130 



It thus appears that there are many of the more eminent patholo- 

 gists of Great Britain, Ireland, and other European countries "who 

 concur in the opinion that no essential difference exists between 

 typhus and typhoid fever. Their observations, however, establish 

 the fact, that dothinenteritis frequently modifies the character of 

 typhus ; and that this complication is more common in some seasons 

 and some countries than in others — a circumstance referable to 

 causes which, though obscure, are clearly adventitious. 



The necroscopic researches in this country have afforded no satis- 

 factory evidence of there being a specific difference between the forms 

 of malady under consideration. On the contrary, the facts already 

 spread before the public, as well as those daily accumulating in our 

 hospital registers, when carefully analyzed and compared with the 

 phenomena of the typhus and t} T phoid epidemics of other countries, 

 show that these diseases are one and the same. Cases presenting 

 the same general features, the same nervous, vascular, eruptive, and 

 other phenomena, and springing from the same efficient cause, are 

 found to differ merely in their complications, one case exhibiting 

 after death various anatomical changes, particularly alterations of 

 the glands of Peyer and Brunner, and others showing no such 

 alterations. 



The strongest testimony, as it appears to us, yet adduced on this 

 side of the Atlantic in favour of the opinion of the non-identity of 

 typhus and typhoid fever, is that furnished by Dr. Gerhard of Phi- 

 ladelphia. This gentleman has described in the American Journal 

 of the Medical Sciences for 1837, two epidemics, occurring in that 

 city in different years, one of which he designated typhus, and the 

 other typhoid fever. In speaking of the former (typhus), he says, 

 "In this large number of autopsies, amounting to about fifty, there 

 was but in one case, and that doubtful in its diagnosis, the slightest 

 deviation from the natural appearance of the glands of Peyer.'* In 

 the epidemic which he denominated typhoid fever, it appears that 

 Peyer's glands were generally affected, and hence he inferred that, 

 notwithstanding the similarity of the general symptoms to those of 

 typhus, that the malady was not typhus. Now, if what has been 

 said of the variety of complications which the same epidemic disease 

 assumes in different years, be true, is it not fair to conclude that the 

 differences in the morbid anatomy of the two epidemics described by 

 Dr. Gerhard were due to incidental causes ; and that the two epide- 

 mics were the same disease modified in different seasons, as in the 



