The Treatment of Chorea with Typhoid Shock

Abstract

Until recent years, it was doubtful whether any type of medical therapy had shortened the course of Sydenham's chorea. Standard medication consisted of prescriptions containing salicylates or some form of arsenic. In as much as the disease usually subsided spontaneously in one to three months, medication probably influenced its course very little.

With the advent of nonspecific fever therapy, we now have a method of treatment which not only shortens the duration of the disease, but also prevents, to some extent, the onset of endocarditis and arthritis if it has not already appeared.

Many authors have advocated passive methods of raising the body temperature, such as the heat cabinet or the induction coil^1,2. Like another group of investigators^3,4, we have employed intravenous typhoid and paratyphoid vaccine with the idea that active participation of the body cells in producing the rise of temperature resembles an active immunity, and that it is more likely to be effective at lower temperatures. We are listing in the order of importance some of the reasons for believing that our method of inducing hyperpyrexia by intravenous typhoid vaccine is especially worthwhile.

1. Safety — we have never had any serious reactions or complications in any case in which we have used this method of typhoid shock, regardless of the patient's age.

2. Comfort — patients do not complain of undue discomfort during the chill or secondary fever following the injection.

3. Control of fever — with the use of a modification of the method of Howard⁵, we have not. . .