930 TYPHOID OR ENTERIC FEVER 



* In an extract from Dr. Fairweather's valuable report on the fevers which prevailed 

 in the spring of the year in the Rawalpindi gaol, which is printed, will be found con- 

 clusive proof that typhus fever must henceforth be regarded as one of the endemic 

 diseases of that district.' 



On the next page we find that Dr. De Renzy uses the most modern 

 nomenclature, and contrasts typhus with typhoid and relapsing 

 fevers. Upon reading this, I determined to come forward, though 

 a most ' unwilling witness ^,' yet without delay — as, from not 

 having seen any notice of this Report, I believed, and believe, I 

 must have been one of the first persons in England to receive a 

 copy of it, — and state that I had received information which led 

 me to believe, in accordance with Dr. Buchanan's suggestion, that 

 typhus — a disease as little, though also as much, afiected in its con- 

 tagiousness and spread by the use of earth-closets as small-pox — 

 did really exist, though alongside of typhoid,, in one of the Indian 

 gaols of which I had written. But on turning to Dr. Fair- 

 weather's Report, at page 80 (Appendix) of Dr. De Renzy's volume, 

 I could not thereby convince myself that it did furnish conclusive 

 proof of the existence of typhus in that gaol. In Dr. Fair- 

 weather's Report notes are given of eight cases, of which five only 

 ended fatally, and with a post-mortem examination. Of these five 

 fatally ending cases, we find it recorded of one (Case 6) that ' his 

 symptoms were more those of enteric than of typhus fever ' ; and as 

 the intestines, in the account of the post-mortem examination, are 

 described as * having the lower part of the ileum one mass of ulce- 

 ration, enlargement and thickening of Peyer's patches,' we need 

 only remark that the diagnosis formed during life was very 

 abundantly confirmed by the autopsy, but that neither seems to 



^ I see from one of Dr. Buchanan's notes, p. 96, that some objection can be raised 

 to my employment of the words * an unwilling witness * when speaking of a person 

 who, like Dr. Mouat, comes forward and publishes, with the truthfulness which we 

 expect and find in such ofl&cials, facts which are, or seem to be, scarcely reconcilable 

 with theories he has advocated. I am not aware that ordinary usage attaches any 

 offensive insinuation to the words alluded to and employed above. Still I may express 

 regret for having employed a phrase which could be misinterpreted. After a ' very 

 critical reading,' however, of my letter in 'The Lancet ' of March 20th, 1869, I think 

 that another of my expressions used there does require amendment. Though John 

 Hunter said that nothing was so difficult as to know when a fact was a fact, I still 

 am sorry that I said that Dr. Mouat's facts had been called in question, as that 

 expression does, T must acknowledge, admit of a harsh interpretation. I do not 

 suppose Dr. Mouat puts this upon it ; I should regret it if any future commentator 

 should do so. 



