This is an acute disease involving largely the small intestine. The bacillus typhosus is accused by the medical profession of responsibility for this condition. There is, under medical mismanagement, swelling and enlargement of the clumps of "lymphoid tissue" (tonsils), called Peyer's patches of the intestine, followed by ulceration and sloughing of these. Hemorrhage from the intestine sometimes follows this sloughing, although nature usually succeeds in sealing the blood vessels before sloughing occurs. The abdomen is tender and distended with gas. The gas pressure upon the heart often overstimulates this organ. On the seventh on eighth day red spots develop on the abdomen.
In severe cases "secondary" disease develops in the kidneys or lungs or spleen or cerebro-spinal centers. Complications and relapses are quite frequent under medical malapractice. The regular treatment of this disease is an unpunished crime. I have analyzed this treatment in detail in my HUMAN LIFE, and the student who is interested in this phase of the subject is referred to that book.
SYMPTOMS: The disease is preceded by a few days or weeks of headache, backache, nosebleed, perhaps, and a period of not feeling very well. There is usually constipation and a coated tongue. The breath is foul and there is often a bad taste in the mouth. For days or weeks the patient is sick and gives no attention to his condition, except, perhaps to drug it. Had he cared for himself properly from the beginning of these symptoms he would be well before any typhoid developed. Dr. Tilden rightly observes: "Typhoid fever (more a disease of adult life) is evolved by feeding and medicating acute indigestion."
After a period as described above, the temperature begins to rise and the patient becomes so weak and miserable that he goes to bed. The fever rises slowly and in from three to seven days reaches 101 to 106. Here it usually remains, under the stuffing and drugging plan, for a week or more, before it begins to fall. It falls and rises for another week or more and finally reaches normal. Under medical care these cases last from two weeks to a few months. The strong man presents a slow, "soft" pulse and the pulse rate is often very slow during convalesence.
During the first few days of the fever, the headache is very severe even, at times, terrible.
Typhoid is a self-limited disease. This is to say, it gets well of itself and the medical profession acknowledges that it has no cure for the disease, although, they do claim great things, all false, of course, for their prophylactic serum. Emerson tells us: "After the fever has gone, convalesence begins. The patient is at first thin and weak, but slowly returns to good health and to even better health than he formerly had."
He also tells us in dealing with complications: "Perforation is the most dreaded complication of typhoid fever, and the cause of death in almost a third of the fatal cases. When the slough peels off, the ulcers usually have a very thin base, sometimes as thin as tissue paper, but in about 5 per cent. of the cases even this gives way and the intestinal contents pour into the abdominal cavity, at once producing peritonitis, which without operation is almost always fatal. (And with operation is equally as fatal. Author.) In the very few cases that do recover there is in the abdomen an abscess which later may require operation. A perforation occurs especially during the third week, although it may at at any time (as we reckon the days), and since due to almost the the same cause as hemorrhage, occurs very often with this."
The reader may not be able to understand why there should by any "intestinal contents" to pour into the abdominal cavity. Fasting would have prevented such a thing. But it is the medical notion that the sick "must eat to keep up strength" and some hold that if the fever patient does not consume even more food than when in health the fever will burn tip the body. A high-calorie diet its usually employed in typhoid.
CAUSES: This disease results from decomposition in the stomach and intestine due to imprudent eating. The more such patients are fed the more decomposition and sepsis will develop. There will be higher fever, more tympanitis, greater suffering and more danger. There will be germs, of course, and the more food is taken the more germs there will be. When such patients are fasted the stools and urine are germ-free by the time convalesence begins.
Milk, butter milk, boiled milk, peptonized milk, koumiss, eggs, meat juice, barley water, strained vegetables, soups, iced tea and ice-cream are among the recommendations made by standard medical authors for feeding in typhoid.
In feeding in typhoid they take about the same position as that taken by Emerson in "influenza." He says: "He should receive the fullest diet possible and should be well purged and stimulated." He adds, and very appropriately so, "the convalesence is long and tedious; it may take months, and for even years the patient may not be well. For this reason, a change of climate, when possible, is a great aid." A change of doctors and methods at the outset would have been wiser.
We still hear much of anti-typhoid inoculation and are advised to be inoculated when we travel into strange territory. The Public Health Report (Vol. 34, No. 13, March 26, 1929), prints in full a circular issued by the Chief Surgeon of the American Expeditionary forces under the title Typhoid Vaccination No Substitute For Sanitary Precautions, in which are cited numerous cases of typhoid among our throughly "protected" (inoculated) soldiers.
In March 1914, five months before the outbreak of the war, anti-typhoid vaccination was made compulsory in the French Army. Yet up to October 1916, there were 113,465 cases of typhoid fever with 12,380 deaths in the French Army alone. There are still two more years of war to be accounted for in these figures.
In the British Army up to December 1918, there were according to General Goodwin, 7,423 cases of typhoid with 266 deaths--practically all of which had been inoculated. These figures do not include the "fearful and unparalleled toll of disease and death from typhoid" in Gallipoli and Mesopotamia. The failure of the British forces in Gallipoli is attributable largely to typhoid. The figures are so horrible that they don't seem to have been given out and cannot be obtained.
In France and Belgium the English forces suffered less from typhoid than did the French. Why? The French were equally "protected." Sir Malcolm Morris and Captain J. Stanley Arthur both stated that the English sanitary conditions were better. Filth and sewage water laughed at the vaccine and the soldiers suffered and died in spite of their "protection." The vaccine could not make uncleanliness safe any more than smallpox vaccine could do so in the war of 1870, or in India.
It is now everywhere admitted that the decline of typhoid fever, along with typhus, cholera, bubonic plague, yellow fever, etc., has been due to hygiene and sanitation. The serum is pushed for commercial reasons only.
CARE OF THE PATIENT: The care of the typhoid patient should now be apparent to the student.
Rest in bed in a well lighted; well ventilated room, with all unnecessary noise and distraction kept away from the patient. A daily warm sponge bath for cleanliness is essential. If it is winter a hot water bottle should be kept at the patients feet.
Absolutely no food except water should pass the patients lips until several days after all acute symptoms are gone.
No drugs of any kind should be employed. No purging; no sustaining" the heart, no controlling the fever and no checking of the bowels should be allowed, Hydrotherapy also should be avoided.
Let the patient alone and he will get well. Feed him and drug him and he may and may not pull through. In the first instance he will be comfortable in three days and out of bed in from seven days to fourteen days. In the second instance he will not be comfortable at any time and will do well to get out of bed in several weeks.
Where hemorrhage occurs, the foot of the bed should be elevated and absolute rest and quiet. No one should be allowed to speak to the patient and no mad-cap endeavors to restore or "sustain" the patient should be resorted to. Hemorrhage will be extremely rare if the case is not stuffed and drugged.