Typhoid State Research Articles

The “typhoid state” revisited

The “typhoid state” occurs classically with typhoid and typhus fevers but is also seen in other infectious diseases. Clinical descriptions of this state as “muttering delirium” or “coma vigil” refer to the peculiar preoccupied nature of the stupor. Picking at the bedclothes and at imaginary objects (carphology and floccillation) are characteristic, as is muscular twitching (subsultus tendinum). There is strong evidence that the death of Falstaff in Shakespeare's Henry V is a vivid description of the typhoid state.

Acute Confusional Insanity and Delirium

This condition, in which severe confusion, disorientation, and restlessness are the principal features, appears to have been first clearly described by Bell (1845), who noted that about 2½ per cent. of the patients admitted to his asylum showed a particular syndrome: they were normal people who were admitted after about a week's acute illness; their appearance and speech suggested fever and delirium like a typhoid state; understanding was limited; they were apprehensive, with distressing but confused delusions; they disliked and suspected their food, and were not sensible enough to be thirsty; they tried to get out of bed, were sometimes violent, and struggled strongly when held. The course of the illness was rapidly downhill, but about a quarter of the patients suddenly made a complete and permanent recovery at the end of two to three weeks, the remainder dying in the same time. There were no specific post-mortem findings.

SYMPTOMS, DIAGNOSIS AND PATHOLOGY OF TULAREMIA

Four clinical types of tularemia have been noted from a study of 679 case reports: Ulceroglandular Type.—The primary lesion is a papule of the skin, later an ulcer, and is accompanied by enlargement of the regional lymph glands. Oculoglandular Type.—The primary lesion is a conjunctivitis and is accompanied by enlargement of the regional lymph glands. Glandular Type.—There is no primary lesion at the site of infection, but there is enlargement of the regional lymph glands. Typhoid Type.—There is no primary lesion nor is there glandular enlargement. (The word is used here in the sense of an absence of manifest external lesions and not as signifying the so-called typhoid state of mind.) SOURCES OF HUMAN INFECTION 1. Ulceroglandular type, 455 cases: Twenty-three were fly-bitten (Chrysops discalis). Thirty-three were tick-bitten (Dermacentor andersoni). Twenty-one were tick-bitten (Dermacentor variabilis?). Six were associated with sheep and ticks. Four were bitten by insects (species?). One

GENERAL OBSERVATIONS ON THE CONDITION KNOWN AS THE "TYPHOID STATE," WITH REFERENCE TO EXAMPLES IN MEDICAL AND SURGICAL PRACTICE.

GENERAL OBSERVATIONS ON THE CONDITION KNOWN AS THE "TYPHOID STATE," WITH REFERENCE TO EXAMPLES IN MEDICAL AND SURGICAL PRACTICE.

On the Plugging of Minute Vessels in the Grey Matter of the Brain, as a Cause of the Delirium and Stupor in Severe Febrile Diseases; and on Other Symptoms of the 'Typhoid State'

On the Plugging of Minute Vessels in the Grey Matter of the Brain, as a Cause of the Delirium and Stupor in Severe Febrile Diseases; and on Other Symptoms of the 'Typhoid State'

On the Plugging of Minute Vessels in the Grey Matter of the Brain, as a Cause of the Delirium and Stupor in Severe Febrile Diseases; and on Other Symptoms of the 'Typhoid State'

On the Plugging of Minute Vessels in the Grey Matter of the Brain, as a Cause of the Delirium and Stupor in Severe Febrile Diseases; and on Other Symptoms of the 'Typhoid State'

Abstract of a Clinical Lecture on the Pathology and Treatment of the Typhoid State in Different Diseases

Abstract of a Clinical Lecture on the Pathology and Treatment of the Typhoid State in Different Diseases

Fowler's Solution in the Typhoid State of Scarlatina or Canker Rash

Fowler's Solution in the Typhoid State of Scarlatina or Canker Rash