The Final Fever

Stanford Archives

When Leland Stanford junior first came down with the ) ) symptoms of typhoid fever in the winter of 1884, his ) ) parents fretted but didn’t panic. The boy’s case ) ) was mild, doctors said, and typhoid was just one of many ) ) infectious ) ) diseases endemic among children and adolescents in the ) ) 19th century. Most healthy youngsters with the diarrheal ) ) bug eventually ) ) recovered on their own and developed immunity.

Still, ) ) there were grounds for concern. Before the development ) ) of modern antibiotics in the late 1940s, typhoid could ) ) be a nasty killer with no respect for rank. Queen Victoria’s ) ) husband, Albert, died suddenly of the disease in 1861 ) ) at the age of 42. During the Boer War, some 13,000 British ) ) soldiers ) ) succumbed to the food- and water-borne illness, more ) ) than all who died in battle. “In the Crimean War it ) ) was terrible,” says James Gamble, a Stanford professor ) ) of orthopedic surgery who has written several journal ) ) articles on 19th-century medicine. “Epidemics would ) ) come whenever there were wars, movements of population ) ) or even concentrations ) ) of people in general.”

Gamble, whose unusual expertise ) ) in Victorian maladies grew out of a love for Dickens’ novels, ) ) says physicians were pretty good at diagnosing typhoid fever ) ) in the late ) ) 1800s and could distinguish it from similar febrile diseases ) ) such as malaria and typhus. They were less sure about ) ) how the disease was transmitted. The typhoid bacillus ) ) Salmonella typhi was first observed in 1880, “but whether ) ) bacteria caused the condition was still debatable,” Gamble ) ) notes. “Some ) ) physicians still thought typhoid could be caused by foul ) ) air, what they called miasma.”

Today it seems clear ) ) that Leland Junior’s fatal illness ) ) came from contaminated food or water consumed during ) ) his lengthy walkabouts in Turkey or Greece. Leland’s ) ) tutor, Herbert Nash, later recalled that the boy was ) ) uncharacteristically quiet on the ride home from a sightseeing ) ) trip to the ) ) ruins ) ) of the Temple of Eleusis and complained of a sore throat ) ) and headache. Later, on the train to Naples, Leland stretched ) ) out on the seat and slept. By the time the Stanfords ) ) arrived in Florence about three weeks later, the bacteria ) ) had invaded ) ) young Leland’s intestinal lining.

Gamble thinks the ) ) physicians who attended Leland Junior may have prescribed “balm ) ) water”—basically ) ) holy water spiked with a little ammonia and orange peel. ) ) Nineteenth-century medical textbooks also were big on ) ) meat broth and “lavements,” elixirs made of stomach-soothing ) ) herbs like chamomile. Aside from those measures and wrapping ) ) the feverish boy in ice-cold sheets, there was little ) ) doctors could do. “Traveling back then was not like ) ) it is now; it was strenuous at best,” Gamble notes. “The ) ) trains were primitive. The wagons didn’t have springs; ) ) they didn’t have heating or air conditioning. . . . ) ) I have a hunch that Leland Stanford Junior’s resistance ) ) was low. His body was trying to fight the disease, but ) ) the bacteria just got the upper hand.”

These days, typhoid ) ) fever kills fewer than 1 percent of patients who receive ) ) proper antibiotic treatment. Yet ) ) the disease still claims about 600,000 victims each ) ) year in developing countries.