The sources and mode of propagation of the continued fevers of Great Britain and Ireland / by William Davidson.

Date:
1841
Catalogue details

Licence: Public Domain Mark

Credit: The sources and mode of propagation of the continued fevers of Great Britain and Ireland / by William Davidson. 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.

    25/86 (page 19)
    the opinion is corroborated that it was the very same affection that is so characterized at the present day. Hildenbrand described it in 1806 more particularly than any previous author. He states that it makes its ap- pearance about the fourth day of the disease on the breast, loins, back, thighs, and arms, as being more warm, but sometimes on the face; that it is so much more abundant as the eyes are red. He also remarks that petechiae may exist with or without the eruption, are not indispensable phenomena, and are only developed in certain conditions. He farther observes that the ex ant heme is sometimes not present in those cases of typhus which are irregular in their progress.*' The typhoid eruption was also a very general characteristic of the epidemic fever which prevailed iu Ireland during the years 1817-18-19. Dr. Bracken makes the fol- lowing statement: “Of about 250 cases which fell under my care in November and December of that year, the majority had eruptions of spots of various appearance as to size, shape, and colour. They were generally of a diffused appearance, gradually shading off, and insensibly disappearing, and of the size of a grain of hemp-seed, but sometimes much larger or much smaller. The distinct, well-defined peteehise were frequently seen of a bright brown or purple colour. The shoulders seemed to be more frequently affected by these eruptions, but the whole surface of the body was often covered by them.”f Drs. Barker and Cheyne give the following account of the eruption, as deduced from reports received from several parts of Munster: “ As the disease ad- vanced it was observed in most or all parts of the province that erup- tions of different kinds, either closely allied to or varieties of those termed petechial, very generally accompanied it. In some instances the erup- tion was papular, or a motley appearance of the skin, ora rash somewhat resembling measles showed itself. At Cork, Dr. M. Barry remarked that in the species of fever which he terms synochus, petechiae seldom occurred earlier than the fourth or fifth day; but his observation, if it does not express it directly, at least implies that their occurrence was frequent. They were generally of a bright red colour, sometimes small, at other times large. He did not consider them dangerous, nor find it necessary to abstain from those measures of depletion which were useful when high excitement prevailed. In a communication from Clonmell, Dr. Fitzgerald states that petechiae occurred in four cases out of five. At Listowel, petechiae was so common that Dr. O’Connell did not see six cases of fever unattended by a petechial eruption, which often ap- peared early in the disease.” In the account of Connaught, the same authors state that “ an early eruption of petechiae, which were often to be observed on the third or fourth day or even earlier, and were visible for four or five days, was a general symptom of the disease; when petechiae E appeared thus early, they were not indicative of any malignancy.” In the report for Ulster, it is stated that petechial eruptions were very com- mon and that they occurred early. For Leinster, the same reporters state that one physician observed the petechiae in seven cases out of ten, some thought them more general than they had been on any former occa- sion, and others represented them as universal. They appeared on the * Hildenbrand, de Typhus contngieux, par J. C. Case, p. 53-4.