Typhon

“ At least we can say for certain that the plague of Athens showed more of the symptoms of typhus fever than of any other known disease; and if Dr. Crawfurd is wrong he had made a very shrewd guess. From my own experience of typhus, which is small, I should certainly be inclined to support him. But typhus nowadays is a thing almost of the past except in times of war. That we owe simply to washing ourselves and our clothes better than of old. ”

“ Typhoid fever, the report found, "is disseminated by the transference of the excretions of an infected individual to the alimentary canals of others." Infected individuals included those in the early and undiscovered stages of the disease, and also convalescents who had passed through the attack but continued to excrete typhoid bacteria. ”

“ The country was going through a serious epidemic of typhus, in addition to diphtheria, typhoid, and other diseases; and in the villages, and small towns, there were no doctors to prescribe for the patients, or to check the spread of the infection. Typhus victims, in ox-wagons, still passed our camp all day long on their way to join the four thousand already buried in the typhus graveyard, a short distance beyond our hospital. ”

“ The one who is attacked by typhoid fever may not be the one who has left dirt for the disease to breed in.
Typhoid fever germs are bred chiefly in manure piles, sewers, or cess-pools, and would not be transmitted to man directly, but there are several indirect ways in which they may be carried. Flies also breed in the same places. Their legs become covered with typhoid germs, and then they fly into houses directly on the food and cooking utensils. ”

“ Typhoid fever (called in England ‘enteric fever’, in France ‘fièvre typhoïde’, in Italy ‘febbre tifoidea’) in many wars has been very widespread among the armies; for example, in the American Civil War, in the Franco-German War (Metz) , and in the Russo-Turkish War of 1877–8. The progress of the disease is well known; between the time of infection and the outbreak of the sickness nine to eleven days usually intervene, sometimes even as much as three weeks. ”

“ Leslie, clearing his throat, “within the past year or two we have made a most weird and startling discovery in typhoid fever. We have found what we now call 'typhoid carriers'—persons who do not have the disease themselves, perhaps never have had it, but who are literally living test-tubes of the typhoid bacillus. It is positively uncanny. Everywhere they go they scatter the disease. ”

“ While typhus fever is a disease of overcrowding and poverty, typhoid may occur where such conditions are entirely excluded; and the connexion of this malady with specific emanations given off from decomposing organic or fæculent matters, or with contamination of food or water by the products of the disease, is now almost universally admitted. Alike in sporadic cases and in extensive epidemic outbreaks the existence of insanitary conditions in house drainage, water supply, &c., can in the majority of instances be made out. ”

“ The Reed- Vaughan-Shakespeare Board was convinced, from the clinical evidence, that many such cases were typhoid. They persuaded Brig. Gen. Fitzhugh Lee, in command of the camp, to order that 50 cases diagnosed by the camp medical officers as malaria or typhomalaria be sent to Fort Myer, where Dr. Carroll had set up his diagnostic laboratory, for microscopic tests. The tests, in every instance, showed the true diagnosis to be typhoid fever. ”

“ An idea got abroad that there is a specific disease which, though resembling both, is neither typhoid nor malarial, nor any of the other recognized forms of continued fever. There is no doubt that in warm climates, besides the known fevers, there are several, if not many, undifferentiated specific fevers. But the clinical group indicated by the term "typho-malarial " is not one of these. Typho-malarial fever is an ordinary typhoid occurring in a person who has been exposed to malarial influences, i.e. who has become infected with the malaria parasite. ”

“ There are harmless forms of bacteria which are capable of growing upon less food than the disease-germs require and they often multiply in badly-polluted waters. Typhoid-fever germs live for a longer or shorter period, and finally die without growth. The few laboratory experiments which have seemed to show an increase of typhoid germs in water have been made under conditions so widely different from those of natural watercourses that they have no value. ”

“ A terrible epidemic of typhus fever occurred in Genoa in 1799–1800, when 14,000 people succumbed within six months. [87] Rasori had noted the first cases as early as the summer of 1799; the patients were fugitives from Upper Italy, commercial travellers and military persons. Not until the end of the winter and in the spring did the disease become very widespread; it attacked principally the poorer people. Rasori held the disease to be ‘nosocomial fever’ (typhus fever) , and his description of it makes this diagnosis seem undoubtedly correct. ”

“ Causes of its outbreak.That all insanitary conditions in respect of drainage of houses and localities furnish the most ready means for the introduction of the contagion of typhoid there is a general agreement, as there is equally that the most certain means of preventing its appearance or spread are those which provide a thoroughly trustworthy and secure drainage, a safe method of disposal of sewage, and a pure and abundant water supply. Typhoid fever is much less directly communicable from the sick to the healthy than typhus. ”

“ Typhoid Fever.—One of the most common germ diseases in this country and Europe is typhoid fever. This is a disease which is conveyed by means of water and food, especially milk, oysters, and uncooked vegetables. Typhoid fever germs live in the intestine and from there get into the blood and are carried to all parts of the body. A poison which they give off causes the fever so characteristic of the disease. The germs multiply very rapidly in the intestine and are passed off from the body with the excreta from the food tube. ”

“ Not only so, but a column of water, some twenty to twenty-five feet in height, is acting like the piston of a pop-gun, and is driving all the accumulated gases charged with the germs of typhoid fever into every house which has communication with the sewers. There is no help for it, the poisonous vapours must be forced out of the drains and must be forced into the houses. That is why, with a rise of the Tiber, typhoid fever is certain to break out in Rome. ”

“ With the differentiation of typhoid fever from typhus fever by Gerhard in Philadelphia in 1837, and by Stewart and W. Jenner in Great Britain in 1849, it became possible to associate the former with excremental, the latter with respiratory filth, “the non-removal of the volatile refuse of the human body.” The question still remained whether typhoid fever was producible by “emanations from decomposing organic matter,” whether it was “often generated spontaneously by faecal fermentation,” as contended by Murchison, who in 1858 proposed the name “pythogenic fever” for typhoid fever ”

“ But at last medical experimenters traced the disease to a certain kind of mosquito, and now, if we drain the swamps and screen our houses and stay in doors after sundown, we do not get yellow fever, nor malaria either. In the same way, if we keep our bodies clean with soap and hot water, we do not get bitten by lice, and so do not die of typhus. If we take pains with our drains and water supply, so that human excrement does not get into it, and if we destroy the filth-carrying housefly, we do not have epidemics of typhoid. ”

“ Of preventable diseases none should receive more attention than typhoid fever, because it is a great scourge and yet it can be prevented by simple means. If we understand that typhoid is a dirt disease, that it comes only from dirt, we shall feel it a disgrace to have an epidemic of typhoid, though one of the saddest features about it is that we must suffer for the sins of others. ”

“ Indeed, it is a humiliating fact that, in those chest-cases where medical science has made the most marvellous discoveries, the actual amount of disease is probably greater than ever it was. The doctors are even quarrelling among themselves, whether certain illnesses are contagious or non-contagious. There is no doubt that scarlatina is contagious; but, at the time of the illness of the Prince of Wales, it was sharply debated whether typhoid fever was infectious or not. ”

“ Even with our present exceedingly imperfect systems, probably not more than between five and ten per cent of typhoid is transmitted in this way; and, if the water-supply were kept clean, this would practically disappear.
Typhoid may not only be transmitted from the earth beneath and the water under the earth, but also from the heavens above, through the medium of flies and dust. The first method is bulking larger every day, especially in country districts and in camps. The modus operandi is simplicity itself. The fly lives and moves and has its being in dirt. ”

“ I believe Lady Clifford has been giving you typhoid culture in your mineral water. I heard the doctor say so. I don't know that we can prove that, or that she gave it to your father in his milk, either; that's all done with. But there's one thing we can prove. There's a little chemist named Cailler—I can tell you where the shop is—who has an analysis of a hypodermic needle the doctor used on your father. It was what caused that sudden relapse. The needle had pure toxin of typhoid in it. I know, because I took it to the chemist myself. ”

“ The infection is communicated from man to man, and very often it is contracted from the clothes, linen, and other effects of typhus patients. Recovery from the disease usually renders a person immune against a second attack. Typhus fever frequently appears nowadays in the eastern and south-eastern parts of Europe, in Hungary and Galicia, and also in Spain, Italy, and Ireland. ”

“ We now know through the researches of Ricketts and others that typhus is carried by vermin, the body louse, Pediculus vestimenti, acting as the vector. Thus the etiology of typhus has suddenly been made clear and we are in a position to formulate measures for prophylaxis and quarantine which will prevent the development of the disease in epidemic form. There is much yet to be learned; perhaps other insects also may act as carriers, but there can be no doubt that typhus is almost exclusively insect-borne. ”

“ It would appear that typhoid is not only a common disease among Europeans in the tropics, but that it is also a very virulent one, with a death-rate twice as heavy as the death - rate of typhoid in England. According to my experience in China, not only is the tropical form grave from the outset, but it is extremely liable to relapse. In England the death-rate is put down at about 1 in 8 attacked; but in India the elaborate and carefully prepared statistics show a death-rate of rather over 1 in 3. Typhoid in India, indeed, kills more European soldiers than does cholera. ”

“ In the same manner as pathologists disagree as to the question, whether the typhus and typhoid fever in man are one and the same disease, so should we long debate, without coming to an agreement, as to that which relates to the typhus and typhoid fever of the ox. ”

“ As we have already seen, the contagious typhus of the ox, at least that of the present [Pg 195] epizootia, is an infectious disease, which varies in the intensity of the functional disorders and the cadaveric lesions to which it gives rise. The typhoid fever, we mean the real one,—for there are other intestinal exanthematic fevers which simulate it,—always localize on the small intestines a pustulous exanthem, and in the typhus of the ox, this pustulous exanthem and the ulcerations by which it is succeeded, are frequently wanting. ”

“ How do flies carry typhoid fever germs? 6. How do these germs get into milk?
Remember. 1. Typhoid germs come from people who have typhoid fever; they are found in the urine and bowel discharges. 2. No one should ever answer Nature's calls except in a place provided for that purpose. 3. No sewage should be allowed to go into any stream until all the germs in it have been killed. [119] 4. Disease germs will live in running water fully as long as they will in still water. 5. The discharges from a single person may infect a whole city. ”

“ We must, moreover, observe that the typhus is of all known distempers the most difficult to treat. It requires in the doctor a degree of skill, of practical experience, vigilance, decision, and sureness of hand which no man can be expected to possess at the first outbreak of the epizootia.
On the other hand, the constitution of the ox, so easily shaken, undergoes in two weeks all the commotion which a man labouring under typhoid fever would be subject to in a month. The phenomena succeed each other with terrific swiftness, leaving scarcely time for us to act, or for the medicines to operate. ”

“ But our army surgeons, wise in tropical diseases from their service in Cuba, Porto Rico, Panama, and the Philippines, are not apprehensive of any grave epidemics in Mexico. They have learned much and rapidly in the last decade and a half, and what they have learned is demonstrable by statistics. Typhoid has ever been a grisly monster to north European and American armies. The Latins and the Asiatics are more immune, this being doubtless due to a rigid selection, operating through many centuries, by which typhoid killed off all that were predisposed to typhoid. ”

“ Since it is clear that flies are abundantly able to disseminate viable pathogenic bacteria, it is important to consider whether they have access to such organisms in nature. A consideration of the method of spread of typhoid will serve to illustrate the way in which flies may play an important rôle.
Typhoid fever is a specific disease caused by Bacillus typhosus, and by it alone. The causative organism is to be found in the excrement and urine of patients suffering from the disease. ”