Typhoid Fever. 
FIFTH PAPER. 
Read in the Section on Practice of Medicine, at the Forty-fifth Annual 
Meeting of the American Medical Association, held at San 
Francisco, June 5-8,1894. 
BY JOHN ELIOT WOODBRIDGE, M.D. 
YOUNGSTOWN, OHIO. 
MEMBER AND EX-PRESIDENT MAHONING COUNTY, OHIO, MEDICAL SOCIETY ; 
MEMBER AND EX-VICE-PRESIDENT OHIO STATE MEDICAL SOCIETY ; 
MEMBER MISSISSIPPI VALLEY MEDICAL ASSOCIATION; MEM- 
BER NINTH INTERNATIONAL MEDICAL CONGRESS; 
MEMBER AND TRUSTEE AMERICAN MED- 
ICAL ASSOCIATION, ETC.. ETC. 
REPRINTED FROM 
THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 
AUGUST 25, 189i. 
CHICAGO: 
FEINTED AT THE OFFICE OF THE JOURNAL OF THE ASSOCIATION. 
1894. TYPHOID FEVER. 
It was my intention to have made in this paper an 
effort to discuss from the scientist's standpoint the 
etiology and treatment of typhoid fever, but the posi- 
tive expressions within the past few weeks of the 
opinions of many of the greatest thinkers of the age, 
that typhoid fever can not be aborted, and in fact, 
that the internal exhibition of drugs can have no 
curative effect, warns me that I have essayed enough 
and that this paper had better be devoted to strength- 
ening the evidence that the claims already made are 
valid, and avoid as much as possible enlarging the 
territory which I shall have to defend. I feel that I 
do not owe the Section any apology for this change, 
because this is a disease that according to eminent 
authority " destroys annually the lives of 50,000 of 
our people, leads to the very brink of the grave 
more than half a million more, which during the 
next twelve months will inflict upon us more in- 
jury, suffering and death than any foreign foe 
could possibly do," and which, I believe, is rapidly 
increasing. A disease whose geographical distribu- 
tion is limited by no boundary lines, whose germs 
may live indefinitely in the icebergs of the frozen 
North, and thrive in the torrid heat of the equator, 
can not be accorded too much attention by this Asso- 
ciation, especially as the medical literature is in such 
a chaotic state as to be exceedingly confusing to those 
who place any trust in it. A literature which is not 
at all creditable to the medical profession as long as 
its recommendations for treatment form such a med- 
ley of contradictions, from "armed expectancy" to 
the most heroic exhibition of the most dangerous 2 
therapeutic agents, from corrosive sublimate to the 
coal-tar derivatives, including almost every known 
poison, and all having most enthusiastic devo- 
tees until finally, the materia medica having been 
taxed to the limit of endurance, a new class of en- 
thusiasts has arisen, and now the bath-tub and 
sponge and the cold pack have their advocates who 
can see nothing but dire disaster in the use of any 
therapeutic agents except cold water. And the most 
amusing, were it not the most tragical publication 
that has ever issued from any press, is the Johns 
Hopkins Hospital Report, Vol.iv, No. 1, on "Typhoid 
Fever," which I have just received, in which the 
learned Professor of the Principles and Practice of 
Medicine of the Johns Hopkins University asserts, 
and I quote him literally : " Since typhoid fever like 
a majority of the specific infections runs a course 
uninfluenced by any known medicines, the duty of 
the physician is to see that the patient is properly 
nursed and fed and that dangerous symptoms should 
they arise are combated by appropriate remedies. In 
hygienic and dietetic measures his activity is inces- 
sant; so far as drugs are concerned his attitude is 
best expressed in the term ' armed expectancy,' giv- 
ing no medicine simply because the patient has a 
fever; nursing and diet are the supports in which we 
trust, the essentials under all circumstances to which 
is added the cold bath, when possible, or cold spong- 
ing for the antipyretic action and stimulating effect. 
Medicines are not as a rule indicated. No known 
drug shortens by a day the course of the fever. No 
method of specific treatment or of antisepsis of the 
bowel has yet passed beyond the stage of primary 
laudation." 
During the past year I have written papers under 
the title "Can Typhoid Fever be Aborted?" for the 
Mississippi Valley Medical Association, the Mahon- 
ing County and the Ohio State Medical Societies, in 
which I presented evidence that typhoid fever can be 
and has been aborted, which would have been accepted 3 
as absolutely conclusive in any profession save that 
which in America's most cultured city failed to recog- 
nize the discoverer of ether until he had lain for a 
Case No. 67. 
generation in an unhonored grave, and his widow had 
lived long in poverty and, I fear, even in want; and 
which in the most enlightened capital of the Old 4 
World made the life of the discoverer of vaccination 
immeasurably burdensome. 
These papers show that after having had, during 
the ten years from 1866 to 1876, about thirty deaths 
from typhoid fever, with an average duration of ill- 
ness of those who recovered of about thirty-five days, 
I abandoned the symptomatic treatment now advo- 
cated by some learned professors and began in 1876 
with extreme caution to treat typhoid fever under 
the same general principles which crudely govern 
my practice to-day. That after having had unusu- 
ally favorable results for four years, in 1880 in my 
local society I condemned all known methods of 
treating typhoid fever and foreshadowed the brilliant 
results I have since obtained from the principles of 
treatment then laid down. That in 1882 I declared 
hemorrhage of the bowels would be unknown if the 
disease were properly treated, saying I believed that 
a law sending to State prison a physician having 
such a result would be wise and beneficent. That in 
1890, to emphasize my statement that typhoid fever 
could be aborted, I offered to compensate any mem- 
ber of my society for every visit made to a patient 
after the tenth day of treatment. That for several 
years I had invariably given a favorable prognosis, 
and that for more than thirteen years I have had no 
death from typhoid, malarial or any continued fever. 
With each of these papers I presented up to the date 
of its reading the histories of the most interesting 
and characteristic cases, exhibiting the bedside charts 
of all the cases treated since June 25, 1893, when I 
first began to keep accurate bedside records. They 
were all freely discussed by many of the ablest mem- 
bers of botJi my local and State societies. The charts 
were verified by the members who had seen the pa- 
tients and my statements were endorsed. 
The criticism of my paper read recently before the 
Ohio State Medical Society was highly gratifying to 
me. The discussion was opened by Dr. Collamore in 
his happiest vein. The general tenor of the remarks 5 
were in favor of giving progressive ideas a warm wel- 
come and a fair trial. There was present but one 
member from Youngstown-Dr. J. E. Cone-who 
said : " Being from Dr. Woodbridge's town and so- 
ciety, I wish to say that we have had several ' fights ' 
on this subject and we have been watching his cases 
for several years to see if he could make his pledges 
good, but so far we have been unable to discover that 
he has made any failures or had a death from typhoid 
fever. And we intend to continue watching his cases 
in the future, and if he has a death we will report it." 
A little speech which read between the lines speaks 
volumes. Prof. Murphy, however, spoke eloquently 
in adverse criticism, saying in substance that there 
could be no curative treatment for typhoid fever and 
he doubted the correctness of the diagnosis and obser- 
vation of any physician who asserted he was able to 
abort the disease. He said I shocked him when I 
said I allowed my patients to sit up, walk about, and 
even to eat solid food. I shall not attempt to quote 
Dr. Murphy's words or essay the hopeless task of re- 
producing or even describing his eloquent speech, but 
as I sat spell-bound listening with admiration to his 
brilliant oratory, I could not help wishing that he 
could see the subject as I see it, and were speaking 
for, instead of against the right; and not long since 
after having read a paper before a medical organiza- 
tion composed largely of the teachers in one of our 
boasted centers of learning, the same general expres- 
sions of opinion were made, one gentleman saying: 
" If there is anything in medicine that is well estab- 
lished, it is that the course of the disease (typhoid 
fever) can not be interrupted." Another gentleman 
who, as I judged, from his special learning and abil- 
ity had been given the closing argument against my 
theories, criticised these charts very severely, saying: 
" With four or five possible exceptions there was not 
a typhoid fever curve among themevidently forget- 
ting that they are presented to show the modification 
of the " curve " by antiseptic treatment; that most 6 
of the patients were examined and the diagnosis veri- 
fied by physicians quite as cautious as himself, and 
that if the "curve" had remained unmodified the 
treatment would have been a failure. 
These oracular assertions (they can not be called 
arguments) should never have been made. We know 
too little of the action of antiseptics, too little of the 
bacteriologic world, of the antagonisms existing be- 
tween these minute denizens to warrant any gentle- 
man, however learned, in placing his individual opin- 
ion above the evidence of years of experience, and the 
testimony of a score of physicians quite as compe- 
tent as himself to make careful observations and ex- 
act diagnoses, especially when among these observers 
are included several ex-Presidents of our local Soci- 
ety and at least one ex-President of our State Society, 
or in placing himself as a stumbling block in the 
pathway of investigation and progress. Had they 
anything better to offer, their opinions ought to be 
carefully weighed, but when they oracularly assert 
that a course of treatment which they have never 
tried and of which they have no knowledge can do 
no good, they are simply lending their learning and 
the weight of their great names to aid in retarding 
the day when typhoid fever shall cease to be at once 
the stigma and the despair of medicine. 
If you accept the theory that typhoid fever is 
caused by a germ, you must accept its corollary, that 
the germ can be destroyed, and if in one receptacle, 
or the alimentary canal of one patient, then as a 
legitimate sequence in every one, and if the physician 
who accepts this theory sees his patient sufficiently 
early and treats every suspicious case on the first ap- 
pearance of suspicious symptoms, he will rarely see 
a typical case of typhoid fever, and never a death 
from the disease. Now the simple fact that I have 
had no death from typhoid fever for more than thir- 
teen years is alone strong presumptive evidence that 
the claims I make are well founded, and when taken 
in connection with my previous record and with the 7 
statement of the last President of our local Society, 
when one of my earlier papers was under discussion, 
that he had no doubt that I had treated more 
than my full share of typhoid fever, entitle the 
subject to careful consideration. Since the unaided 
efforts of one man, however faithfully he may pursue 
his investigations, must be long indeed in accumu- 
lating sufficient data upon which to base a scientific 
discussion of the subject, and longer in giving such 
expression to the finished work as to command the 
attention and the confidence of the great body of a 
profession peculiarly prone to look upon anything 
new with a great deal of suspicion; I therefore ap- 
peal to every member of the American Medical 
Association, and to every physician who treats a case 
of the disease, to aid me in the accumulation of such 
data as shall lead to a better knowledge of typhoid 
fever, and especially of the action of antiseptics in 
its treatment. For this purpose, and because I have 
been unable to find a clinical chart so arranged as to 
make the collection of necessary data practical and 
easy, I have devised one that will enable the busy 
practitioner to make his record valuable with the 
least possible loss of time. 
In conclusion,! wish to call attention briefly to the 
treatment which has already been published, and to 
say that with wider experience I hope to be able to 
eliminate some of the ingredients which give the 
formula such a complex and unscientific appearance. 
I am still using the formula as already published, 
viz.: 
R Podophyllin gr. i. 
Hydrarg. chlor, mit 3 i. 
Guaiacol carb 3 vi. 
Thymol gr. v. 
Menthol gr. v. 
Sacch alb g ii. 
alternated with the 
Eucalyptol 5 x 10 m. 
Guaiacol 2 x 5 m, 8 
No pretense is made that this is the only prepara- 
tion which will cure typhoid fever, nor that all or 
any of its ingredients are necessarily essential, but 
because thus far it has not failed me,1 and crude and 
unscientific as the mixture appears I know of nothing 
better, and I hope no gentleman will say he has given 
my treatment a trial and failed, who has not exhib- 
ited these identical mixtures, alternated as directed; 
nor must he interject anything calculated to interfere 
with their effect. As the mixture is practically harm- 
less it may be exhibited in almost unlimited quanti- 
ties. I, however, advise beginning with exceedingly 
small doses and thus avoid early catharsis. 
As I stated in a former paper, I am ready to go 
wherever in the wide world typhoid fever claims a 
victim, whether it be across the continent or over the 
ocean,and I challenge the publication of any failure. 
1 The accompanying chart, No. 67, shows the need of more exact 
knowledge in the use of antiseptics, since I twice discontinued the use 
of formula No. 1, only to find the temperature again going up, and to be 
forced again to resume it.