26 PRACTICE OF MEDICINE. 



should be suspended, except the mercurials^ to which may be added 

 the acetate of lead, with a view of diminishing the inflammation of 

 the stomach, and also for its astringent properties. Blisters may 

 also be applied to the epigastrium, and the raw surface sprinkled 

 with acetate of morphia. 



In the third stage cordials and stimulants are demanded. Sulphate 

 of quinia, infusions of bark, or serpentaria, carb. of ammonia, cap- 

 sicum, turpentine, wine whey, or brandy and water, may be admi- 

 nistered. External stimulants, as frictions, sinapisms, hot baths, 

 &c., may also be found beneficial. The apartment should be kept 

 well ventilated, and all excrementitious matters removed. 



TYPHOID FEVER. 



Syn . — Comfnon co7i ti72ued fever . — En teric fever. — 2\jphus mitior, 

 — Nervous fever. — Abdominal typhus. — Mucous fever. — Entero- 

 "mesenteric feter. — Follicular enteritis. — Dothinen teritis, 



Syinptoms, course^ ^-c. — The disease is sometimes preceded by 

 prodromic symptoms. There is a sense of weariness, languor, and 

 general uneasiness, slight headache on rising in the morning, dull- 

 ness of intellect, irregular flushes of heat, or chilliness, slight accele- 

 ration of pulse, furred tongue, and a disposition to diarrhoea. These 

 symptoms may last from several days to a week or more, after 

 which the disease is established by the occurrence of a chill followed 

 by the ordinary phenomena of fever. 



The disease being fairly established, there is increased frequency 

 of pulse, ranging from 90 to 110 or 120; the latter usually in 

 females ; as a general rule the pulse is under a hundred. There is 

 headache, with a dull, heavy expression ; pain in the back and limbs ; 

 restlesness and insomnia ; epistaxis, and yellow watery diarrhoea. 



As the disease advances these symptoms become aggravated, the 

 pulse is more frequent and strong ; the skin hot and dry ; the tongue 

 dries, and becomes red at the tip and edges : there is pain in the 

 right iliac region, with a gurgling sound upon pressure ; tympanitis 

 is also present, and there also appears about this time, symptoms 

 either of bronchitis or pneumonia. 



About the seventh or ninth day, if the surface of the abdomen be 

 examined carefully, there will be discovered upon it a number of 

 small, round, red spots, disappearing upon pressure, these are called 

 the rose-coloured spots, or taches rouges, and constitute a characteristic 

 eruption. At the same time a crop of vesicles will also be detected 

 upon the neck and thorax, called sudamina. 



All the symptoms at this period are aggravated, delirium supervenes, 

 with ringing or buzzing sounds in the ears, followed by dullness of 

 hearing or deafness. The eyes are injected, the tongue becomes 

 incrusted with a black coating, which often cracks and peels oflf*, 



