Typhus generally terminates by some imperfect crisis, metastasis, metaschematismus, miliary eruption (which may also be one of the symptoms), furuncles, abscesses, deafness, blindness, etc.

Death takes place by paralysis of the nerves, or by some local affection, inflammation of the bowels, or by colliquation, putrid decomposition.

It is very difficult to measure the exact extent of the danger, owing to the deceptive feelings of the patient, the uncertainty, and the variability of the symptoms, and the opposition which seems to exist between the apparent symptoms and the internal condition. The pulse likewise cannot always be relied upon, inasmuch as a rapid pulse is not always proportionate to the intensity, nor a calm and regular pulse to the unimportance of the disease. The urine indicates an improvement, if the turbid urine become clear, or the clear urine moderately turbid; if a sediment should form at the bottom of a lemon or straw-coloured urine, this is a sign of recovery. The danger increases in proportion as the head is more stupified, insensible, soporous, the patient feels well, the local paralysis spreads over an increasing number of parts; the tongue, for instance, feels paralyzed when talking, or when protruding it from the mouth; there is difficult deglutition, incontinence of urine, involuntary stool, violent convulsions. The greatest danger occurs when the skin is unequally warm, dry, or else covered with clammy sweat, or when a symptomatic miliary eruption, and petechia, break out upon the skin prematurely. Colliquative phenomena are likewise dangerous. "What is remarkable is, that deafness is generally a good sign (Hufeland).

§ 74. The treatment depends upon the individual nature of every case, and the remedies have to be chosen in accordance with the symptoms. The following remedies have proved efficient in the treatment of typhus: Bryonia, Bellad., Rhus, Phosphorus, Nux, Aconitum, Arnica, Arsenic, Ignatia, Acid, phosp., Hyosciamus, Stramonium, Chamomilla, Ipec, Carbo veg., Cina, Pulsat., Cocculus, Lachesis, Mercurius, Camphor, Opium, Hellebore, Valeriana, China, Acid, mur., Spir. nitr. dulcis, Digitalis, Secale cornutum, Staplysagria, Spigelia, Lycop., Natrum mur., Magnes. mur., and others.

Typhus frequently commences as a synochal fever, with congestion of the head and chest. The slight chills on the first and second day, in connection with loss of appetite, debility of the limbs, restless sleep, with frequent starting as if in affright, the elevated temperature of the skin shortly increasing to a stinging, burning heat, with a good deal of thirst, a full, accelerated, rather hard, pulse, and the scanty secretion of urine, point to a deep-seated affection, which will not get well without the interference of art. Only in a very few cases do we succeed in cutting the disease short; the difficulty of accomplishing this is probably owing to the vagueness and uncertainty of the symptoms, which make it impossible to hit upon a certain remedy. Frequently, however, the physician is sent for too late to prevent the development of the disease; the patient or his friends are not sufficiently acquainted with the nature of the symptoms to be aware of their dangerous character.

If typhus should set in with the symptoms of a synocha, such as: violent dry heat, burning skin, alternate redness and paleness of the cheeks, great erethism of the nervous system, restlessness, moaning, 10* tossing about, apprehensive anxiety, painful congestion of blood to the head, vertigo, nightly delirium, dry cough, which racks the abdomen: Aconite is to be exhibited, and should be repeated as the intensity of the fever requires. If there should be no abatement of the fever, or if other dangerous symptoms should make their appearance during the use of Aconite, the continued exhibition of this remedy would be highly improper, and would involve an irreparable loss of valuable time.

Sometimes Belladonna is indicated at the very commencement of the disease by the following group of symptoms: the disease is occasioned by fright or chagrin; convulsive twitchings of the limbs are present; the patient complains of constant uneasiness in the limbs, especially in the hands and feet, sometimes in the head, inducing a constant movement of those parts, and change of position; or the disease sets in with fainting turns, after which an excessive sensitiveness and irritability of all the organs remains, this being the first commencement of typhus; or the fever may commence with a continual drowsiness, increasing to lethargy, with snoring, during which the countenance changes frequently from cold and pale to red and hot, similar changes of temperature being observed in other parts of the body; if the consciousness should remain active during the sleep, the sleep is frequently disturbed by startings as if in affright, by frightful, anxious dreams, with vivid fancies, the fancies continuing in the waking state, with inability to collect one's senses. In the waking state Ave observe in the patient various disturbances of the mind and senses, which do not justify the expectation of a sudden disappearance of the symptoms; the patient is disposed to whine, he is fearful, anxious and restless, he moans, groans, starts out of his bed, complains of internal heat, with headache and vertigo; or else he is indifferent, is not disposed to talk, and is frequently subject to illusions of the senses and the fancy.

As the disease progresses the erethic fever increases, the delirium becomes more furious, the patient has visions in the waking state, startings as in affright, with internal, burning heat, without thirst, distention of the veins of the head, violent throbbing of the arteries of the head, especially in the forehead and temples, violent pressing pains in the temples, from within outward, which become intolerable by movement, conversation, light, walking through the room, and are accompanied by vivid fancies and delirium; the patient stares, the whites of the eyes are red; in his rational moments the patient complains of buzzing in the ears, scintillations, and blackness before the eyes; the lips and buccal cavity are dry, the tongue is red, burning-hot, parched; the appetite is gone, the patient complains of a violent burning thirst, with difficult deglutition, on account of the violent dryness; distention of the abdomen, with sensitiveness to the touch and frequent small diarrhoeic stools. The scanty urine is generally dark-red, becomes turbid, and deposits a reddish sediment. When these symptoms occur, repeated doses of Belladonna are the best remedy.