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.
180/270 page 154
![gascar and Algeria. Altliougli tlie clijiical picture was a variable one, sometimes partaking of that of malaria and sometimes of that of typhoid fever, as a rule the tyiihoid sym])toms wei-e dominant. 4'lie earliest symptoms were manifested by a rise of temi>erature, with oi- without chill, severe headache, sometimes epistaxis, and general body pains. Once established, the fever continued, often irregular in its course, or higher in the morning than in the evening. In 2 cases the initial fever was of short duration and was followed by an almost normal temperature, the latter interrupted by an occasional rise. The pulse followed the oscillations of temperature, remaining in the mean- while frequent. It often varied from 130 to 150 or more to the minute. It was dicrotic, compressible, sometimes threadlike, and was accom- panied by cardiac distress and irregularity. Profound stupor, delirium, great excitement alternating with col- lapse, earthy hue of countenance, dusky, dry lips and tongue, and marked albuminuria, symptoms which indicated the severitj* of the infection, were to be seen in all of these cases. Sometimes the disea.se was ushered in by coma like that of pernicious malaria, death occur- ring during the first week. Thoracic complications (bronchitis and pneumonia) were almost constant. Rose spots were present in 12 cases. Iliac tenderness was present; in some cases constipation. Diarrhea, slight or profuse, was the rule. One patient died with ehol- eriform symptoms. Two cai’dinal symi^toms were never lacking—the earthy color of the face and the marked enlargement of the spleen. There were also enlargement and tenderness of the liver. While death might be caused by the intensity of the infection, it was often in consequence of com]Dlications such as m3mcarditis, paren- chymatous nephritis, gangrene of the lung, lobular pneumonia, abscess of the kidnej^ and spleen, peritonitis, etc. Convalescence was slow and was sometimes marked bj* isolated paroxysms. In all of these patients microscopic examination of the blood made during life and at the beginning of the disease showed, in variable numbers, the malarial parasite (amoebic, segmenting forms, and cres- cents) except in 1 case, in which large doses of quinine had been taken. In this case large numbers of the parasite Avere found in the tissues of the spleen after death. Death occurred in 8 of these cases. Swelling or ulcerations of Peyer’s patches were found in all in varying degree. These changes were often slight. Once or twice they were reduced to a simple psorentery (sim- ple psorenterie). The mesenteric glands were enlarged. The spleen eonstantlj^ increased in size, weighing in one case 700 grams and in another 900 grams, and its surface was of a dark color. The liver Avas enlarged, of abroAvn color and .soft consistencA^ The kidneys showed the lesions of parenchymatous nephritis. Sections of the liA-er shoAved marked pigmented infiltrations of the capillaries. The same pigmen-](https://iiif.wellcomecollection.org/image/b28063223_0180.jp2/full/800%2C/0/default.jpg)
