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.

  • Henry Vandyke Carter
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.

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    datum here carries more weight than the negative; and if once the spirillar organism be clearly detected, diagnosis becomes sure; having in my. experience alv^ays been satisfactorily con- firmed by other available evidence, besides that furnished by the visible blood-state. The most puzzling cases, to me, were those in which I failed in search, under conditions other- wise at first sight promising; yet even here the reason of failure either was, or soon became, conceivable—commonly being an insuflBcient application of the microscopic test. Many times it was only the dried and stained blood-specimens, which furnished clear evidence ; fresh blood giving either negative or dubious indications. Like all instruments of precision, this newer means of investigation calls,for special attention in its use ; and the spirillar test is, I feel sure, but a sample of clinical aids that will presently become essential to accurate diagnosis. Such aid is greatly needed, e.g, for thesure detection of the typhus, typhoid and malarial infectionsand untd. it be obtained, present doubts often prevailing must abide, to the perplexity of both physician and sanitarian. Adverting to the several instances under review, I observe that diagnosis by the ordinary means, if sometimes clear, would at least equally often have been doubtful; and that it actually proved to be insuflBcient, may be inferred from some remarks of Dr. Cody quoted above (in the first Sub-series, Series 1), and was seen as regards the fatal case of ' double pneumonia'— several other instances being wrongly designated, if the validity of the blood-test be itllowable. Satisfactory clinical diagnosis of the obscurer fever cases, may fail—(1) when there is neither famine nor epidemic, and no history of contagion, as causative influence; (2) on clinical grounds, when a relapse is not wit- nessed from not occurring either absolutely or during the short time the patient may haply be detained under observation; or when only a late rela,pse takes place in hospital, so transitory and mild as to attract but little notice—as was frequently experienc- ed during the epidemic of 1877, as well as at this post epide- mic date of 1882 ; and (3), when other symptoms regarded as characteristic, are either wanting or undistinguishable
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