The Clinical Aspects of Spirochætosis Icterohæmorrhagica or Weil's Disease

FiedieV has divided the progress of Well's disease into three stages. According to him, the first 2 or 3 days constitute the initial period. The second stage commences variously from the 3rd to the 6th day following the onset of the disease, and is characterized by icterus, edema of the liver, tumor of the spleen, albuminuria, hemorrhagic diathesis, etc. He classes a defervescent period from the 7th to the 8th day as the third stage, and adds also a stage of convalescence. We believe, however, that a different division of the disease into three periods, i.e., first or febrile stage, second or icteric stage, and a third or convalescent stage, has better justification. As will be explained in detail, each stage has its characteristic features with respect to the behavior of the spirochetes in the blood, the antibodies, the excretion of the organisms with the urine, and their distribution in the organs. According to our view, the first and second stages continue each for about a week; and the convalescent stage begins with the 3rd week of illness, although the boundaries of the different stages are not sharply demarcated. Icterus, the main symptom of the second stage, has its beginning in the middle of the first and reaches its climax in the second period. Febrile Stage.--This stage continues from the onset of the disease to the 6th or 7th day. The main symptoms, which are initiated with chills or high fever, are intestinal disturbances, headache, cramp-