GASTRIC FEVER, CA.TARRHAL AND BILE-FEVER. 635 



fever, as a " haemotogene," that is, as one resulting from disintegration 

 of the blood-corpuscles, and transformation of the released coloring 

 matter of the blood into coloring matter of the bile. When speaking 

 of diseases of the liver, I shall return to the subject, and will here 

 confine myself to the following remarks. In pyaemia, in puerperal 

 fever, and in other infectious diseases, probably as a result of the ex- 

 cessive increase of bodily temperature, there is often parenchymatous 

 degeneration of the most varied organs, in which the blood also par- 

 ticipates. More rarely, in the course of inflammatory affections, such 

 as pneumonia, there is a dissolutio sanguinis (which was recognized 

 by the older physicians), and, as a consequence of this, haemotogenous 

 icterus. But lastly, even catarrhal diseases, affecting the intestinal 

 or bronchial mucous membrane, may lead to parenchymatous degenera- 

 tion of the liver, heart, kidneys, or blood. During the last few years 1 

 have seen many patients with simple bronchial or intestinal catarrh 

 die with severe nervous symptoms, icterus, moderate swelling of the 

 liver, irregular and retarded pulse, albuminuria, etc., without there be- 

 ing any suspicion of an infectious disease. Such cases, which, like 

 " bilious pneumonia," are more frequent at certain tunes, and occur 

 oftener in certain regions, particularly in the tropics, doubtless form 

 part of the bilious fevers of old writers, while another part of them 

 were certainly cases of pyaemia and other infectious diseases. 



Muriatic acid has a great reputation in the treatment of gastric 

 fever. We are undecided as to whether the common prescription of 

 half a drachm of concentrated muriatic acid to six ounces of muci- 

 lage, or of a weak infusion of ipecacuanha (gr. viij f vj), has the 

 favorable effect ascribed to it. At all events, patients usually take 

 this remedy willingly, and it moderates the thirst ; and it is worthy 

 of remark, that this prescription furnishes the gastric juice with the 

 acid to which, as physiology shows, it owes its digestive powers. 



In catarrhal fever we prescribe the alkaline carbonates, particu- 

 larly the tinctura rhei aquosa. I have used this prescription, just as 

 advised by Schonlein, in rather large doses, i. e., a teaspoonful every 

 two hours, with excellent effect; and can fully support its recom- 

 mendation as almost a specific in this disease. I have also observed 

 that the patients do not well bear the customary soups, and get along 

 better if we give them, from time to time, a small piece of black 

 bread, sprinkled with salt. 



In febris biliosa the mineral acids are usually prescribed. Perhaps 

 an antipyretic treatment, such as qiiinine, in large doses, and the en- 

 ergetic abstraction of heat by cool baths, or repeatedly wrapping the 

 body In wet sheets, will do still better. 



