Perforation of the bowel in typhoid fever

Abstract

Under the title Perforation of the Bowel in Typhoid Fever, after dealing briefly with the history of the operative treatment of this condition and the etiology generally of the complication, T propose to discuss more fully the causation, the symptoms in connection with, the diagnosis of and the treatment by surgical measures of this, the commonest and most fatal complication of enteric fever.

I have selected this subject for my thesis, because in my opinion it is one of great and inc+easing importance in medicine and surgery and one which has only in recent years found its way into the literature of this and other countries.

During my residence in hospitals under the Metropolitan Asylums Board, I have had opportunities of seeing several cases in the course of which this complication has occurred and of closely watching the different phases of the illness from the moment of the first sign of perforation until the completion of the operation which gives practically the only chance of life.

I have collected notes of twenty cases of perforation of the bowel treated by operation in the North Eastern Fever Hospital, London, nineteen of which occurred during the years 1901-1904, and one during the present year.

I shall give a short account of these cases, followed by a discussion on their salient points, showing how they compare with similar records of other observers.