The symptoms which denote this affection in typhus, are perfectly
similar to those which have been stated to characterise it in synochus,
but they undergo certain modifications, the true nature of which appears
to me to have been greatly mistaken, and, after the most careful
attention which I have been able to give the subject, the mistake seems
to me to be of so much magnitude, that I think whosoever shall
effectually correct it, will do the greatest possible service to
medicine, and, through it, to his fellow men.
1. There can be no question that, from the very first commencement of
the attack, as well as through the whole course of the disease, the
prostration of strength, both physical and mental, is greater in typhus
than it is in synochus. This greater loss of energy is indicated by
every sign that can be conceived to denote it. The loss of power in the
muscles which support and move the body is oftentimes so complete, as to
be most alarming to the patient and his friends; while the contrast
between the vigor and the torpor of the mind, in the course only of a
few hours, is most striking. From the full and active exercise of its
faculties, it becomes, in that short space of time, quite incapable of
performing any intellectual operation. It is confused and stupid, always
in a greater degree than in synochus, and sometimes to such a degree,
even on the very first day of the attack, as to excite the utmost
apprehension in every one around the patient who takes any interest in
his fate.
2. The chilliness is, upon the whole, greater and longer-continued than
in synochus: yet there is less constantly shivering, and the heat, when
it succeeds this state of chilliness, is seldom as great as in the
latter; while there are cases in which the heat never exceeds the
natural standard.
3. The febrile uneasiness is greater; the restlessness is incessant; the
face is pallid; the features are shrunk; the expression of the
countenance is most peculiar; it is strikingly indicative of weakness
and suffering; the experienced eye can tell at a single glance, even at
this early period, to which of the two types that countenance belongs.
The pulse is always weaker and more rapid than in the corresponding
stage in synochus.
Public-domain text, read in full here on John Shaqi.
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