When typhoid fever kills it does so either by perforation or exhaustion, the proportion of the former being estimated at 5 to 10 per cent. The main factors in producing the exhaustion which causes the death of at least nine-tenths of the fatal cases are toxemia, continued fever, diarrhea and vomiting and intestinal hemorrhage. The heart is ordinarily the best index of the presence and degree of exhaustion, and the most frequent serious pulmonary complication, hypostasis, in its various forms, degrees and consequences is the direct outgrowth of the cardiac weakness. Moreover typhoid fever is not short and sharp like pneumonia, but of long course, and usually attended with decided, often with very great wasting of the muscular and fatty tissues.
Most of us are agreed that we are not as yet acquainted with any therapeutic measures which will either abort or very materially shorten the course of the disease.