Part 188

Tympanites in remittent fever, treatment, 605 in typhoid fever, 286 treatment of, 332 in typho-malarial fever, treatment, 619 in typhus fever, 350

Tympanum, paracentesis of, in scarlet fever, 548

Types of cerebro-spinal meningitis, 804 of intermittent fever, 594 of scarlet fever, 494 of varioloid, 444

TYPHOID FEVER, 237 Synonyms, 237 Definitions, 237 History, 238 Geographical distribution, 241 Etiology, 242 Predisposing causes, 242 Age, influence of, 242 Sex, influence of, 243 Occupation, influence of, 244 Change of residence, influence of, 244 Idiosyncrasy, influence of, 245 Depressing emotions, influence of, 245 Intemperance, influence of, 245 Previous ill-health, influence of, 245 Season, influence of, 245 Elevated temperature, influence of, 246 Rise and fall of subsoil-water, influence of, 247 Exciting causes, 248 Contagiousness, 248 Dissemination, 249 Cases illustrating modes of dissemination, 250 Dissemination of, by drinking-water, 248 By stools, 249 By milk, 252 By atmosphere, 252 By bed-linen, etc., 253 By polluted soil, 253 By putrefied flesh, 257 Spontaneous origin, 254 Duration of virulence of germs, 256 Bacillus typhosus, 258 Incubation period, 259 Morbid anatomy, 260 Lesions peculiar to, 261 Changes in Peyer's patches, 261 Solitary glands, 261 Softening of Peyer's patches and solitary glands, 263 Cicatrization of Peyer's patches and solitary glands, 263 Changes in cæcum and colon, 263 Spleen, 264 Abdominal glands, 264 Lesions not peculiar to, 265 Changes in liver and gall-bladder, 265 Pharynx and oesophagus, 265 Larynx and lungs, 266 Brain and membranes, 266 Muscles, 267 Heart and blood-vessels, 267 Blood, 268 Salivary glands, 268 Kidneys, 268 Symptoms, 268 Clinical description, 268 Physiognomy, 272 Epistaxis, 273 Condition of skin, 273 Odor, 273 Eruption, 273 Sudamina, 274 Tâches bleuâtres, 275 Condition of hair and nails, 275 Pulse, 275 Heart-sounds, 276 Respiration, 276 Frequency of bronchitis, 277 Mental condition, 277 Headache, 277 Delirium, 278 Muscular spasm, 279 tremor, 279 Modifications of sensibility, 279 Hearing, 280 Vision, 280 Taste, 280 Temperature, 280 State of tongue, 285 Fauces, 286 Nausea and vomiting, 285 Anorexia, 285 Thirst, 285 Gurgling, 286 Meteorism or tympanites, 286 Diarrhoea, 287 Character of stools, 287 Intestinal hemorrhage, 287 frequency, 288 causes, 288 importance, 288 Intestinal perforation, 289 frequency, 290 causes, 290 date of appearance, 290 importance, 289 Condition of urine, 291 amount of solids, 291 presence of albumen, 292 Complications and sequelæ, 292 Complicated by pyæmia, 294 Laryngitis, 294 Bronchitis and pneumonia, 294 Pleurisy, 294 Jaundice, 295 Peritonitis, 295 Catarrhal and diphtheritic inflammation of fauces, 295 Parotid swelling, 296 Menstrual disorders, 296 Pregnancy, 296 Suppuration of Bartholini's glands, 296 Periostitis, 297 Oedema, 297 Bed-sores, 297 Followed by impaired intellect, 292 Perversion of the moral sense, 292 Paralysis and chorea, 293 Cardiac degeneration, 293 Arterial thrombosis, 293 Venous thrombosis, 294 Gangrene of vulva and vagina, 293 Hepatic abscess, 295 Tendency to stoutness, 298 Varieties of, 298 Abortive form, 298 Latent form, 300 In children, 301 In aged persons, 302 Relapses in, 302 frequency, 302 course, 303 cases illustrating, 304 causes, 308 Duration, 310 Diagnosis, 311 From typhus, 311 From influenza, 312 From relapsing fever, 312 From epidemic cerebro-spinal meningitis, 313 From simple continued fever, 313 From remittent fever, 312 From the eruptive fevers, 313 From acute tuberculosis, 313 From trichinosis, 314 From the specific inflammations, 314 From acute tubercular meningitis, 314 Prognosis, 314 Symptoms indicating unfavorable, 314 favorable, 316 Influence of hyperpyrexia upon, 314 Nervous symptoms, 315 Heart symptoms, 316 Condition of pulse, 316 Abdominal symptoms upon, 316 Mortality, 316 Tables showing, 317, 318 Influence of season, 318 Sex, 319 Age, 319 Treatment, 319 Habits, 320 Social condition, 320 Recent residence, 320 Corpulence, 320 Organic disease, 320 Childhood, 320 Treatment, 320 Preventive, 321 Necessity of proper drainage in prevention, 321 Disinfection of stools, 321 Hygienic, 322 Importance of ventilation, 323 administering water, 325 Diet, 323 Mild cases, 326 Hyperpyrexia, 327 by cold baths, 327-329 Typho-malarial form, 331 Vomiting, 331 Diarrhoea, 331 Tympanites, 332 Intestinal hemorrhage, 332 perforation, 333 Constipation, 333 Headache, 334 Insomnia, 334 Stupor, 334 Delirium, 334 Albuminuria, 334 Complications, 335 Epistaxis, 335 Pneumonia, 335 Hypostatic congestion of lungs, 335 Thrombosis and embolism, 335 Bed-sores, 335 Convalescence, 335 Use of alcohol, 324 Digitalis, 330 Eucalyptus, 331 Quinia, 330 Silver nitrate, 332 Sodium salicylate, 330 Turpentine, 326 Specific, 336 By calomel, 336 By iodine, 336, 337 Use of thermometer, 284

Typhoidal inflammation, 47

Typhoid state of cholera, 734 following variola, 445

TYPHO-MALARIAL FEVERS, 614 Definition, 614 Frequency, 616 Symptoms, 615 Diagnosis, 616 Prognosis, 616 Mortality, 616 relative mortality of white and black races, 616 Treatment, 618 Of typhoidal element, 618 Of malarial element, 618 Use of quinia, 618 Depurative treatment, 618 Necessity of disinfection of stools, 619 Of tympanites, 619 Of insomnia, 619 Diet, 619

Typho-malarial form of typhoid fever, treatment, 331

TYPHUS FEVER, 338 Synonyms, 338 History, 338 Etiology--Predisposing causes, 341 Over-crowding as a cause, 341 Age, influence of, 342 Debility and fatigue, influence of, 342 Mental and physical overwork, 342 Intemperance, 342 Poverty, 342 Barometric and thermometric variations, 343 Season, 343 Occupation, 343 Individual susceptibility to, 343 Exciting causes, 343 Contagiousness, 343 Nature of contagion, 343 Modes of transmission of contagion, 344 Communication of, by fomites, 345 Period of contagiousness, 345 Spontaneous origin, 345 Period of incubation, 346 Symptoms--Clinical description, 346 Special symptoms, 347 Prostration, 348 Nervous symptoms, 348 Appearance of face, 348 Intellectual condition, 348 Headache, 348 Delirium, 348 Wakefulness, 349 Coma vigil, 349 Perversion of special senses, 349 Muscular tremor, 349 Temperature, 349 Condition of tongue, 350 Anorexia, 350 Thirst, 350 Nausea and vomiting, 350 Condition of bowels, 350 Tympanites, 350 Gurgling, 350 Eruption, 351 Duration of eruption, 351 Tâches bleuâtres, 352 Sudamina, 352 Hyperæsthesia of skin, 352 Odor, 352 Condition of pulse, 351 of heart, 351 Respiration, 352 Pneumonia, 353, 355 Bronchitis, 353, 355 Odor of breath, 353 Hypostatic congestion of lungs, 353 Changes in urine, 353 Varieties of, 353 Mild form, 354 Severe form, 354 Ataxic form, 354 Adynamic form, 354 Ataxo-adynamic form, 354 Inflammatory form, 354 Walking form, 354 Abortive form, 354 Complications and sequelæ, 354 Complicated by erysipelas, 355 Cardiac degeneration, 355 Bronchitis and pneumonia, 353, 355 Pleurisy, 355 Albuminuria, 355 Bed-sores, 355 Scurvy, 355 Dysentery, 355 Jaundice, 356 Parotitis, 356 Serous inflammations, 356 Pyæmia, 356 Disorders of menstruation, 356 Miscarriage, 356 Followed by pulmonary gangrene and phthisis, 355 Morbid anatomy, 356 Alteration of blood, 356 Changes in respiratory organs, 356 Heart and membranes, 357 Liver and kidneys, 357 Spleen, 357 Intestinal tract, 357 Brain and membranes, 358 Diagnosis, 358 From typhoid fever, 358 From meningitis, 358 From measles, 358 From typhoid pneumonia, 359 From delirium tremens, 359 From purpura, 359 Prognosis of, 359 Symptoms indicating favorable, 360 unfavorable, 360 Influence of age, 359 Sex, 359 Former habits, 359 Convalescence from previous illness, 359 Obesity, 359 Mental and physical overwork, 360 Social condition, 360 Race, 360 Mortality, 360 Difference of, in hospital and private cases, 361 Treatment, 361 Preventive, 361 Necessity of isolation, 361 Disinfection, 362 Diet, 362 Quantity of nourishment necessary, 363 Futility of abortive treatment, 363 General treatment, 364 Mild cases, 364 Hyperpyrexia, 364 By cold water, 364 By cold baths, 364 Mode of using cold bath, 364 Prostration, 365 Headache, 366 Delirium, 366 Insomnia, 366 Stupor, 366 Urinary complications, 366 Thirst, 367 Vomiting, 367 Constipation, 367 Parotitis, 367 Pulmonary complications, 367 Use of alcohol in, 366 Opium in, 366 Quinia in, 365 Of convalescence, 368 Necessity of continuing stimulants during convalescence, 368

Tyrosis, 79

Ulceration, complicating vaccination, 468

Ulcers, complicating cholera, 735 following the plague, 781

Umbilication in vaccinia, mechanism of, 464 in varicella, 482 in variola, 438 cause of, 447

Uræmia in scarlet fever, 530

Urinary complications in typhus fever, treatment, 366

Urine, analysis of, importance in general diagnosis, 165 condition of, in cerebro-spinal meningitis, 814 in cholera, 739 in dengue, 881 in influenza, 866 in mild scarlet fever, 506 in grave form of the plague, 779 in pertussis, 841 in pyæmia, 976 in relapsing fever, 387 in remittent fever, 602 in typhoid fever, 291, 292 in yellow fever, 644 suppression of, complicating relapsing fever, 407 in cholera, treatment, 764 in yellow fever, treatment, 653

Urination, difficult, significance of, in diagnosis, 164

Urobilin, 91

Urticaria, complicating diphtheria, 674

Uterus, fixity of, in para- and perimetritis of puerperal fever, 1007 lesions of, in septicæmia, 972

VACCINIA, 455 Definition, 455 Synonyms, 455 History, 458 Etiology, 458 Nature, 455 Variolous origin, 457 Meteorological conditions as a cause, 458 Symptoms, 458 General course, 458 Constitutional, 459 Development of pock, 459 Date of appearance of pock, 459 incrustation of pock, 460 falling off of crust, 460 Description of cicatrix, 460 Irregularities in course, 460 Raspberry excrescence of pock, 461 Lack of elevation in pock, 461 Absence of a constitutional infection, 460 Bryce's test for determining constitutional infection, 461 Diphtheritic pock, 463 Catarrhal pock, 463 Morbid anatomy, 462 Pock, 463 Microspheres and vaccinals of lymph, 463 Microscopical characters of the lymph, 463 Mechanism of umbilication, 464 Composition of crust, 464 Complications and sequelæ, 464

VACCINATION, 465 Synonyms, 465 History of, 465 Protective power of, 461 theories regarding, 461 duration of, 468 against pertussis, 468 Marson's theory of multiple insertions, 467 Time of revaccination, 467 As a means of destroying nævi, 468 Complications, 468 Simple inflammatory, 468 Complicated by dermatitis, 468 Treatment of dermatitis, 469 Complicated by lymphangitis and adenitis, 468 By ulceration and gangrene, 468 Erysipelas, 469 treatment, 469 Complicated by syphilis, 469 treatment, 471 Modes of preventing transmission of syphilis, 470 Complicated by skin diseases, 471 by eczema, 472 Impetigo contagiosa, its relations to, 472 Followed by cutaneous affections, 471 by eczema, 472 Conveyance of constitutional taints in, 471 Technics of, 472 Varieties of virus, 472 Primary vaccine, 473 Horse-pox vaccine, 473 Retro-vaccine, 473 Bovine vaccine, 473 Variola vaccine, 473 So-called points of superiority of humanized vaccine, 473 Relative merits of animal and humanized vaccine, 473 Advantages of animal over humanized virus, 475 Forms of vaccine, 476 Objections to use of crust, 476 Use of dried lymph, 477 liquid or tube lymph, 476 Proper season, 477 Age, 477 Part of body most suitable for, 477 Modes of operating, 478 applying the virus, 478 Storage and preservation of virus, 479 Proper time of collecting lymph for storage, 479 Proper manner of transporting, 480

Vaccination, neglect of, as a cause of variola, 436

Vaccine virus, varieties of, 472 use of, in treatment of rabies and hydrophobia, 907

Vagina, symptoms of diphtheria of, 674

Vaginal injections, use of, for prevention of puerperal fever, 1025

Variations, barometric, influence of, upon course of diseases, 134

VARICELLA, 481 Definition, 481 Synonyms, 481 History, 481 Etiology, 481 Contagiousness, 481 Symptoms, 481 Period of incubation, 482 General, 482 Prodromal stage, 482 Eruption, 482 Umbilication of eruption, 482 Date of appearance of desiccation, 482 Frequency of scarring, 482 Appearance of vesicles on mucous membrane, 483 Morbid anatomy, 483 Complications, 483 Diagnosis, 483 From variola and varioloid, 484 From vaccinia, 484 From impetigo, 483 contagiosum, 483 From eczema pustulosum, 483 Prognosis, 484 Treatment, 485