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of two epidemics, occurring contemporaneously in the same localities, 

 one to bear the title of typhus, and the other of typhoid fever, and of 

 sustaining the distinction between them, — a labour not achievable 

 in the hands of your committee. 



But it is believed that no such distinctive disorders can be recog- 

 nized in nature ; that the two forms of disease have not respectively 

 a development which is peculiar or sui generis ; that the disorders in 

 question do not, as distinct specific affections, occur promiscuously, 

 or side by side, in the same circumstances, from the same causes, 

 among the same class of persons, in the same hospitals, ships, jails, 

 and private dwellings of the poor. The grounds on which we ven- 

 ture to express these opinions we beg leave respectfully to state to 

 the Association; and we do this with the more freedom, as the ques- 

 tion of the identity or non-identity of typhus and typhoid fever 

 should and will continue to attract attention until a unanimity in 

 regard to it is attained among the great body of enlightened phy- 

 sicians. 



As the two forms of disease in question are fevers, and as the 

 problem to be solved is, whether they are, or are not, one and the 

 same malady, it will not be improper to glance at the means by 

 which fevers are distinguished. It is much to be deplored that the 

 distempers comprised in the class febres have not been more per- 

 fectly disentangled, and their specific relations to one another de- 

 finitively settled. That this has not been done, is owing, not to any 

 want of labour or talent devoted to the work, but to the difficulties 

 and obscurities inherent in the subject. 



The means of diagnosis in fevers are threefold; 1st, their efficient 

 causes; 2dly, their symptoms; and 3dly, the alterations produced in 

 the organism discovered after death. 



In regard to the efficient causes of fevers, it is evident that a 

 knowledge of them, for the purposes of diagnosis, is of the highest 

 value; for were they in all cases ascertainable, they would furnish 

 not only a ready and correct diagnosis, but a solid basis on which 

 to rest a natural classification of fevers. 



In respect to the symptoms, in the absence of a knowledge of 

 the causes of fevers, it is clear that they are the only means by 

 which, during life, one kind of fever can be distinguished from an- 

 other. But in forming a diagnosis by these means, the mode of 

 proceeding is in some respects peculiar. Whilst the acute phleg- 

 masia and most other violent local diseases are generally cognizable, 

 by their rational and physical phenomena, immediately, or at an 



