C. WESTON EDWARDS, M. D., DULUTH, MINN.
The fact is frequently overlooked during the course of the treatment of typhoid fever that there is danger of relapses: That the case may be one which is classed by some writers as relapsing typhoid. The physician in charge should bear the fact in mind, that in infrequent cases, relapses occur. If he is looking for their occurrence he will plan his course of treatment somewhat differently from that which he would otherwise adopt.
An intercurrent relapse is one in which after the disease has developed with all its characteristic phenomena, and after the symptoms have abated satisfactorily, and the patient is on a fair road to recovery, with the temperature for from two days to a week almost at the normal point, there will suddenly occur without any apparent cause whatever, a complete repetition of all the previous symptoms. The onset of this recurrence is usually more abrupt than that of the first attack. and in some cases certain typical phenomena such as delirium or a tendency to diarrhea may be exaggerated in the second attack. The temperature may or may not go higher than in the first attack.
This form of the disease must be distinguished from an aggravation of the symptoms induced by carelessness or by errors of diet. It is seldom that there is more than one recurrence, but reference is made to repeated recurrences. In a marked case under my own observation the typhoid phenomena were present to a greater or less degree during a period of four or five months, and consulting physicians were positive that we had in that case five, at least, distinct relapses of the disease. The patient had the best of care, a scientific and rational course was adopted, with but little result from the treatment.