﻿IX, B, 5 Crowell: Intestinal Lesions 455 



TYPHOID FEVER 



The frequence of entamoebic and bacillary colitis in Manila 

 is often referred to, while but little emphasis has been placed 

 on the prevalence of typhoid fever. In our autopsy experience, 

 it is found more frequently than either entamoebic or bacillary 

 dysentery. It will never be known whether this increased sta- 

 tistical frequence of typhoid fever is actual or is due to improved 

 methods of diagnosis and closer investigation. Thirty-seven of 

 the 39 cases occurred in Filipinos, 1 in a Chinese, and 1 in a Japa- 

 nese. No typhoid in Caucasians was encountered in this series. 



The following table excellently exemplifies the usual causes of 

 death in typhoid fever cases and their relative frequence. In 

 22 of 39 cases (56.4 per cent) typhoid lesions were present in 

 the colon as well as in the ileum. 



Tabue III. — Causes of death in 39 cases of typhoid fever. 



Intestinal perforation 12 



Intestinal haemorrhage 5 



Suppurative nephritis (pyaemic) 2 



Lobar pneumonia 2 



Perforation of gall bladder 1 



Toxaemia 17 



Those cases tabulated as dying of toxaemia include those cases 

 in which there were no severe gross anatomical lesions explan- 

 atory of death other than the intestinal lesions, bronchopneu- 

 monia, degeneration of the heart muscle, or other evidences of 

 severe toxaemia. Thirty per cent died of intestinal perforation 

 and 12 per cent died of haemorrhage. 



ENTAMCEBIC COLITIS 



Table IV. — Causes of death in SI cases of entamoehic colitis. 



Liver abscess 9 



Acute peritonitis: 



Perforation " 2 



No perforation 3 



Toxaemia 3 



Intercurrent diseases : 



Lobar pneumonia 2 



Tuberculosis 5 



Perforation of duodenal ulcer 



Accident 



Sarcoma 



Cirrhosis of liver 



Pulmonary abscess 



Arteriosclerosis 



Beriberi 



Postpartum sepsis 



' One of these had also a liver abscess. 



