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While the modern methods of treatment by the general practitioner have done much to reduce the percentage of deaths due to typhoid fever, the rôle played by the surgeon in lessening the death rate occup[ill]es a conspicuous place.
The tubbing and proper feeding do much to keep down temperature and maintain strength, but no medicinal agents nor the most careful management can overcome the great danger of intestinal perforation by ulceration. From a careful perusal of the literature and consultation of authorities we find that about 3 per cent. of all cases present this most dangerous complication, i. e., it is the cause of one-fourth to one-third of all deaths in typhoid fever.
In 3,686 cases, Schultz found peritonitis from perforation in 1.2 per cent., Liebermeister in over 2,000 in 1.3 per cent., while Hölscher found it in 6 per cent. in 2,000 cases, and Murchison in 11.38 per cent.
FRANK L. TREATMENT OF TYPHOID PERFORATIONS. JAMA. 1904;XLII(14):878–881. doi:10.1001/jama.1904.92490590012001d
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