CHAPTER IX 

 THE TREATMENT OF TYPHOID AND PARATYPHOID FEVER 



Investigations in the treatment of typhoid fever formed the basis 

 upon which our modern conception of the nonspecific factors in 

 therapy are based, not only in the very recent contributions to the 

 literature, but in the older work such as that of Rumpf. 



Typhoid Vaccine. In the decade preceding the war the thera- 

 peutic use of typhoid vaccines in typhoid fever had been developed 

 particularly by French scientists (Chantemesse and Widal, Vincent, 

 etc.) and a number of vaccines were elaborated by them, each with 

 some supposed point of superiority. The sensitized vaccine of 

 Besredka had been used with a measure of success. Stern many 

 years ago had suggested the use of an antitoxic agent, while the 

 use of convalescent serum was introduced by Hammerschlag and 

 used also by Konigsfeld, von Jaksch and Pollak. A comprehensive 

 review of this period and of vaccine therapy in typhoid fever in 

 general will be found in Gay's monograph, as well as in the report 

 of Krumbhaar and Richardson. The latter reached the conclusion 

 that the larger the dose of vaccine, the better the therapeutic result. 

 But large doses of vaccine were not in vogue; one hesitated in giving 

 large reactive doses in chronic diseases where there was little risk; 

 naturally enough this caution was more than observed in such an 

 acute condition as typhoid fever where logically it would seem to be 

 decidedly unwarranted to add more toxin to an already overburdened 

 organism. 



Intravenous Injections. From two quite independent sources, 

 however, this established view was rather abruptly overthrown. In 

 Argentine a group of clinicians found that if they injected typhoid 

 vaccine intravenously during the course of typhoid fever certain 

 remarkable critical terminations of the disease were to be observed; 

 in other cases the disease terminated by lysis shortly after the injec- 

 tion; even those that were not affected in so far as the temperature 

 course was concerned seemed much less toxic than before the injection. 

 This work, carried out by Penna, Torres, Dessy, Grafiolo, Fossati and 

 others, formed the basis on which Kraus later began his work with 

 heterovaccination in typhoid fever. 



At about the same time Ichikawa published a series of cases of 

 typhoid fever treated with intravenous injections of typhoid vaccine 

 with similarly striking results. He used a sensitized vaccine for the 



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