ENTERIC FEVER IN BENGAL.
By
J. B.
Hannah, M.D., and Thomas O'Farkeli, II.A., M.D., Assistant Surgeons, 63rd Regiment. (Continued from
page
208.J
Case VII.?Serjeant E 10th January, , age 25, admitted 1871. The following is a short abstract of his case, which was carefully recorded daily :?
Throughout the course of the disease, there was continued fever with great prostration, delirium, yellow enteric diarrhoea, with the peculiar bran-like particles suspended in it, gurgling and pain in the right iliac region, and considerable irritation of the fauces and bronchial tubes. On the 9th day of the fever, there was an eruption of rose-coloured spots on the abdomen and chest; they were succeeded by fresh crops every three or four days, until the 29th day of the disease, or three weeks
first appearance. They were well marked and There was considerable haemorrhage from the bowels The tongue during the course of on two or three occasions. the disease was generally brown and dry. He was 71 days in after
their
decided.
hospital.
was admitted on tho , aged 22, Case VIII.?Private C 11th January, with fever, considerable prostration, gurgling and pain in the right iliac region, and severe yellow diarrhoea. On the 8th day of the fever, there was an eruption of rose-coloured he was 59 days in hospital, and was subsequently sent to
spots; the hills. Case IX,?Private J. H , aged 23, was admitted on the 17th February, having had pyrexia for four days; there was pain and gurgling in the abdomen, but no diarrhoea. Od the 20th, there was an eruption of rose-coloured spots, and on the following day diarrhoea of a typhoid character set in, accompanied with delirium and brown tongue ; fresh crops of spots appeared for
days. The disease was mild throughout, and he was charged after 56 days in hospital. It may be remarked that some
disthis
had been in constant attendance
mail
beginning
on case
VII until the
healthy but thin. Large intestines?The solitary glands
Although this man suffered accompanied by purging of a pain in the right iliac region, restless ?.
typhoid character, with delirium, and a dry brown tongue, yet the presence of the eruption was not sufficiently well marked to warrant the positive diagnosis that it was a case of enteric fever, although we
There was
cular in
shape,
Private G. P as a case of
,
17
18
19
100-2
103-1
76
72
28
Case XII.?Serjeant W aged 25, admitted 31st May ; had been complaining of pyrexial symptoms for two days past; his tongue was covered with a brown fur; pulse 120; considerable
diarrhoea, stools of a yellow ochreous appearance. There is gurgling and pain in the right iliac region. On the evening of the 5th June, or the eighth day of the fever, "rose spots" were visible over the abdomen and back, which were carefully marked ; pain and gurgling still continued in the right iliac region ; the tongue is very brown; diarrhoea continues, and stools present
after death.
the
same appearance as in last report. 8tli June.?The "rose spots" above mentioned
are
nearly
few fresh ones are visible; symptoms as before still present, with considerable diarrhoea and delirium. No change took place beyond the appearance of a few fresh rose spots, and the fading of old ones, until the 18th but
faded,
a
particular
day of the disease, when he began to improve, and with exception ot diarrhoea, which was very persistent, he progressed steadily, but slowly, towards health. lie was 37 days in hospital, and was discharged to attend, which he did for nearly a month. One peculiarity of this case was loss of sensa? tion in the feet, which continued for about 20 days after discharge.
or
19th
the
JUNE,
MONTH. Date. 14
of disease.
...
16
Respirations,
Small intestines.?In the last two feet there were about ten they were small, round, and opposite the attachment of'
Pulse
2
74
ulcers ;
10ir:
rMom Even 101
1
80
flatus.
Morn
30
Pulse.
Lungs.?Highly congested, adhesions on the left side. Heart.?Great deposit of fat, otherwise tolerably healthy. Spleen.?Friable, very black, weighing 8 oz. Kidneys.?Both congested. Abdomen.?Stomach and large intestines distended with
r
29
100
Temperature.
Head.?Some blood inside the calvarium ; marked congestion of the cerebral vessels: on section, the puncta vasculosa very numerous and distinct; about two drachms of straw-coloured fluid in each ventricle; choroid plexus very much congested.
ature
28
27
I
102
101
103
102
100
13 I 14
15
16
I
18
19
16
17
99'3 98*2 93-3 100*2
101 84
101 101
199-4
| I
98'2l
17
18
20
25
23
27
28
26
30
31
99'1 99-2 10U
98
99-3' 99-1
99-3
96-4 9/'3 197
4! 1031100 99-2
.99
t Even iUorn
32|33
96)97
198-2 98 99
70
72
78
80
76
74
8U
80
90
78
79
82
83
80
84
24
22
20 119
20
19
20 18
28
26
22 24
25
20
21 20
llespir- (
24
admitted 9th June, having had two Case XIII.?Private B days' pyrexia; at present he complains of great thirst and headache; he has a coated white tongue, quick pulse and hot skin. On the 8th day of the fever, he was much worse; had a tendency to diarrhoea, with flatulent distension of the abdomen ; his trunk and head were covered with sudamina, hut no rose spots could be detected ; he was heavy and delirious at night. On the 11th day, the tongue was glazed and covered in places with small white patches ; the rose spots appeared,- but were not. very distinct; his body was very thickly covered with sudamina. The stools were of a typhoid character, brownish yellow in color, ,
29,30
84
By
J. B.
Hannah, M.D., and Thomas O'Farkeli, II.A., M.D., Assistant Surgeons, 63rd Regiment. (Continued from
page
208.J
Case VII.?Serjeant E 10th January, , age 25, admitted 1871. The following is a short abstract of his case, which was carefully recorded daily :?
Throughout the course of the disease, there was continued fever with great prostration, delirium, yellow enteric diarrhoea, with the peculiar bran-like particles suspended in it, gurgling and pain in the right iliac region, and considerable irritation of the fauces and bronchial tubes. On the 9th day of the fever, there was an eruption of rose-coloured spots on the abdomen and chest; they were succeeded by fresh crops every three or four days, until the 29th day of the disease, or three weeks
first appearance. They were well marked and There was considerable haemorrhage from the bowels The tongue during the course of on two or three occasions. the disease was generally brown and dry. He was 71 days in after
their
decided.
hospital.
was admitted on tho , aged 22, Case VIII.?Private C 11th January, with fever, considerable prostration, gurgling and pain in the right iliac region, and severe yellow diarrhoea. On the 8th day of the fever, there was an eruption of rose-coloured he was 59 days in hospital, and was subsequently sent to
spots; the hills. Case IX,?Private J. H , aged 23, was admitted on the 17th February, having had pyrexia for four days; there was pain and gurgling in the abdomen, but no diarrhoea. Od the 20th, there was an eruption of rose-coloured spots, and on the following day diarrhoea of a typhoid character set in, accompanied with delirium and brown tongue ; fresh crops of spots appeared for
days. The disease was mild throughout, and he was charged after 56 days in hospital. It may be remarked that some
disthis
had been in constant attendance
beginning
on case
VII until the
healthy but thin. Large intestines?The solitary glands
Although this man suffered accompanied by purging of a pain in the right iliac region, restless ?.
typhoid character, with delirium, and a dry brown tongue, yet the presence of the eruption was not sufficiently well marked to warrant the positive diagnosis that it was a case of enteric fever, although we
There was
cular in
shape,
Private G. P as a case of
,
17
18
19
100-2
103-1
76
72
28
Case XII.?Serjeant W aged 25, admitted 31st May ; had been complaining of pyrexial symptoms for two days past; his tongue was covered with a brown fur; pulse 120; considerable
diarrhoea, stools of a yellow ochreous appearance. There is gurgling and pain in the right iliac region. On the evening of the 5th June, or the eighth day of the fever, "rose spots" were visible over the abdomen and back, which were carefully marked ; pain and gurgling still continued in the right iliac region ; the tongue is very brown; diarrhoea continues, and stools present
after death.
the
same appearance as in last report. 8tli June.?The "rose spots" above mentioned
are
nearly
few fresh ones are visible; symptoms as before still present, with considerable diarrhoea and delirium. No change took place beyond the appearance of a few fresh rose spots, and the fading of old ones, until the 18th but
faded,
a
particular
day of the disease, when he began to improve, and with exception ot diarrhoea, which was very persistent, he progressed steadily, but slowly, towards health. lie was 37 days in hospital, and was discharged to attend, which he did for nearly a month. One peculiarity of this case was loss of sensa? tion in the feet, which continued for about 20 days after discharge.
or
19th
the
JUNE,
MONTH. Date. 14
of disease.
...
16
Respirations,
Small intestines.?In the last two feet there were about ten they were small, round, and opposite the attachment of'
Pulse
2
74
ulcers ;
10ir:
rMom Even 101
1
80
flatus.
Morn
30
Pulse.
Lungs.?Highly congested, adhesions on the left side. Heart.?Great deposit of fat, otherwise tolerably healthy. Spleen.?Friable, very black, weighing 8 oz. Kidneys.?Both congested. Abdomen.?Stomach and large intestines distended with
r
29
100
Temperature.
Head.?Some blood inside the calvarium ; marked congestion of the cerebral vessels: on section, the puncta vasculosa very numerous and distinct; about two drachms of straw-coloured fluid in each ventricle; choroid plexus very much congested.
ature
28
27
I
102
101
103
102
100
13 I 14
15
16
I
18
19
16
17
99'3 98*2 93-3 100*2
101 84
101 101
199-4
| I
98'2l
17
18
20
25
23
27
28
26
30
31
99'1 99-2 10U
98
99-3' 99-1
99-3
96-4 9/'3 197
4! 1031100 99-2
.99
t Even iUorn
32|33
96)97
198-2 98 99
70
72
78
80
76
74
8U
80
90
78
79
82
83
80
84
24
22
20 119
20
19
20 18
28
26
22 24
25
20
21 20
llespir- (
24
admitted 9th June, having had two Case XIII.?Private B days' pyrexia; at present he complains of great thirst and headache; he has a coated white tongue, quick pulse and hot skin. On the 8th day of the fever, he was much worse; had a tendency to diarrhoea, with flatulent distension of the abdomen ; his trunk and head were covered with sudamina, hut no rose spots could be detected ; he was heavy and delirious at night. On the 11th day, the tongue was glazed and covered in places with small white patches ; the rose spots appeared,- but were not. very distinct; his body was very thickly covered with sudamina. The stools were of a typhoid character, brownish yellow in color, ,
29,30
84
