Enteric fever : its prevalence and modifications, ætiology, pathology and treatment as illustrated by Army data at home and abroad / by Francis H. Welch.

  • Welch, Francis H.
Date:
1883
Catalogue details

Licence: Public Domain Mark

Credit: Enteric fever : its prevalence and modifications, ætiology, pathology and treatment as illustrated by Army data at home and abroad / by Francis H. Welch. Source: Wellcome Collection.

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    the occurrence of anomalous perspirations. On this point Dr. Murchison says :—“ The pyrexia of enteric fever is essentially remittent, and cases have occurred in my own practice and been noted by Trousseau and other observers, especially in malarious countries, where it has put on at first an intermittent type.” “ Moreover it may happen that cases of enteric fever, mostly mild, present the intermittent character from first to last ; and that they are really cases of enteric summarized in the Brit. Med. Jour., April 30th, 1881 :—“enteric fever with typho-malarial symptoms.” A lance corporal, age 23, service 2 years, had never been abroad and had never had ag-ue, admitted from the Royal Barracks, Dublin. The case commenced with “continued rigors”; until convalescence set in the symptoms and temperature phases were “ those of an or- dinary case of enteric fever;” but during the convalescence the patient was liable to “frequent remissions with the regular rigors succeeded by the hot stage and sweating of true malarial fever for which it was necessary to treat him with quinine.” Hence it was only at the commencement and termination that the paludal paroxysm was simulated, and my chief rea- son for bringing it forward is to show that this so-called mala- rial character is independent of climate for cause, is seen in the army in the United Kingdom no less than on foreign stations, and is independent of prior ague or traced malarial element in the frame at the time being, and occurring in the otherwise or- dinary course of European enteric fever. Rigors are not un- common at the onset, and the type of the fever at the close is remittent if not intermittent, and in the absence of traced malaria with known modifications of the enteric disease, is it necessary to go beyond the enteric cause itself to explain the phenomena ? I have seen essentially the same sequence in Measles in India in three children of the same family, no paludal element could be traced nor had the children shown the slightest subsequent indications eighteen months at least having elapsed, but in them quinine failed in its action to stop the daily recurrence of the febrile paroxysm.