The typhoid condition / by J Milner Fothergill.

  • Fothergill, J. Milner (John Milner), 1841-1888.
Date:
[1873]
Catalogue details

Licence: Public Domain Mark

Credit: The typhoid condition / by J Milner Fothergill. Source: Wellcome Collection.

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    circle. This phenomenon is associated with various grave con¬ ditions. The typhoid state is almost certainly followed by death when it has come on gradually and lasted for weeks, as I have known uraemia do in at least two marked cases. Somewhat of change occurred, as a lightening of the symptoms, and then again a deep¬ ening of them, each oscillation marking a graver stage, until death terminated the scene. When we remember the marked characteristics of this typhoid condition, we can scarcely wonder that, up to a comparatively recent period, the oncome of such a condition was described as the original disease u turning to typhus.” The older physicians, whose recognition of a disease was much more largely founded on mere naked eye changes and appearances than is now the case, and who were not so well acquainted as we fortunately are with both pathology and etiology, really thought that the affection under which the patient laboured was veritably converted into typhus fever. Their idea of typhus was much more comprehensive than ours is, and admitted both enteric or typhoid fever, and what are now regarded as typhoid conditions. Nor can we wonder, such being the case, that when they saw symptoms so allied to those of advanced typhus, and which they regarded as pathognomonic of it, symptoms not only allied to it in appearance, but also in gravity and danger to life, they thought indeed that typhus had supervened. What unfortunate results ensued from this, especially as to fear of infection in the alarmed relatives and attendants, it is needless to say. It is not likely that such error is common now 5 still there is reason to fear that old impressions linger long after they are supposed to be extinct, and it is possible that there may still remain here and there vestiges of this ancient and erroneous pathology. Should the considerations given heic have the effect of rousing some physician connected with a large hospital to institute careful comparisons betwixt the typhoid con¬ dition in specific fevers and an allied state in non-specific affections, betwixt these and the condition more distinctly known as uimmia,^ not only as to symptoms, but as to temperature and the amount ot urea, or the suppression of urine—indeed to clearing up the mystery still hanging over this important and interesting subject, and among other things annihilating utterly the old impressions of a disease changing to typhus, it would indeed be well 5 and the woik would form a decided addition to our knowledge. As to how such elevation of temperature as leads .to the institu¬ tion of increased histolysis is primarily originated, it is not yet pos¬ sible to speak definitely. The existence of a centre in the cerebro¬ spinal system which regulates temperature has been hypothecated by Fischer, much as the vaso-motor centre of Traube and Ludwig governs vascular changes ; but such temperature centre is yet merely an hypothesis, resulting, however, from both experimentation an