Notes on Gastro-Enteritis, Dysentery, and Enteric Fever

J. W. Washbourn
1900 BMJ (Clinical Research Edition)  
AN attempt has been made by a sedes of experiments and records througpout the year to ascertain if any reliable cutaneous reactiori is given by enteric group carriers, after the mann,er of a von Pirquet reaction. The only reference in the literature available is one giving a series of reactions for testing the time limits of T.A.B. inoculations by Gay and Force in their typhoidin test-British Medical Journal, October, 1917. At the beginning of. the year while discussing .anaphylaxis in
more » ... with serum anaphylaxis cases which had occurred in the, station and also general reactions to vaccines, it. occurred to me that possibly ,enteric carriers might give either an enhanced / reaction to dead cuHures of the causal organism, or show local anaphylaxis ~o a serum possessing high amounts of antibodies to, that ca'usal organism. Aceordingly a series of small experiments was commenceq., with a ,view to test the local skin reactions for all enteric cases in the depot. There were at that time several cases being tested" one actual carrier:, and also three officers who' had been carriers but had completed,these tests. The results were so ' marked in some cases that the whole experiment was continued on thronghout the year. # ' It was soon obvious that there is no definite reaction to high-titrel::lerum, nor is there any theoretical reason for a true anaphylactic rea9tion and the serum applicatio:t;l was abandonE)d. The experiment ,was therefore continued, only as to the local reactions to toxins of dead cultures of a mixture of enteric group org?nisms and a control. As the year passed, these cases became really interesting in~hat , they appeared to be giving definite results. The detailed table is given below. , The actul11 method is carried' out as foHows: Three platinum loopfu~s of the following substances are placed on the' forearm, the skin of which has been thoroughly cleansed with spirit; and an area of about one inch in diameter is scarified through the liquid, which is then allowed to dry,:and no dressing applied. The ,three substances used at first were : (a) f;'teri)i~ed normal saline as a control; (b) a mixed high-titre serum of Bacillus typhosus, paraA\and para B; (c) a' mixed killed culture of B. typhosus, para A and para B of about 200 millions per cubic centimetre. After, a short time the ordinary T.A.B. vaccine was substituted for this. ' Where only two lines of results are given in column 5, these !\re always the' results of. (a) the control, and (c) the T.A.B. vaccine.' Throughout" the' series (a) and (c) should be taken asgiv~ng the actual result. The reaction is noted every twenty· four hours until it fi~ally dis~ppears and is read aE! follows;-
doi:10.1136/bmj.1.2059.1455 fatcat:lhvtrhgj7neajddbltw3b4hare