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regarded as theoretical, and therefore affords grounds for a diversity 

 of opinion. The fact that patients affected with the disease, in 

 certain conditions, are foci of the typhus poison, must be granted by 

 all observers. But the admission of this fact does not necessarily 

 impose the obligation to consider the poison a specific virus, analo- 

 gous in its origin and distinctive properties to that of small-pox or 

 measles; and that it is not so, is the view taken of it in this report. 

 As here contemplated, it is the product of the chemical changes 

 which take place in the excretions or debris of the body in health 

 and disease, accumulated in close apartments, — a poison more fre- 

 quently and readily generated by the exhalations and other excre- 

 tive matters of typhus patients, than by those of persons suffering 

 under other forms of disease, or in the state of health, — a subtle 

 aeriform principle, appropriately denominated idio-miasma, one of 

 the generic forms of infection; and hence, typhus, instead of being 

 classed among the contagious epidemics, is arranged among the in- 

 fectious. In this theory is found a ready explanation of the origin 

 and prevalence of typhus in jails, hospitals, ships, and the houses of 

 the poor ; and, also, of the mode in which cleanliness and ventilation 

 arrest and exterminate the disease. These hygienic means, so effect- 

 ive against the general propagation of the disease in the upper classes 

 of society, seem clearly to intimate the true nature and source of the 

 typhus poison. 



So entirely were the symptoms and course of the ship fever, as it 

 occurred in New York, correspondent with the descriptions given of 

 typhus in the standard works on Practical Medicine, that nothing in 

 detail need be said in respect to them. It is sufficient to observe, 

 that among the emigrants the malady was marked by great prostra- 

 tion at an early period of its development, requiring liberal ad- 

 ministrations of the most efficient means of stimulation and support. 

 Petechia were more general than in some former years. Though 

 sometimes running to a fatal issue under a simple form, the disease, 

 in its graver varieties, was generally attended with cerebral, thora- 

 eic, or abdominal complications. Erysipelas, often assuming a 

 phlegmonous character, occurred in many cases, and frequently re- 

 sulted in extensive sero-purulent deposits. Fluid collections of this 

 kind were most common in the parotid glands, eyelids, and scalp. 

 Secondary attacks happened in a few instances; and among the 

 sequelae was noticed an affection of the eyes of an amaurotic form. 



As to the rate of mortality among the sick in the various hospitals 

 of the United States and of Canada, there has been a great disparity; 



