TYPHUS

This term (implying to burn with a concealed and smothered flame) is applied to certain continued fevers, attended by great debility and a tendency to putrefaction. It is contagious or infectious, and often epidemic, and is most prone to attack debilitated persons, especially where aided by want of cleanline , good food, and fresh air; so that it often spreads in hospitals, jails, camps, and other situations where such causes a ist its progre . This form of fever is liable to several modifications, commonly termed low fever, putrid fever, nervous fever, jail fever, . Its attack is generally characterized by inordinate muscular and nervous debility, and by great depre ion of spirits, wearine , flying pains, sighing, and a frequent, small, hard, and fluttering pulse; the tongue is foul and brown, and the taste impaired, and not unfrequently nausea and bilious vomiting prevail, constituting that variety of typhus which is sometimes called bilious fever. As the disease advances, the debility increases; the mouth becomes very foul, and the breath fetid; the urine deposits a brown sediment, and, together with the motions, is fetid, and rapidly putrefies; all these sjmnptoms increase in intensity; the speech becomes inarticulate, muttering, and delirious; there is a tendency to bleeding from the nose, mouth, and bowels; petechiae, or livid spots, appear upon the surface; the pulse sinks and intermits; the mind wanders; hiccup comes on; the hands and feet become cold; and, under these horrible symptoms, the patient dies. Such is an outline of the progre of a typhus fever to a fatal termination. In this climate it may endure for three weeks or a month; but in hot countries the symptoms follow each other more rapidly and violently, and it is not of more than eight or ten days' duration. When it does not terminate fatally, the symptoms begin to a ume a more favourable aspect about the twelfth or fourteenth day; the pulse improves, the patient gets some tranquil sleep, perhaps perspires; the urine deposits a red sediment; bilious stools are pa ed; he becomes more tranquil in mind and body, and his symptoms gradually disappear till health is restored; but it is a disease the event of which must be anticipated with the utmost caution, for attacks apparently mild sometimes terminate fatally, and in other cases the constitution has rallied under the most alarming and malignant features. At the very commencement an emetic and a mild aperient are proper, followed up by aromatic opiates, with camphor and ether. It is po ible that some particular symptom, indicative ef local congestion, may call for bleeiing or blistering: the former, except in some very rare cases, should be local only, and very limited as to quantity. Serpent aria, Peruvian bark, cascarilla, and Colombo are the tonics which are most relied on; and, with these, camphor, aromatic confection, opiate confection, and ether; or, if agreeable to the stomach and bowels, sulphuric and muriatic acids, in small doses, and acidulous drinks. Wine and brandy, and, in some cases, bottled ale and porter, are requisite to keep up the general powers of the system; but care must be taken lest their use should be followed by over-excitement, and the quantity in some measure regulated by the previous Jiabits of the patient. Broths, jellies, and the varieties of farinaceous food, may constitute the diet; and, in all cases, the utmost attention must be paid to extreme cleanline , frequent change of linen, ventilation, and the due use of chlorine fumigation. On the first attack of typhus, the eff"usion of cold water, performed two or three tunes a day, often affords much relief; and afterwards, when the shock of such a remedy would be too great, sponging the head and body with cold or with slightly tepid water is productive of infinite comfort. [s. 1285]