LECTURE V. 



Delivered February 17, 18761 



ON THE SURGICAL COMPLICATIONS AND SEQUELS OP THE 

 CONTINUED FEVERS. 



By William W. Keen, M.D., 



OP PHILADELPHIA. 



The province of the physician and that of the surgeon are, 

 in general, sufficiently sharply defined and differentiated, yet 

 they have many points of contact. "While some diseases belong 

 exclusively to the province of the one, and some to that of the 

 other, other diseases may fall with equal propriety under the 

 care of either practitioner. Still another class of cases, how- 

 ever, beginning in the domain of Medicine, may terminate in 

 that of Surgery, and we may lack their complete history from 

 the very fact of this division of their care and interest. 



Among the diseases classed as strictly medical, none deserve 

 the appellation more definitely than the continued fevers, and 

 especially T^-phus and Typhoid. Yet I hope to show that 

 fevers ai'e not infrequently the cause of the gravest and least 

 expected surgical troubles, mention of which is generally 

 omitted, even in our best text-books on medicine, still more 

 rarely noticed in works on surgery, and where noticed, it is 

 only with the greatest brevity.^ 



' " The cases of constitutional disease discovered by fever might serve 

 to illustrate a large part of the convalescence of fever, a subject of the 

 highest interest and full of promise of utility to one who will carefully 

 study it. The sequelse of scarlet fever are commonly enumerated ; those 

 of typhoid fever, especially those seen in surgical practice, are scarcely 

 less numerous, but seem less known." Just as this is going to press, I 

 find the above remarks by Sir James Paget, in his extremely interesting 

 Clinical Lectures and Essays, London, 1875, p. 378. 



1 (1) 



