Part 166

Depressing emotions, as a cause of typhoid fever, 245

Dermatitis, complicating vaccination, 468 vaccination, treatment, 469

Desquamation, date of, in mild scarlet fever, 506 in erysipelas, 633 in relapsing fever, 377

Desiccation in varicella, 482 in variola, 440

Diagnosis, general, 148 divisions of, 148 main direction of inquiries, 148 proper method of procedure, 150 significance of alteration of voice in, 158 of anthrax in animals, 936 in man, 942 of cerebro-spinal meningitis, 826 of cholera, 750 of comatose form of pernicious malarial fever, 609 of dengue, 884 of diphtheria, 689 of erysipelas, 635 of idiopathic parotitis, 624 of glanders in horse, 918 of glanders in man, 923 of influenza, 872 of intermittent fever, 594 of leprosy, 792 of the plague, 782 of pyæmia from septicæmia, 978, 979 of remittent fever, 600 of rabies and hydrophobia, 900 of relapsing fever, 418-422 of rötheln, 587 of rubeola, 575 of scarlet fever, 532 of simple continued fever, 234 of symptomatic parotitis, 627 of typhoid fever, 311-314 of typho-malarial fever, 616 of typhus fever, 358, 359 of vaccinia, 464 of varicella, 483 of variola, 447 of varioloid, 444 of yellow fever, 648

Diaphoretics, use of, in yellow fever, 649

Diarrhoea in cerebro-spinal meningitis, 814 in cholera, 738 results, 738 treatment, 760 in mild scarlet fever, 503 in pyæmia, 975 in relapsing fever, 405 in rubeola, treatment, 581 in septicæmia, 977 treatment, 983 in typhoid fever, 287 treatment, 331

Diarrhoeal diseases from impure water, 182

Diathesis, 127 hereditary, transmission, 130

Diet in anthrax, 944 in beriberi, 1042 in cerebro-spinal meningitis, 834 in cholera, 763 in convalescence, 206 in erysipelas, 639 in glanders, 924 in influenza, 874 in relapsing fever, 430 in pertussis, 848 in puerperal fever, 1036 in pyæmia, 982 in rubeola, 579 in typhoid fever, 323 in typho-malarial fever, 619 in typhus fever, 362 in yellow fever, 654 of convalescence, 206

Digestion, condition of, in cerebro-spinal meningitis, 814

Digestive tract, condition of, in glanders, 921 in idiopathic parotitis, 623

Digitalis, use of, in puerperal fever, 1033 in relapsing fever, 428 in scarlet fever, 543 in typhoid fever, 330 in yellow fever, 651

DIPHTHERIA, 656 Synonyms, 656 Definition, 656 History, 656 et seq. Panum's view regarding relation of bacteria to, 667 Etiology--Age, influence of, on causation, 680 Sex, influence of, on causation, 680 Causes of frequency of, in childhood, 680 Pharyngeal, buccal, and nasal catarrh a cause of, in children, 680 Physiological causes of, greater frequency in childhood, 681 Family predisposition, 681 Thermometric and barometric changes a cause, 682 Season as a cause, 682 Filth as a cause, 682 Polluted air as a cause, 682 water as a cause, 683 milk as a cause, 683 Contagiousness, 678 Modes of transmission of poison, 678 In the lower animals, 683 Transmission of, from lower animals to man, 683 Artificial production of membrane, 684 Invasion, 676 duration of incubation period, 679 Symptoms--Prodromal stage, 667 duration, 667 localized redness of mucous membranes, 667 Different manifestations of diphtheritic process, 668 Severe form, 668 appearance of membrane in severe form, 668 Gangrenous condition of membrane, 669 Swellings of glands at angle of jaw as sign of invasion of nasal cavities, 669, 670 Mode of invasion of nasal cavities, 669 Mode of spread to nasal cavities, 669 Nasal form, 669 Conjunctival form, 670 Aural form, 670 Laryngeal form, 671 Formation of membrane in larynx, 671 Tracheal and bronchial forms, 671 primary form, 672 Oral form, 672, 673 Intestinal form, 673 Of wounds, 673 Eruption of, 674 Vulvar and vaginal forms, 674 In puerperal women, 674 Vesical form, 674 Placental, 674 Liability of open wounds, 672, 679 Tendency to second attacks from chronic nasal and pharyngeal catarrh following, 670 Complications and sequelæ, 672 complicated by fibrinous pneumonia, 672 by broncho-pneumonia, 672 by erysipelas, 673 by urticaria and purpura, 674 by kidney affections, 674 by albuminuria, 674 by granular degeneration of blood, 675 by cardiac degeneration, 675 by symptoms of cardiac degeneration, 675 by embolism, 675 by acute endocarditis, 675 by leucocythæmia and Hodgkin's disease, 675 by nervous diseases, 675 by paralysis, 676 seat of, 676 date of appearance, 676 fatty degeneration and atrophy following, 676 sensory, 676 Secondary form, 671 Morbid anatomy--characters of the membrane, 685 Mode of formation of membrane, 685 Varieties of membrane in, 686 Rindfleisch's definition of diphtheritic inflammation, 686 Changes in the heart, 686 fatty and granular degeneration, 686 endocarditis, 687 cardiac thrombi, 687 Changes in lungs, 687 Spleen, 687 Liver, 687 Kidneys, 687 Muscles, 687 Lymphatic glands, 687 Mucous membranes, 688 Influence of different mucous membranes upon characters of false membrane, 688 epithelia upon growth and spread of false membrane, 688 Changes in intestines, 689 nervous system, 689 Diagnosis--significance of localized pharyngeal injection, 689 From muguet or thrush, 690 Follicular stomatitis, 690 Significance of glandular swelling, 690 lymphadenitis in nasal form, 690 Of laryngeal form, 691 Significance of absence of fever, 691 Of paralysis, 691 Prognosis--symptoms indicating favorable, 692 unfavorable, 692 Significance of glandular swelling, 692 In nasal, 692 Of fetid and putrid discharges, 693 Of epistaxis, 693 In laryngeal, 692 In tracheal, 692 Of tracheotomy, 692 significance of state of pulse after, 692 of dry respiration after, 692 of temperature-range after, 692 of character of membrane, 692 Influence of temperature, 693 state of pulse, 693 complications, 693 bronchitis and pneumonia, 693 endocarditis, 693 albuminuria, 693 affections of sensorium, 693 purpura, 693 icteric discoloration of skin, 693 Of relapses, 694 Treatment--hyperpyrexia, 694 Reflex symptoms, 694 Vomiting, 694 Futility of expectant, 694 Use of stimulants, 694 Amount of stimulants necessary, 695 Importance of general treatment, 695 Futility of venesection, 695 Prophylactic, 696 Danger of self-infection, 696 Prevention of self-infection, 696 Isolation, 696 Closure of schools and public places during epidemics, 697 Disinfection, 698 Special, 701 Local, 701, 709 by steam, 701 Use of water, 702 Ice and cold, 702 Cold baths, 702 Mode of applying cold, 702 Contra-indications to use of cold, 703 Solvents of pseudo-membrane, 703 Use of lime-water, 703 Slaking lime, 703 Lactic acid, 703 Pepsin, neurin, and chinolin, 703 Papayotin, 703 Pilocarpine, 704 objections to, 704 Turpentine inhalations, 704 Ammonium chloride, 704 Mercury, 705 Tincture of chloride of iron, 706 Carbolic acid, 707 Salicylic acid, 707 Quinia, 708 Bromine, 708 Boric acid, 709 Sodium salicylate, 709 Ozone, 709 Sulphur and cubebs, 709 Chlorate of potassium, 699 Dose of chlorate of potassium, 700 Danger in large doses of chlorate of potassium, 701 Mechanical removal of membrane, 709 Cauterization of membrane, 709 Glandular swellings, 710 Abscess of glands, 710 Of nasal form, 710 danger of permitting sleep in, 712 local applications, 710 Of conjunctival form, 712 Of laryngeal form, 712 use of emetics, 712 Of paralysis, 713 by strychnia, 713 by electricity, 713 artificial alimentation, 713 Of cutaneous form, 713

Diphtheria, complicating rubeola, 573 scarlet fever, 514 of genitalia in puerperal fever, 1002

Diphtheritic endometritis, 987 exudations, complicating rubeola, 735 membrane, cauterization, 709 mechanical removal, 709 conjunctivitis, 670 treatment, 712 inflammation, causes, 51 distinguished from diphtheria, 50 paralysis, treatment, 713 pock in vaccinia, 463

Disease, 35 Causes, 125, 175 arsenical poisoning, 193 climate, 185 cold, 133 contagion, 135, 200 epidemic influences, 135 errors of diet, 135 exciting, 125 exercise, abnormal, 134, 198 deficient, 135 functional, 134 habitation, 186 heat, 133 hereditary, 132 humidity of atmosphere, 133 improper clothing, 198 impure air, 177 ice, 185 water, 182 ingestive, 135 intemperance, 197 mental, 204 minute organisms, 141 predisposing, 125 pre-natal, 126, 175 poisons and misuse of medicines, 135 soil, condition of, 187 Definition of, 135 Elevation of site, influence of, 134 Means of discovery, 175 Abdominal, hot climate as a cause, 133 Respiratory, cold as a cause, 133 Prevention, 175 Respiration in, 156 Theory of--bioplastic, 140 chemical, 138, 140 fermentation, 138 germ, 138 points of objection, 142 undecided state, 147 Zymotic, table of, 136

Disinfectants, varieties, 202

Disinfection in anthrax, 937, 943 in cholera, 758 in diphtheria, 698 of glanders, 925 in the plague, 784 in puerperal fever, 1025, 1028 in pyæmia and septicæmia, 980 in scarlet fever, 201, 538 in typhus fever, 362 methods, 201 practical difficulties, 201 principles, 201

Dissecting poison, relation of, to causation of puerperal fever, 1018 wounds, relation of, to causation of septicæmia, 962

Dissemination of influenza, 863 in typhoid fever, 249 of puerperal fever by physicians, 1018

Diuretics, use of, in scarlet fever, 555 in wet beriberi, 1042

DRAINAGE AND SEWERAGE, 213 Back, ventilation of traps, 221 Disposal of liquid wastes by irrigation, 225 Frequency of leakage in waste-pipes, 222 Necessity of, in prevention of typhoid fever, 321 Of houses, 188 Necessity of abundant water-supply in, 220 Of soil, 226 Perfect, fundamental requirements, 213 Removal of human excrement, 215 of liquid household wastes, 220 Varieties of grease-traps, 221 Ventilation of waste-pipes, 223

Drainage-pipes, effects of large traps, 220 of too large bore, 220 of vertical position, 220

Drinking-water as a medium of disseminating typhoid fever, 248 propagation of cholera by, 723

Dropsies, 67-71

Drugs, use of, in the plague, 784

Dry form of beriberi, symptoms, 1040 treatment, 1043