CHAPTER XXXIX
TYPHUS FEVER
Definition and Synonyms
Definition.—Typhus fever is an acute infectious disease, possibly caused by Rickettsia prowazeki. There is a fairly abrupt onset, with a continued fever lasting about two weeks, followed by a critical fall or rather rapid lysis of temperature. About the fifth day a rose spot eruption, similar to that of typhoid, first appears about the loins and abdomen later on extending over the trunk and extremities. The rash tends to become petechial and stands out rather prominently on a general cutaneous mottling. The stuporous state is a marked feature of the disease. It is transmitted by lice.
Synonyms.—Jail fever; Ship fever; Putrid fever; Petechial fever; Typhus exanthematicus. Ger. Fleckfieber; Fr. Typhus exanthématique; Sp. El tabardillo; Ital. Typho-esantematico.
History and Geographical Distribution
History.—Hirsch notes that the history of typhus fever belongs to the dark pages of the world’s story, at times when war, famine, and misery of every kind are present. It is reasonable to suppose, according to this author, that many of the pestilences of ancient times and the Middle Ages were typhus fever. This disease was prevalent among the Spanish soldiers at the time of the conquest of Grenada and the designation of the disease then used (Tabardillo) is the one now given typhus fever in Mexico.
The disease was first described with sufficient accuracy by Frascatorius, in the 16th century, to enable us distinctly to differentiate it from plague; the stuporous states of the two diseases having previously caused them to be confounded. In England, in the 16th century, the disease was very prevalent in the jails and court officials attending the trials of prisoners often contracted the disease and died; hence the designation “black assizes.”
During the Thirty Years War, in the 17th century, typhus fever spread over central Europe.
Typhus fever was very prevalent at the time of the epidemic of plague known as the great plague of London and it is a matter of practical interest that the two diseases were not infrequently confounded by medical men. There were some very severe epidemics of the disease in Ireland in the 19th century.