A History of Epidemics in Britain, Volume 2 (of 2): From the Extinction of Plague to the Present TimeCreighton, Charles
History
A History of Epidemics in Britain, Volume 2 (of 2): From the Extinction of Plague to the Present Time
Creighton, Charles
Epidemics -- Great Britain -- History
frequent, it could hardly have escaped the systematic apparatus of
clinical case-taking and post-mortem examination, with preservation and
drawing of specimens, for which Guy’s Hospital was already noted under the
influence of Bright and his colleagues, and in which the staff of St
George’s Hospital would appear to have been not less competent. Although
Dr Hewett, in 1826, identified his cases with the _dothiénentérite_ of
Bretonneau, yet neither he nor Dr Bright took the abdominal ulcerations or
sloughs as distinctive of a new kind of fever. They regarded them rather
as a new complication of “idiopathic” typhus fever, a “complication” which
appealed to them more on the side of treatment than of systematic
nosology; hence the writings of both physicians are occupied mainly with
the benefit of calomel in relieving the congestion of the bowels and in
checking the diarrhoea.
It is undoubted that cases of enteric fever in 1826-27 were relatively
more numerous in London than in Dublin and Edinburgh, where the epidemic
fever was almost wholly of the relapsing type. In Edinburgh, at least, the
comparative infrequency of enteric fever for years after it had been
recognized in Paris, Tours and other French cities, and had been found in
London as a common autumnal type, can be proved beyond cavil. Writing long
after of the first epidemic of relapsing fever in Edinburgh, Christison
said:
“Of enteric typhus (typhoid fever) we saw nothing then [1817-20], nor
for many years afterwards. If it might have been overlooked during
life, it could not have been missed after death. For our dissections
were many, and, to meet the bias of the day for finding a local
anatomical cause for all fevers [the doctrine of Broussais], every
important organ in the body was habitually looked to. Nevertheless we
were constantly met with the want of morbid appearances anywhere,
unless slight signs of vascular congestion in various membranous
textures be considered such[351].”
These vascular congestions were, indeed, scanned closely for traces of
ulceration, after Bright’s plates of 1828, and any little irregularity on
the surface of a congested Peyer’s patch was liberally construed in that
sense, as in Craigie’s reports subsequently. But in the Edinburgh epidemic
of 1827-29, the anatomical signs of enteric fever were wanting until the
end of it. Writing in 1827, Alison said that he had dissected 26 cases
dead of the epidemic fever, without finding intestinal ulceration in one
of them. Christison, however, says that a very few cases of enteric fever
were dissected in Edinburgh in 1829[352].
In Dublin, also, the anatomical mark of enteric fever was missed in
1826-27, in the few dissections that were made during the epidemic[353].
An opinion in a widely different sense was given on that point by Stokes
twelve years after the event, to which I refer in a note[354].
Public-domain text, read in full here on John Shaqi.
Reviews
Reviews
No reviews yet
Be the first to share your thoughts on this work.
Elsewhere in the archive
Join the Discussion
Join the discussion
Sign in to leave a comment or review.
Sign InorCreate an account