TYIM. I:R. 



In tlie year 1873 an epidemic oi' I r 200 people were 



attacked, broke out in London in tin- parishes of St. George's, Ha uare, 



Mary lei >.. ne, and Paddin.irton. It \\ . proved that it was due t 



tain ination of the milk by the r.\ 1 ,i' i\ j-i 



on one of the milk farms. Since this occurrence many people make a point of 

 always having their milk sailded, and it is undoubtedly a wise precaut 



Although typhoid is, in the large majority of cases, caused by taking the poison 

 into the system with the food or drink, there is no doubt that it may originate from 

 the inhalation of the emanations from sewers, <kc., containing typhoid stools. 

 possibility of infection in this manner does not prove that the poison is a gas, and 

 the general opinion is that the infectious agent consists of minute particles suspended 

 in tin's air. 



Typhoid fever is a disease which attacks young people mu: |wntly 



than old. More, than half the cases occur between the ages of fifte< : 

 five. It is seen more frequently in men than in women, and, curiously enough, 

 pregnant women and those who are suckling are seldom attacked. Unlike many 

 other diseases, it attacks by preference the strong and the healthy, those who are 

 suffering from chronic ailments usually escaping. It is a disease which is no 

 respecter of persons; the high and the low, the rich and the poor, are all liable 

 to suffer from it ; but, at the same time, well-to-do people are far more frequently 

 attacked than their poorer neighbours. From the frequency with which it prevails 

 amongst the higher ranks of society, it would almost seem as if the habits of life, 

 and the varied rich and plentiful diet of the more opulent classes, induced a condition 

 of susceptibility to its influence. The largest number of cases occur in the months 

 of September, October and November. It is probable that fatigue and exposure 

 do much to accelerate an attack, although they are in themselves powerless to 

 cause it. 



A person who has once had typhoid fever is not very likely to suffer from it 

 aim in, but second attacks of typhoid are far more common than second attacks of 

 small-pox, measles, or scarlatina. The immunity conferred by typhoid fever is not 

 very perfect. 



We must now consider the different symptoms of typhoid fever. The attacks 

 vary very greatly in severity ; in some cases they are so severe that life is almost 

 inevitably destroyed, whilst in others they are so trifling that the physician i 

 in doubt whether there was any true disease or not. Our description refers to a 

 simple case of typhoid of moderate severity. 



In the first place, there are usually certain premonitory symptoms. They are by 

 no means characteristic, but last longer than in most other fevers. The p 

 a general feeling of malaise, feels ill all over, is silent and indolent, and complains 

 of weariness and pains in the limbs. The countenance is dull and heavy, the appe- 

 tite is diminished, and the tongue swollen and furred. Sometimes there is gid<; 

 and usually headache, especially over the forehead. The sleep is restless and dis- 

 turbed by bad dreams. Sometimes there are pains in the bowels, and diarrha-a. but 

 not usually, unless purgatives have been taken. After a time fever sets in, often 

 accompanied by frequent chills. 

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