A system of practical medicine. By American authors. Vol. 1 : $b Pathology and general diseases
History
A system of practical medicine. By American authors. Vol. 1 : $b Pathology and general diseases
Medicine -- Practice
It would seem only natural that intemperance, by diminishing the
powers of resistance in the individual, would increase his liability
to contract typhoid fever, but there is no proof that it does so. Few
of the patients who have come under my care were intemperate, and
still fewer were broken down by this cause. There is also no evidence
that grief, fear, or any other depressing emotion is a predisposing
cause of the disease, and the same may be said of bodily fatigue and
overcrowding. On the other hand, much importance has been attached by
writers to idiosyncrasy as a predisposing cause of typhoid fever. What
the peculiarities of constitution are which increase the liability to
the disease are not definitely known, but there can be no question
that it occurs much more frequently, and is much more fatal, in some
families than in others.
Typhoid fever occurs with the greatest frequency in this country, as
it does with very few exceptions elsewhere, during the latter half of
summer and the early part of autumn. Indeed, its greater prevalence at
this season than at other times has given to it the name of "autumnal"
and "fall fever," by which it is popularly known in many sections of
this country as well as of England. On the other hand, the disease is
usually at its minimum in May and June. The number of cases, however,
does not usually immediately diminish upon the onset of cold weather.
On the contrary, R. D. Cleemann,[23] from a comparison of the
mortality returns of Philadelphia for a period of ten years, observed
that after diminishing in November they not infrequently underwent a
marked increase in December. Of 621 cases treated at the Pennsylvania
Hospital during the last ten years, 89 were admitted during spring,
259 during summer, 182 during autumn, and 91 during winter. Of 5988
cases treated at the London Fever Hospital,[24] 759 were admitted in
the {246} spring, 1490 in summer, 2461 in autumn, and 1278 in winter.
Of the whole number, 27.7 per cent. were admitted in the two months of
October and November, and in April and May only 7.3 per cent.
Hirsch[25] has published statistics which do not differ materially
from these. He also mentions the interesting fact that in Rio Janeiro
the maximum of the disease occurs in the months from March to June,
or, in other words, in the season which in that latitude corresponds
to our autumn. There are, however, some exceptions to the general rule
of the greater prevalence of the disease during the autumn. Bartlett,
who was aware of its greater frequency at that time, refers to an
extensive and fatal epidemic which occurred in the city of Lowell in
Massachusetts during the winter and early spring; and similar
visitations have been observed in other places.
[Footnote 23: _Transactions of the College of Physicians of
Philadelphia_, 3d S. vol. iii.]
[Footnote 24: Murchison.]
[Footnote 25: _Handbuch der Historisch-Geographischen Pathologie_,
Stuttgart, 1881.]
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