GASTRIC FEVER, CATARRHAL AND BILE-FEVER. 631 



mended not to attempt treatment in children under one year old. 

 A mixture of kamala, kousso, and filix mas, each 3 ss, with water 

 iv, of which a teaspoonf ul was given every three hours, expelled 

 a worm from a child ten months old. 



The fact that, in spite of enemata and the use of santonin, some 

 persons have thread-worms for years, may be regarded as favoring 

 the idea that these worms are to some extent propagated in the 

 human intestine; the frequent relapses being due to the enemata 

 having only been employed till the local symptoms had ceased, not 

 till all the worms had been expelled.] 



(In a former edition, trichiniasis was considered at this place, 

 but in this one I shall speak of it among the infectious diseases ; 

 the reasons for this will be stated when speaking of its etiology.) 



CHAPTEK X. 



GASTRIC FEVEE, CATARRHAL AND BILE-FEVER. 



MANY physicians, particularly among the Germans, describe as 

 gastric fever a disease running an acute course, in which high fever is 

 only accompanied by dyspeptic symptoms, and generally by diarrhoea, 

 while there are usually no symptoms that would indicate severe dis- 

 ease of any important organ. Celebrated authorities, particularly 

 those clinical observers who have developed in hospital, and have had 

 only hospital practice, consider all cases of so-called gastric fever as 

 mild cases of typhus. I cannot at all agree with this view. Every 

 physician in private practice often has the opportunity of seeing, after 

 errors of diet, without any suspicion of infection, symptoms of variable 

 duration, which exactly answer to those of gastric fever. If this be so, 

 even where we can find no error of diet, we must be careful about in- 

 ferring that there is an infection, and must acknowledge the possibility 

 that catching cold, atmospheric and telluric influences, and other 

 sources of injury, may excite a similar set of symptoms. But I will 

 not attempt to deny that numerous slight cases of typhus are diagnos- 

 ticated as gastric fever. 



As a rule, gastric fever begins with several slight chills, rarely with 

 one severe one. The pulse quickly rises to 100 or more. According 

 to the few observations that have been made, the temperature is some- 

 times normal, in other cases it is decidedly increased ; it may reach 

 from 102 to 105. The constitutional disturbance is very marked. 

 The faintness is so great that the patient remains in bed ; the limbs, 

 particularly at the joints, pain " as if they would burst." The insup- 

 portable headache is usually increased by laying the head on a feather 



