On the surgical complications and sequels of the continued fevers / by Willialm W. Keen.

Date:
1877
Catalogue details

Licence: Public Domain Mark

Credit: On the surgical complications and sequels of the continued fevers / by Willialm W. Keen. 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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    decimated armies and often displaj-ed a most frightful tendency to gangrene. But of late, whether in civil or military practice, if we may judge from the scanty gleanings 1 have been able to obtain from the journals and the experience in our own civil war as well as in the late European wars, the condition of the sick has been so ameliorated that gangrene is happily a rare complication. The history of the extraordinary series of cases reported by Estlander, well illustrates these predisposing causes. In Ein- land, a financial crisis and a series of bad harvests from 1862, were followed in 1865-1 by sporadic cases of fever, mainly typhoid; but from the thrifty habits of the people and govern- mental support, the epidemic was at first neither severe nor extensive. Then came the cold and rainy summer of 1867, followed by a very bad harvest. That winter, typhus raged in almost every household, so that often the well were not numer- ous enough to nurse the sick. The death-rate rose from 2.74 per cent, to 7.69 per cent. Instead of an annual increase in the population of over 15,000, it decreased, in 1868, nearly 94,000; and this in a population of less than 2,000,000. Of 105 doctors, 30 sickened and 8 died. Up to 1868 not a case of gangiene occurred, but in the first seven months of that year 28 cases occurred. Then came the bountiful harvest of 1868, and by August the epidemic had almost disappeared. Yet the lingering effects of the previous want were seen in six later cases of gangrene. But such an experience is altogether exceptional. Erom other writers I have rarely obtained^more than two or three cases. Estlamler's U oases were all, except one, from typl.os; bnt of tire remaining 79 oases, 43 followed typl.oid, 23 typhus The influence of age is not very marked, as is seen in the fact that of 67 oases, 8 ooourred before 16, 27 from 15 to 28 and 32 after 25 years of age. Bnt sex, as usual, has a m.arkecl 3
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