Volume 1

Report on the origin and spread of typhoid fever in U.S. military camps during the Spanish War of 1898 / by Walter Reed, Victor C. Vaughan and Edward O. Shakespeare.

  • Walter Reed
Date:
1904
Catalogue details

Licence: Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)

Credit: Report on the origin and spread of typhoid fever in U.S. military camps during the Spanish War of 1898 / by Walter Reed, Victor C. Vaughan and Edward O. Shakespeare. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

    49/778 (page 25)
    Chattanooga. There is no further record concerning the disposition of these patients. From the time of its arrival, throughout its stay at Chiclianiauga, cases of enteritis were c^uite common. Some of these were recognized as typlioid fever after they had l)een trans- ferred to the division hospital. We will not give a complete list of the recognized and prol)ahle cases of typhoid fever in this regiment, but instead we will give a summary of the cases which occurred before and after the regiment left Chickamauga. There were 60 prob- able cases of typhoid fever in the regiment before Jidy 22, the date when it left Chickamauga Park. Of these 60 cases of probable typhoid fever, 15 were recognized as typhoid either in the regimental or in the hos- pital report, while 45 show some other diagnosis. The diagnosis most popular, apparently, in this regiment was enteritis. Most of the patients taken sick at Chickamauga were sent to hospital with a diagnosis of enteritis. It will thus be seen that this regiment became quite widel}^ infected with typhoid fever during its stay at Chickamauga; indeed, as we have already stated, there can be little doubt that the regiment reached (Jhickamauga infected with typhoid, but the infection had become quite widespread at the time of its departure from this place. When the I'egiment left Newport News, July 27, it sent 22 cases of undiagnosed fever to the Marine Hos- pital. All of these proved to be cases of typhoid, and of course all were infected at Chickamauga, From July 27, the date of sailing for Porto Rico, to August 14, there appear on the records 64 cases of prolonged fever; 20 of these are diagnosed typhoid, 24 malaria, 13 diarrhea, and 7 enteritis. It would seem that by August 14, twenty-two da3^s after leaving Chicka- mauga, all cases infected at Chickamauga should have manifested some symptoms of the disease. We will now endeavor to ascertain whether or not typhoid fever diminished immediately after the period of incu- bation had been passed since leaving Chickamauga. From August 15 to 31, inclusive, 89 cases of pro- tracted fever appeared in the regimental sick reports. All of these were sent to hospital or placed on hospital ships and were returned to the United States. We have not been able to obtain the records of the various hos- pitals to which these patients were sent. We will therefoi'e be compelled to accept the regimental diag- noses. Of the 89 cases of protracted fever originating from August 15 to 31, inclusive, 60 were recognized by the regimental surgeon as typhoid fever. It is true that they were not all diagnosed as typhoid, for some of them are entered under the diagnosis of enteric fever and some are recorded as continued fever. We think it only fair, however, to regard all of these as recognized cases of typhoid fever. There were 18 cases of malaria, 8 of diarrhea, and 3 of enteritis. It will thus be seen that 60 cases of undoubted typhoid fever occurred in this regiment during the latter half of August. We must therefore conclude that the removal of the camp from Chickamauga and the voyage to Porto Rico did not relieve this regiment of its typhoid-fever infection. From September 1 to 15, inclusive, there were in the regiment 126 cases of protracted fever. Six of these were recognized as typhoid, 88 are registered as malaria, 29 were diagnosed diari-hea, and 3 are registered under the diagnosis of enteritis. From this record it would appear that from six to eight weeks after the regiment left Chickamauga the number of new typhoid fever cases gradually decreased. From September 15 to 30, inclusive, there were 95 cases of protracted fever in the regiment. Typhoid fever does not occur in the record. Twenty-one cases are registered as undetermined fevers and 84 cases are diagnosed malaria. It is more than probable that some of the cases designated as undetermined fever were really cases of typhoid. It would certainly be unsafe to conclude from this record that typhoid fever disap- peared from the regiment. From Octobc]' 1 to 14, inclusive, there are in the regi- mental records a register of 57 cases of protracted fever. Thirteen of these are recorded as typhoid fever, 39 are designated as malaria, and 5 are diagnosed diarrhea. It will be seen from this that typhoid fever continued in the regiment up to the middle of October, and we will trace it to a later date. From October 15 to November 4, inclusive, there are 33 cases of protracted fever given in the regimental records. Of these, 13 are recognized as typhoid, 15 as malaria, 2 as diarrhea, and 3 enteritis. Notwithstanding the apparent break in the existence of typhoid fever during the month of September, we think it is quite certain that typhoid fever continued quite uninterruptedly in this regiment throughout its difi'erent encampments and until it returned to the United States and was disbanded. We may make the following sunnnarv concerning the protracted fevers in this regiment: Protracted fevers at Chickamauga: Recognized typhoid fever 15 Otherwise diagnosed 45 Total - 60 Protracted fevers at Newjjort News: Recognized typhoid fever 22 Protracted fevers in Porto Rico from July 28 ti) August 14: Recognizeil typhoid fever 20 Malaria 24 Diarrhea 13 Enteritis 7 Total 64 Protracted fevers in Porto Rico fnjin August 15 to 31, inclusive: Recognized typhoid fever 60 Malaria 18 Diarrhea 8 Enteritis 3 Tntal 89