CHAPTER XXII
TYPHOID FEVER IN THE TROPICS, AND TYPHO-MALARIAL FEVER
TYPHOID FEVER
THE existence of typhoid fever in the tropics was for long not only ignored but actually denied, even by physicians and pathologists of repute. Formerly, the idea of malaria so dominated all views of tropical fevers that nearly every case of pyrexia, other than those of the most ephemeral description, or those associated with the exanthemata or with manifest inflammation, was relegated to this cause. When ulceration of the ileum was encountered post mortem the lesion was regarded, not as the specific lesion of the fever, but merely as a complication. More correct views prevail at the present day, and typhoid now ranks not only as a common disease in the tropics, but, to the European there, as one of the most commonly fatal. Little is known about typhoid as a disease of natives; Rogers has shown that in Calcutta, at all events, it is by no means uncommon among all classes. As a disease of Europeans it is only too familiar to the army surgeon in India and to the civil practitioner in most if not in all parts of the tropical world.
Besides being the scourge of the young European in India, typhoid is common enough in Japan, in China, in Cochin China, in the Philippines, in the Malay country, in Mauritius; the French have had large experience of it in Algeria and their West African possessions; the British have had similar experience in South Africa. It is also found in the West Indies; in Nigeria, even; in fact, wherever it has been properly looked for.
