A complaint, combining Inflammation of the Lungs with some of the worst symptoms of Typhoid Fever, has frequently prevailed, as an epidemic in various parts of America, and has sometimes been exceedingly fatal. It was first noticed in the year 1806, in a town in Massachusetts, from whence it spread gradually, winter after winter, through New England, into Canada and the Middle States, until in 1813 it had reached Philadelphia. In 1815 it prevailed in South Carolina, and again in 1816, since when it is seldom that a winter has passed without some cases of it.

The same complaint is stated as being not uncommon in Ireland, and a number of cases are stated to have been admitted into the Westminster Hospital, in London, in 1838. It has also prevailed in various parts of Scotland. It has sometimes been called Spotted Fever; and in some localities has been known under the names of Cold Plague, Head Pleurisy, and Bilious Pleurisy.

Its mode of attack is sometimes uncertain, but it usually commences with a chill, which is often of great severity and long continuance, the heat of the whole surface being to the touch much below the standard of health. This cold stage is sometimes so intense as to destroy the patient before the slightest reaction occurs. Where the disease is violent in its attack, the patient may suddenly become cold and pulseless, lethargic, and often insensible without previous complaint. Dr. Gibbes has known instances in which the patient was found dead, or died within three or four hours after being in apparent health. Dr. Mackintosh, of Edinburgh, has seen the disease, in the strongest subjects, prove fatal in from forty-eight to sixty hours. Being usually brought on by exposure to a cold and damp atmosphere, its attacks are assisted by all those causes that depress the vital energies of the system, such as bodily or mental fatigue, intemperance, improper or deficient diet, insufficient clothing, mental distress or anxiety, long watching, etc.

During the cold stage, the breathing is short and painful, and there is usually pain in both the chest and head, and occasionally also in the. back, limbs and other parts of the body, resembling rheumatism. The muscular strength is diminished, and there is great restlessness. The heat is often unequally diffused over the body, some portions being hot and others are comparatively cool. Occasionally the skin becomes hot, dry, and harsh, while at other times, it is cool, relaxed and clammy. After a longer or shorter time, reaction ensues, and the pulse becomes fuller and more frequent, but seldom hard. Generally a cough comes on within twenty-four hours, by which the pain in the chest is greatly-increased, particularly if the cough is dry; as soon as expectoration commences, the pain in the chest is mitigated. The matter expectorated is usually a thick, tenacious mucus, often tinged with blood, but at other times of an ash or dark brown colour.

Occasionally, but not always, there is a peculiar pink tinge on the face, which is at the same time puffed or bloated: this tinge is at times observed on other parts of the body.

The tongue, at the commencement of the disease, is often clean but red, particularly at its edges; at other times it is thickly coated with a yellow mucus, Which, as the disease progresses, changes to a dark brown, the tongue becoming at the same time hard, dry and rough.

In many cases, there is great restlessness and delirium from the commencement of the attack.

As the disease advances, the teeth become coated; the breathing shorter and more oppressed; the strength lower; the pulse smaller and weaker; the patient sinks into a state of low muttering delirium, and death soon terminates the scene. The duration of the disease is very uncertain; it may last for a few hours or many days. The pulse becoming fuller and firmer, the surface of the body getting warm, soft, and moist, the tongue cleaner and less red, the delirium diminishing, the expectoration becoming more free and copious, the cough less frequent and annoying, the pain in the chest less intense, the breathing easier, and the occurrence of sleep, from which the patient awakes refreshed, are good indications of improvement. Recovery, however, is generally slow, while slight exposures, or imprudence of any kind, is very apt to bring on a relapse.


If the inflammatory symptoms are very severe, it may in some cases be necessary to take blood from the arm, but generally, it will be sufficient to apply leeches to the seat of pain, or to apply cupping glasses. The patient should be placed in a hot bath if possible; if not, the feet and legs should be put into hot water, and this may be repeated every few hours. A brisk purgative may be given, either of Castor Oil, or Cathartic, No 3, or the Cathartic Pills, No. 4. Large blisters over the chest will also be necessary.

The following mixture may be given:

Antimonial Wine........................Half an Ounce.

Ipecacuanha Wine.....................Half an Ounce,

Oatmeal gruel sufficient to make....Half a Pint.

An adult may take two tablespoonfuls every three hours, and ten grains of Dover's Powder at bedtime.

As long as the inflammatory symptoms continue the diet of the patient must consist of gruel, sago, milk, etc. But where there is much prostration and extreme muscular debility at an early stage of the disease, it will be necessary to keep up the strength of the system. In this case the patient may take Camphor and Carbonate of Ammonia.

Carbonate of Ammonia.........................5 Grains.

Sweet Spirit of Nitre........ ...................30 Drops.

This may be taken every hour, in a glass of water; and the following pills may be taken at the same time:

Camphor..............................12 Grains.

Opium.................................. 1 Grain.

Crumb of bread, sufficient to make into 12 pills, two for a dose.

When the disease has subsided, and merely debility remains, the patient may begin to take Quinine in one or two grain doses, three rimes a day, or he may take the Citrate of Iron and Quinine in five grain doses. At the same time he may take nourishing food; as Beef Tea, Boiled Chicken, Boiled or stewed Mutton, and occasionally a little wine.