Typhomalarial fever as a specific disease is not recognized by medical authorities today, but for the last half of the nineteenth century it was a frequently useful diagnostic category of diverse and often imprecise meaning. Joseph J. Woodward, a U.S. Army surgeon, defined the term during the American Civil War for those camp diseases “in which the malarial and typhoid elements are variously combined with each other and with the scorbutic taint.” Woodward considered the disease “a new hybrid of old and well known pathological conditions,” but one that was distinct, both clinically and at postmortem, from malarial and typhoid fevers.

Distribution and Incidence

William Osier once wrote that typhomalarial fever existed “in the minds of doctors but not in the bodies of patients.” If so, it existed in the minds of many American doctors in the South, Midwest, and western regions of the country as well as in the minds of military and other European physicians practicing in the unsanitary, malarious regions of the globe, particularly the Mediterranean, British India, and some areas of China. It was primarily an Anglo-American phenomenon, although there are a few reports from southern Europe, which indicate that the possibility of the diagnosis was at least considered.

Etiology and Epidemiology

Typhomalarial fever was generally regarded as a noncontagious, infectious disease that resulted from exposure to the atmospheric or environmental infections or toxins that caused malarial fevers and typhoid fevers. Most commonly, patients were previously debilitated, or their vital powers were depressed in some way.