Typhus was for centuries a disease which both in superficial symptomatology and name was confused and compounded with Typhoid and other enteric-dysenteric diseases. In the early nineteenth-century more rigorous physicians began to distinguish the two on clinical grounds, and only with the last gasp of the late-nineteenth and early-twentieth centuries did the new science of Bacteriology finally provide materials and findings sufficient to assert the separate transmission routes/vectors and identities of the various microbes and their resultant human diseases.

Brief Annotated Bibliography of Typhus

James Carmichael Smyth, 1795. A description of the jail distemper as it appeared amongst the Spanish prisoners at Winchester in the year 1780; with an account of the means employed for curing that fever, and for destroying the contagion which gave rise to it. London: J. Johnson. 8vo, pp. viii + 248. Smyth (1742-1821) was a London physician elected to Fellow of the Royal Society, 1799. The "gaol fever" of his day was typically associated with overcrowding and resultant filth, and Smyth recommended washing/hygiene measures without yet recognising any role for the frequent body lice. His novel medicament was the nitrous oxide (laughing) gas, newly discovered by Leeds chemist Joseph Priestley 1772, though the efficacy in epidemic fever was negligible. Fumigation with sulphur, and burning of dirty clothing and bedding, were apparently not employed. Smyth's methods were found favourable and used again, in a typhus outbreak amongst 479 Russian prisoners taken aboard the naval vessel HMS Union in 1795.

John Armstrong MD. 1822. Practical Illustrations of Typhus Fever, of the Common Continued Fever, and of Inflammatory Disease &c. With Notes by Nathanial Potter MD. Philadelphia: James Webster, 2nd U.S. edition from 3rd British edition. pp. 439.

Pierre Alexandre Louis. 1829. Recherches anatomiques, pathologiques et therapeutiques sur la maladie connue sous les noms de gastro-enterite, fievre putride, adynamique, ataxique, typhoide, etc... Vol. I. Paris: Bailliere, pp. xii + 548. English trans. Boston 1836. (Anatomical, Pathological and Therapeutic Studies of the Illness Known by the Names Gastro-Enteritis, Putrid Fever...Typhoid, Etc,). This was perhaps the first study to link the term "typhoid" with the patient's characteristic disturbed mental state, and the first to describe in detail the typical rose-coloured spots. Here "typhoid" = typhus-like, i.e. in certain of the presenting symptoms/appearances.

. Enoch Hale. 1839. History and Description of an Epidemic Fever, Commonly Called Spotted Fever (which prevailed at Gardiner-Maine, Spring of 1814). Enoch Hale was MD Harvard 1813, and presented his "Observations on the typhoid fever of New England" at the Annual Meeting of the Massachusetts Medical Society, 29 May 1839. Published by Boston: Whipple & Damrell. pp. 79. The study gave an early and clear distinction between "spotted typhus" and typhoid fever, and was supported by other workers such as Elisha Bartlett.

1842. Elisha Bartlett. The History, Diagnosis and Treatment of Typhoid & Typhus Fever, with an essay on...Yellow Fever. pp. xvi + 393. Philadelphia: Lea & Blanchard. Elisha Bartlett (1804-1855) was born at Smithfield-Rhode Island and became MD Brown Medical School in 1826. His numerous academic/teaching posts included Professor of Pathology & Materia Medica, Berkshire Medical College, Pittsfield, Massachusetts, and Columbia University’s College of Physicians & Surgeons of New York City as Chair of Materia Medica and Medical Jurisprudence.

Henry Grafton Clark. 1849. Ship Fever, So Called: Its History, Nature and Best Treatment. Fiske Fund Prize Dissertation for 1849. Rhode Island Historical Society. Boston: Ticknor, Reed & Fields, 1850. Boards, pp. 48. "British typhus", known from the shipping-lanes, was carefully distinguished from typhoid fever.

Toribio de Ayerza. 1858. Paralelo entre el tifo y la fiebre tifoidea. Doctoral dissertation, Univ. Buenos Aires. Published by Buenos Aires: Imprenta de La Revista, 1858. pp. 54. Another careful comparison/comparative study of typhus and typhoid, in a largely pre-bacteriology period still.

Conway Evans. 1865. Overcrowding and Typhus. London: Royal College of Surgeons of England. Sewn, pp. 22.

Thomas Wrigley Grimshaw. 1866. On atmospheric conditions influencing the prevalence of typhus fever. Sewn, pp. 12. London: Royal College of Surgeons of England. Whilst Pasteur and John Tyndall in particular would clarify the general role of air movements in the spread of fermentative and disease-organisms (Bacteriology), the role of such a vector of transmission for typhus was non-existent, and the tick-borne vector's recognition was still several decades away. The water-borne transmission of true typhoid would be resolved first, in the 1880s, by Koch and his co-workers Eberth and Gaffky.

James C. Wilson. 1881. A Treatise on the Continued Fevers. pp. 365. New York: William Wood & Co. A discussion of the then prevailing views and treatment of influenza, cerebro-spinal fever, enteric fever, typhoid fever, typhus fever, relapsing fever and dengue fever.

James C. Wilson, S. Solis-Cohen and A.A. Eshner. 1895. Fevers, Including general considerations, typhoid fever, typhus fever, influenza etc.. Compiled from the Annual of the Universal Medical Sciences, 1884-1894. Philadelphia: F.A. Davis & Co., pp. xviii + 585 + Plates. Offered a standard summary of medical excellence before the work on typhus and its variant, Spotted Mountain Fever, by H. T. Ricketts, c.1910.

William Osler. 1901. Editor, with additional notes, of H. Curschsmann MD. Typhoid Fever and Typhus Fever. Philadelphia: W.B. Saunders & Co. pp. 646. 1901. Part of Nothnagel's Encyclopedia of Practical Medicine Series. An influential treatise of the period. William Osler (1849-1919), MD McGill University 1872, and Professor of the Faculty of Medicine 1874, was in 1893 one of the four founding professors of the Johns Hopkins University School of Medicine. From 1905 he was Regius Chair of Medicine at the University of Oxford; founding President of the Postgraduate Medical Association, 1911, and Baronet 1911. The final resolving of the enigma of typhus, however, came from the bacteriologists working in the field, one of whom lost his own life in confirming the transmission vector or pathway.

Robert Muir and J. Ritchie. 1910. Manual of Bacteriology, 5th edn., pp. xxiii + Plates I-VI + 688. London: Hodder & Stoughton. Henry Frowde: Oxford Univ.Press. Robert Muir MD (1864-1959) was Professor of Pathology at the University of Glasgow, and a practising bacteriologist, whilst Ritchie was sometime Professor of Pathology at Oxford, and Superintendent, Royal College of Physicians Laboratory, Edinburgh. Their highly respected standard account of the new science, then presented in a fifth revised edition, was published just as Howard Taylor Ricketts, in Mexico City, was carrying out his final and fatal proof of the aetiology of typhus. Only one reference was made to "Typhus Fever", and succinctly summarised the bacteriological position of 1909-10:

Up until recently all attempts to elucidate the etiology of this disease by ordinary bacteriological methods have given equivocal results. Certain experiments, however, performed by Nicolle in 1909, during an outbreak in Tunis, are of importance...It was found that macacus sinicus [monkey] could be infected by means of the body louse...These experiments probably throw important light on the etiology of the condition, and on the means by which the disease is spread in man. [Muir & Ritchie. 648, Appendix J]

Howard Taylor Ricketts. 1910. Unpublished observations during an outbreak of typhus in Mexico City. Ricketts (1871-1910) was a U.S. pathologist-bacteriologist-immunologist whose name became synonymous with the causative agents of Rocky Mountain Spotted Fever and the closely allied Typhus Fevers. This researcher's experimental methods extended to dedicatedly testing samples upon himself, and this sadly led to his early death in the 1910 Mexico epidemic. He was nevertheless able to isolate the pathogen, a small coccobacillus subsequently assigned to a new Genus and named after the deceased bacteriologist - Rickettsia rickettsia. He also confirmed the transmission vector via an insect/body louse, as he had done earlier at the University of Chicago for Rocky Mountain Fever and its small animal-tick. Among other memorials to Ricketts is the Howard Taylor Ricketts Research Prize of the University of Chicago, instituted in 1912.

C. E. Terry. 1913. Typhus Fever and Typhoid Fever: A Report on Papers Read at the Southern Medical Association Meeting, Jacksonville, Florida November 12-14 1912. Vol. 28. A further treatment of the confusions between typhoid-dysentery-relapsing/undulating fever. Dysentery had been successfully drawn into the bacteriological sphere c. 1898 by the Japanese worker Shiga, for whom the organism "Bacillus dysenteriae" would be renamed "Shigella dysenteriae". Undulating fever had become known as Brucellosis, after the British Army worker Bruce, who had discovered its bacterium and transmission pathway amongst troops on the island of Malta some decades earlier.

Last modified 7 December 2016