Bilious fever

“ It is to be lamented, that it is not in pulmonary consumption only, that the effects of a disease have been mistaken for its cause. Water in the brain, a membrane in the trachea, and a preternatural secretion of bile, have been accused of producing hydrocephalus internus, cynanche trachealis, and bilious fever, [83] whereas we now know they are the effects of those diseases only, in the successive order in which each of them has been mentioned. It is high time to harness the steeds which drag the car of medicine before, instead of behind it. ”

“ The pond was filled with earth, and the family were afterwards free from an annual bilious fever.
26. A hog-stye has been known to produce violent bilious fevers throughout a whole neighbourhood in Philadelphia.
27. Weeds cut down, and exposed to heat and moisture near a house.
Fevers are less frequently produced by putrid animal, than by putrid vegetable matters. There are, however, instances of their having been generated by the following animal substances in a state of putrefaction.
1. Human bodies that have been left unburied upon a field of battle. ”

“ In fevers of every kind, and in every stage of life, there is a disposition to effusion in that part to which there is the greatest determination. Thus, in inflammatory fever, effusions take place in the lungs and in the joints. In the bilious fever they occur in the liver, and in the gout in every part of the body. The matter effused is always influenced by the structure of the part in which it takes place. ”

“ On the fourth day, it generally presents so perfect a remission, as to cause the patient, in many cases, to imagine himself perfectly free from disease, and induce [Pg 57] him to get up, and even sometimes to walk out. This remission, which sometimes amounts to an intermission, so far as an experience of upwards of forty years can authorize me to decide, is never found to attend in bilious fever, in which, if there be any remission, and recurrence of the unpleasant symptoms, the former is always a real convalescence, and the latter an accidental relapse. ”

“ Hence intermittent, nervous, putrid and bilious fevers, are common in the country, and prove fatal to many of its inhabitants. Young children are very subject to the worm-fever, which cuts off multitudes of them. The dry belly-ache, which is a dreadful disorder, is no stranger to the climate. ”

“ Continued Fevers are generally of a Bilious character, except in winter, when they are more or less connected with irritation of the lungs, or with Rheumatic affections, when they are termed Catarrhal or Rheumatic Fevers. If the bilious symptoms prevail, give Aconite and Baptisia during the chills and high febrile stage, at intervals of an hour, and during the declining stage of the fever, give Podophyllin and Mercurius until a perfect intermission is produced, when the same treatment should be adopted as in intermittents. ”

“ Use the "Cascade" and open the pores. Wash the stomach, take two or three hot injections daily, and a hot sheet pack. This treatment, with baths and rubbing, will cure an ordinary case of bilious fever in about three days. Avoid all drugs. Nature will call for food when it needs it.
LA GRIPPE. This is the modern name for influenza. It resembles an ordinary cold in its symptoms, but is far more violent in its effects. Acute pains in the head and kidneys are symptoms that are usually present. If neglected, it may develop into pneumonia, or consumption. ”

“ A bilious rheum, in addition to paleness and redness of colour, occasions a sensation of heat and acute pain, and is speedily determined to the skin, nor is it attended with much swelling. It is exacerbated by heating applications, and relieved again by cooling, which, for the most part, is the case with all the others, but more particularly when the exciting cause is bilious. Fever also frequently comes on at the height of the paroxysms, and then they are thirsty. ”

“ Explanations of this kind may edify those who understand them; but, though we should declaim ever so much about excitement and excitability, it is plain, that, in every one who comes from a cold country to a warm one, the liver is affected in a manner that the rest of the body is not. In some constitutions, or from exciting485 causes in any constitution, this affection of the liver may be augmented, and no doubt at last produce a bilious fever, which may be varied in a number of ways, according to the nature or the energy of these causes. ”

“ Especially is it caused by the excessive use of fats and sweets. How does this biliousness produce nausea in the pregnant woman, and why does it show itself in this way, when she was comparatively well previous to this condition?
In the new process of gestation the whole system is roused to action, and nature makes an effort to [Pg 47] relieve the organs of all foreign or bilious matter. Her first means to produce this result is by nausea and vomiting. Many women have an attack of bilious fever, more or less severe, in the first months of pregnancy. ”

“ Indian Type.—In the relapsing fever of Asia there is a marked tendency for the patient to collapse at the time of the crisis. There are rarely more than two relapses and in probably 25% of cases there is no relapse. There seems to be a greater tendency to liver complications in the Asian types than elsewhere and such cases form a large part of the death rate from this disease. Bilious vomiting and jaundice, with a typhoid-like state and the occurrence of various inflammatory complications, especially parotiditis, are noted. ”

“ In April, some few of the Soldiers, on their Return from the Winter-Expedition into Hesse-Cassel, had Fevers attended with bilious Symptoms; but they were rather of the continued, inflammatory Kind, and tending to malignant, than such as could be called remitting. [156]
The first Time that I saw much of this Fever, was among the Sick sent to Bilifield in the End of June 1761; soon after the Army took the Field. The Remissions were short, and it partook much of the Nature of the common Inflammatory Fever; and most of them were cured by the antiphlogistic Method. ”

“ There is a disease in North-Carolina, known among the common people by the name of the “pleurisy in the head.” It occurs in the winter, after a sickly autumn, and seems to be an evanescent symptom of a bilious remitting fever. The cure of it has been attempted by bleeding, in the common way, but generally without success. It has, however, yielded to this remedy in another form, that is, to the discharge of a few ounces of blood obtained by thrusting a piece of quill up the nose. ”

“ The same thing has been justly said of the exhalations which produce the bilious intermitting, remitting, and yellow fever. No experiment that has yet been made, has discovered their presence in the air. ”

“ This disease, in addition to the symptoms of cutting, cramping pains in the bowels, as in common colic, has great distress in the stomach, with nausea and vomiting, the bowels being costive, the feet and hands cold, sometimes cold sweats occur. There is also considerable fever, and frequently headache is present. The substance vomited is at first dark bilious matter, but if the case continues a long time, stercoraceous (fecal) matter will be thrown up. ”

“ Like 'General Tazo' of Madagascar, this fever is a malignant bilious-remittent. The eyes become hot, heavy, and painful when turned upwards; the skin is dry and burning, the pulse full and frequent, and the tongue furred; appetite is wholly wanting (for a whole week I ate nothing) , but a perpetual craving thirst afflicts the patient, and nothing that he drinks will remain upon his stomach. During the day extreme weakness causes anxiety and depression; the nights are worse, for by want of sleep the restlessness is aggravated. ”

“ I have recently met with a case in England in which a severe attack, followed by a still more severe and prolonged relapse, was the first manifestation of a blackwater-fever infection which must have been acquired at least nine and a half months previously— the time that had elapsed since the patient left Africa.
Symptoms.— The onset of blackwater fever is usually sudden. A slight or, more generally, a very severe rigor is followed by intermitting, or remitting, or irregular fever with marked bilious symptoms. ”

“ SYMPTOMS.——The first symptoms of this fever are generally yawning, stretching, pain, and giddiness in the head, with alternate fits of heat and cold. Sometimes the patient is affected with a delirium at the very first attack. There is a pain, and sometimes a swelling, about the region of the stomach; the tongue is white, the eyes and skin frequently appear yellow, and the patient is often afflicted with bilious vomitings. The pulse is sometimes a little hard, but seldom full, and the blood, when let, rarely shews any signs of inflammation. ”

“ When the fever has continued a few days, the symptoms of inflammation usually subside, and the disease takes a putrid form; a bilious or putrid diarrhœa supervenes, the stools become involuntary, and the patient dies.
Although this disorder begins sometimes like a regular fever, and at others shows symptoms of genuine inflammation; yet it seems to differ from both, and exhibits those symptoms of irritation, with sudden depression of strength, quick and low pulse, dizziness, glazy eyes, and that species of delirium which denote a diminished energy of the brain ”

“ The renal epithelium shows cloudy swelling passing on to fatty degeneration and desquamation. The tubules, here and there, are filled with infarcts, either of an albuminoid material or of débris of desquamated epithelium, corresponding with the numerous casts which can be discovered in the albuminous urine. Diagnosis.— The diagnosis of yellow fever is treated of in one of the chapters on malaria and in that on black water fever (see pp. 114, 288) . Practically, the only two diseases with which severe yellow fever is likely to be confounded are bilious remittent and hæmoglobinuric fever. ”

“ CAUSES.——The immediate cause of the jaundice is an obstruction of the bile. The remote or occasional causes are, the bites of poisonous animals, as the viper, mad dog, &c. the bilious or hysteric colic; violent passions, as grief, anger, &c. Strong purges or vomits will likewise occasion the jaundice. Sometimes it proceeds from obstinate agues, or from that disease being prematurely stopped by astringent medicines. In infants it is often occasioned by the meconium not being sufficiently purged off. Pregnant women are very subject to it. It is likewise a symptom in several kinds of fever. ”

“ But this cooling salt should never be administered in cases where the violence of the fever depends on bilious or putrid impurities in the abdomen; and where the patient is subject to hemorrhages or fluxes of blood, arising from a vitiated state of the fluids. ”

“ This disease was also prevalent in the West Indies. The symptoms were slight cold, followed by extraordinary prostration of strength, laborious respiration, cough, obtuse pains at the precordia and in the chest and limbs. The malady presented the signs of a bilious distemper, the countenance becoming yellow; insensibility or coma, and sometimes delirium, supervened, when the patient was taken off with all the symptoms of a regular bilious plague or yellow fever. About this period a deadly epizootic broke out among the dogs in Madrid ”

“ The remittent fever is the most formidable of our autumnal diseases, especially when of a highly bilious type. In most seasons, these diseases are easily managed, and yield to a dose or two of medicine. ”

“ It approaches somewhat to fever; the patient complains of severe pain in the legs, sometimes vomiting a watery fluid, and sometimes bile." (White—Bengal Reports, p. 68.)
The same gentleman afterwards observes, "The disease continues to present a milder aspect, and now occurs but rarely: loss of pulse and coldness are seldom observed."
On the decline of a particular epidemic, Mr. Alardyce observed many cases in the 34th regiment, with bilious discharges throughout. (Orton, 1st Ed. 128) . ”

“ The distempers are fevers of the remitting or intermitting kind; for, though sometimes they may continue several days without sensible remission, yet they have in general a great tendency to it. If the season be very sickly, some are seized with a malignant fever, of which they soon die. The body is covered with blotches of a livid colour, and the corpse, in a few hours, turns quite livid and corrupted. At this time fluxes prevail, which may be called bilious or putrid, the better to distinguish them from others which are accompanied with inflammation of the bowels. ”

“ Strangers soon after their arrival are attacked with a fever which seems to be caused by the malarious exhalations from the earth. The fever shows itself by loss of appetite, pains in the back, severe and long-continued headache, together with gastric troubles that develop into bilious remittent fever. ”

“ When the liver is involved, as in bilious colic, bile also is ejected. Nothing peculiar exists in the ejecta of morning sickness in pregnancy. The ejecta contain mucus in gastritis, blood in ulcer and in cancer of the stomach, stercoraceous [p. 163] material in obstruction of the bowels, black vomit in bad cases of yellow fever. Hysterical vomiting sometimes closely imitates the latter in appearance. Other affections attended by vomiting are cholera morbus, remittent fever, brain disease, Bright's disease of the kidney, etc. ”