Symptoms referable to the nervous system are peculiarly distinctive of typhoid fever. They may appear at any stage of the disease, from the very onset far into convalescence, and they are to be attributed in part to the intoxication resulting from the underlying infection, in part to the pyrexia and in part to the secondary asthenia and the attendant changes in the fluids and tissues of the body, together with the individual predisposition. Of these symptoms headache is the most common, while sleeplessness, delirium, stupor and muscular twitchings are fairly constant. More persistent mental derangement is much less frequent, having been observed by Curschmann in but 42 patients among 4,000 cases of typhoid fever. In 35 of these the mental disturbance occurred during the febrile stage, in 2 during defervescence and in 5 during convalescence. In 32 the mental state was one of melancholia or quiet delirium, with or without
THE PSYCHOSES COMPLICATING TYPHOID FEVER.. JAMA. 1902;XXXIX(12):704–705. doi:10.1001/jama.1902.02480380040007
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