Typhus, a malignant contagious fever, attended with remarkable prostration of strength. - Great disputes have prevailed among physicians, respecting the real nature and proper denomination of this malady; but, as the names by which it has been distinguished, mostly depended on the different degrees of violence, observed in its progress, and a variety of other circumstances, we shall briefly describe this dangerous fever.
Beside the usual febrile symptoms, a typhus is characterised by uncommon dejection ; languor ; interruption of the animal functions ; and weakness of pulse: the tongue appears moist and clean, or covered with a thin white coat; the urine is pale. After a few days, the patient feels anxiety; depression at the pit of the stomach ; and becomes delirious; till at length he 19 seized with stupor, which frequently terminates in a profound sleep : the excretions by stool and urine pass off involuntarily; rily; and about the 14th, 17th, or 21st day, the scene is often closed with convulsions; though sometimes protracted to a later period.
Causes: - Contagion, or infection, by contact with diseased persons ; excessive evacuations of every kind; depression of mind ; a studious life, attended with nocturnal watching; long subsistence on crude and impure food ; putrid effluvia of poisons and hospitals, arising from corrupted substances, stagnated waters, etc.
The event depends entirely on the greater or less violence of the symptoms, and the relative tendency to putrescence : hence, the following are deemed favourable signs: a gentle moisture over the body; especially when succeeded by a moderate looseness ; and the strength of the patient appears to be supported by the remedies applied. On the other hand, delirium ; continual watchfulness ; sickness; and convulsions; cold or clammy sweat, emitting a cadaverous odour; all these are inauspicious omens, especially when the patient lies on his back with his knees drawn up, and the body gliding downward. If the spots, that generally appear about the 11th or 14th day, be of a dark and livid hue, great danger may then be apprehended.
Cure : - Abstinence from all animal food, and an immediate removal from a contaminated atmosphere to a clean, dry, and airy situation. If the alimentary canal be oppressed by crudities, either an emetic, or moderate laxative, according to circumstances, should be timely administered. Mild su-dorifics, in conjunction with tonics, especially the Peruviail bark, and vegetable acids, conveyed in copious draughts of diluents, with the addition of wine, have generally been found beneficial. If the head be much affected, blisters, applied to the neck, sometimes afford relief. Should the patient, about the 7th, 11th, or 14th day, feel oppression, anxiety, and uneasiness, an eruption on the neck, chest, or back, may be suspected ; in which case, gentle cordials will be proper. Colliquative sweats may be counteracted by the use of generous wine and bark. When the appetite returns, the patient should first subsist on thin, chicken and other broths ; weak jellies of sago, hartshorn, etc. Thus, slight attacks of this fever may often be removed. But, when it rises to a degree of malignity (such as is often experienced in hot climates, on account of the noxious exhalations during the night), it will be advisable to attend first to the necessary evacuations; after which, the bark, aether, and camphor, should be freely administered with red or Rhenish wines, fixed air, and other antiseptic remedies : if the eyes appear wild, and the speech be quick, blisters, or fomentations of vinegar and warm water, ought to be immediately applied to the feet. Cold bathing, however, has often been attended with more salutary effects. According to the late theory and practice of Dr. REich, the liberal use of the mineral acids, especially of the muriatic, or spirit of salt, has proved of the greatest service; but, neither this powerful medicine, nor bathing or affusion with cold sea-water, can with safety be ventured upon, without medical advice; for no disease demands more professional sagacity and judgment than the true typhus.
Consistently with our promise (vol. ii. p. 269), we shall only add, from our own recent experience, that the internal use of this acid, when large doses of it are required, is liable to many serious objections, which must ever prevent its general adoption. But we are nevertheless convinced that it may, in all cases, be safely applied in the form of liniments, fomentations, and baths : thus, a very large, and much larger proportion than by swallowing it, may be daily, nay, hourly, introduced into -the system, especially in the earlier stages of the disorder, before the patient's strength is too much exhausted. Farther, we are of opinion, that in desperate cases, where a valuable life is at stake, the muriatic acid, sufficiently diluted, may be introduced into the stomach, by means of the tube contrived for that purpose by Mr. SavigNy. - Such attempts, however, can be justified only by the most pressing circumstances, and should never be made without medical assistance.