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another, the order of the occurrence, as well as the peculiarity of all 

 the phenomena, should be observed. When this is carefully done, 

 there is generally no difficulty in discriminating particular fevers. All 

 cases of fever are to be considered of the same nature in which the 

 constitutional symptoms occur in the same order, and agree in their 

 general features. The local, contingent, and minor symptoms, as 

 well as the variations in the mode of attack, violence and duration 

 of the morbid phenomena, indicate modifications of the disease, and 

 nothing more. A physician practically versed in the diagnosis of 

 fevers, on visiting the wards of a hospital in which the various spe- 

 cies of essential fevers are assembled, will distinguish each particular 

 kind of fever, not by tenderness of the abdomen, gurgling in the 

 bowels, diarrhoea, and epistaxis — for these phenomena may or may 

 not be present in fevers unlike each other — he will found his diag- 

 nosis on the type, and general course and peculiarity of the pheno- 

 mena manifested in the nervous, vascular, and secretory functions. 

 In individual cases, in which the type and characteristic symptoms 

 of a special form of fever are not as fully and clearly developed as 

 is necessary to settle the diagnosis, he will await their .occurrence, 

 inquire into the etiology of the disease, and avail himself of the light 

 thrown on the nature of the malady by the occasional or contingent 

 symptoms. Thus, in yellow fever — a disease usually well marked 

 and distinguishable by a train of general symptoms, cases occur in 

 respect to which a doubt may exist as to their true nature, until the 

 appearance of black vomit, an event in itself of no value as a diag- 

 nostic of a specific form of fever, except when it concurs with certain 

 diagnostics presented by the general system. 



Now in typhus and the typhoid fever of Louis, the morbid 

 phenomena are so correspondent in the sensorial, vascular and other 

 functions, and are so similarly catenated or related to one another 

 from their accession to their termination, that the attempt to assort 

 and group them, so as to make them express two different diseases, 

 is a labour which, it appears to us, must fail to show any distinction 

 which is found in nature and cognizable by practical minds. 



If such be a just view of the subject, in what light are we to regard 

 the phenomena considered by Louis and others, as establishing a spe- 

 cific difference between the two forms of disease in question ? To say 

 nothing of the rose-coloured spots, delirium and epistaxis, are not the 

 meteorism, tenderness of the abdomen, gurgling in the intestines 

 and diarrhoea, occurring in fever, simply indicative of abdominal 

 derangement, in the same manner as cough, expectoration, and cer- 



