The typhoid condition / by J Milner Fothergill.

  • Fothergill, J. Milner (John Milner), 1841-1888.
Date:
[1873]
Catalogue details

Licence: Public Domain Mark

Credit: The typhoid condition / by J Milner Fothergill. Source: Wellcome Collection.

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    ing, sub-delirious—the picture of weakness and helplessness ; and yet this unhappy sufferer actually performs, day by day, an amount of work that might well be envied by the strongest labourer in the land.” He regards the animal heat given out in typhus to stand to that of health as 45 to 40. lie goes on to say, “ If you could place your fever patient at the bottom of a mine twice the depth of the deepest mine in Cornwall, and compel the wretched sufferer to climb its ladders into open air, you would subject him to less torture, from muscular exertion, than that which he undergoes at the hand of nature, as he lies before you, helpless, tossing, and deliri¬ ous on his fever couch.” After this can we feel surprised at the terrible prostration of the later stages of fever, or at the muscular weariness which tells of the tissue-changes ? Can we wonder, either, at some of the violent efforts of delirium occasionally mani¬ fested in the earlier stages, which are merely the outcomes of muscular combustion—other forms of force than heat? 4. The Excess of Urea.—After pyretic conditions we have in¬ creased quantities of urea, etc., in the urine. It might appear more correct to have said “during” than “after,” but “after” is pro¬ bably more correct in relation to the causation. “ There is found, too, on the whole, a direct relation between the temperature and the amount of urea,” says Murchison; and again he says, “Ac¬ cording to Brattler there is a close correspondence between the amount of urea and the temperature, the greater the amount of urea the greater the temperature.” Hot only is urea found to be in¬ creased in typhoid fever, but uric acid, and the other products of histolysis, are also found in excess. This increase in the waste pro¬ ducts, or, as denominated above, the ashes of histolysis, is very con¬ siderable. Vogel and Warnecke found 1065 grains of urea ex¬ creted in 24 hours in a case of typhoid fever, the normal amount of urea being about 400 grains. In a case of pymmia, 1235 grains of urea were excreted in one day. The amount of uric acid ex¬ creted daily is about 8 grains, but in a case of fever, Handheld J ones has found it as high as 23’76 grains. Dr Parkes has given great attention to the relation of urine to temperature, and in a case of typhus he examined the urine for eighteen days consecutively, and found the proportion on the average to have been 530 grains as compared to a normal of 400 grains. The increase was found every day. The relation of urine solids to temperature cannot yet be regarded as finally settled, but such indications as are warranted by the present state of science will be referred to again shortly. 5. The Condition of the Muscular Structures before and after Death.—As might fairly be deduced from the foregoing considera¬ tions, the muscular structures after death are much affected in pyretic affections. Laennec long ago pointed out the changes that are undergone by the voluntary muscles in typhus, and his observa¬ tions have been followed out by others, notably Zenker, on the muscles after typhoid; and his observations, in turn, have been