The disease usually began with a chill, headache, palpitation of the heart, difficulty in breathing, and later a profuse, very malodorous emission of sweat from all parts of the body. The patient quickly lapsed into a state of lethargy. The progress of the disease was uncommonly rapid; ‘in one day either the disease or the patient came to an end,’ says Fracastorius. Any patient who did not succumb, recovered completely after one or two weeks. From the sixteenth century on notices are more abundant; we now hear of epidemics of typhus fever throughout all Europe, although we do not know positively where the disease first appeared. ‘At all times,’ says Hirsch,[19] ‘as far back as historical investigation is able to follow the course of typhus fever at all, the disease has always been bound up with the most dismal calamities of the nations. The supposition is therefore justified that, in the numerous war-pestilences and famine-pestilences of antiquity and the Middle Ages, regarding which we have no medical reports and must rely only upon the chronicles, typhus fever has played a conspicuous rôle.’ By this, however, Hirsch does not mean to say that the specific disease in all the so-called war-pestilences was typhus fever; on the contrary, he adds: ‘In saying this I by no means wish to imply that I always identify “war-pestilences” and “famine-pestilences” with epidemics of typhus fever; those pestilences, appearing at epochs of general misery, for the most part represent a mixture of diseases, especially catarrh of the stomach, dysentery, scurvy, typhus fever, and frequently malaria and typhoid fever, which not only by chroniclers, but also by medical statisticians, have quite often been lumped together as _one disease_.’ It is to-day almost impossible to analyse these accounts, in which we can distinguish only individual characteristics of those various diseases. This appears most distinctly in the reports of the chroniclers and historians regarding the war pestilences and famine pestilences of antiquity, and it also explains the futile effort of the historians to reduce to one disease known to us the numerous and complicated symptoms which they have looked upon as the expression of a single disease-process—an effort which has led some of them to the somewhat extravagant conclusion, that they were diseases which are now extinct. The same backwardness, furthermore, characterizes—though to a lesser extent—the descriptions which the physicians of the seventeenth and eighteenth centuries wrote of the epidemics of ‘putrid fever’, ‘bilious fever’, and ‘mucous fever’ occurring at that time. Here, too, in many cases it was evidently a question of the simultaneous outbreak of various diseases, the nature of which even the most expert critic could not afterwards determine with certainty.