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April 13, 1912


Author Affiliations

Rosemont, Pa.

JAMA. 1912;LVIII(15):1114. doi:10.1001/jama.1912.04260040130011

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Patient.  —John M., carriage-builder, aged 32, previously healthy, had a typical attack of typhoid six years ago, in the Bryn Mawr Hospital. One month after recovery he noticed, in the middle of the right tibia, an area of tenderness and edema measuring about 3 inches in length. The condition was only slightly painful and did not interfere with his work. It inconvenienced him greatly, however, because any accidental abrasion in the affected region was very slow in healing; behaving, in fact, like an ordinary varicose ulcer and yielding only to firm strapping and bandaging. The condition continued without intermission, and the area involved increased in extent upward, until within 1 inch of the tubercle of the tibia.

Treatment.  —Nov. 20, 1911, a dose of 90 million dead typhoid bacilli was injected in the right ankle and ten days later, 180 million. Following the second injection there was an intense local

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