TYPHUS FEVER 677 



ment and form he interpreted as parasites not very unlike the plasmo- 

 dium of malaria. Subsequent investigations of Field l and others have 

 failed to substantiate Mallory's conclusions. 



TYPHUS FEVER 



Typhus fever is an infectious disease which is characterized by an 

 incubation time of 5 days or more, high temperature, and a petechial 

 rash. It has been characterized as peculiarly a disease of filth and 

 has epidemically disappeared in most of the civilized countries, al- 

 though it is still endemic in certain parts of Europe, North and South 

 America, and occurs epidemically in Mexico under the name of Tabar- 

 dillo. In New York it has recently been found to exist not infrequently. 

 It was described as a new clinical entity by Brill, and has been spoken 

 of as Brill's disease, but the work of Anderson and Goldberger has 

 shown that Brill's disease is identical with typhus fever. Great advances 

 have been made in the knowledge of the disease during the last few years. 



In 1909, Nicolle 2 successfully inoculated an anthropoid ape, and 

 Anderson and Goldberger 3 in the same year succeeded in inoculating 

 lower monkeys, rhesus and capuchin. Similar successful monkey in- 

 oculations were made by Ricketts and Wilder, 4 by Gavino and Girard. 5 

 In these animals inoculation with blood from active cases is followed 

 by a rapid rise of temperature after an incubation time of 5 days or 

 more, and the fever remains high for 3 to 5 days, after which it comes 

 down by lysis. Occasional recrudescences have been noticed in monkeys. 

 Goldberger and Anderson have had a mortality of 2 per cent in their 

 monkeys. The disease may be transmitted from monkey to monkey 

 with the blood, which is infectious during the febrile period and may be 

 so for as long as 32 hours after the temperature returns to normal. 



The disease was at first suspected to be caused by a filterable virus, 

 an opinion which is still held by some observers. Most workers agree 

 today, especially because of the work of Anderson and Goldberger, 

 that filtered blood will not convey the disease, and, although Nicolle, 

 Conor and Conseil,. Ricketts and Wilder, and others have reported 



1 Field, Jour. Exper. Med., vii, 1905. 2 Nicolle, Compt. rend. Acad. d. Sc., 1909, 

 p. 157; Ann. de 1'inst. Past., 1910, 1911, 1912. 



3 Anderson and Goldberger, Jour. A. M. A., 1912, p. 49; Jour. Med. Res., 1910, 

 p. 469: N. Y. Med. Jour., 1912, p. 976. 



4 Ricketts and Wilder, Jour. A. M. A., Feb., 1910, p. 463; ibid., April 16, 1910, 

 p. 1304; ibid., April 23, 1910, p. 1373; ibid., July 23, 1910, p. 309. 



' Gavino and Girard, cited from Anderson and Goldberger. 



