There must be many variations in the onset of a disease, the course of which may be so mild as to be practically unnoticed, or which may kill after an explosive course of only a few days.
Especial stress has recently been laid on the variations in the onset of typhoid fever, as if these irregular cases were a new feature. It is probably nearer the truth to assume that the great improvements in the diagnostic methods in typhoid fever, especially the Widal reaction, have established the identity of a fairly large number of cases which formerly escaped recognition, and by reason of this, it may be added, were undoubtedly largely instrumental in spreading the disease. These irregular cases are much more frequent in infants and children than they are in adults; yet I prefer to restrict my remarks to-day to some of the irregular cases in adults which are
MANGES M. THE ABRUPT ONSET OF TYPHOID FEVER.. JAMA. 1905;XLV(27):1996-1999. doi:10.1001/jama.1905.52510270002002