1826.] Monthly Medical Report. 95 



symptoms wliicli have been (iescril)etl. Tlio kind of ajwriciit medicine necessary for tlie 

 cure of tlie coni|)laint varies, of course, willi the constitution of the jxiticnt, and the 

 l)revious duration of urgent symptoms. Calomel is the most elTectual, hut care should 

 be taken in its administration at tliis season of the year, lest the >;ums Hiotrid become 

 unexpectedly affected. The well-known black dose is pcrluips, after all, the most efl'cc- 

 tual remedy which can he given. 



Having now mentioned two ailments of a mild kind whicli Iiave distinguished -Jic last 

 month, the reporter proceeds to the notice of another of a much more formidable cha- 

 ructer, winch has lately excited considerable atlei.tion in the upjier as well as the .in- 

 ferior classes of society — typhus fever. It has been very general, very severe, ai.«', 

 unfortunately, it must be added, unusually fatal during the last montli. 'I'yphns fever 

 is one of those diseases whose prevalence is peculiarly atlectcd by states of the utuio- 

 sphere, and no doubt can be entertained that the warmth and moisture of the air, 

 which has been the daily theme of friendly conversation since the setting in of Dcctm- 

 ber, have been particularly favourable to the development of typhoid fever. 'ITie ad- 

 missions into the Fever Ilosjiital liave been, and still continue to be, veiy nunieruus ; 

 and the reporter, at a late visit, noticed ujany cases of uiuisual severity. It is scarcely 

 to be supposed, after the numerous allusions to fever which liave recently nj)]><'are(l irt 

 this IMaga/iiie, that any of its reiidcrs can be in doubt as to the real sense cf the term 

 tiii'hus ; but as a clear understanding of exjiressions in ccmn'.on use is highly dcyirullc, 

 ami as the reporter ai>pears now fur the first time in the i>ages of the Monii;i.y 

 Magazini;, he may, ])erhaps, be indulged with leave to state, in a few words, the notion 

 which he attaches to the terms ////>// 1/.? and tt/phoid (ever. 



Several circumstances arc cmivdied in tlie phrase tj/jdiiis fever. It is not a. simple or 

 elementary term, but it involves three or four scfiorntc i;otions. In the rn>t place, by 

 typhus fever, is meant a fever running a lem/llieiud cour.-e, hardly ever less than twenty- 

 one days. This is the exclimcc sense in which the term was ujcd by Sjuivages in his 

 excellent NosoliHjia Mclhcdica. In the second place, there is attached to the term 

 typhus the notion of a fever, attended with symptoms of depressed nervous power and 

 great depravatiun, no less than diminution of secretions. Thiidly, by the term t>/phi:s 

 j%t)er is understood a fever which, in whatever way it may have (rigiiiatcd, is capable, 

 at some period of its progress, and under circumstances favourable to such an event, of 

 propagating itself by contiifiion. Such is the com))lex term typhus, and it is only by 

 viewing it in this extended manner, that a just notion of the term c;in ever be formed. 

 Typhus may be, of course, either of a milder or severer sort — (t_vi)hus iiiitlor and yravinr 

 of Dr. CuUen). That which has prevailed lately is the typhus mitior : and a case of the 

 kind whicli the reporter was engaged in examining, on the very day when he assumed tlie 

 duties in which he is now engaged, terminated fatally, so late as the thirty-filth day of- 

 the disease. In this case deafness occurred from an early period, disproving (as far as a 

 single instance can go) the notion entertained by the old physicians, tiiat deafness was a 

 favourable sign in fevers. 



On the ICth of last month (November) tlic reporter was called ujjon to visit a young 

 German who, in a state of high mental excitement, swallowed above three drachms of 

 pure powdered opium. The coroner's inquest upon the body was biiefly noticed in tlie 

 Morning Chronicle of Saturday, November 19. The following particulars of the cas^e 

 may perhaps be worthy of being placed iijion record : — 'I'he ))oison was taken at seven 

 o'clock in the afternoon, and medical assistance was obtained at eight. The ordinary 

 means of discharging the contents of the stomach liaving failed, partly through the 

 obstinate resistiuicc of the patient, and partly through the paralyzing influence of the 

 opiiun; the stomach pump was put into operation soon after nine o'clock, by Mr. Cor- 

 bett of Titchborne-street, Haymarket, with most comjilete and admirable effect. In 

 about a quarter of an hour the whole of the opium appeared to have been removed, but, 

 to ensure the complete clearance of tlie stomach, the operation was continued for five or 

 six minutes longer. No dithculty whatever occmred in any part of the process. It is 

 to be regretted, however, that the mischief had already been done. While the pumj> was 

 in operation, hunied on, probably, by the previous violent stniggles of tlie patient, the 

 symptoms of oppressed braiii manifested themselves. The breathing became stertorous, 

 the pupils of the eyes strongly contracted, and the counten.ince cadaverous. The able 

 physician who had now assumed the management of the case (and whose temporary 

 absence the reporter had stipplied), directed, with great judgment, a vein to be opened. 

 As this did not yield the due quantity of blood, the temporal artery was divided, from 

 which dark-cohvrrd blond issued. Cold art'usion was next liberally applied, and every 

 possible effort made to support the system by coffee and other availai)le supjilies, but 

 they were veiy iuelfectual, and the death of tlie young man was momentarily expected. 

 He did not expire, however, until seven o'clock the following nioriiing, twehe boms 

 after the jioison luul been taken. It was highly satisfactory to find, upon examination of 

 the body after death, that no opium remained in the stomach, and that no injury what- 

 ever had been done, by the pump, to the very delicate mucous membrane of that organ. 



8, Upper Jojm-strcet, Gulden-square, Dec. 2], 1825. Gzoxge Gkegouv, y..D. 



