118 



somnolence, delirium, coma-vigil, deafness, aphonia, stupor, subsultus 

 tendinum, picking of the bedclothes, and at imaginary objects in the 

 air, small, frequent and feeble pulse, pungent heat of skin, petechial 

 eruptions, sudamina, dry and brown or black fur on the tongue, 

 accumulations of dark sordes on the teeth and gums, epigastric pain, 

 tenderness of the abdomen, gurgling in the intestines, diarrhoea, 

 meteorism, hemorrhage from the nose and bowels, and retention of 

 urine. 



Though such are the phenomena which occur in typhus and typhoid 

 fever, yet all of them may not present themselves in every case; but 

 it is observable that many of them, and especially those attendant on 

 the last stage of fatal cases, are developed consecutively and in various 

 degrees of force, in every individual example of both diseases. 



Now it is among the phenomena enumerated, that we must seek 

 for the diagnostic symptoms of the two diseases, if any such phe- 

 nomena exist. If the diseases be specifically different, they should 

 respectively present certain pathognomonic or characteristic symp- 

 toms. If they possess no such symptoms, nor any other diagnostic 

 phenomena, they are obviously not distinct disorders. But let us 

 examine the symptoms with a view to ascertain how far they indi- 

 cate diseases different in their nature. 



It is generally admitted that there is much variety in the symp- 

 toms of the premonitory and successive stages of typhus; and a 

 similar variety, it is acknowledged, occurs in the corresponding 

 stages of what is called typhoid fever. The incipient symptoms are 

 often, for the most part, precisely the same in both maladies ; and in 

 whatever subsequent parallel stages we examine the tAvo disorders, 

 we find no signs by which to distinguish them as different species of 

 fever. If in the several periods or stages of t} r phus we observe par- 

 ticular combinations of symptoms, we find the same combinations in 

 the several periods of typhoid fever. Phenomena which are usually 

 present in typhus are sometimes absent, or but slightly developed; 

 and the same is true in typhoid fever. The constitutional phenomena 

 in the latter disease are grouped, and transformed in the same man- 

 ner as are those which occur in the former. So far then as the general 

 symptomatology of these diseases enables us to form a judgment, 

 they are essentially the same. This conclusion, it is believed, might 

 be sustained by an appeal to numerous cases recorded as genuine 

 examples of typhus and typhoid fever. 



The phenomena on which the advocates for the distinctive nature 

 of typhoid fever mainly rely in forming their diagnosis, are, it ap- 



