Volume 1

The science and practice of medicine / By William Aitken ... From the 4th London ed., with additions, by Meredith Clymer.

William Aitken

Date:: 1866

Credit: The science and practice of medicine / By William Aitken ... From the 4th London ed., with additions, by Meredith Clymer. Source: Wellcome Collection.

Provider: This material has been provided by the University of Massachusetts Medical School, Lamar Soutter Library, through the Medical Heritage Library. The original may be consulted at the Lamar Soutter Library at the University of Massachusetts Medical School.

955/972 page 945

$II. [The following articles should have heen inserted respectively, at page 362, and page 700. SPINAL SYMPTOMS IN TYPHOID FEVER. Certain symptoms happen occasionally in the course of Typhoid Fever, which show more or less disturbance of the functions of the spinal cord. They have been but little noticed by systematic writers. and have generally been looked upon as accidental complications, or referred to spinal or cerebro-spinal meningitis.* They should not be * Whilst intercurrent nervous affections in typhoid fever, referable to the brain, cerebro-spinal system, and the sympathetic, have been fully described by writers, those due to the spinal cord alone, have either had but slight recognition, or been passed by, and have generally failed to receive any precise, or physiological inter- pretation. That they have been observed from time to time for many years is shown by looking over the vast bibliography of typhoid fever, and most physicians who have had large experience of this disorder cannot but have frequently met with them. Amongst those who first mentioned them is Bierbaum, of Dorsten (Berlin Medicin. Zeitung, Nov., 1860, quoted by Lombard and Eauconnet). Forget, of Strasbourg (Traite de V' Enterite Folliculeuse, 1841), describes a rheumatismal form of typhoid fever, in which there was evident implication of the spinal system; and in his Rela- tion de VEpidhnie Cephalo-rachidienne, 1841, details a case of typhoid fever happening during the epidemic, in which the nervous phenomena were so marked, that it simu- lated the prevailing disorder. Lombard and Fauconnet (Etudes Cliniques sur quelques points de VHistoire des Fievres Typho'ides, Gaz. Med., 1843), describe very fully the spinal symptoms, giving several illustrative cases, and remarking that they had been surprised at their frequency since their attention had been called to them. AVallach (CanstaWs Jahresbericht, vol. iv, 1844), confirms the observations of the Swiss physi- cians ; whilst the occasional occurrence of spinal symptoms in the course of the dis- ease are remarked upon by Kramer, Ilmoni, Seitz, Eisenman, and others (1842—52). Miiller, in an account of a terrible epidemic of typhoid fever in the village of Kalw, Y\irtemberg (1851—52), mentions particularly the frequency of certain symptoms— spasms and paresis of portions of the muscular system—and insists upon their spinal origin; and they were noticed in the Cracow epidemic by Dietl, and in that of Konigsburg by Hirsch (1857). They are alluded to by Ecederer and Wagler, in their account of the Gottingen epidemic; Wunderlich describes vaguely a spinal form of typhoid fever (Handbuch der Patholog. u. Therap., 1852); and Greisinger refers to it. (Virckow's Handbuch der Spec. Path. u. Ther.). Piorry reported two cases in 1849; Armitage speaks of the spinal cord being implicated in typhoid fever (Bull, de Therap., 1851); Poulet mentions the spinal symptoms constantly present in the epidemic at Plancher-les-Mines in 1857, without, however, recognizing their pathogeny (I'Union Medicate, 1857); and Bourgogne found them in the epidemic of Conde, and described them in his Obs. de Fievres Typho'ides compliquees de symptomes appartenants a une lesion de la moe'lle epinilre (Jour, de Med. de Bruxelles, 1860). In a Report on the Famine Fever of Ireland, by Dr. Robert Law, of Dublin (Dublin J'aw. Med. Science, No. xvi, 1849), he speaks of the suffering from the spinal symptoms by the patients; Dr. Robert Ritchie notices them (Practical Remarks on the Continued Fevers of Great Britain, Monthly Jour, of Med. Science, 1846) ; and Christison1 says they are much more distressing in synochus (typhoid) than in typhus fever. But 1 [Fevers: their Diagnosis, Pathology, and Treatment. By Meredith Clymer, M.D. Philadelphia, 18-16.] VOL. I. 60$