CHAPTER XXIV 

 TYPHUS FEVER 



Typhus fever, also known as jail-fever, ship-fever, army-fever, 

 and by a large number of other names, of which about a hundred 

 have been collected by Murchison,* has long been known, but was 

 probably not recognized as a definite disease before 1760, when 

 Gaul tier de Sauvage endeavored to give it individuality, ,or 1769 

 when Cullum of Edinburgh defined it. Its eventual separation 

 from typhoid fever, with which it continued to be confused, was 

 the result of the studies of Gerhard " On the Typhus Fever which 

 occurred in Philadelphia in the Spring and Summer of 1836, Etc."t 

 The Germans still speak of typhus abdominalis , meaning typhoid 

 or enteric fever, and typhus exanthematicus , meaning the typhus 

 fever of the present day. The Spanish and Mexicans call it tahardillo. 



The disease is largely a disease of poverty, filth and crowding, and 

 is of frequent occurrence both in sporadic and epidemic form where 

 such conditions occur permanently or temporarily. Its most 

 common epidemic occurrence is therefore among the slums, in jails, 

 in ships, in asylums, in hospitals and in armies. With the improved 

 hygienic conditions of the present time its occurrence in consider- 

 able epidemics is much diminished, and it is not to be expected in 

 sanitary dwellings, among cleanly people or in well-regulated 

 institutions. 



It is undoubtedly transmissible and therefore infectious, but 

 it early became clear that the infection was not air-borne and did 

 not readily pass from individual to individual. Further, it seems 

 clear that the survival of an attack confers immunity against future 

 infection. 



Though its infective and micro-organismal nature is clear, the 

 specific micro-organism has not yet been discovered. This is not 

 because it has not been made the subject of much investigation in 

 many countries by capable men, but rather because of peculiar 

 circumstances that make the discovery difficult, if not impossible. 



The early investigations of the subject were confined to dem- 

 onstrating the truly infectious nature of a disease whose transmissi- 

 bility was so uncertain as to permit the escape of large numbers of 

 those exposed to it. 



In 1876 MoczutkowskiJ inoculated himself with the blood of a 



* "A Treatise on the Continued Fevers of Great Britain," 3d edition, 1884, p. 

 161. 



fAmer. Jour, of tlie Med. Sciences, 1836, xix, p. 283; 1837, xx, p. 289. 

 j"Allgemeine Med. Central Zeitung," 1900, Lxvin, 1055. 



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