94 TYPHUS FEVER 



ease and superstition that medical records of value are almost wholly 

 wanting. In the siege of Granada in 1489 no less than 17,000 of 

 Ferdinand's soldiers died of a fever which was designated as "Tabar- 

 dillo," on account of the spots appearing on the skin. This term is 

 still one of the Spanish names for typhus. In the sixteenth century 

 two Italian physicians, Fracastorius of Verona and Cardanus of Pavia, 

 described typhus fever so plainly that there can be no doubt about 

 the disease which then prevailed. In four years (1550-1554) more 

 than one million people in Tuscany were destroyed by typhus. Fra- 

 castorius describes the disease as "Febris pestilens," and states that it 

 was vulgarly known as "Lenticulae" or "Puncticula." He says from 

 the fourth to the seventh day red eruptions appear on the arms, chest, 

 and back. They resemble flea bites, only are somewhat larger. They 

 also resemble lentils and from this comes the popular name. The most 

 marked symptoms mentioned are great prostration, feeble pulse, 

 injected conjunctivae, and low muttering delirium. Some are som- 

 nolent while others are excited and wakeful, while in still others these 

 states alternate. The disease lasted from seven to fourteen days, 

 rarely longer. The majority of those who were bled died and a sup- 

 porting treatment proved best. Cardanus and other Italian physicians 

 stated that many of the practitioners of the time mistook this disease 

 for measles, and Massa of Venice wrote on the distinctions between 

 the eruptions of this disease and those of measles and smallpox. About 

 the middle of the sixteenth century this disease was widely prevalent 

 in France and Coyttarus of Poitiers wrote a monograph on it, under 

 the title "De Febribus Purparatis" and somewhat later Ambrose Pare, 

 the distinguished surgeon, wrote of "febris pestilens" which was 

 marked by eruptions resembling the bites of fleas or bed bugs. 



Morbus Hungaricus appeared in the army of Maximilian II in 

 Hungary in 1566, and soon spread over the greater part of Europe. 

 Sennertus and others have left descriptions of this epidemic. The 

 skin was marked by flea-bite eruptions. Headache was intense and 

 followed by delirium. In some, the tongue became black, parotid 

 abscesses developed and gangrene of the limbs occurred. 



Under the title, "Febris maligna puncticularis seu peticularis," 

 Castro of Verona (1580) pictured the symptoms. The pulse is small 

 and weak; the tongue dry and black; the face and eyes greatly con- 



