Abstract of 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:
- 1900
Licence: In copyright
Credit: Abstract of 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.
178/270 page 152
![(bncwning the 3 cases of Group IT, the author says: “The enteric symptoms wwe well marked, giving a clear history of the dis<?ase.” There were lassitude, etc., “followed by diarrhea, epistaxis, and tympanites, and in one case slight hemorrhage.” In these cases the parasite was found “confined to the corpuscle, not free in the blood.” In one of these cases, during the third week when convaIe.scenc<- appeared to have been establi.shed and temperature was normal, he had a sudden access of fever two days in succe.ssion. Examinaiion showed the ‘plasmodium malarice.. Patient recovered. The other cases of this groiip died, T from peritonitis and 1 fi-om pnetimonia. Kinyoun does not record the variety of the parasite found in his cases. In 1894, W. Gilman Thompson, in a paper before the Association of American Physicians, reported .3 cases of mixed malarial and typhoid infection. The following is taken from Thompson’s hi.story of one of his cases; On his admission his appearance suggested typhoid fever, and he was treated accordingly 83’' the Brand method of cold tuh-hathing. There was slight enlarge- ment of the splenic area of dullness, great prostration, diarrhea, and a typical typhoid tongue, dry, coated on the dorsum, with thin red margins and swollen papillae. There was continued fever, which lasted for seven weeks, and during this period the patient developed the following s3Tnptoms: A genuine t3'phoid eruption, there being some forty distinct rose spots on the abdomen and chest, which appeared in successive groups; hemorrhages from the bowels, of which there were four or five of considerable amount; tympanites, bronchial catarrh, slight albuminuria with granular casts, semistupor and delirium, subsultus. great prostration and emaciation, and the facies of the typhoid condition. On the thirteenth day of the illness there was a severe chill, lasting about three- quarters of an hour, and so violent that the patient shook the bed. It was accom- panied by a rise of temperature to 106.6° F., but there was no sweating. During the third week two other chills occurred of equal violence. As the first took place before the hemorrhage, and also before the eruption became decisive, and as there was nowhere evidence of suppuration, it appeared possible that there might be error in the diagnosis, and the blood was carefully examined for the mala- rial plasmodium. It was found in exceptionall}’^ large nnmbers in the red cor- puscles and also independent of them. When the next chill and exacerbation of temperature occurred quinine was given llypodermicall3^ with the effect of reduc- ing the temperature 4.5° (105.5 to 101° F.). This treatment was several times repeated, and on one occasion at the end of the third week the temperature was temporaril}’^ reduced from 106.4° to 99° F. No more chills occurred after the beginning of the fourth week, but the use of quinine was continued b3’ the mouth, and the bathing, previous^' interru])ted by the hemorrhages, resumed. The patient made a good recovery, and after fift3'-five days in the hospital was ilis- charged, cured. With reference to these easi's Tliompsoii says: In the first case reported the plasmodium became active during the height of the typhoid disease. In the second and third cases the malarial s3’mptoms remained latent (although the plasmodium must have been already present) until the force of the enteric infection had been (ompleteb’ expended, when they assailed a body weakened by a fever of considerable duration.](https://iiif.wellcomecollection.org/image/b28063223_0178.jp2/full/800%2C/0/default.jpg)
