The Surgical Complications and Sequels of Typhoid Fever

This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1898 Excerpt: ...or circulation, and may thus give the patient time to recuperate his forces for a later and more radical operation if that proves to be necessary. In one case1 two aspirations were needed and it was observed that the typhoid bacilli from the second puncture were less virulent than those from the first. Five were males and four females; four were under twenty years old and four from twenty to thirtythree; all arose after the third week and two as late as two months from the onset of the fever. Heart.--There are also recorded two cases of purulent pericarditis2 and one of an abscess in the wall of the heart. Of the former, one was found at the autopsy, the patient, a boy of nine, dying on the seventeenth day. The latter 3 was in a man of 1 Weintraud, Berlin. klin. Wochen., 1893, xxx, 345. 2 Zeller, La France Med., 1881; and Le Clerc, La Trance Med., 1881, 54. a Driguet, quoted by Michon, Contrib. al, Etude des Suppur. dans la Fievre Typholde, These de Lyon, 1890. thirty-six, who died on the thirtieth day, and was likewise found at the autopsy. In view of the so frequent and characteristic changes in the heart muscle, it is rather singular that rupture of the muscular fibers, hematomata, and abscess are not more frequent in the heart. Save this one case, they are conspicuous by their absence. It is to be noted, also, that the typhoid bacillus lias been found in the muscular tissue of the heart itself.1 The treatment of a purulent pericarditis of typhoid origin would differ in no way from one arising from any other cause, except that the fever, if convalescence be not yet fully established, would seriously diminish the chances of recovery. 1 Chantemesse and Widal, Gaz. I lend., March 4, 1887, 146. (See also pp. 23 and 59, ante.) CHAPTER XIV. TYPHOID AFFECTIONS O..