124 



can we regard the able researches on the subject, by Louis and 

 numerous other pathologists, in Europe and America. 



2. Of the Morbid Anatomy of Typhus and Typhoid Fever. — As, 

 then, the vital phenomena, observed during the progress of the two 

 forms of disease in question, lead to the conclusion that they are not 

 specifically distinct in their nature, it seems that the opinion, that 

 they are so, has arisen from the discovery of dothinenteric lesions 

 in one form of the malady and not in the other. The theory which 

 localizes the cause of fever in the stomach and intestines, so fashion- 

 able in the last thirty years, is obviously the source to which may 

 be traced the distinction which is made between typhus and typhoid 

 fever. Stated in a brief form, the theory, in relation to these dis- 

 eases, is explicitly this ; a fever with ataxic or adynamic symptoms 

 in which the glands of Peyer and Brunner are tumefied and ulcerated 

 is typhoid fever ; and that a fever attended with similar constitutional 

 phenomena, and in which those glands are not diseased, is not 

 typhoid, but some other species of fever. That Louis employs the 

 fact of the non-existence of dothinenteric lesions in febrile cases, to 

 prove that the disease is not typhoid fever, is shown in his work on 

 yellow fever, in giving the diagnosis of which he specially distin- 

 guishes the two diseases anatomically, by the normal condition of 

 the intestinal glands in one of them, and the constant alteration of 

 them in the other. 



That there is a great and fundamental error in the doctrine 

 which makes a specific difference between the diseases to which our 

 inquiries relate, may, we think, be shown by adverting to a few of 

 the anatomical facts and general arguments which bear directly on 

 the subject. 



If a diseased state of the agminated and isolated glands of the 

 bowels constitute the peculiar and essential anatomical character of 

 typhoid fever, then certain other maladies considered by every ob- 

 server as different in their nature, should be regarded as identical 

 with that disease; for there is abundant evidence to show that in 

 many instances of the disorders referred to, those glands are inflamed, 

 tumefied or ulcerated. 



It must here be noticed that by the term anatomical character of 

 a disease is meant, according to Louis, a morbid condition of organic 

 lesion which invariably occurs in the same disease, and which, with 

 certain other phenomena, distinguishes the disease from all others. 

 Thus, in speaking of yellow fever, he says, "The red or black mat- 



