On the identity or non-identity of typhoid and typhus fevers / by William Jenner.
- Date:
- 1850
Licence: Public Domain Mark
Credit: On the identity or non-identity of typhoid and typhus fevers / by William Jenner. 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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![tlie agminated glands. One, in wliicli the thickening depended on the deposit of a pale whitish friable matter, of cheesy consistence, in the substance of the submucous cellular tissue—the plaques dares of T^ouis; and another, in which the thickening was due to swelling of the mucous and submucous tissues,—the plaques molles of the same author. Ulceration follows both forms of thickening. These cases farther illustrate the following facts:— \stj That ulceration of the solitary and agminated glands may commence in two modes; on the one hand, by softening of the mu- cous membrane, abrasion of the extremely softened superficial tissue, and then enlargement of the breach of continuity thus formed, in depth and extent, by simple ulceration; on the other, by sloughing of a portion of the submucous tissue containing the before-described deposit, and of the mucous membrane over it, and then extension of the ulcer in breadth and width, by the separation of minute sloughs from the edges of the breach of continuity, left after the separation of the slough first formed. 2d, That when the whole of the deposit has sloughed out, no fi*esh deposit is formed; and that, consequently, as the whole of that deposit is seated in the submucous tissue, destruction of the muscular fibres of the intestine must be the result of simple ulceration. SfZ, That resolution of the disease affecting the patches may in some cases occur before ulceration has taken place. 4i/i, That ulcers of considerable size may heal. bth, That no contraction follows, within a short period, the heal- ing of the ulcers. 6^A, That ulcers, dependent for their origin on the presence in the system of the fever-poison, may, after the fever has run its course, continue to spread, retard recovery, and even cause death by perfora- tion. 1th, That while some of the ulcers are undergoing the heahng process, others may be spreading; or, as Rokitanski says, may pass mto the state of atonic ulcers. These atonic or simple ulcers, left after the termination of the fever, are a frequent cause of lengthened duration of illness in cases o/ typhoid fever. Four cases only of twenty-three offered examples of the plaques dures. In no case that proved fatal after the 30th day was any of the whitish deposit discovered in the submucous cellular tissue; and this agrees with the experience of Louis, for the thirteen examples of the plaques dures detailed in his great work on Typhoid Fever, proved fatal before the 30th day of the disease. I doubt, however, if it be correct to regard all the cases which proved fatal at a later period as examples of the plaques molles, because it is probable that the de]K)sit constituting the plaques dures takes phu-e at an early ])eriod of the flisease.—(1 have seen it very extensive in the intestine of a girl who died four days after she had been engaged at the wash-tub, at whu li](https://iiif.wellcomecollection.org/image/b21954653_0072.jp2/full/800%2C/0/default.jpg)
