In many instances, however, the amendment is so gradual, that we can scarcely say when it begins. Sometimes the favourable crisis is preceded by an aggravation of most of the former symptoms, and a marked increase in the general distress.

Certain evacuations are also sometimes observed to accompany or be connected with the favourable change, and the most common of these is the evacuation of sweating.

When convalescence has once fairly begun, it goes on rapidly, and recovery from Typhus Fever is mostly both early and complete.

Typhus Fever is now generally acknowledged to be highly contagious. We find even in hospitals,where cleanliness and ventilation are prized and enforced, that this fever attacks most of the persons who come oftenest and most closely in contact with those already sick with it; chiefly the nurses, next the clinical assistants, and the most assiduous of the students, and the medical officers. Every physician (writes Dr. Tweedie, whose testimony relates to Typhus, rather than to any other species of fever) connected with the London Fever House, with one exception, has been attacked with fever; and three out of eight have died of it. Also the resident medical officers, matrons, porters, laundresses, domestic servants not connected with the wards, and every female who has performed the duties of nurse, have one and all, invariably been the subjects of fever. And to show that the disease is capable of being conveyed by means of contagion contained in clothes, the laundresses whose duty it is to wash the patients' clothes, are so invariably attacked with fever, that few women will undertake the office.

In the year 1866, a widow woman was living with one of her daughters, in the small village of Scorton in Lancashire. This was considered a model village; it contained no public house or beer-shop, and its inhabitants were quite healthy and free from fever. Another of the widow's daughters fell ill of Typhus Fever at Wigan. The daughter from Scorton went to Wigan to attend upon her sister, and was herself attacked. Shortly afterwards, the mother went to their assistance, and she, too, caught the malady. The daughter who had left her home died; the other returned with her mother to Scorton, both of them being then in a convalescent state. On arriving at Scorton, they were helped out of the conveyence which took them from the railway station to their house, by a man who soon afterwards was attacked with the fever and died. The disease then appeared in the house of a man named Wells, for whom the widow used to wash. Three of Wells's family were taken ill, and one of his daughters died of the disease. Gradually the epidemic spread from house to house, till of 36 families living in the village, 23 were more or less affected with the fever. Eighty cases occurred in and around the village, and ten of them were fatal.

The cook of Trinity College, Cambridge, living in a street called the Petty Curry, had a daughter in London who fell ill with Typhus Fever, and who insisted upon going home. At that time there was probably no case of fever in Cambridge: certainly none in the Petty Curry, as Dr. Haviland satisfied himself by inquiry.

The girl was very ill indeed after she reached her father's house; but she ultimately recovered. Every inhabitant of that house, except an old seasoned nurse, became affected with the fever; and three or four of them died. But no fever existed in the other houses in the same street. When one of the sick persons was convalescent, it was thought that her recovery might be accelerated if she were put into a lodging at Trumpington, a small village two or three miles from Cambridge, in which there certainly was then no fever. Here she and the old nurse were waited on by a servant belonging to the Trumpington House. That servant soon sickened of the fever, and was sent to Addenbrook's Hospital, where she died.

These are samples of the large stock of evidence we possess of the contagiousness of Typhus Fever. Dr. Murchison, however, believes, that Typhus Fever may be generated spontaneously, independent of contagion. The poison, he says, is generated by the concentration of the exhalations from living beings, whose bodies and clothing are in a state of great filth. This opinion was maintained, on the ground of large opportunities for observation by the late Professor N. Chapman, of Philadelphia, as well as by Dr. G. B. Wood.

Treatment

Where choice can be made, a large apartment should be selected for the sick person. Unless the weather be very hot, there should be a fire in the room, for it acts as a ventilator. (Not a fire in a shut-up stove, but, if possible, in an open fireplace; and, if a stove is unavoidable, the door of the stove should be kept open; all "drums" are to be avoided, and you should be careful that the stove-pipe is not fitted with one of those abominations called "dampers," as they throw a vast deal of foul gas into a room, and many persons have lost their lives through using them,) The air of the chamber should be kept fresh by having a window or a door (according to the weather) always open; or both window and door. Bed and window curtains, carpets, and all superfluous articles of furniture should be removed. Great care should be used in keeping the patient clean, by sponging his body frequently with warm water-to which a little Carbolic Soap may be added,- and by frequently changing his sheets and body-linen; and these should be at once immersed in water, in which Condy's fluid, or Chloride of Lime, or Carbolic Acid, has been mixed; and all discharges from the sick person's body, should be received into a vessel containing one of the above disinfectants, or a strong solution of Sulphate of Iron, (Green Copperas.)

All unnecessary intercourse with the patient, by his family and friends, should, for his sake as well as for theirs, be forbidden. As life advances the susceptibility to the disease seems to diminish, for which reason the nurses and other attendants on the patient should not be very young; and, if possible, it is desirable that they should themselves have had the fever. All who approach the sick-bed should take care to avoid as much as possible, inhaling the patient's breath, or the emanations which proceed from his person.