Spotted fever

“ The contagion, -like that of typhus, appears to be most active in the immediate vicinity of the patient and to be greatly lessened by the access of fresh air. It is capable of being conveyed by clothing. The incubation of the disease is about one week. The symptoms of the fever then show themselves with great abruptness and violence by a rigor, accompanied with pains in the limbs and severe headache. ”

“ Peculiarities.—The miliary fever, though not contagious, is an epidemic disease, and sometimes a critical symptom in the autumnal putrid fever. It generally commences its attack with a cold shivering, which is succeeded by intense heat, pain in the head and loins, oppression on the breast, and difficulty of breathing. An itching and prickling sensation is felt in the skin, which, between the seventh and fourteenth days, is covered with numerous small, red, and distinct pimples, that appear first on the neck and chest, and gradually spread over the whole body, excepting the face. ”

“ In the more malignant form the fever runs high, 100° to 107° Fahr., and all the characteristic symptoms are well marked: dulness, sunken eyes, eruption on the skin, discharges from eyes, .nose and mouth, shivering fits, difficult breathing, dry, harsh cough, miliary eruptions on the gums, accumulation of bran-like exudate within the lips, fetid breath, with certain nervous phenomena, and dysenteric dejections. Death generally occurs in four or five days, the course of the disorder being more rapid with animals kept in sheds than with those living in the open, and in summer than in winter. ”

“ Almost the only cause for a fever is disease germs growing in the body. We can make a person have any kind of fever by planting a few of the germs of the fever in the right part of his body.
We are made sick by the germs of fevers more often than by all other causes put together. Here is a list of common diseases caused by fever germs:—colds and sore throats, most stomach aches, blood poisoning in wounds, boils and pimples, tuberculosis, whooping cough, measles, chicken pox, diphtheria, scarlet fever, typhoid fever, smallpox, and malaria. ”

“ One attack usually confers immunity.
Symptoms.—Incubation is about three to four days. There may be a fore-warning period, but the attack is usually sudden, with chills, headache, backache, rise in fever, and general feverish symptoms, vomiting, and constipation. Early in this disease the face is flushed, while the conjunctiva and the mucous membrane lining the eyelids is congested and slightly jaundiced. Fever is 102 or 103 degrees, and falls gradually after one to three days. Pulse is slow, and while the temperature rises, it again falls. ”

“ The circumstances which seem to favour the communication of the yellow fever from one person to another, by means of what has been supposed to be contagion, are as follow:
1. A patient being attended in a small, filthy, and close room. The excretions of the body, when thus accumulated, undergo an additional putrefactive process, and acquire the same properties as those putrid animal matters which are known to produce malignant fevers. ”

“ Few escape this exotick contagion, especially in childhood and in cities. It attacks the same persons but once in life; and, with us, is said to be most epidemick in winter.
Morbillous symptoms are fever, impaired appetite, heaviness of the head and eyes, somnolency, catarrh, acrid defluxion from the fauces, nose, and eyes, with hoarseness, sneezing, and lachrymation; short dry cough, and some difficulty in respiration. Prior to the eruption, there is generally anxiety about the breast, palpitation of the heart, itching of the face, peevishness, and considerable fever. ”

“ But there is a grade of fever, which transcends in force that which produces inflammation. It occurs frequently in hydrophobia, dysentery, colic, and, baron Humboldt lately informed me, upon the authority of Dr. Comoto, of Vera Cruz, in the yellow fever of that city, when it proves fatal in a few hours after it attacks. In vain have physicians sought to discover, by dissections, the cause of fever in those cases, when followed by death, in the parts of the body in which it was supposed, from pain and other symptoms, to be principally seated. ”

“ They are at all times too serious to be left, with safety, in the hands of the domestic practitioner. Medical aid, therefore, should be instantly sought for, as much depends on proper management during the first stage of the fever. The approach of this disease may be known, by attending to the symptoms which precede the eruption, in the following order: First, the patient complains of shivering, with a sense of coldness, a thin watery discharge from the nose, hoarseness, cough, and a continued flow of tears from the eyes, which appear red and inflamed. ”

“ In the worst forms of fever the blood gets so impure that it steams out, through the breath, vapors [450] which are able to produce the same kind of disease in other people, and which are, under these circumstances, termed infection. The infectious poison-vapors of fever get so strong when they are received into close rooms, and are not allowed to be blown away, that they often kill persons who breathe them in that state, very quickly. ”

“ Exciting causes are exposure to cold, wet, burns, extensive skin tears (lesions) , scarlet fever, diphtheria, typhoid fever, measles and acute tuberculosis, poisons; and pregnancy is one cause when it occurs in women.
Symptoms.—After exposure or scarlet fever the onset may be sudden, sometimes with chills or chilliness, variable fever, pain in the loins, watery swelling of the face and extremities, then of other portions of the body like the abdomen, then general dropsy. Sometimes there is nausea, vomiting, headache, delirium, or very deep sleep. ”

“ Venesection may be used in the distinct small-pox early in the disease, according to the strength or hardness of the pulse; and perhaps on the first day of the confluent small-pox, and even of the plague, before the sensorial power is exhausted by the violence of the arterial action? Cold air, and even washing or bathing in cold water, is a powerful means in perhaps all eruptive diseases attended with fever; as the quantity of eruption depends on the quantity of the fever, and the activity of the cutaneous vessels ”

“ That such a cause exists, he proves from observing that “of any number of men, one half of whom go near a person ill of a fever, and the other half do not, a greater number of the former will be infected, in a short period afterwards, than in those who do not.” He says he has known, in such circumstances, seven out of nine infected with the disease. This infection is not discoverable by smell or any other organ of sense; neither can the greatest attention to cleanliness disarm it of its malignity. ”

“ A favorable termination is indicated by a gradual amelioration of all the symptoms, or sometimes by profuse perspiration, sudden cessation of nausea, rapid return of the pulse to its natural fullness and strength, or other marked event, which seems to indicate a crisis in the disease.
The symptoms of yellow fever vary exceedingly at different times, in different localities, and in different persons. Sometimes a person is smitten with the disease as with apoplexy, falls into a profound collapse, and dies in a few hours. ”

“ The plague, as has already mentioned, in its very severe state appears most commonly in the beginning of an epidemic season, and is neither very common nor very infectious. The most common mode in which it invades the patient is with the symptoms of a malignant fever; and of cases of this kind Dr. Russel has made up his five classes of patients, the first or deadly kind having been already described. In his second class, the next in malignity to the fatal kind, the disease made its attack with a slight shivering, succeeded by fever with giddiness, vomiting, head-ach, and sometimes looseness. ”

“ The periodical pains in the head, eyes, ears, jaws, hips, and back, which occur in the sickly autumnal months, and which impart no fulness, force, nor frequency to the pulse, are all misplaced fevers. There are, besides these, many other local morbid affections, which are less suspected of belonging to febrile diseases. The nature of these states of fever may easily be understood, by recollecting one of the laws of sensation, that is, that certain impressions, which excite neither sensation nor motion in the part of the body to which they are applied, excite both in another part. ”

“ We have already seen how, in the course of various diseases, the pulse is quickened, and the temperature raised, constituting that state which we commonly call fever, but as the local ailment subsides the fever disappears. There is, apart from smallpox, measles, and the other so-called eruptive fevers, only one real essential fever commonly met with in childhood, and that is what the doctors call typhoid fever. ”

“ Thus the introduction of another sensorial power, that of sensation, converts an intermittent fever into a continued one. If it be attended with strong pulse, it is termed febris sensitiva irritata, or pyrexia, or inflammation; if with a weak pulse, it is termed febris sensitiva inirritata, or typhus gravior, or malignant fever. The seat of the inflammation is in the glandular or capillary system, as it consists in the secretion of new fluids, or new fibres, which form new vessels, as they harden, like the silk of the silk-worm. ”

“ In some cases even the matter formed beneath the skin becomes in some degree contagious, at least so much so as to produce fever of the hectic or malignant kind, as soon as it has pierced through the skin, and has thus gained access to some kind of air; as the fresh puss of a common abscess; or the putrid pus of an abscess, which has been long confined; or of cancerous ulcers.
From this analogy there is reason to suspect, that the matter of all contagious diseases, whether with or without fever, is not infectious till it has acquired something from the air ”

“ I wish these symptoms to be remembered by the reader. They will form the corner stone of a system which I hope will either eradicate the disease altogether, or render it as safe as an intermitting fever, or as the small-pox when it is received by inoculation.
Frequent as these precursors of the fever were, they were not universal. Many went to bed in good health, and awoke in the night with a chilly fit. [95] Many rose in the morning after regular and natural sleep, and were seized at their work, or after a walk, with a sudden and unexpected attack of the fever. ”

“ They had no other communication with the infected but through the tents.
“These,” says Pringle, “are instances of high malignity. The common course of the infection is slow, and only catching to those constantly confined to the bad air. Sometimes one will have this fever about him for several days before it confines him to his bed; others I have known complain for weeks of the same symptoms without any regular fever at all ”

“ DEFINITION.—A continued fever, occurring in widely-extended epidemics, and due to a specific cause; it is characterized by early catarrh of the mucous membrane of the respiratory tract, and in many cases also of the digestive tract; by quickly oncoming debility out of proportion to the intensity of the fever and the catarrhal processes; and by nervous symptoms. There is a strong tendency to inflammatory complications, especially of the lungs. Uncomplicated cases are rarely fatal except in feeble and aged persons. An attack does not confer immunity from the disease in future epidemics. ”

“ He shows, on the contrary, that the atmosphere of a room such as that spoken of in the passage just quoted must have the power of inducing fever in others besides the patient. He even says that "the poison formed by the exhalations given off from the living bodies of those affected by fever is by far the most potent febrile poison derived from animal origin."
Then, it might be asked, of what consequence is it to insist on the disease being non-contagious? If fever-patients can give fever to others, it is a mere matter of words whether you choose to call it "contagious" or "infectious." ”

“ Miliary fever, febris purpurata, rubra and alba, is never epidemick, and is denied to be a primary disease; but is spurious, symptomatick, accessary, or fortuitous; it is very rare, and may be complicated with the nervous and putrid, and with small pox and measles. The miliaris alba is more frequent amongst the female sex, especially during the puerperal state, and in other females debilitated by fluor albus, and hemorrhages, of weak constitutions, delicate, prolifick. It sometimes exhibits previous symptoms of angina, pleurisy, catarrh, rheumatism, erysipelas. ”

“ The natural crisis is various by nasal hemorrhage, by sweats, turbid urine, diarrhœa; and the duration of the fever from four to eleven days. The Febris Diaria of a few days continuance, is a sort of minor or infant species, an appendix of the inflammatory: it begins suddenly with nausea, vomiting, shivering, cold, headach, lassitude, heat of the skin, flushed face, restlessness, or disturbed sleep, strong quick pulse: and is rarely dangerous. ”

“ A more aggravated degree of malignity will generate a greater quantity of infection, and, as it may be confined in a larger or smaller space, it will be less or more noxious. A fever332 may be called malignant, when, with the symptoms of debility, there is a cadaverous smell arising from the body, an unusual fœtor of the breath, stools, and other excretions, the tongue black and parched, the eye dusky or yellow, the countenance bloated and dejected, and the skin sallow. ”