CHAPTER VIII 



TYPHOID FEVER 



History. In his writings on epidemics, Hippocrates (fifth century 

 B. C.) describes certain continued fevers with moderate disturbances 

 of the bowels, much wasting and delirium, lasting sometimes forty 

 days, and recovering rarely by crisis, more frequently irregularly. 

 These can hardly be other than cases of typhoid fever. Galen 

 observed similar cases and described them under the names "hemitri- 

 taeus" (used by Hippocrates) and "febris semitertiana." These 

 names were used for centuries. In the seventeenth century Spigelius 

 writing under the title "De Febre Semitertiana" reports necropsies in 

 which spots and sloughs were observed in the intestine. Similar 

 lesions were found and reported by other Italian physicians. Near 

 the middle of the same century an English physician, Willis, made 

 necropsies and observed like changes in the intestine. About the 

 same time, the father of English medicine, Sydenham, described a 

 fever lasting from fourteen to thirty days with a tendency to diarrhea, 

 delirium and epistaxis. 



In the eighteenth century many contributions to the knowledge 

 of this disease were made. Morgagni described the intestinal ulcers, 

 perforations, and enlarged mesenteric glands and spleen. Tissot of 

 Lausanne gave a good description of the disease as did Huxham of 

 England. The latter's picture is sketched in the following words : 



The patient at first grows listless and feels slight chills and sudors with 

 uncertain flushes of heat and a kind of weariness all over. This is always 

 attended by a heaviness and dejection of spirit. A nausea and disrelish of 

 everything soon follow. Though a kind of lucid interval of several hours inter- 

 venes, yet the symptoms return with aggravation, especially towards night ; the 

 head grows more heavy, the heat is greater, the pulse quicker; a great torpor 

 or obtuse pain affects the head and is commonly succeeded by some degree of 

 delirium. In this condition the patient often continues five or six days, seem- 

 ing not very sick; about the seventh or eighth day the giddiness, pain or heavi- 

 ness of the head becomes much greater, often delirium appears with universal 

 tremors and muttering, the tongue grows often very dry, often very thin stools 



