Chapter LXVII: Part II: , Showing Predominance of Malarial Element . . . . 617 (66)

TYPHOID FEVER, 237
Synonyms, 237
Definitions, 237
History, 238
Geographical distribution, 241
Etiology, 242
Predisposing causes, 242
Age, influence of, 242
Sex, influence of, 243
Occupation, influence of, 244
Change of residence, influence of, 244
Idiosyncrasy, influence of, 245
Depressing emotions, influence of, 245
Intemperance, influence of, 245
Previous ill-health, influence of, 245
Season, influence of, 245
Elevated temperature, influence of, 246
Rise and fall of subsoil-water, influence of, 247
Exciting causes, 248
Contagiousness, 248
Dissemination, 249
Cases illustrating modes of dissemination, 250
Dissemination of, by drinking-water, 248
By stools, 249
By milk, 252
By atmosphere, 252
By bed-linen, etc., 253
By polluted soil, 253
By putrefied flesh, 257
Spontaneous origin, 254
Duration of virulence of germs, 256
Bacillus typhosus, 258
Incubation period, 259
Morbid anatomy, 260
Lesions peculiar to, 261
Changes in Peyer's patches, 261
Solitary glands, 261
Softening of Peyer's patches and solitary glands, 263
Cicatrization of Peyer's patches and solitary glands, 263
Changes in cæcum and colon, 263
Spleen, 264
Abdominal glands, 264
Lesions not peculiar to, 265
Changes in liver and gall-bladder, 265
Pharynx and oesophagus, 265
Larynx and lungs, 266
Brain and membranes, 266
Muscles, 267
Heart and blood-vessels, 267
Blood, 268
Salivary glands, 268
Kidneys, 268
Symptoms, 268
Clinical description, 268
Physiognomy, 272
Epistaxis, 273
Condition of skin, 273
Odor, 273
Eruption, 273
Sudamina, 274
Tâches bleuâtres, 275
Condition of hair and nails, 275
Pulse, 275
Heart-sounds, 276
Respiration, 276
Frequency of bronchitis, 277
Mental condition, 277
Headache, 277
Delirium, 278
Muscular spasm, 279
tremor, 279
Modifications of sensibility, 279
Hearing, 280
Vision, 280
Taste, 280
Temperature, 280
State of tongue, 285
Fauces, 286
Nausea and vomiting, 285
Anorexia, 285
Thirst, 285
Gurgling, 286
Meteorism or tympanites, 286
Diarrhoea, 287
Character of stools, 287
Intestinal hemorrhage, 287
frequency, 288
causes, 288
importance, 288
Intestinal perforation, 289
frequency, 290
causes, 290
date of appearance, 290
importance, 289
Condition of urine, 291
amount of solids, 291
presence of albumen, 292
Complications and sequelæ, 292
Complicated by pyæmia, 294
Laryngitis, 294
Bronchitis and pneumonia, 294
Pleurisy, 294
Jaundice, 295
Peritonitis, 295
Catarrhal and diphtheritic inflammation of fauces, 295
Parotid swelling, 296
Menstrual disorders, 296
Pregnancy, 296
Suppuration of Bartholini's glands, 296
Periostitis, 297
Oedema, 297
Bed-sores, 297
Followed by impaired intellect, 292
Perversion of the moral sense, 292
Paralysis and chorea, 293
Cardiac degeneration, 293
Arterial thrombosis, 293
Venous thrombosis, 294
Gangrene of vulva and vagina, 293
Hepatic abscess, 295
Tendency to stoutness, 298
Varieties of, 298
Abortive form, 298
Latent form, 300
In children, 301
In aged persons, 302
Relapses in, 302
frequency, 302
course, 303
cases illustrating, 304
causes, 308
Duration, 310
Diagnosis, 311
From typhus, 311
From influenza, 312
From relapsing fever, 312
From epidemic cerebro-spinal meningitis, 313
From simple continued fever, 313
From remittent fever, 312
From the eruptive fevers, 313
From acute tuberculosis, 313
From trichinosis, 314
From the specific inflammations, 314
From acute tubercular meningitis, 314
Prognosis, 314
Symptoms indicating unfavorable, 314
favorable, 316
Influence of hyperpyrexia upon, 314
Nervous symptoms, 315
Heart symptoms, 316
Condition of pulse, 316
Abdominal symptoms upon, 316
Mortality, 316
Tables showing, 317, 318
Influence of season, 318
Sex, 319
Age, 319
Treatment, 319
Habits, 320
Social condition, 320
Recent residence, 320
Corpulence, 320
Organic disease, 320
Childhood, 320
Treatment, 320
Preventive, 321
Necessity of proper drainage in prevention, 321
Disinfection of stools, 321
Hygienic, 322
Importance of ventilation, 323
administering water, 325
Diet, 323
Mild cases, 326
Hyperpyrexia, 327
by cold baths, 327-329
Typho-malarial form, 331
Vomiting, 331
Diarrhoea, 331
Tympanites, 332
Intestinal hemorrhage, 332
perforation, 333
Constipation, 333
Headache, 334
Insomnia, 334
Stupor, 334
Delirium, 334
Albuminuria, 334
Complications, 335
Epistaxis, 335
Pneumonia, 335
Hypostatic congestion of lungs, 335
Thrombosis and embolism, 335
Bed-sores, 335
Convalescence, 335
Use of alcohol, 324
Digitalis, 330
Eucalyptus, 331
Quinia, 330
Silver nitrate, 332
Sodium salicylate, 330
Turpentine, 326
Specific, 336
By calomel, 336
By iodine, 336, 337
Use of thermometer, 284

Typhoidal inflammation, 47

Typhoid state of cholera, 734
following variola, 445

TYPHO-MALARIAL FEVERS, 614
Definition, 614
Frequency, 616
Symptoms, 615
Diagnosis, 616
Prognosis, 616
Mortality, 616
relative mortality of white and black races, 616
Treatment, 618
Of typhoidal element, 618
Of malarial element, 618
Use of quinia, 618
Depurative treatment, 618
Necessity of disinfection of stools, 619
Of tympanites, 619
Of insomnia, 619
Diet, 619

Typho-malarial form of typhoid fever, treatment, 331

TYPHUS FEVER, 338
Synonyms, 338
History, 338
Etiology--Predisposing causes, 341
Over-crowding as a cause, 341
Age, influence of, 342
Debility and fatigue, influence of, 342
Mental and physical overwork, 342
Intemperance, 342
Poverty, 342
Barometric and thermometric variations, 343
Season, 343
Occupation, 343
Individual susceptibility to, 343
Exciting causes, 343
Contagiousness, 343
Nature of contagion, 343
Modes of transmission of contagion, 344
Communication of, by fomites, 345
Period of contagiousness, 345
Spontaneous origin, 345
Period of incubation, 346
Symptoms--Clinical description, 346
Special symptoms, 347
Prostration, 348
Nervous symptoms, 348
Appearance of face, 348
Intellectual condition, 348
Headache, 348
Delirium, 348
Wakefulness, 349
Coma vigil, 349
Perversion of special senses, 349
Muscular tremor, 349
Temperature, 349
Condition of tongue, 350
Anorexia, 350
Thirst, 350
Nausea and vomiting, 350
Condition of bowels, 350
Tympanites, 350
Gurgling, 350
Eruption, 351
Duration of eruption, 351
Tâches bleuâtres, 352
Sudamina, 352
Hyperæsthesia of skin, 352
Odor, 352
Condition of pulse, 351
of heart, 351
Respiration, 352
Pneumonia, 353, 355
Bronchitis, 353, 355
Odor of breath, 353
Hypostatic congestion of lungs, 353
Changes in urine, 353
Varieties of, 353
Mild form, 354
Severe form, 354
Ataxic form, 354
Adynamic form, 354
Ataxo-adynamic form, 354
Inflammatory form, 354
Walking form, 354
Abortive form, 354
Complications and sequelæ, 354
Complicated by erysipelas, 355
Cardiac degeneration, 355
Bronchitis and pneumonia, 353, 355
Pleurisy, 355
Albuminuria, 355
Bed-sores, 355
Scurvy, 355
Dysentery, 355
Jaundice, 356
Parotitis, 356
Serous inflammations, 356
Pyæmia, 356
Disorders of menstruation, 356
Miscarriage, 356
Followed by pulmonary gangrene and phthisis, 355
Morbid anatomy, 356
Alteration of blood, 356
Changes in respiratory organs, 356
Heart and membranes, 357
Liver and kidneys, 357
Spleen, 357
Intestinal tract, 357
Brain and membranes, 358
Diagnosis, 358
From typhoid fever, 358
From meningitis, 358
From measles, 358
From typhoid pneumonia, 359
From delirium tremens, 359
From purpura, 359
Prognosis of, 359
Symptoms indicating favorable, 360
unfavorable, 360
Influence of age, 359
Sex, 359
Former habits, 359
Convalescence from previous illness, 359
Obesity, 359
Mental and physical overwork, 360
Social condition, 360
Race, 360
Mortality, 360
Difference of, in hospital and private cases, 361
Treatment, 361
Preventive, 361
Necessity of isolation, 361
Disinfection, 362
Diet, 362
Quantity of nourishment necessary, 363
Futility of abortive treatment, 363
General treatment, 364
Mild cases, 364
Hyperpyrexia, 364
By cold water, 364
By cold baths, 364
Mode of using cold bath, 364
Prostration, 365
Headache, 366
Delirium, 366
Insomnia, 366
Stupor, 366
Urinary complications, 366
Thirst, 367
Vomiting, 367
Constipation, 367
Parotitis, 367
Pulmonary complications, 367
Use of alcohol in, 366
Opium in, 366
Quinia in, 365
Of convalescence, 368
Necessity of continuing stimulants during convalescence, 368

Tyrosis, 79

U.

Ulceration, complicating vaccination, 468

Ulcers, complicating cholera, 735
following the plague, 781

Umbilication in vaccinia, mechanism of, 464
in varicella, 482
in variola, 438
cause of, 447

Uræmia in scarlet fever, 530

Urinary complications in typhus fever, treatment, 366

Urine, analysis of, importance in general diagnosis, 165
condition of, in cerebro-spinal meningitis, 814
in cholera, 739
in dengue, 881
in influenza, 866
in mild scarlet fever, 506
in grave form of the plague, 779
in pertussis, 841
in pyæmia, 976
in relapsing fever, 387
in remittent fever, 602
in typhoid fever, 291, 292
in yellow fever, 644
suppression of, complicating relapsing fever, 407
in cholera, treatment, 764
in yellow fever, treatment, 653

Urination, difficult, significance of, in diagnosis, 164

Urobilin, 91

Urticaria, complicating diphtheria, 674

Uterus, fixity of, in para- and perimetritis of puerperal fever, 1007
lesions of, in septicæmia, 972

V.

VACCINIA, 455
Definition, 455
Synonyms, 455
History, 458
Etiology, 458
Nature, 455
Variolous origin, 457
Meteorological conditions as a cause, 458
Symptoms, 458
General course, 458
Constitutional, 459
Development of pock, 459
Date of appearance of pock, 459
incrustation of pock, 460
falling off of crust, 460
Description of cicatrix, 460
Irregularities in course, 460
Raspberry excrescence of pock, 461
Lack of elevation in pock, 461
Absence of a constitutional infection, 460
Bryce's test for determining constitutional infection, 461
Diphtheritic pock, 463
Catarrhal pock, 463
Morbid anatomy, 462
Pock, 463
Microspheres and vaccinals of lymph, 463
Microscopical characters of the lymph, 463
Mechanism of umbilication, 464
Composition of crust, 464
Complications and sequelæ, 464

VACCINATION, 465
Synonyms, 465
History of, 465
Protective power of, 461
theories regarding, 461
duration of, 468
against pertussis, 468
Marson's theory of multiple insertions, 467
Time of revaccination, 467
As a means of destroying nævi, 468
Complications, 468
Simple inflammatory, 468
Complicated by dermatitis, 468
Treatment of dermatitis, 469
Complicated by lymphangitis and adenitis, 468
By ulceration and gangrene, 468
Erysipelas, 469
treatment, 469
Complicated by syphilis, 469
treatment, 471
Modes of preventing transmission of syphilis, 470
Complicated by skin diseases, 471
by eczema, 472
Impetigo contagiosa, its relations to, 472
Followed by cutaneous affections, 471
by eczema, 472
Conveyance of constitutional taints in, 471
Technics of, 472
Varieties of virus, 472
Primary vaccine, 473
Horse-pox vaccine, 473
Retro-vaccine, 473
Bovine vaccine, 473
Variola vaccine, 473
So-called points of superiority of humanized vaccine, 473
Relative merits of animal and humanized vaccine, 473
Advantages of animal over humanized virus, 475
Forms of vaccine, 476
Objections to use of crust, 476
Use of dried lymph, 477
liquid or tube lymph, 476
Proper season, 477
Age, 477
Part of body most suitable for, 477
Modes of operating, 478
applying the virus, 478
Storage and preservation of virus, 479
Proper time of collecting lymph for storage, 479
Proper manner of transporting, 480

Vaccination, neglect of, as a cause of variola, 436

Vaccine virus, varieties of, 472
use of, in treatment of rabies and hydrophobia, 907

Vagina, symptoms of diphtheria of, 674

Vaginal injections, use of, for prevention of puerperal fever, 1025

Variations, barometric, influence of, upon course of diseases, 134

VARICELLA, 481
Definition, 481
Synonyms, 481
History, 481
Etiology, 481
Contagiousness, 481
Symptoms, 481
Period of incubation, 482
General, 482
Prodromal stage, 482
Eruption, 482
Umbilication of eruption, 482
Date of appearance of desiccation, 482
Frequency of scarring, 482
Appearance of vesicles on mucous membrane, 483
Morbid anatomy, 483
Complications, 483
Diagnosis, 483
From variola and varioloid, 484
From vaccinia, 484
From impetigo, 483
contagiosum, 483
From eczema pustulosum, 483
Prognosis, 484
Treatment, 485

_Varicella Prurigo_, nature, 484

Varieties of beriberi, 1039
of grease-traps, 221
of pernicious malarial fever, 606
of rubeola, 568
of sewer-traps, 191
of typhoid fever, 298

VARIOLA, 434
Definition, 434
Synonyms, 434
History, 434
Etiology, 435
Contagiousness, 435
Nature of contagium, 435
Mode of entrance of contagium, 435
Duration of activity of contagium, 435
Period of greatest activity of contagium, 435
Modes of transmission, 435
Race, influence of, 436
Season, influence of, 436
Sex, influence of, 436
Neglect of vaccination as a cause, 436
Individual idiosyncrasy, 436
Protection from, by previous attacks, 436
Effect of pre-existing skin disorders, 436
Symptoms, 436
Stage of incubation, 436
Invasion, 436
Variolous rash, 437
date of appearance, 437
significance, 437
Simon's triangle, 437
Stage of invasion, 438
Eruptive stage, 438
Characters of eruption, 438
Position of eruption, 438
Stage of vesication, 438
Umbilication, 438
Maturation, 439
Characters of mature pock, 439
Condition of patient in suppuration stage, 439
Pustules on mucous surfaces, 439
Stage of desiccation, 439
General, during desiccation, 440
Secondary fever, 439
Date of appearance of secondary fever, 439
Confluent variety, 440
Seat of lesion, 441
Condition of mucous surfaces in confluent, 441
General condition in confluent, 441
Hemorrhagic variety, 442
First form, 442
Second form, 443
Lesions of, 443
Variolic purpura, 442
Complications and sequelæ, 445
Complicated by eye diseases, 445
Erysipelas, 445
Nasal inflammation, 445
Furuncles and abscesses, 445
Muscular paralysis and hemiplegic attacks, 445
Laryngitis, 446
Gangrene of genitalia, 446
Followed by a typhoid state, 445
Pathology and morbid anatomy, 446
Cutaneous lesions, 446
Formation of papule, 446
Vesicle, 446
Cause of umbilication, 447
Repair of pock, 447
Hemorrhagic variety, 447
Changes of viscera, 447
Diagnosis, 447
From measles, 448
From scarlatina, 449
From pustular skin diseases, 449
From dermatitis medicamentosa, 449
From syphiloderm, 449
From acneform disease, 449
From typhoid fever, 450
From typhus fever, 450
Prognosis, 450
Symptoms indicating unfavorable, 450
Influence of sudden defervescence of eruption, 450
Pregnancy and childbed, 450
Fatality of, in the unvaccinated, 450
Influence of vaccination after development, 451
Treatment, 451
Preventive, 451
Hygienic, 451
Necessity of cleanliness, 454
Invasion stage, 452
Eruption, 452
Exclusion of sunlight for prevention of pitting, 452
Use of warm baths, 453
Hot water compresses, 453
Stimulants, 454
Hemorrhagic form, 454
Disposition of clothes and body after death, 454

Variola of vaccine, 473

Variolic purpura, 442

VARIOLOID, 443
Symptoms, 443
Invasion stage, 443
Eruption, 444
Types of, 444
Identity with variola, 444
Treatment, 451

Veins, condition of, in cholera, 737
intestinal, lesions of, in cholera, 745
jugular, thrombi of, in symptomatic parotitis, 626
lesions of, in pyæmia, 967
in symptomatic parotitis, 626

Venesection in cholera, 764
in rabies and hydrophobia, 908
in relapsing fever, 431
futility of, in cerebro-spinal meningitis, 830

VENTILATION, 177 _et seq._
Defects, 179
Distribution of air, 180
Estimation of carbonic acid in air, 178
Insufficient, evil effects, 181
Importance of, in treatment of typhoid fever, 323
Methods of calculating amount of air-supply, 179
Modes of investigating merits of a plan, 179
Of waste-pipes in drainage, 223
Of soil-pipes, 189
Proper size of flues and registers, 179
Relation of, to heating apparatus, 180
Varieties of ventilators, 180
Velocity of air, 180

Ventilators, varieties, 180

Venous emboli, 63
thrombosis, following typhoid fever, 294

Veratrum viride, use of, in puerperal fever, 1033
in scarlet fever, 543
in yellow fever, 651

Vertigo in cerebro-spinal meningitis, 812
in relapsing fever, 384
significance of, in general diagnosis, 158

Vesication in variola, 438

Vesicle in variola, morbid anatomy of, 446

Views, earlier, concerning nature of puerperal fever, 990
modern, concerning nature of puerperal fever, 992

Virus of anthrax, period of greatest virulence, 928
of rabies, localization of, in wound, 893
of vaccination, varieties of, 472
vaccine, manner of transporting, 480
storage, 479

Viscera, lesions of abdominal, in the plague, 781
in cerebro-spinal meningitis, 824
in erysipelas, 635
in variola, 447

Vision, modifications of, in relapsing fever, 399
in typhoid fever, 280

Vital statistics, registration, 208

Voice, alteration of, in diagnosis, 158

Vomit, character of, in cerebro-spinal meningitis, 813
in cholera, 738
in grave form of the plague, 779

Vomiting during intermittent fever paroxysm, 593
in cerebro-spinal meningitis, 813
in cholera, 738
treatment, 761
in diphtheria, treatment, 694
in general peritonitis of puerperal fever, 1010
in mild scarlet fever, 503
in para- and perimetritis of puerperal fever, 1007
in pyæmia, 975
in remittent fever, treatment, 605
in rubeola, treatment, 581
in septicæmia, 977
in typhoid fever, 285
treatment, 331
in typhus fever, 350
treatment, 367
in yellow fever, 644
treatment, 652
significance of, in general diagnosis, 162

Vulva, symptoms of diphtheria, 674

W.

Wakefulness in relapsing fever, 384
in typhus fever, 349

Walk, significance of, in diagnosis, 161

Walking form of typhus fever, 354
of yellow fever, symptoms, 654

Washstands, stationary, dangers from, 216

Waste-pipes, effects of large bore in, 220
leakage in, 222
tests for, 222
ventilation, 223

Water, collections of, effect upon public health, 187
fear of, in rabies and hydrophobia, 899
height of subsoil, influence of, on prevalence of cholera, 722
importance of, in treatment of typhoid fever, 325
impure, microscopic characters of, 184
diarrhoeal affections from, 182
disease from, 182
chemical examination of, 183, 184
value of chemical examination of, 183, 184
impurity of, from metallic salts, 182
from organisms, 184
nature of impurities, 182
polluted, as a cause of diphtheria, 683
stagnant, production of malaria by, 187
standards of purity, 184
subsoil, level of, 188
supply, contamination of, from privy-vaults, 192
cess-pools, 192
chloride test for detecting impurities in, 192
tables of analyses, 184
use of, in diphtheria, 702

Water-closets, defects of, 217
location, 218
varieties, 191
ventilation, 192, 217

Waxy degeneration, 84

Welch on cause of oedema of lungs, 72

Wet form of beriberi, symptoms, 1040
treatment, 1042

Whooping cough, 836
relation of, to rubeola, 561

Winds, influence of, on spread of influenza, 860

Wound, appearance of, in rabies and hydrophobia, 895, 899
changes in, in pyæmia, 976
condition of, in septicæmia, 977
influence of characters of, in causation of pyæmia, 958
treatment of, in pyæmia, 981
in septicæmia, 983

Wounds, diphtheria of, 673

Y.

YELLOW FEVER, 640
Synonyms, 640
Definition, 640
Etiology, 640
Specific origin, 640
Poison of, inconvertibility, 840
Birthplace, 641
Characteristics, 641
Ponderability, 641
Vitality, 641
Influence of heat and cold on development, 641
Impossibility of transportation of, by air, 641
Transportability of, by fomites, etc., 641
Nature of fomites, 641, 642
Fixity of, 643
Slowness of extension, 643
Medium of admission to system, 642
Localization of epidemics by atmospheric impregnation, 642
Anxiety, grief, and fatigue as causes, 643
Insusceptibility, in negroes, 644
from idiosyncrasy, 643
Protective power of previous attacks, 643
Duration of incubation period, 643
Symptoms, 644
Mild cases, 644
Initial, 644
Physiognomy, 644
Neuralgia and muscular pains, 644
Cerebral, 644
Condition of tongue, 644
Gastro-intestinal canal, 644
Vomiting, 644
Character of matters vomited, 644
Condition of urine, 644
Pulse, 644
Relation of pulse to temperature, 645
Perspiration, 645
Stages, 645
Masked forms, 653
Walking forms, 654
Paroxysmal stage, 645
Calm stage, 645
Hemorrhages and jaundice, 646
Prognosis, 646
Symptoms indicating unfavorable, 646
Influence of crowding the sick, 646
Pregnancy and parturition, 647
Condition of patient at time of attack, 647
Temperature, 647
In hospital cases, 647
Mortality, 647
Variableness, 647
Difference in hospital and private cases, 648
Diagnosis, 648
Significance of physiognomy, 648
State of pulse, 648
Albuminous urine, 648
Hemorrhagic tendency, 648
Yellow discoloration of skin, 648
Morbid anatomy, 649
Changes in liver, 649
Treatment, 649
Futility of abortive, 649
Importance of early, 649
Indications for, 649
Simple form, 649
Early stages, 649
Diaphoresis, 650
Jaborandi, 650
Neuralgias and muscular pains, 651
Hyperpyrexia, 651
by cold, 651
Hemorrhages, 651
by tincture of iron, 652
Nausea and vomiting, 652
Urinary suppression, 652
Failure of reaction from cold stage, 653
Convulsions and delirium, 653
Use of digitalis, 651
Aconite, 651
Veratrum viride, 651
Gelsemium, 651
Hæmostatics, 652
Quinia, 650, 651
Quinia and opium in combination, 651
Hygienic, 654
Necessity of absolute rest, 654
Diet, 654
Children, 655
Typhoid cases, 655
Time of return to solid food, 655

Z.

Zymosis, meaning of term, 137

Zymotic diseases, relation of, to puerperal fever, 1020
table, 136

END OF VOL. I.