An account of the epidemic fever of 1847-48, more especially as deduced from the statistical records of the extra accommodation of the Royal Infirmary : with a suggestion and plan for improved and more economical temporary erections for future occasions / by Robert Paterson, M.D.

  • R.H. Paterson
Date:
[1848?]
Catalogue details

Licence: Public Domain Mark

Credit: An account of the epidemic fever of 1847-48, more especially as deduced from the statistical records of the extra accommodation of the Royal Infirmary : with a suggestion and plan for improved and more economical temporary erections for future occasions / by Robert Paterson, M.D. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    Of the nurses and others whose duty it was to come near the fever wards, it may be affirmed that none escaped taking one or other form of the disease who had not had it previously, while some had both the prevalent forms of it, viz. typhus and relap- sing fever. The eruptions which have appeared during the course of this epidemic have been of two descriptions, the measly and the pe- techial. The measly has been present in nearly every case of typhus, and often served, as it was principally depended on, to characterize the d isease. It seemed generally most strongly marked on the trunk of the body; over the epigastric region, or between the shoulders, it was in general to be discovered there, if at all exist- ing on the body. No prognostic character could be drawn from the early measly or typhoid eruption, or from its dullness or vividness, as regards the future mildness or severity of the disease. Its livid colour always marked a bad form of disease. In two cases this measly-looking eruption gradually passed into bright petechias, and it seemed to occur in the following manner. The eruption was a vivid one at the beginning, and although having an irregular shape, had a regular equable red colour. Gradually it became punctuated, and at last several of these puncta seemed to'run into each other, and to form small petechial ecchymoses. Petechise themselves appeared but in a small number of the cases. This eruption was not confined to typhus, but was occasionally seen in the relapsing fever, but only in the first attack. Much difficulty was experienced in distinguishing, in certain cases, between flea-bites and petechise. Thus we observed in certain whole families that every one was covered with purple- coloured marks much resembling ordinary flea-bites, the majority of them having central stigmata, and yet in such numbers that it was impossible for us to suppose that any individual could have been so much bitten. The explanation, I think, was afterwards arrived at. The cases in which the petechise were seen were principally those that came in in the greatest state of destitution, who had been filthily lodged, ill-clothed, and worse fed ; and it was often observed in three or four members of a family coming in at the same time, and seemed to depend on the vitiated condition of the fluids of their bodies from destitution and want. In this way can be readily explained the numerous cases in which we found some of these petechise with central stigmata and some without them in the same person. The purpurous tendency existing in the constitution gave rise to an unusually large ecchymosis around every flea-bite, which otherwise would have been a mere point; in addition to these, however, the vitiated state of the blood was
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