Selected monographs.

Date:: 1888

Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs. Source: Wellcome Collection.

191/440 (page 173)

The mean duration of the very serious cases as -31 days. those of moderate intensity, as 18 the lightest cases, as - - 10 giving an average for the whole number of 19-6 days. He, however, called particular attention to the fact, that the cases were much less numerous, and the affection greatly milder, and much less fatal than usual, the mortality, commonly i in 3 or 4, being only i in i2*6. Being firmly persuaded that the remarkable length of typhoid fever often depends upon conditions not commonly adverted to, I beg the reader's indulgence while I go into some details on the subject. What I wish to establish is,, that typhus, when uncomplicated with any secondary affec-. tiou, terminates in convalescence or death in the course of a single attack; in other words, that a second attack of typhus does not occur in the course of one and the same ill- ness. On the other hand, it shall be my object to prove, that such is not the case with typhoid fever. With respect to typhus, I allege generally, notwithstanding- the high authority of Dr. Copland, who maintains directly the contrary,^ that (apart from secondary complications, which often completely change the course and termination of the disease) however long may be the period of excitement, —^however, long the adynamic stage,—^however tedious the period of convalescence, I have never, among thousands of cases, seen a single case of relapse, in the proper sense of the term, after the symptoms had begun to decline. Is this objected to as vague ? I appeal to the following facts. Of 139 cases, examined during the course of the disease with great minuteness, I find that 11-9 presented no secondary complications. Of these 20 died at the height of the fever, the symptoms having presented a constantly increasing inten- sity till the fatal termination. The remaining 99 offered, without a single exception, a steady aggravation of all the symptoms till a certain period (more or less distant, according to circumstances, from the beginning of the disease), after which they exhibited as steady a decline. The remaining 19 were complicated in varying pi'oportions ' 'Dictionary,' p. 1012, aii. Typhus Fever.