SURGICAL COMPLICATIONS AND SEQUELS OF FEVERS. 3 



studied of late by ophthalmic writers, as to leave but little 

 fiirtlier to be said, and I must refer those who desire to study 

 it to the appended Bibliograph3^ 



I shall include only such cases as diseases of the joints, 

 oedema glottidis and necrosis of the cartilages of the larjaix, 

 which often require tracheotom}', necrosis of the bones, gan- 

 grene of the extremities and other parts, fistulce of various 

 kinds, and tlie like. 



The records of many cases are extremely imperfect, some 

 in fact are mere allusions, and I have been compelled therefore, 

 in tabulating them, to come as near tlie truth as may be. The 

 frequency of many symptoms is therefore greater than appears 

 from my tables. Especially is it difficult to discriminate 

 between tj-phus and typhoid fevers as causes. The earlier 

 cases, before the essential abdominal lesion of typhoid was 

 recognized, are all classed as t^'phus, and even to-da}'' man>' 

 cases, especially in German books and journals, are briefly 

 called " typhus," meaning "t^'phus abdominalis," i.e., typhoid. 

 If any error exist, therefoi'e, it will consist in assigning too 

 many cases to typhus proper, for I did not feel permitted to go 

 back of the record unless plainly authorized to do so by the 

 history or the post-mortem. 



I. DISEASES OP THE JOINTS. 



Two forms of disease of the joints are found, first a i^oly- 

 articular inflammation, which may assume either a rheumatic 

 or a pyemic form ; and, secondly, a monarticular inflammation. 



The rheumatic variety I shall at once dismiss. The pyemic 

 form of inflammation is not ver}^ common, for Murchison, with 

 his immense experience in the London Fever Hospital, has 

 seen but one case. It follows the usual course of pyemia, 

 both in its symptoms and its usually fatal issue. Hnss and 

 others have referred it to suppurative phlebitis from bedsores, 



