The later history of spirillum fever at Bombay, 1882-83 : memoir based upon cases read before the Medical and Physical Society / by H.V. Carter.

  • Carter, H. V. (Henry Vandyke), 1831-1897.
Date:
[1884]
Catalogue details

Licence: Public Domain Mark

Credit: The later history of spirillum fever at Bombay, 1882-83 : memoir based upon cases read before the Medical and Physical Society / by H.V. Carter. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    10/38 (page 8)
    the spleen became enlarged next day, when, too, slight jaundice appear- ed : the fever was continuous for two days longer, and then abruptly subsided with copious sweats, much depression, and the advent of very restless delirium ; temperature 97°, pulse 80. The urine near acme of the attack was plentiful, specific gravity 1017, of albumin and bile a trace. Neither early history nor symptoms at first were very peculiar, and the diagnosis was remittent fever : blood not examined micros- copically. On account of the remarkable depression attending the febrile crisis, a suspicion, however, arose that the attack was due to spirillar infection; and the patient was detained in hospital. Sodium salicylate had been freely exhibited without any very marked effect in reducing the high temperature; rallying was tolerably prompt, the body-heat soon resuming a normal level; and though the pulse declined for two days longer, apparent convalescence gradually ensued. On the seventh day after crisis there was a slight evening rise of temperature, which on the following day was more decided; and then the relapse became manifest, lasting three other days and sho^ving fever of remittent charac- ter, the successive evening temperature being 105°, 104'8,° and finally 105-8°F., with a pulse rising to 136 per minute just after the crisis ; the respii-ation also quickened to 30 per minute ; and there was some distress at the acme. During this recurrence the symptoms were those of relaps- ing fever; and the blood displayed scantily the spirillar organism, though not distinctly so tiU after dessication and staining. The critical defervescence was pronounced, the temperatui-e sinking from 105°, pulse 136 (at 11° p. m.) to 100° next morning, 96° at evening, and about midnight so low as 92° F., pulse 50 : depression was then great, yet without delirium; and a reaction soon began (temperature 97°, pulse 70 next day), which was followed by prompt convalescence in the course of the thirteen days longer the patient could be induced to stay in hospital. There were some slight indications of a second relapse at about the tenth day of the period : emaciation was persistent. The temperature chart of this man is characteristic of ordinary relapsing fever, and it was recognised by an ex- perienced medical officer acquainted with ' country' fever in N. India^ as being similar to what he had often seen there : this identification appeared to me suggestive. No. 2.—M., set. 16, in reduced health, was admitted with high fever of four days' duration, which next day culminated at 104-8°, pulse 148, respiration 36; there was then some jaundice and deUrium, mufch splenic and hepatic tenderness mth enlargement; a small amount of albumin in the urine. Defervescence on the ensuing day (tempera- ture 1002°, pulse 128, respiration 28, much sweating)..and next day,