The medical complications, accidents and sequels of typhoid fever and other exanthemata / by Hobart Amory Hare ... and E.J.G. Beardsley ... with a special chapter on the mental disturbances following typhoid fever, by F.X. Dercum ... with 26 illustrations and 2 plates.

H. A. Hare

Date:: [1909]

Credit: The medical complications, accidents and sequels of typhoid fever and other exanthemata / by Hobart Amory Hare ... and E.J.G. Beardsley ... with a special chapter on the mental disturbances following typhoid fever, by F.X. Dercum ... with 26 illustrations and 2 plates. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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$lii^'li fVvcr, (lie colljipsc, iiiid, (iii;illv, llic inciiiiiof'jil symptom- ;ii<- of interest. Ill some instances in wliicli lii;^!! ninpcniluiv- i-: nolcil when tlie ])liysici;ui first sees the j);itienl, it is not in re;ility llie earlifst perversion of norniiil (emperalure in tlial ;i mild :\\u\ nnnrdieefj fever lias been |)rescn( for some days, even iIioumIi die pnticnl lias felt perfectly well. Hi^h initial teniperatnres should place die j>liy>ici;iii on hi.-> guard, heciuise they may mean severe infection or srjme ^rave complication which he must search for and ijiscovcr, and partic- ularly is this the case if the initial temperature is ushered in or is followed by a chill or ri<^or. In some of these ca.ses careful study of the history of the patient \\\\\ reveal an exposure to malarial infection, and an examination of the blood may reveal the presence of the malarial parasite, although, as pointefl out farther on, this organism is apt to be absent from the blood during the active period of typhoid fever. The more sudden the appearance of the disease, and the more rapid the rise of temperature in the beginning of the first week, so much the more should one expect in general a short and even abortive attack, and the more rapidly the temperatiu-e falls, as the end of the first week is approached, the l)etter the prognosis, particularly if the daily fluctuations are marked. Very sudden development of true hyperpyrexia at this stage, unless it is due to some severe complication, is very rare. Chills.—In some instances, not commonly met with, typhoid fever uncomplicated by other states is ushered in by severe chills. As already pointed out, these are most apt to appear in children, and they may indicate the development of some coincident infection. Chills may, however, be due to the typhoid infection itself. They are met with more frequently at the onset of a relapse than at the primary onset. In a case under our care, a man of thirty-five years, after several days of malaise, without fever, was seized with a violent rigor and at once became so ill that he was forced to go to bed, where he passed through a severe attack of the disease. Osier, in his consideration of chills in typhoid fever, diAides them into six classes. (1) Where the chills occur at the onset of the$