Typhus (The name)

TYPHUS. The name T. comes from the Greek word typhos and in its direct sense means smoke, fog, and in a transferred sense - confusion, clouding of consciousness. It was used to denote acute diseases accompanied by fever and disturbance, clouding of consciousness. In view of the fact that such a condition can be observed in a number of diseases that have nothing in common with each other etiologically, patho-anatomically and sometimes very little clinically, it is natural that under this name various forms of diseases were previously united, the basis for the classification of which served only the aforementioned symptoms. Only as the etiology, patho-anatomical changes and peculiarities of clinical course were studied more deeply, individual nosological units began to be distinguished from the general group of typhoid diseases. The name T. was introduced into pathology by Boissier de Sauvages in 1768 and Liebermeister, who described special types of T.: typhus carcorum, nervosus, comatosus, castrensis, icteroides, etc. In this purely symptomatic meaning, the name T. gradually came into general use to denote cases of clearly expressed typhoid condition, regardless of the causes causing it. During the period of dominance of the anatomical direction in pathology, an attempt was made to establish an anatomical unity of the disease for the concept of T. In 1804, Prost established the constancy of intestinal changes in severe fevers, which were called gastric, mucous, adynamic (Achard). A number of authors, initially in France (Louis, Bretonneau, Trousseau, Petit), and later in other countries, noted in many cases, symptomatologically classified as typhoid, the presence of characteristic lesions of the small intestine and mesenteric glands. There were even individual epidemics, in all cases subjected to section, the aforementioned patho-anatomical changes were found. The data obtained served as the basis to consider these anatomical changes characteristic of T., and the disease itself as a local lesion of the intestines. In addition to this form of the disease, cases were observed that were similar in clinical symptoms but without the mentioned intestinal lesion. This circumstance forced to abandon the recognition of the identity of these forms of the disease, and the further study of patho-anatomical changes and the presence of individual most characteristic clinical symptoms gave grounds to establish the existence of "many forms of typhus" (Liebermeister). These forms, depending on the localization of the pathological process, received the names of abdominal, cerebral, pulmonary, typhus, etc. Some authors considered these forms as different diseases, others made a distinction in anatomical changes depending on the localization of the same pathogenic agent in various organs or explained it by complications. Since the etiological principle was laid at the basis of the classification of infectious diseases, it became fully clear that there exist separate viruses causing these diseases sui generis, and it became clear that under the general name T. various diseases were united, similar in some clinical symptoms but completely different in the etiological aspect. At present, the name T. has been preserved only for four diseases: abdominal typhus, typhus, relapsing fever, and Manchurian typhus. Through the work of Jenner and Griesinger, abdominal typhus was separated from typhus in the middle of the 19th century. Typhus was выделен as an independent nosological unit in 1856 by Griesinger; relapsing typhus - in 1873 after Obermeier found spirochetes in the blood of patients. The specificity of abdominal typhus, which was выделен as a special disease from the beginning of the 19th century on the basis of patho-anatomical changes, was finally established after Ebert in 1880 discovered the causative agent of the disease. Under the name of Manchurian typhus, Botkin and Zimnitsky during the Russo-Japanese war of 1904-05 described a disease belonging to the group of paratyphoid infections (Tushinsky). In medical practice, the name of typhus of undetermined form and typhoid (status typhosus, febris typhoidea) is sometimes still preserved, under which acute febrile diseases with an undiagnosed diagnosis go, after clarification of which these diseases turn out to be one of the forms of T. (paratyphoid) or acute infections, but having no relation to T. The nomenclature of typhoid has been retained for two completely different forms of the disease - for biliary and choleric typhoid. The first form of the disease, described for the first time in 1853 by Griesinger, is a severe form of relapsing typhus with sharply expressed symptoms of septic lesion of the body; the second can be detected in cholera patients during the recovery period after the algid period (see Cholera) and is considered as a secondary infection caused by the activation of intestinal microbes (Bact. coli, Bac. proteus) (Zlatogorov). .ilwn.- see lig. st. Vryugshoy, muiji, Relapsing typhus, Paratyphoid and Typhus.

M Kirzev.