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Thursday, April 18, 2013

Typhoid Fever

By Alfred Jay Bollet, M.D.
 
Feared and often fatal, typhoid fever was one of the most terrible epidemic diseases in the 1800s. Typhoid is an intestinal infection that is spread by ingesting food or water contaminated with the bacteria called "Salmonella typhi". Such contamination was usually widespread in army camps, and caused huge epidemics. During the Civil War, there were 75,418 cases in white Union soldiers and 27,,058 (36%) of then died. Black troops encountered the disease at a comparable rate, and the Confederate records that exist indicate a similar experience.

The disease was at its peak during the first full year of the war (July 1, 1861, to June 30, 1862). During that period, 5.9% of Union soldiers (based on the army's mean strength that year) were diagnosed with typhoid fever; 2% of the entire army died from it.
The next year, when there was still active recruitment, 4.9% of the men reportedly had typhoid fever and 1.7% died.

In subsequent years, the incidence of typhoid fever averaged about 1.5% of the army's mean strength, and less than 1% died. There are no exact statistics on the incidence of disease in Confederate troops during this period, but anecdotal reports from physicians and commanders suggest a similar experience.

Patients with severe typhoid experience fever and severe generalized malaise as the bacteria spreads through the body. These patients usually develop transient red skin lesions called "rose spots" and have diminished mental function. Paralysis of wall muscles in the bowel can lead to intestinal dilation, distending the abdomen; nineteenth-century physicians described this phenomenon as "adynamia". Diarrhea or constipation may occur, and performation of the intestine can lead to death. Typhoid can also cause bronchitis, leading to pneumonia.

There were no effective treatments for typhoid. Physicians attempted to treat the symptoms using analgesics and quinine (as an antipyretic), and tried to find a palatable, appropriate diet for sufferers. Occasionally, these measures did some good. However, some physicians prescribed calomel for typhoid fever, causing mercury poisoning in many of the patients.
  
Excerpted from: "Civil War Medicine: Challenges and Triumphs" by Alfred Jay Bollet, M.D.
PHOTO: President Lincoln's son, Willie, who died of typhoid fever at age 11.

15 comments:

typo in paragraph 6 symptoms is spelled syumptoms and treat is spelled traet

could you say some stuff about the confederate states?

Um, did you mean "perforation" of intestines, rather than performations? Is that even a word?

washing your hand before eat something... but it's often forgotten...

It's amazing how far medical science has come in 150 years...

Nice blog. I recommend that Bitter Gourd Leaves are one of the best home remedies for typhoid fever.

The bacteria enters the body through the mouth in food and water

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