i^ 561 



At the coii.iurnceiiient .l AD attack of typhus f.-v.-r, a dilliculty is B01 



experienced in recognising the exact nature of the complaint, and i iltj ifl 



not always removed even when tin- rash makes its appearance. The erupt i 

 sometimes, though not commonly, a ;nx>d d-al like that of measles. T. 

 appear about the same day after ' of the illness; an<l in chi 



especially it is often no e**J matter to say from which of the two diseases the 

 patient is suffering. The eruption of typhus is of a smaller patt< i in measles, 



and it seldom assumes a CL-M-,: ale arrangement. "\Vln-n tin- rash is much elevated 

 above the skin this is a point in favour of measles, and the same may be 

 a cold in the head is a prominent symptom. 



There is usually very little dilliculty in distinguishing typi. 



fever, but as these two diseases were formerly confounded, it mu\ uninterest- 



ing to compare their most prominent features in a tabular form : 



TYPHUS AND TYPHOID FEVERS COMPARED. 



Typhus l-\ vi >. Typhoid Fever. 



1. Age. May occur at any age. Rare in old people. 



2. Social condition. Occurs chiefly among the Occurs as frequently among the rich as the 



lower classes of society. poor. 



3. Contagiousness. Very contagious. Nut contagious. 



4. Onset. Well marked. Often insidious. 



5. General appearance. Very dull; pupils of Less apathetic ; pupils of eyes usually dilated. 



- usually contracted. 



6. Bkeding from nose. Rare. Not uncommon at onset. 



7. Eruption. Appears before the seventh day; Does not appear till seventh day ; comes out in 



comes out in a single crop ; spots at first successive crops ; spots elevated, and dis- 



not elevated, and may not disappear on appear on pressure. 



pressure. 



8. Diarrhoea. Not common ; stools natural or Common ; stools yellow like pea-soup. 



dark in colour, if loose, of a muddy consis- 

 tence. 



9. Tongue. Nearly always dry. May be moist. 



10. Duration. On an average fourteen days; On an average twenty-two days; may prove 

 in fatal cases death always ensues before fatal after the twentieth day. 



the twentieth day. 



11. Relapses. Rare. Not uncommon. 



12. Convalescence. Rapid. Slow. 



Practically one would not need to compare all these different points to 

 distinguish between the two diseases. Usually it is important to consider the 

 nature of the fever prevailing in the town or neighbourhood, and to inquire care- 

 fully as to the possibility of the patient's exposure to any source of infection. 



At present we know of no means either of curing or shortening the duration of 



typhus. The symptoms may be advantageously treated, and the patient's streni^h 



may be supported through the time of the fever, but we have no means at our 



disposal for arresting the progress of the disease. It is almost needless to say that 



36 



