Observations on the present epidemic of typhus / by Robert Perry, M.D.

  • Perry, Robert, active 1866.
Date:
1866
Catalogue details

Licence: Public Domain Mark

Credit: Observations on the present epidemic of typhus / by Robert Perry, 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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    and secondary purulent effusion amongst the femoral and lumbar muscles and fasciae. Dr. Murchison states, that out of nearly 700 cases of typhus which came under his care in 1862, not a single instance of phlegmasia dolens occurred. He, however, relates the history of a fatal case, admitted into the London Fever Hospital in 1857, where at the autopsy no clot was found in the femoral vein^ but merely the swelling of the left leg, a fatty heart, and acute atrophy of the liver. The third death, in a patient under 15 years of age, occurred in the case of J. D., a boy aged 12, admitted on September 12 along with his father, who also had typhus, with a copious eruption. The boy was admitted on the third day of the fever. The typhus rash appeared between the 4th and 5th days. Symptoms of acute pneumonia set in upon the 9th day, and the case terminated fatally on the 16th day, with all the usual signs of gangrene of the lungs. The horribly foetid odour emitted by the breath, and the pinched and anxious expression of the countenance, together with the physical signs on percussion and auscultation, left no doubt on my mind as to the nature of the case, although I was not permitted to verify my diagnosis by an autopsy. A liberal supply of stimulants and nourishment, quinine, nitro-muriatic acid, inhalations of chlorine, and chlorinated washes, are recommended for such cases. Quinine and acid, with stimulants, and as mucli nourishment as could be taken, were given in this case, but proved as futile as such remedies usually do in similar cases. The fourth death, under 15 years of age, occurred in the case of a girl, on the 11th day of the fever, and within 48 hours after admission. The fifth in the case of a girl 14 years of age, on the 16th day of her illness, and apparently from uncomplicated typhus. The total number of cases in patients of 15 years of age and under was 245, with 6 deaths—2*44 per cent., or, in round numbers, with a mortality of less than 2J per cent.; and by deducting those cases in which death was clearly attributable to the complication or secondary affection, the mortality would only be 1*18, or less than 1J per cent. In Dr. Murchison's statistics of cases admitted into the London Fever Hospital during ten years, there are 563 cases of 15 years of age and under, with a mortality of 35, or rather above 6 per cent. Did time permit, I might analyze in a similar manner the remainder of the deatlis above fifteen years of age; but as I am aware how difficult it is to follow the details of figures, I will merely say that there occurred as complications or secondary affections—
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