125 



ter found in the stomach and intestines, not having been found in 

 all the cases, it cannot be considered an anatomical character of that 

 disease." But he adds, "it is not so with the alteration of the liver 

 which was more or less exactly the same in all the cases, and which 

 for that reason ought to be considered as the essential anatomical 

 character of the yellow fever of Gibraltar of 1828." 



Now, if we use the term anatomical character in the rigorous 

 sense in which it is employed by Louis, are we not bound to consider 

 every fever in which Peyer's glands are diseased or ulcerated as 

 typhoid fever? No special form of lesion of the intestinal glands, 

 analogous to the special form of lesion of the skin in small-pox, is 

 described as distinctive of the typhoid affection, for every morbid 

 condition of them, except perhaps the tuberculous, is recognized in 

 the disease. 



The truth is, disease of the glands of Peyer and Brunner, is in 

 none of its forms, in the strict sense of Louis, an anatomical character 

 of any one species of fever. It occurs in disorders unlike in their 

 causes, and dissimilar in their character. It occurs occasionally in 

 the different kinds of koino-miasmatic fevers, and also, now and then, 

 in the contagious exanthemata. It occurs especially and most fre- 

 quently in idio-miasmatic or genuine typhus, and in febrile maladies 

 which, in their progress become adynamic, or, as it is usually and 

 properly said, typhoid. It occurs more generally in typhus, in some 

 years, and in some localities, and countries than in others ; and when 

 it occurs it is an effect or complication, and not the cause of the 

 febrile disturbance of the system. 



If these statements be correct, and that they are so, might, we 

 think, be established by abundant testimony, there are no solid rea- 

 sons for considering the affection of Peyer's glands a feature distin- 

 guishing the typhoid fever of Louis from the typhus of England and 

 other countries. We have already shown that these diseases are so 

 similar in their symptoms, that they cannot by these means be 

 rationally characterized as different species. Whatever variety of 

 forms they exhibit in their general or local phenomena, they scarcely 

 ever fail to manifest a unity of type and character ; and consequently 

 they should be regarded as the same disease. Indeed, as we have 

 said before, were it not that post-mortem examinations had revealed 

 a lesion of Peyer's glands, there never would have been a question 

 as to their identity. 



With all the light which modern pathological anatomy has shed 

 on the nature and complications of fever, and with all the aid afforded 



