XI 

 PATHOLOGY OF TYPHUS IN MAN 



1. MATERIAL 



THIRTY-NINE post mortems were made upon the St. Stanislaus 

 Hospital cases. One proved to be a case of general miliary 

 tuberculosis and one case was that of a youth who died of 

 pericarditis several weeks after recovery from typhus. The 

 value of the remaining thirty-seven post mortems is largely 

 due to the rapidity with which we were permitted to examine 

 the bodies after death. Sixteen post mortems were made within 

 two hours or less after death, seven were made between two 

 and three hours. Only ten post mortems were done later than 

 five hours. We are therefore able to base our descriptions upon 

 tissues affected to a minimum degree by post-mortem changes, 

 an absolute essential for the highest type of histological 

 work and for the demonstration of minute parasites in lesions. 



The histology of the skin is further supported by twenty- 

 eight specimens, excised under local anaesthesia during life, 

 from cases in all stages of the disease. 



The duration of the cases autopsied extended from the 

 seventh day to the twenty-fourth (see Table XV) so that the 

 series afforded ample material for the study of the evolution 

 of the lesions in typhus. 



2. MACROSCOPIC PATHOLOGY 



(a) The skin: Every case showed evidence of the rash, in 

 the late cases small brownish areas only persisted in the sites 

 of the previous lesions. The length of the post-mortem period 

 affects the appearance of the rash in early cases as the macules 

 fade rapidly after death. Petechial and larger areas of hem- 

 orrhage persist. Small petechiae and small thrombosed blood 

 vessels in the skin may be demonstrated at post mortem by 



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