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.

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    I mentioned this subject to my friends at Glasgow, and they allowed me to dissect the body of a person in whom I said no doubt could exist as to the presence of follicular disease; judge then, how great was my astonishment at not being able to detect a single trace of this morbid change in any part of the intestinal canal, and at finding no marks of disease save some redness and softness of the mucous membrane of the stomach, which may have been produced by inflammation, but more probably was owing to vascular congestion, occurring during the last stage of the disease, or even during the agony that precedes death.”* Dr. Lombard, however, was not convinced by this inspection; and on his arrival at Dublin he examined the bodies of two patients who had died of typhus at different hospitals, and with the same results. It thus appears that the symptoms of typhus and the typhoid fever are nearly the same, and that they cannot be distinguished from one another; so that upon this ground their separation cannot be maintained. But those who support the difference of the two affections rest their proof chiefly upon the pathological lesions which are found in the intestines. M. Louis characterizes the typhoid fever under the following descrip- tion: “An acute malady accompanied with a febrile movement more or less intense, variable in its duration, proper to young persons, chiefly to those who are placed within a short time in circumstances new to them, the cause of which is unknown, commencing by a violent shivering, ano- rexia, thirst, and in the great majority of cases by colics and diarrhoea, very soon accompanied by feebleness which is small in proportion to the other symptoms, then more or less quickly somnolence, stupor, delirium, i meteorismus, sudamina, lenticular rose-coloured spots, ulcers on the sacrum, ulcerations more or less deep of the skin, in the parts occupied by blisters, deafness, various spasmodic movements, or permanent con- i traction of the limbs; symptoms some of which disappear after a certain i time, others increase for the most part in a progressive manner, when the patients die, or diminish more or less rapidly, at length to disappear altogether if the affection has a happy termination ; the anatomical cha- i racters of which consists in a special alteration of the elliptic plates of the ilium.f .... Of all these lesions one only is constant, being found in all the subjects: I speak of the alteration of the elliptic plates of the small intestines, to which may be added the alteration of the mesenteric glands; I have regarded it as inseparable from the ex- istence of the affection under review in forming the anatomical character, i And as it was more or less great with some subjects who died on the eighth day of the disease, as with the greatest number the first symp- ft toms indicated a lesion of the intestinal canal, as the alterations ot the small intestines was greater than those of the colon, which was sound in a sufficiently large number of cases, I am warranted to conclude that the alteration of the elliptical plates commenced at the beginning of the disease.”t M. Chomel, although he appears strongly inclined to sup- I port the doctrines of M. Louis and the other trench pathologists, makes j the following candid avowal of his opinion deduced from a rigid exami- nation of all the pathological facts connected with the typhoid fevei . I “If, to this consideration furnished by analogy, we join these two other * Dublin Journal of Medical Science, vol. x. p. IS. , + Louis de Gaslro-Enterite, tom. ii. p. 317. 1 Ibid., torn. l. p. « •