﻿IX, B, 4 



Gutierrez: Typhoid Fever in the Philippines 



373 



ANALYSIS OP SYMPTOMS 



General appearance. — In frank cases, except in the mildest, 

 the typhoid clinical picture is present. "Flushed faces" were 

 noted in 51 cases, typhoid tongue was noted in 108, typhoid facies 

 in 81, typhoid state in 25, bleeding from the gums and lips 

 was found in but 8 cases, and "rose spots" were found in 26 

 cases, although they were not especially looked for. It has 

 been a common belief among practitioners about Manila that 

 rose spots are rare in typhoid among Filipinos. I have not been 

 able to find any evidence to justify this conclusion. If rose 

 spots are not especially searched for, they will be overlooked 

 oftener in the dark-skinned race than will be the ease in fair- 

 skinned patients. In the last 15 cases of this series, rose spots 

 were searched for with care, with the result that they were 

 found in 11, or 73.66 per cent, of the patients. 



Delirium probably is not as prevalent as it is in temperate 

 climates. It was present in 19 of my cases, or 13.86 per cent. 

 Seven cases were of the low-muttering type, and 12 patients 

 had wild delirium. The lowered incidence of delirium is prob- 

 ably due to the unusually low fever encountered in many of our 

 patients. "Typhoid state" was present in only 18.24 per cent 

 of this series. 



The circulatory system. — The heart presented the usual toxic 

 effect of this disease, and no peculiar conditions were noted. 

 The usual pulse found in typhoid fever was encountered in this 

 series. The rate was disproportionately low as compared with 

 the fever, and was one of the important symptoms that was 

 looked for, especially when the fever was irregular. 



Table IV 



. — Pulse rate in typhoid. 









Pulse not over 100 



throughout high 



temperature. 



Pulse not over 100 



for two or more 



days. 



Pulse not over 100 

 throughout fever. 



Number. 



Per cent. 



Number. 



Per cent. 



Number. 



Per cent. 



Males.. 



47 

 16 



55.95 

 35.71 



24 



10 



3 



26 

 2 



28.57 

 35.70 

 23.07 



33.30 

 11.10 



13 

 8 

 10 



18 

 16 

 27 



15.47 

 28.35 

 76.92 



30.00 



88.90 



100. 00 





Children 



Rogers: 



Males - - 



22 



36.06 



Females 



Children ___ 











i 1 



The spleen. — Probably next in importance to the pulse rate 

 comes the spleen. Of 118 cases, the spleen index was recorded 

 in 31. In 16 it was enlarged 2 centimeters or more below the 



