TYPHUS FEVER 105 



There is certainly one great lesson which it teaches and that is that 

 the health conditions of the poor are of interest to all. No nation can 

 be great so long as its laboring classes live under unhygienic condi- 

 tions. Typhus impoverished Europe not only by its high mortality but 

 by the great emigration from its shores, leaving the degenerate to 

 beget its generations. 



Before leaving the history of typhus in Europe, I wish to quote the 

 definition of the disease given by the greatest English authority of the 

 nineteenth century, Murchison: 



A disease attacking persons of all ages generated by contagion, or by over- 

 crowding of human beings, with deficient ventilation, and prevailing in epidemic 

 form, in periods or under circumstances of famine and destitution. Its symp- 

 toms are : more or less sudden invasion marked by rigors or chilliness ; fre- 

 quent, compressible pulse; tongue furred and ultimately dry and brown; 

 bowels, in most cases, constipated ; skin warm and dry ; a rubeoloid rash appear- 

 ing between the fourth and seventh days, the spots never appearing in 

 successive crops, at first slightly elevated, and disappearing on pressure, 

 but, after the second day, persistent, and often becoming converted into true 

 petechiae ; great and early prostration; heavy flushed countenance; injected 

 conjunctivae; watchfulness and obtuseness of the mental faculties, followed 

 at the end of the first week by delirium, which is sometimes acute and noisy, 

 but oftener low and wandering; tendency to stupor and coma, tremors, sub- 

 sultus, and involuntary evacuations, with contracted pupils. Duration of the 

 fever from ten to twenty-one days, usually fourteen. In the dead body no spe- 

 cific lesion; but hyperemia of all the internal organs, softening of the heart, 

 hypostatic congestion of the lungs, atrophy of the brain, and edema of the 

 pia mater are common. 



Typhus fever became epidemic in Mexico soon after the conquest 

 (1530) and has continued in endemic form with occasional severe 

 exacerbations to the present time. According to Liceaga the second 

 recorded epidemic occurred in 1545 and the third in 1575. In 1736- 

 1737 the disease is said to have killed 192,000. During the nineteenth 

 century there were many exacerbations, the most extensive of which 

 was in 1861. At the present time typhus is common in Mexico. 



Importations of typhus by immigrants into this country have been 

 constant and it is probable that at no time have our large cities been 

 wholly free from it, but in most instances it has been limited to 

 recently arrived immigrants and those directly in contact with them. 



