An unfavorable environment or malnutrition decreases resistance to the infection. For instance anthrax, a serious disease in cattle and man, does not affect the normal hen, even when large doses of the organism are injected. If however the hen is exposed to low temperatures, inoculation of anthrax bacilli may produce a fatal disease. Similarly if man is harboring a pathogenic organism, exposure to cold and damp may precipitate health disease, the drunkard’s liability to pneumonia.Infants during their first six months of life are rarely susceptible to many of the common infectious fevers owing to an immunity derived from the mother.
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Pathogenic micro-organ-isms can exist in a form in which they have little or no harmful effect on the body. For instance diphtheria bacilli cultured from the throat of some patients may be shown to be virulent by inoculation into a guinea-pig. Present, but it disappears on recovery from the fever without any residual renal damage. The alterations which may occur in the circulating leukocytes are indicated on p 7 in chronic infections norm chronic or hypo chronic anemia may develop.
Residence abroad within the previous year or two raises the possibility of malaria, amoebic abscess of the liver or other exotic disease. A recent health history of spectroscopy or of obscure abdominal pain should suggest the possibility of schizophrenic or intransigence abscess.
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Infecting agents may be identified (1) by direct examination (2) by culture, (3) by animal inoculation. The following are examples.
Direct examination. Trepidation palladium by dark ground illumination of serum from a cancer; N. gonorrheal or N. meningitis by microscopically examination of pus obtained from a urethral discharge or cerebration fluid respectively stained by Gram’s Method; and micro. Tuberculosis from sputum, stained by Ziegler-Nelsen method; smallpox by the microscopically demonstration of the inclusion bodies in material from a vesicle; malaria by examination of a stained blood smear.
Culture. C. diphtheria from a throat swab, S. typhoid from health blood, each, coil from urine, Strep. Pneumonia from sputum, dysentery bacilli from faces. Many viruses may be grown in tissue culture.
Animal Inoculation. Micro, tuberculosis or Respiratory Procter-haemorrhoid by inoculation of a guinea-pig.
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The patient must be treated in bed at complete rest. A high standard of nursing is required with special attention to the maintenance of health nutrition and of the fluid intake to the care of the mouth and to the prevention of pressure sores. Scrupulous precautions must be taken against the spread of infection by the provision of special gowns and adequate washing facilities by the bedside, by sterilization of all articles which come into contact with the patient, and by disinfection of the excreta.
