TYPHOID FEVER. 623 



of my assistant), complained of rigors, great depression, tightness of 

 the head, frontal headache, weakness of the limbs, loss of appetite, and 

 other symptoms common to the incubation stage of typhus. After a 

 time there were stronger chills, with subsequent continued feeling of 

 heat, increase of pulse, great apathy, and disturbed sleep. Some pa- 

 tients were slightly delirious. There were also catarrhal symptoms; 

 the injected eyes were very sensitive to light, the nasal mucous mem- 

 brane was swollen and dry, the nose stopped up ; but, more especially, 

 there was troublesome cough, by which a scanty tough secretion was 

 brought up. We daily expected the eruption and the enlargement of 

 the spleen, not doubting that the cases were commencing typhus ; but 

 these two characteristic symptoms did not occur ; toward the end of 

 the first week, the constitutional disturbance, fever, and catarrhal 

 symptoms disappeared, and the patients began to convalesce ; they re- 

 covered very slowly, and were not generally able to leave their bed 

 before the end of the second week. 



TREATMENT. "We have no remedy for arresting exanthematic ty- 

 phus ; hence we are limited to a symptomatic treatment. As this is to 

 be directed chiefly against those symptoms that threaten the life of the 

 patient, particularly against the fever, and since in treating abdominal 

 typhus also combating the fever is the most important indication, we 

 shall defer our remarks on this subject to the next chapter. We may 

 also refer to the next chapter for the treatment of dangerous increase 

 of respiratory difficulty, for great collapse, bed-sores, and other danger- 

 ous symptoms, for just the same points arise in abdominal typhus, and 

 require the same remedies. 



CHAPTER VIII. 



ABDOMINAL TYPHUS ILEOTYPHUS (TYPHOID FEVER). 



ETIOLOGY. The belief that exanthematic typhus is a simple, and 

 abdominal typhus a complicated form of the same disease ; that, in ab- 

 dominal typhus, besides the changes that the blood undergoes in exan- 

 thematic typhus, there are changes in other organs directly concerned 

 in the formation of the blood, in the intestinal and mesenteric glands, 

 lacks all foundation. We shall not deny that there is a certain resem- 

 blance between the symptoms of the two diseases; but the resem- 

 blance is not perfect, and is not much greater than that between exan- 

 thematic typhus and typhous measles ; hence, we do not consider it 

 justifiable to regard the changes of the blood in the two diseases as 

 being the same, or that the poison producing the one is the same as 

 that causing the other. It is perfectly inadmissible to represent at> 



