Electrocardiographic Study of Typhoid Myocarditis.

During the last century the conception of circulatory failure in the course of acute infectious diseases has been subjected to changes in several instances. Circulatory failure of every kind has, of course, a serious influence on the action of the heart itself, and for this reason in infectious diseases it was considered in those early days (1860-95) as heart failure, and the anatomical damage of the myocardium was much investigated, especially by French authors. A revolution of this conception was brought about by the investigations of Romberg and Paessler (1899); they showed the paralytic effect of bacterial toxins on the vasomotor centre and considered circulatory failure in infectious diseases merely as a paralysis of the peripheral blood vessels, the heart failure being mainly due to the condition of shock from the infection. This interpretation has been widely accepted till our days. Later it was shown that in a considerable number of infectious diseases electrocardiographic changes can be found. This fact could apparently be related to the previous findings of myocardial damage. Indeed anatomical damage to the heart muscle occurring in a number of infections, especially rheumatic fever, diphtheria, scarlet fever, variola, and more rarely in cerebrospinal fever and other diseases, as well as in typhoid fever which is discussed in this paper, has been described during the second'half of the nineteenth century. Electrocardiographic changes were found in acute infections such as rheumatic fever, diphtheria, pneumonia, scarlet fever, streptococcal sore throat, cerebrospinal fever, typhus, Malta fever, grippal infections, cholera, and epidemic parotitis. Our own findings in a hundred typhoid cases will be described and discussed here.