The Indianapolis journal. [volume] (Indianapolis [Ind.]) 1867-1904, 1898-09-24
SOLDIERS AND THEIR FEyERs.
Hospital Physician DiscOurses UpOr
Typhoid and Malaria.

DIR. j. v. Shoemaker. president OF the
Medlco-C hirurgical Hospital furnishes the
Following interesting facts concerning fever
among the returned soldiers:
Among the soldiers now under treatment
at the Medico-Chirurgical Hospital large
majority are suffering from fever. There is
class of fevers in which the elevation of
temperature is the predominant symptom.
Ihese diseases are termed essential fevers,
ana they fall into two varieties, the con-
tinuous and periodical fevers. Of the for
mer variety typhoid fever is the great OK
ample and of the latter malaria is the
type. These are the diseases which have
stricken down so many of our soldiers.
typhoid and malarial fevers are distin-
guished by their course, symptoms and tenn
perature record. In typhoid the beginning
is insidious.
The early symptoms are not alarming.
ually for the first week. Every evening" as
recorded by the thermometer, it is one de-
gree Fahrenheit higher than upon the day
before at the same hour. The morning
temperature is rather less than that of the
evening, but also mounts in the same
steady manner. During the second week
the temperature remains at a uniform
height, which may not be above 103 but
may reach or ever. exceed 105.
In the third and fourth weeks the tenn
perature declines in the same gradual way
in which it first reached the maximum
During the second and third week the nerv-
Gus depression is extreme. The heart is
weak, the patient apathetic, or delirious
and restless. The tongue is dry, there is
intestinal liberation and other symptoms
hemOrrhage or Ter1Cration. At the end of
the first week a valuable sign of typhoid
fever IS the occurrence of rose-colored
spots upon the abdC Een.
In malarial fever the rise of Temporal
ture is sudden. The attack begins with a
decided chill. In the simplest variety of
malaria the chill is followed by fever and
respiration, after which the temperature
falls to normal There is then complete
intermisslon for twenty-four or forty eight
hours, when the same cycle recurs. This is
known as the intermittent form. In sec
ond, or remittent, variety the temperature
remits-that Is, it declines toward, but does
not reach, the normal. At certain intervals
the symptoms are aggravated. This form is
accompanied by considerable disturbance
of stomach and bowels, and is therefore,
also called bilious remittent fever The
malarial feVers of tropical and semi-trop-
ical countries are still more severe and run
a rapid and violent course.
An examination of number of tenn
perature sheets of patients under treat
ment in the Medico-ChirurgicaI Hospital
will demonstrate how the curve corresponds
to the foregoing description mounting
gradually to certain point in typhoid fever
laria. In fact, if the temperature in a con-
tinued fever remained as high as the point
which 1t often attains in malaria we should
feel serious apprehension for the life of the
ratient But in ALL except the most per-
nicious, forms of malaria we know that
the temperature will either intermit or re-
We have likewise in malarial fever a
valuable objective sign which points to the
nature of the disease just as the rose-col-
cred spots indicate the presence of typhoid
fever. Enlargement of the spleen is a very
significant sign of malaria This sign is al
ways readily obtained by making palpa-
ton upon the left side at the lower level
OF the ribs. The healthy spleen can be OUT
lined by its dizziness, but IN, malaria ii de-
scends far below the ribs and many extend
as far as the brim of the pelvis.
We have in recent years gained in our
exact knowledge Of the cause of these
di seases Both are caused by the develop
ment within the blood Of a certain germ.