375 



of fever which constituted the bulk of the epidemic, was one of short 

 periods, terminating in three, five, seven, or nine days. The second 

 of these periods was the most frequent. The disease was rapidly 

 formed, and rapidly terminated, and developed itself with energy 

 from the commencement. The patient would be seized with nausea, 

 headache, pain in the back, and chilliness. Towards evening all 

 these symptoms increased, and the febrile paroxysm was fully formed, 

 — chills became rigors, nausea increased to vomiting, which harassed 

 the patient for the first three or four days, and frequently continued 

 through its whole course. On the evening of the fifth or seventh 

 day, the exacerbatio critica commenced, and terminated in a profuse 

 perspiration, which continued through the night. The following 

 morning the crisis was complete, and the patient convalescent. The 

 patient was liable to one, two, or three relapses, which prolonged the 

 whole duration of his illness even beyond that of the most protracted 

 typhus. The liability to relapse was one of the most striking cha- 

 racteristics by which this fever was distinguished from all previous 

 epidemics. 



In the number of the London Med. G-azette before quoted, Mr. 

 Mackenzie gives the following as the most striking features of the 

 epidemic fever as it prevailed in Glasgow in 1843. The fever is 

 remittent in its type — it is sometimes attended with petechia, but 

 not with the measly eruption ; — it is often accompanied with jaun- 

 dice — its first paroxysms coming to a crisis within seven days, a re- 

 lapse happening almost invariably, but the patient rarely suffering 

 more than two paroxysms; — the mortality does not exceed three and 

 a half per cent. It prevails only among the poor, and in ill-venti- 

 lated parts of the city. The fever begins with rigors, headache, and 

 nausea. A striking feature is the frequent and excessive vomiting, 

 attended by pain throughout the whole body, somewhat resembling 

 rheumatism. The patient is generally several days ill, say five or 

 six, when a decided change takes place by profuse perspiration at 

 night. The next morning he is much better. The remissions vary 

 — in some they last only for three or four days — in others for two 

 or three weeks. Nineteen out of twenty relapse — the relapse occurs 

 with the very same symptoms as the original attack. The disease 

 is highly contagious, and is never observed to merge into exanthe- 

 matic typhus. No particular post-mortem appearances are disco- 

 vered. The treatment is generally simple and symptomatic. 



I am indebted to Dr. Swett, of the New York Hospital, for the 

 following account of the fever as it prevailed in this city during the 



