§ 84. Typhus lentus. Lentescent typhus.

This kind of typhus is a primary, idiopathic disease, which does not depend upon any local affection, and may be occasioned by various causes.

The essential character of the disease is great nervous debility and prostration of all the functions. It developes itself slowly, sometimes for months, without any inflammatory symptoms. Sometimes it sets in as a sequel of an acute fever, inflammatory typhus; or it may arise from excessive physical and mental exertions, venereal excesses, onanism, great loss of blood, chronic hemorrhages, and blenorrhoea. The symptoms of such a fever are: small, quick, variable pulse; changeable urine; chilliness and coldness more frequent than heat; no sweat, or only evanescent sweat; cerebral symptoms; spasms; hypochondriac mood, which is greatest in the morning and before breakfast, when the patient feels worst; the fever is less after dinner, and then the patient feels better; these last symptoms distinguish the lentescent typhus from a hectic fever which depends on local causes. § 85. The treatment of slow typhus does not essentially differ from that of ordinary typhus. The following medicines will be found the most efficient: Cocc, Camph., Acid, phosp., Phosphorus, Lycop., Ignat., China, Ipec, Arsenic, Verat. alb., Plumb., Mercur., Helleb. niger, Digitalis, Conium, Cuprum, Stannum.

If the disease arise from care and chagrin, a small dose of Acidum phosph. is the most certain remedy (according to Rummel it may, in that case, be given alternately with Arsenic); if it arise from grief, one or two doses of Ignat. 18 will cure it.

Cocculus is an excellent remedy, if the disease be occasioned by frequent vexation and irritation of temper; the symptoms being as follows: frequent evanescent attacks of a disagreeable, burning heat, and redness of the cheeks; evening exacerbations characterized by hot hands, sensation of dry heat all over the body, sleeplessness at nights; or frequent shiverings in the day-time accompanied with great debility, so that the patient is obliged to lie down; the patient is very sensitive and irritable.

Repeated doses of Camphor may be administered when the temperature of the skin is very low, and the patient is very weak and not very sensible.

Ipecacuanha is undoubtedly one of the most distinguished remedies in this disease; it ought to be repeated frequently.

Veratrum, not too high, is an excellent remedy when the febrile paroxysm sets in at times in the evening, at times in the morning, with redness and heat of the face, heat of the hands, intermingled with febrile shiverings and accompanied with great despondency; between the paroxysms the body feels cold, and a cold sweat makes its appearance, at least upon the forehead, the patient being, moreover, very weak and listless.

Helleborus niger is indicated by the following symptoms: constant chilliness of the whole body with cold hands, burning heat internally, the head feels dull and stupid; the patient complains of drowsiness, heavinesss and debility of the feet, stiffness of the knee-joints. These symptoms occur when out of bed; as soon as the patient lies down he feels hot and sweats, without thirst.

China, Arsenic, and Digitalis, have been mentioned in detail in the chapters on typhus.