INFECTIOUS JAUNDICE. notes of this interesting condition, by writers described as Weil's disease, have appeared in the Retrospect of Medicine of this journal. Several cases have been observed in Montreal within the last few months. The patients were children, and the prominent symptoms were jaundice and fever. Infection was probable, as some of the children in the neighborhood was similarly attacked. The whole subject is attracting considerable interest in Europe, and many cliuical observers are paying attention to it. Frankel, in the course of " an article On the Study of the so-called Weil's Disease,"* relates the history of a case in which symptoms resembling decidedly those of Weil's disease came on as the result of an external wound which had taken on a slightly erysipelatous action. The symptoms soon declined, and the patient became free from fever and felt almost well, except that he suffered from great lassitude. After some eleven days he experienced a slight relapse with moderate elevation of temperature and an increase in the enlargement of the liver and of the spleen.
Some
some
*
Schmidt's Jahrbucher
Mai,
1889.
der
Ge sammten
Medicin,
15
HEART COMPLICATIONS IN GONORRHOEA.
Dec., 1889.]
This observation induced Frankel to make a careful critical examination of the numerous disease, publications 011 the subject of Weil's and he came to the conclusion that ? the collection of symptoms described by Weil have no specially characteristic significance either in their {Etiology, symptomatology, or in their anatomical relations. Evidently in the cases described it appears to act as a septic infection in which the poison euters the body from without The febrile jaundice, the or from the intestine. extensive implication of the nervous system, the enlargements of the liver aud of the spleen, the albuminuria, are no more characteristic of a special disease than the relapsing type of the fever. Frankel, therefore, proposes to abolish the name Weil's Disease, and to substitute for it that of Infectious or Septic Jaundice. " The following reasons for regarding this affection a* an independent one have been advanced : From acute yellow atrophy of the liver it is distinguished by the swelling of that viscus, by t.be high temperature, by the simultaneous swelling of the spleen, by the involvment of the kidneys, and by the absence of liajmorrhage, and from catarrhal jaundice by the hio-her range of temperature and the implication of?the spleen, liver, and kidneys. It resembles relapsing fever in many respects, especially the variety "called by Griesinger, bilious typhoid. This disease, however, never exists in a sporadic form, and hence may be excluded even in the absence of the important negative evidence that would have been furnished by an examination of the blood for the spirillum of Obermeier. The concurrence of jaundice, apyretic intervals, and distinct relapses, suffices to exclude the view that the affection is an abortive typhoid * * * * * complicated with jaundice. the widely-varying symptoms and -postAmong mortem appearances ot the numerous cases of ' < Weil's disease now 011 record, there is nothing distinctive of a hitherto unrecognized disease. On the other hand, there is strong evidence that some of them were cases of septic poisoning. In Frankel's case, which corresponded in all respects with- those described by Weil, the point of septic infection was a wound of the head; and in Fedler's cases, at least in the nine butchers, the infection may have entered the system in a similar manner, through cuts and abrasions too slight to attract attention, or through the ingestion of decaying meat."*?The Montreal Medical Journal, August, 1889.
18S9^dik?r
^ie
Philadelphia
Medical
Xews, May 25th,
375
Some
some
*
Schmidt's Jahrbucher
Mai,
1889.
der
Ge sammten
Medicin,
15
HEART COMPLICATIONS IN GONORRHOEA.
Dec., 1889.]
This observation induced Frankel to make a careful critical examination of the numerous disease, publications 011 the subject of Weil's and he came to the conclusion that ? the collection of symptoms described by Weil have no specially characteristic significance either in their {Etiology, symptomatology, or in their anatomical relations. Evidently in the cases described it appears to act as a septic infection in which the poison euters the body from without The febrile jaundice, the or from the intestine. extensive implication of the nervous system, the enlargements of the liver aud of the spleen, the albuminuria, are no more characteristic of a special disease than the relapsing type of the fever. Frankel, therefore, proposes to abolish the name Weil's Disease, and to substitute for it that of Infectious or Septic Jaundice. " The following reasons for regarding this affection a* an independent one have been advanced : From acute yellow atrophy of the liver it is distinguished by the swelling of that viscus, by t.be high temperature, by the simultaneous swelling of the spleen, by the involvment of the kidneys, and by the absence of liajmorrhage, and from catarrhal jaundice by the hio-her range of temperature and the implication of?the spleen, liver, and kidneys. It resembles relapsing fever in many respects, especially the variety "called by Griesinger, bilious typhoid. This disease, however, never exists in a sporadic form, and hence may be excluded even in the absence of the important negative evidence that would have been furnished by an examination of the blood for the spirillum of Obermeier. The concurrence of jaundice, apyretic intervals, and distinct relapses, suffices to exclude the view that the affection is an abortive typhoid * * * * * complicated with jaundice. the widely-varying symptoms and -postAmong mortem appearances ot the numerous cases of ' < Weil's disease now 011 record, there is nothing distinctive of a hitherto unrecognized disease. On the other hand, there is strong evidence that some of them were cases of septic poisoning. In Frankel's case, which corresponded in all respects with- those described by Weil, the point of septic infection was a wound of the head; and in Fedler's cases, at least in the nine butchers, the infection may have entered the system in a similar manner, through cuts and abrasions too slight to attract attention, or through the ingestion of decaying meat."*?The Montreal Medical Journal, August, 1889.
18S9^dik?r
^ie
Philadelphia
Medical
Xews, May 25th,
375
