126 



by researches, directed to the elucidation of the connections between 

 the symptoms of fevers, and the structural alterations which occur 

 in this class of diseases, can it be determined with a degree of cer- 

 tainty, approaching the exactness with which we are able to an- 

 nounce the existence of a pulmonary or cerebral complication, that 

 the glands of Peyer are diseased in a given case of fever? A high 

 degree of probability that they are affected may be inferred from par- 

 ticular symptoms; but after all, nothing but an autopsy can establish 

 the fact. 



That dothinenteritis occurs in genuine typhus is proved by the 

 concurrent testimony of many physicians, who have enjoyed the 

 most extensive opportunities of studying the disease, in all its forms 

 and varieties of complication, and whose learning and talent for 

 observation entitle their opinions to implicit confidence. "While, on 

 the other hand, it is shown by their inquiries that the intestinal 

 glands are frequently affected in typhus; it, is on the other, demon- 

 strated that in the form of fever denominated typhoid, the follicular 

 disease of the bowels is sometimes wanting. To cite all the proofs 

 which might be adduced in support of these remarks, would require 

 wider limits than the present occasion affords. The statement of a 

 few facts, bearing on the points in question, will sustain what a 

 greater number could not render more evident. And first, let us 

 advert to the evidence of some European authorities. 



In no country is typhus more prevalent than in Ireland. The 

 disease is there seen in all its varieties, symptomatic and anatomical ; 

 and it is to the enlightened physicians of that country that we are 

 indebted for much valuable information in relation to the nature of 

 the disease. Dr. Kennedy, in giving an account of the typhus which 

 prevailed in Dublin in 1837-38, says: "The only post-mortem ap- 

 pearance that was at all constant, Avas congestion of the vessels of 

 the membranes of the brain." — "But if this epidemic typhus was 

 not characterized by any uniform or constant pathological changes, 

 it was very remarkable for the almost total absence of those abdomi- 

 nal lesions which have been regarded by some as the invariable 

 attendants of typhus fever. Indeed, in this respect, this epidemic 

 affords a striking and conclusive refutation of the false and hasty 

 generalizations of the French pathologists on this subject. In this 

 respect, also, it differs altogether from the epidemic fever of 1826 

 (which the writer had an ample opportunity of investigating while 

 in charge of fever patients, supported at the expense of the govern- 

 ment, at the Meath Hospital that year), in which in a large proportion 



