood condition which will react with a genuine typhoid culture is stronger proof of a suspected organism being the genuine typhoid bacillus than capacity of a doubtful culture to react with typhoid blood, as clumping has been shown to occur with other organisms. Hence the production of the blood reaction experimentally with an organism isolated from a sus- pected water should not be omitted when it is necessary to operate under very rigid conditions of experiment. ^ A T9ST FOK TTPHOIO INFECTION IN WATEB. The only use to which typhoid serum reaction appears to have heen appUed so far by others in connection with suspected water is in the testing of organisms isolated by the usual means to see whether they react. I have already published elsewhere * short accounts of some experiments where impure twenty-four hours' bouillon cultures containing typhoid and colon bacilli were treated by adding sufficient typhoid serum to produce clumping, and then in one to two hours, when this was complete, were filtered through an inch of sand, as done in the Sedgwick-Rafter method for the quantitative microscopi- cal analysis of water sediments. It was found that the filtrate yielded almost exclusively red colonies when grown on lactose litmus agar, whereas those obtained from the sediment were nearly all blue ones, showing that the separation of typhoid and coli by this means is rapid and complete. Care must be taken to decant or filter the culture before adding the coagulant (typhoid serum), as there is always some sediment with Bacillus coli at the end of the twenty-four hours' incubation. Introducing a thread or cotton filament, on which ty- phoid blood or serum has been dried, into the culture leads to localized clumping of the typhoid bacilli about and upon it. The paralytic effect of the typhoid serum, however, prevents this method of separation from being entirely satisfactory. I have found that for the me- chanical separation to take place the typhoid bacillus must be present in considerable amount, and I have not yet worked out a satisfactory routine method of apply- ing it to the examination of faeces or water. * Centralblatt fiir Bakteriobgie, xxi, and British Medical Journal^ December 5, 1896 (abstri^ct m American Medico-surgical Bidletin, Janit* orylO, 189V* 1 A TBST rOR rrPUOIB INm-IION IK WATEB. 6 forl™!,^^^''''?!-''*^.'"'' ""^ '""^"»« recommended correctly stated by Alpers and Murray * does nnf foi, pUce but by „eut«,i.i„g with soda solu ionTC Wn able to obtain .t after slight delay. Alpers and MuL are not qmte correct in stating that the typhoid serur«ac t.on has only been applied to blood mmina Ls E the'SoT ^"^ """'''' ^- ^- «"-'! "- ^ AlDe^Tn^ w ;'"' ."""""" *° ^hat mentioned by Alpera and Murray for the purpose of identifying sui^ pected organisms isolated by culture from water or fa^^ In fact, this was the chief use to which the typhoid s^m ♦ Americar Medico mrgical Bulletin, March 25, 1897 mtm ^^^^j^^^^:W^^W^^^''^. The KewTork Medical JoumaL A WSEKLT REVZSW OF MEDldNM BDITBD BT FRANK P. FOSTER, M.D. THE PHYSICIAN who would keep abreast with (he advances im medical science must read a Ut-g weekly medical journal, in whidi scientific fiu:ts are presented in a clear manner ; one for widch the articles are written by men of learning, and by those who are good and accurate obsenrers ; a journal that is stripped of every feature irrdevaat to medical science, and gives evidence of being carefully and consdea- tionsly edited ; one that Dears upon every page the stamp of desire to elevate the standard of the profession of medicine. Such^a journal lalfills its mission— that of educator — to the highest dq;ree, for not eoly does it inform its readers of all that k new in theory and practice, but, by means of its correct editing, instructs them in Hut very importaiU yet mnch-neglected art of expresraig their thoughts and ideas in a dear and correct manner. Too much stress can not be laid upon this featnre^ •o ntterly ignored by the '* average " medical periodicaL Without making invidious comparisons, it can be truthfully stated fhat no medical journal in this country occupies the place, in these par- ticulars, that is held by Thk New yorr Medical Tournal. No ether journal is edited with the cai« that b bestowed on this ; none contains artides of sud) high scientific value, coming as they do from the pens of the brightest and mo^t learned medical men of America. A glance at the list of contributors to any volume, or an examination of any issue of the Journal, ^ill attest the truth of these statements. It is a journal for the masses of the profession, for the country as well as for the dty practitioner ; it covers the entire range of medidne and surgery. A very important feature of the Journal is the number and ^uacter of its ulustrations, whidi are unequaled by those of any other journal in the worid. They appear in frequent issues;, whenever called for by the artide wfaidi they accompany, and no espense is spared to make Uiem of superior excellence. Snbacription price, $5.00 per annnin. Volnmet bqi;iii in Jftniutry and July. published by D. AFPLETON ft CO., 12 Fifth Avenue, New YoiIe.