Paratyphoid fever / by R.D. Keith.

  • Keith, Robert Donald.
Date:
1904
Catalogue details

Licence: In copyright

Credit: Paratyphoid fever / by R.D. Keith. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    (3) It had the character of an acute infectious disease and this depended on the surroundings. This was shown in the first house epidemic, where all the persons coming in close contact with the first patient were also attacked by the disease, while those of the household isolated from that patient escaped. (4) In slight as well as in severe cases there was a remittent and an intermittent stage in the temperature and occasionally a somewhat critical fall. One was afebrile throughout. (5) The frequency of the pulse was found to correspond on the whole with the temperature. It was regular, equal and weak, and occasionally, during the intermittent stage of the temperature, small. (6) The gastro-intestinal tract was affected. There were vomiting and borborygmus in the initial stages. The tongue was always more or less coated. There was abdominal pain but no tenderness, and iliac gurgling was constant. The spleen was only occasionally palpable, but often enlarged on percussion. As a rule there was diarrhoea, which was often followed by constipation ; the stools during the stage of diarrhoea being thin, yellow, and often very foetid. The urine contained as a rule no albumen, but showed a deposit of lithates. In many cases the indican reaction was present and also the “ diazo ” reaction. (7) As a rule the sensorium was free, but some of the patients were somnolent and apathetic. Delirium was rare. (8) Spots were present in half the cases. (9) The blood serum agglutinated the paratyphoid “ B ” bacillus in all cases. (10) Bronchitis was the most common complication. (11) Sore throat was often present at the commencement of the disease. (12) Only seldom was there slight haemorrhage from the bowel. The disease was in all probability water-borne. In February 1902 an epidemic broke out in one of the regiments stationed in the town of Saarbriick in Germany. This was investigated by Conradi, Drigalski and Jurgens (8). This at first showed the characters of an influenza epidemic. The patients were affected with sore throat, tonsilitis, fever and diarrhoea, and in several of the cases influenza bacilli were found in the sputum. At the same time, however, the suspicion which had existed from the first that it might be typhoid fever was further strengthened by a positive Widal’s reaction in one of the cases. Rigorous bacteriological and sanitary measures were adopted. All the cases in which there was the slightest suspicion of disease were isolated ; and by the 19th of February,
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