This disease is of a low sinking character, the nervous system being particularly involved. Under this head we may include the dreaded, and so often fatal, ship and hospital fevers They are in reality a violent form of Typhus.
This fever may assume from the commencement the form of Typhus, or, as is very often the case, especially under the prostrating treatment of the Allopathic school, other varieties of fever may run into this low sinking and more dangerous malady. Besides the two forms already mentioned, there are three forms of Typhus, more or less distinct, notwithstanding the general symptoms may be the same. These are:
1. Cerebral Typhus, or Typhus cerebralis, affecting principally the brain and the nervous system
2. Typhus Abdominalis or abdominal Typhus, where some part of the abdomen is the principal seat of the disease.
Typhus in its progress may indicate a high state of nervous action (Typhus versatalis), or the patient may be constantly inclined to stupor (Typhus stupidus), or it may be of a putrid character (Typhus Putridus), where there is a strong tendency to disorganization and decay. This is the most alarming form of the disease.
The causes are numerous, and some of them remote. It may arise from hunger, bad food, ill-ventilated apartments, where numbers are crowded into a small space and the air rendered highly impure, exposure, want of cleanliness and those hundred causes, to which the poor are exposed. It may arise also from chagrin, sadness, grief, care, disappointed love, disappointment in business, violent exertions of the mind and body, venereal excess, depressing emotions, excessive heat, prostration from disease, or from medical treatment, which may be worse than the disease; dampness, cold, and a peculiar state of the atmosphere, which may fail to give sufficient sustenance to the vital forces, and thus develop epidemic Typhus.
The progress of the disease is often slow, sometimes lasting twenty-one or twenty-eight days, and even longer. The convalescence is also slow, and the patient, unless great care is used, very liable to a relapse. The precursory symptoms, headache, lassitude and a general derangement of the system, unless controlled by appropriate remedies, not unfrequently last for days and even weeks. Perfect quiet, great cleanliness, a room well ventilated and not too dark, are absolutely essential. There are several indications which every good nurse can watch, and which will indicate to a certain extent the danger, or immediate prospect of convalescence.
1. The Pulse. Should this gradually become quiet and even, hope would naturally and justly brighten, but the more accelerated it becomes, the more the danger to the patient increases. A constant variation in the pulse is a worse indication even than its frequency.
2. The Urine. Should it be clear, thick, brown, bloody, or with a cloud floating or rising towards the surface, or with a sediment, with the urine turbid above it, the danger is great, but should there be a gradual clearing up of urine previously thick, or previously clear urine become turbid, improvement is indicated.
3. Haemorrhages, especially by urine and stool, diarrhoea, putrid, fetid smell, are indicative of putrid dissolution. Deafness, though naturally exciting alarm in the friends, is by no means an unfavorable symptom.
This disease, notwithstanding it steals on, as a general thing, slowly, yet it firmly and surely gains a footing, unless arrested by appropriate remedies, and may in a short time so prostrate the system as to render the prospect of recovery very extremely hazardous. During the premonitory stage, the patient is languid, easily tired; he loses his appetite, the tongue becomes white, and inclined to tremble. There are wandering pains in the head, chest, back, abdomen or extremities, fullness and giddiness of the head, drowsiness, and unsound and un-refreshing sleep at night. These precursory symptoms may last for days or weeks. The commencement of the fever is marked, not by a violent chill, but by slow chills alternating with heat, and sometimes violent headache. The expression of the face is dull and heavy, and there is no desire for exertion either of the mind or body. On pressing heavily on the abdomen near the right hip, a sensation of pain is distinctly felt. As the disease progresses, the skin becomes dry and hot, the appearance of the tongue is exceedingly variable. At times it may be clean, smooth and red, then again slightly furred, the tip and edges red, with a dark brown almost black streak in the centre, or the whole tongue become dark and excessively dry. Sordes form about the teeth. Delirium, generally of a low muttering kind, although sometimes more violent in its character, a vacant or indifferent look, perfect indifference to every thing, stupor, gradually sinking down in the bed, diarrhoea, etc, are among the symptoms which may be developed during the progress of the disease.
Perfect quiet, cleanliness, a room well ventilated and not too dark, cold water, or toast water, whenever desired, are of course essential. If during the precursory symptoms there should be chilliness, lassitude, with alternate heat, headache, giddiness, rheumatic pains, pain in the back, furred tongue and restlessness at night, Bryonia and Rhus, two drops or twelve globules in a tumbler of water may be used in alternation a tablespoon-ful at a dose two hours apart. These will often be sufficient to arrest the disease, but should inflammatory symptoms set in, such as a dry and burning skin, hard full pulse, restlessness, thirst, congestion of blood to the head, Aconite should be administered.
Mix two drops or twelve globules in a glass half full of water, and give a teaspoonful every two hours.