A FEW PRACTICAL REMARKS ON ENTERIC FEVER IN INDIA.
By
Geokge S.
Off9-
?
Ranking, M.B., Cantab., Surgeon, I. M. D., Charge, 6tk Bengal Cavalry, Sitapur.
Medical
This disease is of and
so
great importance, both from its fre-
rate of mortality in India, that discussion of the various points connected with its semicology is especially to be encouraged, the more so that in India
quent
occurrence
high*
a
the disease is
so
malarial fevers
often masked
as
to render
by a
the coincident occurrence of diagnosis, which
differential
shall be
unerringly accurate in any given case, a matter of difficulty In considering enteric fever clinically, wo must not come to the bed-side of the patient looking for the hard and fast lines laid down in text books treating of the symptoms of this disEven in England where the disease runs what may be ease. considered a fairly independent course, we find the symptoms varying widely in different epidemics. In one epidemic the head symptoms will predominate, in another the bowel symptoms ; in one set of cases there will be profuse diarrhoea ; in another absolute constipation. So that in this country, where hardly any disease (more especially of febrile nature) can be said to exist, per se, where the external surroundings of the patient tend more or less to the depression of the vital powers, we extreme
need not, I say, wonder at any deviations from the course laid down in describing typical cases, nor need we wonder at the extreme fatality of enteric fever in India even when combated
by *
the most
approved
56 per cent,
as
methods of treatment.
compared
with 17 per
There cannot be
cent, in England.
THE INDIAN MEDICAL GAZETTE.
288 the are
slightest
doubt that many cases of
feturned under other
genuine
enteric fever
from the
heads, simply
reluctance
" enteric" a fever which of many medical officers to return as does not conform in all respects to the typical disease. This is, I believe, a matter which no one will deny.
way of diagnosis are often very great, great deal of anxious thought and careful balanc-
The difficulties in the and unless
a
brought to analyse symptoms observed, these difficulties often prove insuperable, and it is not till the patient is on the post-mortem table that the doubts of counter-balancing
and
ing
are
the medical attendant are set at rest. The principal diseases with which enteric fever is confounded seem to me to be as follow :? Remittent fever. Simple continued fever.
(a.) (&.) (c.)
pneumonic typhoid. I omit bronchitis, diarrhoea, and one or two other heads under which cases of enteric are undoubtedly occasionally return
By
Geokge S.
Off9-
?
Ranking, M.B., Cantab., Surgeon, I. M. D., Charge, 6tk Bengal Cavalry, Sitapur.
Medical
This disease is of and
so
great importance, both from its fre-
rate of mortality in India, that discussion of the various points connected with its semicology is especially to be encouraged, the more so that in India
quent
occurrence
high*
a
the disease is
so
malarial fevers
often masked
as
to render
by a
the coincident occurrence of diagnosis, which
differential
shall be
unerringly accurate in any given case, a matter of difficulty In considering enteric fever clinically, wo must not come to the bed-side of the patient looking for the hard and fast lines laid down in text books treating of the symptoms of this disEven in England where the disease runs what may be ease. considered a fairly independent course, we find the symptoms varying widely in different epidemics. In one epidemic the head symptoms will predominate, in another the bowel symptoms ; in one set of cases there will be profuse diarrhoea ; in another absolute constipation. So that in this country, where hardly any disease (more especially of febrile nature) can be said to exist, per se, where the external surroundings of the patient tend more or less to the depression of the vital powers, we extreme
need not, I say, wonder at any deviations from the course laid down in describing typical cases, nor need we wonder at the extreme fatality of enteric fever in India even when combated
by *
the most
approved
56 per cent,
as
methods of treatment.
compared
with 17 per
There cannot be
cent, in England.
THE INDIAN MEDICAL GAZETTE.
288 the are
slightest
doubt that many cases of
feturned under other
genuine
enteric fever
from the
heads, simply
reluctance
" enteric" a fever which of many medical officers to return as does not conform in all respects to the typical disease. This is, I believe, a matter which no one will deny.
way of diagnosis are often very great, great deal of anxious thought and careful balanc-
The difficulties in the and unless
a
brought to analyse symptoms observed, these difficulties often prove insuperable, and it is not till the patient is on the post-mortem table that the doubts of counter-balancing
and
ing
are
the medical attendant are set at rest. The principal diseases with which enteric fever is confounded seem to me to be as follow :? Remittent fever. Simple continued fever.
(a.) (&.) (c.)
pneumonic typhoid. I omit bronchitis, diarrhoea, and one or two other heads under which cases of enteric are undoubtedly occasionally return
