File:Typhoid fever and typhus fever (1901) (14802625213).jpg

Identifier: typhoidfevertyph00curs (find matches)
Title: Typhoid fever and typhus fever
Year: 1901 (1900s)
Authors: Curschmann, H. (Heinrich), 1846-1910 Osler, William, Sir, 1849-1919 Stengel, Alfred, 1868-1939
Subjects: Typhoid fever Typhus fever Typhoid Fever Typhus, Epidemic Louse-Borne
Publisher: Philadelphia London : W.B. Saunders

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he fact that the proportion of 8.4 per cent, of cases in which tworelapses occurred, as disclosed by the Hamburg statistics, exceeds thatyielded by my previous and subsequent experience. I believe the occur-rence of such cases to be, on the average, much less frequent—4 per cent,would probably represent the usual conditions. With reference to the severity of repeated relapses, this appears tome to be generally slighter than that of the first relapse or of the recru-descence. The contrary, however, is not altogether rare. Thus, lastyear I saw in consultation a second extremely severe relapse of twenty-six days duration occur nine days after the termination of the firstmild relapse of only eleven days duration; and also previously Ihad repeatedly encountered cases in which the second relapse exceededthe first in duration by a third and even by half. I have observedeven the third relapse to be considerably more severe and more pro-tracted than the two preceding ones. 364 TYPHOID FEVER.
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RECRUDESCENCES ÄND RELAPSES. 365 Von Ziemssen has made the following instructive tabulation of 4 casesof double relapse: Duration of the first relapse. Duration of the second relapse. First case Three weeks. Fourteen days. Second case Three weeks. Fifteen days. Third case Eleven days. Seventeen days. Fourth case Fourteen days. Twenty-three days. Just as the occurrence of the single relapse bears some relation tothe age of the patient, so age also appears to play a role in repetitionsof relapses and recrudescences. Here also young persons are distinctlymore frequently attacked. Thus, at Hamburg, among 44 cases ofdouble relapse, 12 occurred in children. If, in conclusion, a few remarks be made concerning the mode ofdevelopment of relapses and recrudescences, it should first be againmentioned that at the present day these are generally considered to berepetitions of the primary morbid process, dependent upon the infectionresponsible for this, and not the result of a new invasion by typh

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