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May 4, 1901


JAMA. 1901;XXXVI(18):1255. doi:10.1001/jama.1901.02470180037003

Hemorrhagic typhoid fever does not mean cases marked by intestinal hemorrhage, ordinary epistaxis, and petechial eruption, but certain infrequent instances in which there occur multiple hemorrhages in various parts of the body, especially the skin and some mucous membranes. It is the hemorrhagic putrid fever of the early French writers. Cases have recently been described by Nicholls1 and Hamburgher.2 Multiple hemorrhages are rare in typhoid fever. Hamburgher states that of 1900 cases in Basel only 3 showed hemorrhagic diathesis. The case he describes is the first in the history of the Johns Hopkins Hospital. Uskow observed 4 in 439 fatal cases, representing 6513 instances of typhoid fever. In Montreal 3 cases occurred among 543 patients. The hemorrhages occur oftenest in the skin, but may take place also from mucous membranes; there may be bleeding from the gums, epistaxis, hematuria, and bleeding from the vulva. Murchison saw fatal epistaxis.

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