TYPHOID FEVER 



5932 



TYPHUS FEVER 



water, or through the handling of milk by un- 

 clean persons. There are also a few unfortu- 

 nate persons known as ''carriers," who are im- 

 mune to attacks themselves but nevertheless 

 are at all times carrying in the system disease 

 germs which are a constant source of infection. 

 Prevention. Within recent years there has 

 been a widespread educational campaign to 

 teach people how to avoid the disease, and 

 there has been a remarkable decline in the 

 death rate and in the number of cases in many 

 large cities. The New York City Department 

 of Health issued the following directions in 

 1916. They should be followed by every indi- 

 vidual : 



Keep yourself in good health. Do not use 

 alcoholic drinks. Keep your home and your 

 body clean. Always wash your hands before 

 eating. -Drink only the best milk; if in doubt, 

 boil it. Drink only pure water ; if in doubt, boil 

 it. Eat only pure, good food. Fresh-cooked food 

 is safest ; heat kills the germs. Avoid salads, raw 

 vegetables and raw oysters, unless you know they 

 come from a clean place. Wash ice when it comes 

 und keep the icebox clean. Do not put ice in drink- 

 ing water or on food. Deal only with good, clean 

 food stores. Don't eat at dirty restaurants. Keep 

 flies out of your rooms and away from your food. 

 Be careful when you go to the country ; be sure 

 of what you eat and do not drink from a strange 

 spring or stream. Never visit where there is a 

 case of typhoid fever. Be careful about friends 

 who have had typhoid fever; they may be car- 

 riers. Where there is an outbreak of typhoid 

 fever use only boiled water for drinking, and also 

 boil milk just before it is used. If typhoid fever 

 is in your house or neighborhood, or you are ex- 

 posed to the disease in any way, or are likely to 

 be, have yourself immunized. 



People are made immune by vaccination, 

 which consists in three hypodermic injections 

 of a prepared vaccine. Protection is believed 

 to last about three years. That the belligerent 

 armies in Europe were comparatively free from 

 typhoid attacks during the War of the Nations 

 was due to the universal application of this 

 vaccine method. During the Boer War there 

 were more than 20,000 cases among the British 

 troops; from the beginning of the war in Eu- 

 rope up to 1917 there were fewer than 1,500 

 cases among the British forces in France and 

 Belgium. 



Symptoms and Treatment. It takes from 

 eight days to two weeks for the fever to mani- 

 fest itself after the germs have entered the sys- 

 tem. The attack comes on gradually; early 

 symptoms are rising temperature, nausea, di- 

 minished appetite, headache, pains in the back 

 and limbs and bleeding at the nose. At the 

 end of a week or so the patient has a tempera- 



ture of from 103 to 105, and an eruption of 

 pink spots breaks out on the abdomen. The 

 spots disappear in two or three days, but are 

 followed by others. Cases sometimes end fa- 

 tally at the end of the second week through 

 hemorrhage (caused by ulcers eating into the 

 blood vessels) or through perforation of the 

 intestine. The fever begins to decline during 

 the third week, but this is a period of grave 

 danger, because the patient suffers from weak- 

 ness, tremors of the muscles, delirium and 

 weakening heart; at this time death may re- 

 sult from exhaustion. In most cases the patient 

 begins to convalesce during the fourth week. 



Treatment is mainly along hygienic and di- 

 etary lines. It is important that the fever be 

 controlled, and this is done by means of spong- 

 ing baths or the wet pack. Aside from anti- 

 septics used in intestinal injections, few drugs 

 are used. Liquid food and cool water are im- 

 portant items in the diet. To prevent the 

 spread of the disease, all implements, utensils 

 and clothing used about the patient must be 

 thoroughly disinfected, and discharges must be 

 either disinfected or burned. C.B.B. 



Consult Hare's Reference Handbook of Uic 

 Medical Sciences; Whipple's Typhoid Fever: Its 

 Causation, Transmission and Prevention. 



TYPHOON, tifoon' , the local name for cy- 

 clonic storms which sweep over the Philippine 

 and Japanese islands to the neighboring coast* 

 of China nearly every year during the months 

 of August, September and October. They orig- 

 inate near the equator, when the Pacific dol- 

 drums are farthest north, and after moving 

 towards the northwest turn northeast, often 

 doing great damage in Japan. Storms of the 

 same nature in the West Indies are called hur- 

 ricanes. 



Related Subject*. The following articles in 

 these volumes will be of interest in connection 

 with this discussion of the typhoon : 

 Cyclone Tornado 



Doldrums Whirlwind 



Hurricane . Wind 



Monsoon 



TYPHUS, ti'jus, FEVER, a dangerous and 

 highly contagious disease, occurring chiefly in 

 slum districts, prisons and army camps and 

 other places where overcrowding and lack of 

 sanitation prevail. It is also known as jail 

 fever and spotted I ever, the latter name refer- 

 ring to a characteristic eruption appearing in 

 the course of the disease. The germ which 

 causes it was discovered in 1914 by Dr. Harry 

 Plotz, of the Mount Sinai Hospital staff, New 



