. Virginia medical semi-monthly. oftyphoid fever which had a number of compli-cations; but especially one complication whichis generally considered, I believe, a very formi-dable matter. The patient was a young woman,between 30 and 45 years of age, whose healthhad been excellent except for an acute attackof rheumatism, mainly confined to the righthand and fingers, some two or three years pre-viously. First saw her about the 11th of November,1896, and found what might be either typhoidfever or malaria. The symptoms were not defi-nite, and it was four days later before I satis-fied myself of my
. Virginia medical semi-monthly. oftyphoid fever which had a number of compli-cations; but especially one complication whichis generally considered, I believe, a very formi-dable matter. The patient was a young woman,between 30 and 45 years of age, whose healthhad been excellent except for an acute attackof rheumatism, mainly confined to the righthand and fingers, some two or three years pre-viously. First saw her about the 11th of November,1896, and found what might be either typhoidfever or malaria. The symptoms were not defi-nite, and it was four days later before I satis-fied myself of my diagnosis. Several exami-nations of the blood for the malarial parasitewere negative, and at that time I did not haveWidals reaction to help me. However, thepatient was put to bed and given the benefit ofthe reserved diagnosis until the disease devel-oped sufficiently for me to know what condi-tions I had to treat. During the first week inbed, probably the second week of the disease,there was nothing of more than usual In January, \, .899—two years after recovery — patient is perfectly well, with no evidence whatever of lung trouble. THE VIRGINIA MEDICAL SEMI-MONTHLY. 643 The temperature ran along from 101° to 103J°and began to decline about the fourteenth dayfor two mornings, but rising to 101° to 102°again at night. At this point, instead of be-ginning convalescence, as I had hoped, therewas a steady rise of temperature for four days,when a hemorrhage from the bowels occurred,followed by a gradual descent of the curve foranother four or five days, making a distinctbut short relapse of eight days duration. Ex-cept for a slight quickening of the pulse, theloss of blood, which was moderate in amount,seemed to do no mischief. At the end of this relapse, the twenty eighthor twenty-ninth day of the disease, I againlooked for beginning convalescence, but wasdisappointed. The temperature for the follow-ing eight days was quite erratic, varying fromsubnormal to 102
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