Meningitis and Convulsions
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Osler on typhoid fever: differentiating typhoid from typhus and malaria.Cunha BA..
Early in the history of medicine, physician had a difficult time differentiating acute febrile illnesses without localizing signs. Typhoid fever and malaria share common features, which caused diagnostic problems during the 1800s. Physician even introduced a new term, typho-malaria, a testimony to their diagnostic confusion. Osler, consummate clinician and careful observer, had vast experience with typhoid fever and malaria. He was able to easily discern between the key features of both of these infections. He also relied on fever patterns to clearly differentiate typhoid fever from malaria. Osler is credited for debunking the term typho-malaria. His clinical description of typhoid fever remains unsurpassed. Clinicians still can benefit greatly from reading Osler's clinical description of typhoid fever.
On a personal note, I doubt great grandmother Addie K. died from malarial in the midst of winter in New York City. The 1887-1888 winter, by all accounts, was unusually cold and later produced the "The Great White Blizzard of 1888" on the east coast and "The Children's Blizzard of 1888" in the upper mid west. Addie K's death certificate states the doctor began caring for her on December 10th. Malaria in New York City in December? It is much more likely Addie succumbed to typhoid due to using water for cooking and drinking directly from the Hudson River while navigating to New York City or while docked in the Atlantic boat basin. Sewerage into the river ran freely from the cities along the river - Troy, Albany, Kingston, Newburgh, Yonkers and Manhattan. Sanitation on barge boats was not treated and went directly into the waters and if Addie used a bucket dipped into the river water for her cooking, there was a good chance the culprit was typhoid.
There is one other possibility and that is that the death certificate is completely wrong. There is some evidence that Addie had an infant girl, Eleanor at the time of her death. Perhaps, the cause of death was puerperal fever, an infection after childbirth. We will never know.