Part 183

Reflex irritability in hydrophobia, 899 symptoms in diphtheria, treatment, 694

Registration of dogs for prevention of rabies, 904

Relapse, in relapsing fever, 381

Relapses, cause of, in typhoid fever, 309 duration of, in typhoid fever, 304 frequency of, in typhoid fever, 302 in cerebro-spinal meningitis, 820 of diphtheria, prognosis of, 694 in rubeola, 563

RELAPSING FEVER, 369 Definition, 369 Synonyms, 369 History and geographical distribution, 369 Etiology, 370 Destitution and filth as causes, 370 Intemperance as a cause, 370 Starvation and over-crowding as a cause, 371 Age, relation of, to causation, 371 Sex, relation of, to causation, 371 Nationality, relation of, to causation, 371 Season, relation of, to causation, 371 Occupation, relation of, to causation, 372 Specific origin, 370, 372 Contagious nature, 372 Transmission of contagion, 373 Area of contagious atmosphere, 373 Spirillum, 373 Mode of detecting, 373 Inoculation, 374 Incubation period, 376 General clinical description, 374 Invasion, 376 Special symptoms, 376 Odor, 378 Physiognomy, 376 Bronzing of face, 376 Eruptions, 377 Hepatic eruptions, 377 Sudamina, 377 Desquamation, 377 Primary paroxysms, duration, 378 Temperature, 378 at crisis, 378 peculiarities, 382 Relapse, 381 Duration, 381 Absence, 380 Frequency, 382 Later relapses, 381 Cases illustrating frequency of relapses, 394 Average duration of paroxysms, 381 Intermission, duration, 381 Pulse, 382 Relation of pulse to temperature, 382 Character of pulse during paroxysm, 383 Pulse at crisis, 382 During intermission, 383 Character of heart-sounds, 383 Convulsions, 384 Mental condition, 384 Headache, 383 Wakefulness, 384 Vertigo, 384 Delirium, 384 General tremor, 384 Muscular rigidity, 384 Muscular and joint pains, 385 Cause of muscular and joint pains, 385 Seat of muscular and joint pains, 385 Motor paralysis, 385 Debility, 386 Perversion of special senses, 386 Respiration, 386 Relation of respiration, temperature, and pulse, 386 Bronchitis and pneumonia, 387 Condition of urine, 387 Urine of paroxysm, 388 of intermission, 388 Thirst, 389 Anorexia, 389 Condition of tongue, 389 Nausea and vomiting, 390 Hæmatemesis, 390 Condition of bowels, 390 of abdomen, 390 Spleen, enlargement, 391 Liver, enlargement, 391 Jaundice, significance of, 391 Epistaxis, 393 Hemorrhages, 393 Convalescence, 393 Varieties, 395 Grave form, 395 Multiple or protracted form, 395 Abortive form, 395 Case illustrating subintrant form, 396 Complications, 396 Peculiarities of temperature, 397 Mental hebetude, 398 Local palsies, 398 Severe rheumatic pains, 399 Disorders of vision, 399 Ophthalmia, 399 Disorders of hearing, 400 Otorrhoea, 400 Swellings and effusions of joints, 400 Bed-sores, 400 Gangrene, 400 Abscesses, 400 Anæmia, 400 Oedema, 400 Sudden collapse and syncope, 401 Hemorrhages from mucous surfaces, 401 Pericarditis, 402 Heart-clot, 402 Thrombosis and embolism, 402 Laryngitis, 403 Bronchitis, 403 Splenic enlargement, 403 Rupture of spleen, 403 Parotitis, 404 Pleurisy, 404 Pneumonia, 404 Pulmonary gangrene, 404 Metastatic abscesses of lungs, 404 Pharyngitis and tonsillitis, 405 Hiccough, 405 Diarrhoea, 405 Dysentery, 406 stools, 406 Suppuration of mesenteric glands, 406 General and local peritonitis, 406 Emaciation, 407 Renal disorders, 408 Albuminuria, 407 Suppression of urine, 407 Incontinence of urine, 407 Hæmaturia, 409 Glycosuria, 410 Metastatic inflammation of kidneys, 410 Disorders of menstruation, 410 Pregnancy, 410 Sequelæ, 398 Local palsies, 398 Acute miliary tuberculosis, 404 Dyspepsia, 406 Anæmia, 400 Morbid anatomy, 410 Post-mortem appearance of body, 410 Changes in voluntary muscles, 410 Blood, 411 Granule-cells of blood, 412 Changes in pericardium, 411 Heat, 411 Gastro-intestinal canal, 412 Solitary and agminated glands, 413 Mesenteric glands, 413 Larynx and pharynx, 413 Pleura, 413 Lungs, 413 Brain and membranes, 413 Liver, 414 Bile-ducts and gall-bladder, 415 Spleen and capsule, 416 Pancreas, 417 Peritoneum, 417 Kidneys, 414 Bladder, 414 Lymphatic glands, 417 Marrow of bones, 417 Diagnosis, 418 Presence of spirillum as a means, 418 From typhus fever, 418 From typhoid fever, 419 Grave form of, from typhoid fever, 420 From bilious remittent fever, 420 Yellow fever, 420 Small-pox, 421 Acute gastro-hepatic catarrh, 421 Simple febricula, 421 Rheumatic fever, 421 Acute yellow atrophy of liver, 422 Parotitis, 422 Cerebral diseases, 422 Prognosis, 422 Symptoms indicating unfavorable, 424 Influence of variations of temperature, 424 Cerebral symptoms, 424 Character of eruption, 425 Hiccough upon, 425 Epistaxis, 425 Cough upon, 425 Heart complications on, 425 Hepatic enlargement upon, 425 Splenic enlargement upon, 425 Jaundice upon, 425 Albuminuria, 425 Mortality--bilious typhoid form, 422 Influence of type of disease, 423 Stage of disease, 423 Season, 423 Habits and previous health, 424 Sex, 424 Age, 424 Race, 424 Cause of death in, 426 Treatment--indications for treatment in regular cases, 426 Hyperpyrexia, 426 Cause of failure of antipyretics, 429 Insomnia, 429 Headache, 429 Nausea and vomiting, 430 Constipation, 430 Jaundice, 431 Muscular tremor, 432 soreness and pains, 432 At critical fall of temperature, 432 Renal complications, 432 Epistaxis, 432 Collapse, 433 Necessity of absolute rest in, 432 Résumé of treatment, 432 Diet, 430 Special remedies, 431 Use of antiperiodics, 428 Arsenic, 427 Atropia, 429 Bromide and chloral, 430 Blisters, 431 Chloroform, 431 Cold baths, 428 Digitalis and other antipyretics, 428 Hyposulphite of sodium, 428 Opium, 429 Quinia, 426 Salicylic acid and salicylates, 428 Simple febrifuges, 428 Stimulants, 430 Venesection, 431

REMITTENT FEVER, 598 Definition, 598 Malarial nature, 598 Etiology, 598, 599 Relation of, to intermittent fever, 599 Symptoms, 599 Prodromal stage, 599 Paroxysm, 599 Temperature, 599 Epistaxis, 602 State of tongue, 600 Stomach, 602 Bowels, 602 Urine, 602 Jaundice, 600 cause, 600 Nervous symptoms, 602 Physiognomy, 600 Pulse in, 602 Duration of, 602 Diagnosis, 600 From intermittent fever, 600 From typhoid fever, 600 From yellow fever, 600 Prognosis, 602 Mortality, 599 Morbid anatomy, 602 Changes in skin, 603 Liver, 602 Spleen, 602 Treatment, 603 Main indications, 603 Use of quinia, 603 Amount of quinia, 603 Causes of failure of quinia, 604 Adjuvants to quinia, 604 Use of depuratives, 604 Purgatives, 604 Opium, 604 Of hemorrhage, 605 Of tympanites, 605 Of vomiting, 605

Renal disease, complicating relapsing fever, 408 scarlet fever, 525

Residence, change of, in treatment of beriberi, 1042

Resolution, incomplete, in idiopathic parotitis, treatment, 625 of symptomatic parotitis, treatment, 628 of erysipelas, 633 of inflammation, 54

Respiration in cerebro-spinal meningitis, 814 characters of, in idiopathic parotitis, 623 in general peritonitis of puerperal fever, 1010 in mild scarlet fever, 504 in relapsing fever, 386 in septicæmia lymphatica, 1012 in typhoid fever, 276 in typhus fever, 352 in croup, 157 in disease, 156 kinds of, 156 significance of, in general diagnosis, 156

Respiratory diseases, relation of, to rubeola, 561 organs, lesions of, in typhus fever, 356 spread of diphtheria into, 671 tract, alterations of, in scarlet fever, 531

Rest, necessity of, in cholera, 760 in rabies and hydrophobia, 907 in relapsing fever, 432 in yellow fever, 654

Retention-cysts, 116, 122

Retro-vaccine, 473

Re-vaccination, time of, 467

Rheumatic and cardiac inflammation in scarlet fever, treatment, 556

Rheumatism, complicating scarlet fever, 521

Rickets, hereditary nature, 128

Rigidity, muscular, in relapsing fever, 384

Rindfleisch's definition of diphtheritic inflammation, 686

RÖTHELN, 582 Definition, 582 Synonyms, 582 History, 582 Etiology, 583 Age as a cause, 583 Sex as a cause, 583 Specific origin, 583 Nature of contagion, 583 Modes of transmission, 583 Period of greatest contagiousness, 583 Distinct nature, 584 Frequency of second attacks, 584 Relapses, 584 Symptoms, 585 Incubation period, 583, 585 Duration of incubation period, 583 Prodromal stage, 585 Eruption, 585 Duration of eruption, 585 Characters of eruption, 586 Types of eruption, 586 Condition of mucous membranes, 586 Swelling of lymphatic glands, 586 Temperature, 587 Complications and sequelæ, 587 Diagnosis, 587 From measles, 587 From scarlet fever, 587 From symptomatic skin eruptions, 588 Prognosis of, 588 Treatment of, 588

RUBEOLA, 557 Definition, 557 Synonyms, 557 History, 557 Etiology, 557 Nature of contagion, 558 Relation of straw fungus, 558 Mode of entrance into body, 558 Modes of dissemination of contagion, 559 Inoculation, 559 Stage when most easily propagated, 560 Race, influence of, 561 Age, influence of, 561 Sex, influence of, 562 Climate as a cause, 560 Pregnancy and parturition as a cause, 561 Scrofula as a cause, 561 Diseases of respiratory organs as a cause, 561 Relation of, to acute diseases, 561 to chronic diseases, 561 to whooping cough, 561 Influence of nervous diseases upon susceptibility, 561 Frequency of epidemics, 560 in new-born, 562 second attacks, 563 Relapses in, 563 Symptoms, 563 Incubation stage, 563 Duration of incubation stage, 560 Prodromal stage, 564 Temperature, 564 Catarrhal symptoms, 564 Punctated appearance of palatal and faucial mucous membrane, 564 Convulsions, 565 Duration of, 565 Eruptive stage, 565 Temperature of, 566 Character and seat of eruption, 566 General symptoms, 567 Symptoms at decline, 567 Temperature at decline, 567 Duration of eruptive stage, 567 Varieties of, 568 Inflammatory or synochal, 568 Hemorrhagic (rubeola nigra), 569 Without eruption, 568 catarrh, 568 Deviations from ordinary course, 569 Peculiarities in seat of eruption, 569 in character of eruption, 569 Relapses of eruption, 570 Complications, 570 Causes, 570 Complicated with epistaxis, 570 Skin disorders, 570 Pemphigoid eruptions, 571 Ear diseases, 570 Eye diseases, 571 Faucial inflammation, 571 Laryngitis, 571 Bronchitis and capillary bronchitis, 571 Pneumonia, 571 Pulmonary oedema, 572 Acute miliary tuberculosis, 572 Heart-clot, 572 Intestinal catarrh, 572 Convulsions, 572 Diphtheria, 573 Sequelæ, 573 Followed by general miliary tuberculosis, 574 Chronic pulmonary tuberculosis, 573 Coryza, 574 Ophthalmia, 574 Otitis, 574 Intestinal catarrh, 574 Cutaneous diseases, 574 Bone and joint disease, 574 Nervous affections, 574 Granular meningitis, 574 Albuminuria, 574 Gangrenous affections, 574 Morbid anatomy, 575 Changes in skin, 575 Diagnosis, 575 Value of punctated appearance of palatal and faucial mucous membranes, 575 Salient points in diagnosis, 575 From rötheln, 576 Scarlet fever, 576 Variola, 576 Roseola and erythema, 577 Typhus, 577 Roseola syphilitica, 577 Prognosis, 577 Factors to be considered in making, 577 Influence of hygienic surroundings, 577 previous health, 578 complications, 578 Mortality, 578 Influence of stage of disease, 578 of age, 578 Treatment, 578 Preventive, 578 Isolation, 578 Hygienic, 579 Diet, 579 Uncomplicated cases, 579 Results, 579 Hyperpyrexia, 580 Retrocession of eruption, 580 Epistaxis, 580 Diarrhoea, 581 Nausea and vomiting, 581 Constipation, 581 Cough, 581 Eye complications, 581 Aural complications, 581 Bronchitis and pneumonia, 581 Convulsions, 581 Use of aconite, 580 Inunctions, 580 Quinia, 580 Stimulants, 580

Salicylic acid, use of, in diphtheria, 707 in relapsing fever, 428

Saliva, propagation of rabies and hydrophobia by, 891

Salivary glands, lesions of, in typhoid fever, 268

Sanitary inspection of houses, 187

Sarcoma, 118

SCARLET FEVER, 486 History, 486 Etiology--Specific origin, 487 Germ theory, 488 Microbes, 488 Modes of cultivation of microbes, 488 Modes of entering the system, 490 Modes of communication, 490 Dissemination of, by milk, 491 Fixity of the poison, 491 Solid nature of the poison, 492 Duration of incubation, 492, 493 Contagiousness, 494 Area of contagiousness, 494 Age, influence of, in causation, 500 Variations in type, 494 Surgical, 495 distinguished from septicæmic efflorescence, 497 effect of poison upon inflammation of wounds, 498 Obstetrical, 498 liability of parturient women to, 498 relation of, to puerperal septicæmia, 499 Immunity of infants, 500 Clinical facts regarding, 501 Relapses in, 501 Frequency of second attacks, 501 Sympathetic sore throat in, 502 albuminuria in, 502 Symptoms, 502 Ordinary form, 502 Premonitory, 502 Nervous system, 503 Vomiting in, significance, 503 Diarrhoea, 503 Condition of tongue, 504 of faucial and nasal membranes, 504 Respiratory, 504 Efflorescence, 504 Seat of greatest intensity of eruption, 504 Cause of absence of eruption, 505 Date of desquamation, 506 Temperature, 505 Digestive system, 505 Urine, characters, 505 Duration, 506 Malignant or grave form, 507 Digestive system, 507 Pulse, 507 Eruption, 507 Temperature, 507 Nervous symptoms, 507 Condition of fauces, 508 Of throat, 508 Nasal cavities, 508 Lymphatic glands, 508 Duration, 508 Irregular form, 508 Causes, 508 Absence of eruption, 508 Hemorrhagic form, 509 Anginose form, 510 Complications and sequelæ, 510 Complicated by severe nervous symptoms 510 Throat symptoms, 511 Adenitis, 511 Inflammation of neck, 511 Gangrene of neck, 512 Oedema of glottis, 512 Diphtheria, 514 course of diphtheria, complicating, 516 Croupous inflammation of fauces, 516 Coryza, 520 Otitis, 520 course of otitis, complicating, 520 results of otitis, complicating, 521 By rheumatism, 521 By cardiac inflammations, 522 By dilatation of heart, 523 By heart-clot, 523 By pleuritis, 523 By nephritis, 525 By glomerulo-nephritis, 527 By albuminuria, 525 By anasarca and oedema, 529 Order and date of appearance of anasarca, 529 By head symptoms due to uræmia, 530 Morbid anatomy, 530 Changes in the blood, 530 Respiratory tract, 531 Abdominal organs, 531 Post-mortem appearance of eruption, 532 Changes in the kidneys, 526 hyaline degeneration of kidneys, 527 intestinal nephritis, 528 parenchymatous nephritis, 526 Changes in the liver, 531 Diagnosis, 532 From measles, 532 From erythema, 533 From rötheln, 533 From diphtheria, 533 Prognosis, 533 Influence of complications upon, 533, 535 type upon, 534 age upon, 534 Of grave cases, 535 Mortality, 534 Treatment, 536 Preventive, 536 Isolation in, 537 Inoculation as a prophylactic, 536 Belladonna as a prophylactic, 536 Sodium sulpho-carbolate as a prophylactic, 537 Listerine as a prophylactic, 537 Boric acid as a prophylactic, 537 Disinfection in, 201, 538 Hygienic, 539 Therapeutic, 539 Mild cases, 540 Inunction in, 541 Hyperpyrexia, 541 by cold, 541 Mode of applying cold, 542 Antiseptic, 545 Complications and sequelæ, 545 Pharyngitis, 545 local, 546 Coryza, 546 local, 547 Otitis, 547 local, 549 paracentesis of tympanum, 548 Nephritis and albuminuria, 550 modes of producing diaphoresis, 551 local, 555 Convulsions, 556 Rheumatic and cardiac inflammation, 556 Pleuritis, 556 Convalescence, 544 Use of aconite and veratrum viride, 543 Alcohol, 544 Ammonium carbonate, 544 Carbolic acid, 545 Cathartics, 554 Diuretics, 555 Digitalis, 543, 555 Ice, 542 Jaborandi and pilocarpine, 552 Sodium salicylate, 543 Quinia, 543