CLINICAL OBSERVATIONS IN TYPHUS FEVER

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Abstract
This study was undertaken principally to observe the various physiologic changes occurring in typhus fever with special attention directed to the status of the general circulation. Previous descriptions of the disease frequently refer to cardiac collapse, cardiac failure or cardiac weakness and in areas where typhus is prevalent it is almost a routine procedure to administer cardiac stimulants in the form of digitalis, ouabain or perhaps some other substitute. Likewise, in certain sections cardiac drugs are given because of the extremely weak and toxic appearance of the patient with the thought in mind that these cardiac tonics will improve the circulation. The latter is not in accord with the actual physiologic effect of digitalis, and Luten1has shown that the only clinical indication for digitalis and drugs with digitalis-like action is "evidence of cardiac failure" and in certain arrhythmias. In our study there was no clear indication for cardiac

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