8. The connexion between delirium and muscular tremor, between muscular
tremor and subsultus tendinum, and between both, and the passing of the
stools and the urine unconsciously, has already been pointed out. Like
delirium, muscular tremor is much more constantly present in typhus than
in synochus; and its relation to delirium is so close that it is
sometimes observed to supervene on the very same day; frequently on the
day following; and, if it appear at all, it is seldom longer absent than
the third. Its degree likewise is commonly in proportion to the violence
of the delirium; and though early and great delirium may appear without
it, yet it very rarely appears without delirium; and in general all
these symptoms form one series or train; pain disappearing, confusion of
mind increasing, muttering incoherence supervening, and muscular tremor
and involuntary and unconscious stools rapidly succeeding.
9. In the commencement of typhus the pulse is sometimes of good
strength, and it may not exceed 90 in frequency; but as the disease
advances it uniformly becomes weaker, smaller and quicker; so that death
rarely takes place before it has reached 120. In the severer cases it is
weak, quick, and easily compressed at a very early period.
10. The respiration is often not very obviously affected, but if it be
attentively observed it will usually be found to be shorter and quicker
than natural.
11. The tongue is always foul on the first or second day; it seldom
continues moist longer than three or four days; it is often quite dry as
early as the fourth, especially on the body and at the root; the apex
and the edges sometimes remain moist a day or two longer; but in a short
time the whole tongue becomes perfectly dry and of a brown colour; as
the disease advances the colour often changes to a darker and darker hue
until it becomes quite black; it is then frequently fissured into deep
chaps, while the lips and teeth soon become covered with a black sordes.
Were the sensibility not greatly altered, such a condition of the mouth
and tongue must be attended with insatiable thirst; yet thirst is often
not felt, although at other times it is considerable.
12. In the early stage of typhus the skin is frequently hot; as the
disease advances the heat lessens: through the greater portion of the
disease it is moderately warm; towards its termination it becomes cool,
and some days before death it falls below the natural standard. It is
always of a darker colour than in synochus: the whole surface is of a
dull and dusky tinge. Sometimes it is covered with dun coloured
petechiæ, at others with petechiæ of a florid colour.
Public-domain text, read in full here on John Shaqi.
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