SURGICAL COMPLICATIONS AND SEQUELS OF FEVERS. 53 



follow in its track. In two cases I have found facial pais}', 

 from involvement of the seventh nerve. Facial deformity and 

 anchylosis of the jaw are sometimes seen. In none does 

 hemorrhage from the carotid appear to have followed. 



The death-rate is largely increased in such cases, since of 

 352 cases, 125 died and 227 recovered, a mortality of nearly 

 one-third. The sex is named in onlj' 19 cases, of which 14 were 

 niales. Contrary to the fact in other complications, except in 

 perineal fistulfe, this disease is most common after 30. Of 

 211 cases, the average age, according to Murchison, was 3H. 

 It is certainlj^ very rare in children, for I have found but 2 

 cases under 15. Typhus was the preceding fever in 352 cases, 

 and t^^phoid in only 26. Most cases do not go on to suppu- 

 ration, for of 101, I find 40 suppurated and 61 did not. The 

 abscesses generally discharge by one or often by several 

 openings, the external meatus being frequently one of them. 

 As Ndlaton has pointed out, even where it has thus opened, 

 if we would avoid burrowing and other subsequent troubles, 

 we must open it still more freely, in order to divide the parotid 

 fascia. 



CONCLUSIONS. 



If now, by way of review, we cast our eyes back over the 

 general results of all the complications and sequels we have 

 studied, we may arrive at some useful and important con- 

 clusions.^ 



1. T3'phoid, probabl}' from its usuall}- longer duration, is by 

 far the more prolific source of such surgical troubles except 

 parotitis, especially when we consider that many cases tabu- 

 lated as typhus are really typhoid. Of 433 cases, typhoid was 

 the preceding fever in 252, typhus in 119, and other forms of 

 continued fever in 62. 



' In this summary I have not included the cases of parotitis in the 

 figures. 



