As with typhoid, so with Malta fever, cholera, and some other
infective diseases. And the unimaginable fineness of this reaction
goes far beyond the time of the disease. Months, even years, after
recovery from typhoid, a fiftieth part of a drop of the blood will
still give Widal's reaction: and it has been obtained in an infant
whose mother had typhoid before it was born. A drop of dried blood,
from a case suspected to be typhoid, may be sent a hundred miles by
post to be tested; and typhoid, like diphtheria, may now be submitted
to the judgment of an expert far away, and the answer telegraphed
back. It would be difficult to exaggerate the practical importance of
this reaction for the early diagnosis of cases of typhoid fever,
especially those cases that appear, at the onset, not severe.
MALTA FEVER
The specific organism of Malta fever (Mediterranean fever), the
_bacillus Melitensis_, was discovered in 1887 by Surgeon-Major David
Bruce, of the Army Medical Staff. Its nature and action were proved by
the inoculation of monkeys. The use of Widal's reaction is of great
value in this disease:--
"The diagnosis of Malta fever from typhoid is, of course, a
highly important practical matter. It is exceedingly difficult
in the early stages." (Manson, _loc. cit._)
As with typhoid, so with Malta fever, Netley led the way to the
discovery of an immunising serum. In the course of the work, one of
the discoverers was by accident infected with the disease:--
"He was indisposed when he went to Maidstone to undertake
anti-typhoid vaccination, and after fighting against his illness
for some days, he was obliged to return to Netley on 9th
October. Examination of blood-serum (Widal's reaction) showed
that he was suffering from Malta fever. It appears that he had
scratched his hand with a hypodermic needle on 17th September,
when immunising a horse for the preparation of serum-protective
against Malta fever; and his blood, when examined, had a typical
reaction on the micrococcus of Malta fever in 1000-fold
dilution. The horse, which has been immunised for Malta fever
for the last eight months, was immediately bled, and we are
informed that the patient has now had two injections, each of 30
cub. cm. of the serum. He is doing well, and it is hoped that
the attack has been cut short." (_British Medical Journal_, 16th
October 1897.)
About fifty cases had up to September 1899 been treated at Netley
"with marked benefit: whereas they found that all drug-treatment
failed, the antitoxin treatment had been generally successful."[36] A
good instance of the value of the serum-treatment of Malta fever is
published in the _Lancet_, 15th April 1899. For a later account of
this treatment and of its efficacy, see the _Philadelphia Medical
Journal_, 24th November 1900.
Public-domain text, read in full here on John Shaqi.
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