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

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

    172/222 (page 160)
    As to the nature of the disease, the conclusion arrived at is that it is due to a specific cause ; but whether so or not, there is the fact, apart from all theory, that it is made up of stages of sequential evolution embracing a definite time period, and that it presents different degrees of intensity. During the first half we have symptoms referable to the cause in the system and the structural phases it originates—pri- mary ; during the second half symptoms referable to changes in the structural lesions—secondary. Again, we fcave no known antidote, we cannot prevent the evolution of the cause or cut short its stages, hence we have to guide the individual through the necessary disease cycle with the least injury to the system ; and we may do much in limiting the range of disease ac- tion to that which is essential and the sympathetic systemic disturbance. Medicinal.—In the early stage attempts have been made to curtail the pyrexia, or to moderate the dis- ease degree, by quinine in large doses to 3ss. or more in the 24 hours. Should there be any malarial ele- ment, suspected only or clearly manifested by the character of the fever, the importance of reducing this to inertness is manifest, and the potency of one or two large doses of quinine to effect this is unques- tionable. It may be assumed that quinine has no influence on the virus, it does not prevent the sequen- tial phases, nor does it lessen their degree; but grant- ing this, is this drug useless, has it no influence in modifying symptoms? It appears to have a sedative action on the vascular system and brain, and in large doses the thermometer not only does not mark so high an ascent of the body heat, but the morning re-