A case of typhus or ship fever, with remarks / By Wm. Ingalls.

  • Ingalls, William, 1769-1851.
Date:
1848
Catalogue details

Licence: Public Domain Mark

Credit: A case of typhus or ship fever, with remarks / By Wm. Ingalls. Source: Wellcome Collection.

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    The compressibility of the pulse was what induced me to abstain from depletion ; having observed in fevers, when the pulse, though apparently full and strong, is easily compressible, and believing this state of the artery to be the result of nervous irritation and not of inflammation, I have uniformly avoided depletion. In short, I have conceived this mode of discrimination between irritation and inflam¬ mation to be an unerring guide in the treatment of fevers, so far as it respects depletion. This case, it is evident, could not be traced to the influence of malaria or human effluvia, nor had local inflammation an agency in its production ; but it undoubtedly arose from a general excitation of the nervous system. Hence it is obvious, cases of ephemera may exist independent of the agency of miasma, and, of course, it cannot be deemed as par¬ taking of the nature of intermittents. On this account I prefer the ordinal arrangement of pyrexia by Cullen, to the classification of Good. It is allowed by every authority that has come under my notice, and it is granted by Good himself in his Study of Medicine, a diur¬ nal repetition of the ephemera for a competent length of time is essential to the production of continued fever. This, however, I conceive to be an assumption more ingenious than sound. In my opinion, every disease, to be entitled to generic distinction, must have its seat in a different organ or class of organs. Cases of typhus must have come under the cognisance of every practitioner of medicine, in which symptoms of ephemera, if at all, have scarce¬ ly been discernible. Hence the ephemera loses its generic title as soon as symptoms of typhus appear, and to suppose its diur¬ nal repetition to be essential to the explanation of the remissions and exacerbations of typhus does not appear to be well founded or defensible. It will be allowed to be hardly debateable ground that there is a close resemblance between ephemera and synocha, but the analogy between the ephemera and typhus will not be so readily conceded. Even the synocha; unless it be identical with the ephemera, we need not be under the necessity of allowing it to consist of a daily return of the latter, as all the forms and varieties of disease depend on certain impressions made on various organs; but it is not philoso¬ phical or necessary to make diseases which widely differ in their o rigin and seat, to be the same.