Remarks on the changes which are supposed to have taken place in the type of continued fever / by Charles Murchison.

  • Charles Murchison
Date:
[1858]
Catalogue details

Licence: Public Domain Mark

Credit: Remarks on the changes which are supposed to have taken place in the type of continued fever / by Charles Murchison. Source: Wellcome Collection.

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    of Cullen.1 I am aware that Dr Christison, and many other dis¬ tinguished authorities, still regard this fever as a mere variety of typhus; but whether this be the case or not, whether the poisons of the two diseases be identical or different, whether, in short, the diseases themselves be different species or different varieties of the same affection, are questions quite unnecessary to the present in¬ quiry. What I maintain is, that this relapsing fever, which seems only to occur in the epidemic form at lengthened intervals, has been at all times remarkable for its small mortality, as compared with that of the ordinary typhus, and that when no bleeding has been resorted to, the mortality has been even smaller than under the heroic practice, which was resorted to in Edinburgh during the epi¬ demic of 1817-20. Dr Christison tells us that the mortality from this epidemic, under the bleeding system, was from 1 in 22 to 1 in 30, or, in other words, from 4J to 3J per cent.; and out of 743 cases which came under the notice of Dr Welsh, who wrote a history of the epidemic, and who was the great advocate for copious bleeding, 34, or 4J per cent., died. Now, this relapsing fever was no new disease in 1817. Fre¬ quent mention is made of it by that accurate observer Rutty, in his History of the Weather and Seasons, and of the Prevailing Diseases i?i Dublin, as having occurred in Ireland during the last century. The following extract from Rutty’s work shows that an epidemic of relapsing fever occurred in Ireland in the autumn of 1739, while it also indicates that, even at that remote period, particular attention was attracted by the small mortality which it occasioned, this small mortality, moreover, being a concomitant, if not the consequence of a non-recourse to medical interference of any sort. 66 The latter part of July, and the months of August, September, and October (1739) were infested with a fever, which was very frequent during this period, not unlike that of the autumn of the preceding year, with which compare also the years 1741, 1745, and 1748. It was attended with an intense pain in the head. It terminated some¬ times in four, for the most part in five or six days, sometimes in nine, and commonly in a critical sweat. It was far from being mortal. I was assured of seventy of the poorer sort at the same 1 Relapsing Fever may be defined as follows :—A disease commencing very abruptly with a sensation of coldness and rigors, and attended by quick and often incompressible pulse, white tongue, tenderness at the epigastrium, vomiting, enlarged liver and spleen; occasionally jaundice ; constipation ; high coloured urine ; great heat of skin, but no eruption ; severe headache, and pains in the back and limbs; restlessness ; and rarely slight delirium;—an abrupt cessation of all these symptoms, with free sweating between the fourth and seventh days, usually on the fifth ;—after a complete apyretic interval (during which the patient may get up and walk about), an abrupt relapse on the fourteenth day from the first commencement, running a similar course to the first attack, and terminating on or about the third day of the relapse ;—rarely sudden syncope and death ;—after death, no specific lesion, but in most cases enlargement of liver and spleen.