ENTERIC 



1363 



Little Fever, Irregular Low Fever, Low Fever, Bilious Fever, Bilio-gastric 

 Fever, Bilious Continued Fever, Night-soil Fever, Cesspool Fever. 



French Synonyms. — Fi^vre Typhoide, Dothienenterite, Fievre Continue, 

 Fievre gastrique, Fievre nerveuse, Enterite septicemique, Adeno-meningee, 

 Fievre meningogastrique. 



Italian Synonyms. — -Febbre tifoide, Tifo addominale. 



German Synonyms. — Abdominaltyphus, Nervenfieber, Darmtyphus, 

 Gastriches Fieber. 



The Latin synonyms are very numerous, and have been classified by 

 Murchison into : — 



[a) From supposed resemblance to typhus: Typhus nervosus, T. mitior; 

 T. gangliaris vel entericus, Ileo-typhus; Typhios, Typhus (of many old 

 writers) . 



(&) From mode of prevalence: Febris non-pestilens. 



[c) From its remittent character: Febris semitertiange seu composita; 

 Tritaeophya typhodes. 



[d) From its length: Febris lenta. 



[e) From septic symptoms : Febris putrida, Febris putrida quae vulgo lenta 

 appelatur; Febris putrida aut biliosa; Febris a putredine orta, 



(/) Resemblance to hectic fever: Febris hetica. 



\g) Occurrence of gastric symptoms: Febris gastrica, Febris acuta stoma- 

 chica aut intestinalis ; Synochus biliosis. 



[h) From intestinal symptoms: Febris mucosa, Febris pituitosa, Febris 

 mesenterica maligna, Febris intestinalis. 



[i) From supposed origin from worms : Febris verminosa, Typhus 

 verminosus. 



With regard to the nomenclature, we have adopted the term Enteric Fever, 

 used by Ritchie in 1846, because we describe under the term three distinct 

 diseases caused by distinct micro-organisms, all of which produce symptoms 

 either identical with or so closely resembling one another as to be nearly 

 impossible of clinical separation at the present time. 



Definition. — The term ' enteric fever ' is used at the present time 

 to indicate three clinically similar fevers: typhoid fever due to 

 Bacillus typhosus Eberth, 1880, the paratyphoid fevers due to 

 B.paratyphosus A Schottmiiller, 1901, and5. paratyphosusB Schott- 

 miiller, 1901, and varieties of these bacilli. 



History, — The history of enteric fever may be considered under 

 two headings — viz., the general history of the disease, and the special 

 history of its occurrence in the tropics. 



It is quite impossible to recognize it with any degree of certainty 

 in the meagre descriptions written by Hippocrates and the ancient 

 physicians, which may or may not have referred to this disease. 

 In the Middle Ages enteric fever, typhus fever, and relapsing fever 

 were always confused with plague until Fracastorius, in the six- 

 teenth century, distinguished typhus (which included enteric fever 

 and relapsing fever), or febris pestilens, from plague, or febris vere 

 pestilens. Spigelius, in 1624, is probably the first writer to clearly 

 recognize the symptoms of enteric fever, because he described in 

 Padua a disease characterized by fever, abdominal pain and tender- 

 ness, diarrhoea and delirium, having remissions and relapses, and 

 associated with the post-mortem appearances of inflammation in 

 the ileo-c3ecal region. Similar descriptions can be found in the 

 writings of Willis in 1659, who drew a distinction between febris 

 pestilens and a febris lenta, the latter being associated with the en- 



