29S ANNALS 0 F

IX.

The Hi/lory of a remarkable Cafe of TyphuS

Fever, immediately fucceeded by Meafles,
terminating fiuccefsfnlly, By Dr George
Mofiman Phyjician, Bradford, Torkjlnre-

Boy about twelve years of age be-

came intlifpofed on the 27th
Pie complained of a i*1
September. pain
his head and bowels, accompanied with flight
rigors, lols of appetite, and univerfal lati-
tude.
Thefe fymptoms continued for fome days*
and, being at a boarding-fchool, it Wras
thought proper to remove him to the abode
of his family. This was accomplifhed, with-
out much inconvenience, on the feventh
day from the firft attack. The two follow'"
ing days he was able to fit up occafionally*
A confiderable degree of thirfl now fupcl~
vened, and the fenfation of cold became
ft"
more
ltrong and frequent. Two of the
inily were under the influence of the incoj>eS
'
at
 MEDICINE, 1797. 299

at the time of his arrival; and he had ne-

ver had that difeafe.

complaints were at firft deemed trif-

His

ling, and were fuppofed to have been indu-

ced by a flight cold. Little attention was
therefore paid to him. But as I was con-
sulted for the children who were then la-

bouring under the difeafe of contagion al-

ready mentioned, I was requefted to give
an
opinion upon his cafe.
In addition to the fymptoms defcribed,
^ found his about his tongue
pulfe 100 ;
dry. and furred ; his eyes remarkably dull,
ar*d heavy ; a conftant and extremely fetid
diarrhoea ; a dejection of fpirits, ex-
great
prefied by frequent and involuntary iiglis.
fliort, from the aggregate of appear-
ances, I had a ftrong fufpicion that the fe-
Ver would aflume very lerious form.
a

I hinted
my fufpicion to the family, but
did not give me much credit for my
?pinion, and therefore declined the exhibi-
tion of urged, in vain,
I
any medicine.
^le of
propriety adminiftering an emetic,
lo be followed by a diaphoretic, regimen.
The
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This was on the 5th of October, and I faW

no more of him till the morning of the

7th.
I then found every fymptom much aggra-
vated indeed, and the fever feemed to ap-

proach rapidly to the worft fpecies of typhus-

His fkin was extremely hot and dry. His

pulfe 120. His tongue furred,' as before,

and black. The diarrhoea had increafed,
and the evacuations had become more of-
fenlive. He feemed much reduced, and
there was an evident linking after each dis-
charge. Petechia began to be vifible 011
his breaft and arms. He was more dejected
than before, and he iighed more

quently.
The family were now eager to adopt any
I
plan which might be recommended, and
prefcribed for him a compofition of tin#*
?
1 14"

of opium, of caflor, and of ferpentaria :

be adminiltered every hour, in a fpoonfi^
iiis
or two of
ftrong negus. I admitted into
chamber a free current of air. I ordere
his mouth, face, and hands, to be freqncn
ly waflied with cold water; and his lineI
to be changed, at lcaft once a-day.
Oftober

Jlk
 MEDICINE, 1797. 301;

'
October 8. I vifited him early, and found
that he had palled a very bad night. He
had taken the drops and negus in confider-
able quantity. He had had three or four
loofe ftools. He had reje&ed his medicine
twice. He had a flight degree of delirium.
His pulfe 130, weak and feeble. His
was

tongue and mouth were black. He had

extreme dcjection and fighing. Petechia

every where vifible. I continued the tinc-

tures, and had them adminiftered every
hour, in a fpoonful of old Port. His com-
Uion drink was, equal parts of brandy and
Water.
9th. I faw him, and found the fymp-
tonis pretty much the fame as yefterday.
He had occafionally rejected his medicine.
He kept finking down to the bottom of the
^ed, employed in catching the
and was

Rothes. When he was fpoken to, he whif-

Pered an anfwer partly rational; and at in-
*ervals he knew every body about him.
?^e had had no evacuation by ftool. I dif-
c?ntinued the tin6t. opii, but recommended
'l
fteady perfeverancc in the ufe of the other
tinctures,
 302 ANNALS OF

tinctures, and ordered them to be exhibited

in brandy and water.

ioth. He had forae loofe ftools in the

night; and 1 repeated the tinct. opii, in

fmall dofes, every three or four hours.
nth. He had had a very bad night.
X
Had rejected every thing. No more loofe
ftools. Pulfe 140. PetechicE as before. A
confiderable difficulty of breathing. A flight
coldnefs of the extremities. He was much
inclined to doze with his eyes half open.
The pupils wereinfenfible of the approach
of a lighted candle; and the ftrongeft vo-

or
latile falts, applied to his nofe, had little
the
no effect upon him. At this ftage of
dileafe, I applied blijlers to the breafl. and
legs.
12th. He had had three loofe ftools du-

ring night, notwithftanding the exhibi-

the
tion of tinct. opii every hour. His fkin ^aS

dry; his tongue black; his pulfe 144.

blifters had operated well. I continued the
ufe of the to he
tinctures, and directed them
exhibited in a
fpoonful of a cordial julep*
compofed of Sp. aether, nitrof. Tindt. cardam?
this*
comp. Sp. cinam. &c. In addition to

J
 MEDICINE, 1797. 303

I recommended a conftant and regular fup-

ply of red Port, and brandy and water.
Under this regimen, and nearly in the fame

fituation, he continued till the 14th.

1 had heard of good effeds produced by
the application of cold water, in fevers of
the malignant kind. And I recollected,
that in proof of its advantages, Dr Wright
?f Jamaica had Hated fome cafes, in the
Seventh volume of the London Medical
Journal. I therefore determined to try the
Partial ufe of cold water in this deplorable
cafe. ?
v

He accordingly had his legs and arms

^allied with water feveral times a-day. He

Reined much refrefhed after every applica-
and the frequency of his pulfe was
^uch diminifhed.
J5th. I entertained hopes of his re-

covery. The application of cold water had

keen regularly ufed, and with manifeft ad-

vantage. He had had a bottle and a half

old Port, and half a bottle of brandy, ex-
cited in fmall portions, fo as to confume
whole in the lpace of twenty-four
^?urs. He had had a tolerable night. His

pulfe
304 ANNALS OF

pulfe was ioo. Petechia of a paler colour.

He had had no more fetid ftools. He had a

gentle moifture upon his fkin, more efpe-

cially upon the extremities, and parts where
the cold water had been applied. I difcon-
tinued the tind. opii, and brandy and wa-
ter ; and directed the tinch caftor, See. to

be adminiftered every three or four hours,

accompanied by large potations of wine.

I did not fee my patient again till the

morning of the 17th. I then found his pulfe

a
tenfe and full, and about 120. He had
confiderable degree of rednefs about hlS

eyes, a fhort cough, and much difficulty

breathing. He had complained of rigors'
There was a conftant limpid difcharge fro111
both noftrils. His tongue, which had

lately been black, had upon it a thick

white fur, and he had great thirft. ThlS
was on the 2ill day from the commencc-

ment of the complaint, and on the i4^1

from his arrival at home.
I have already obferved, that two of ^ie

family laboured under the contagion of

meq/les at the time of his arrival. The/
wei ^
 MEDICINE, 1797, 305

were removed three days afterwards to a

conliderable diftance.
From the phenomena juft now defcribed,
and other circumftances, I had a
ftrong
contagion of the meafles
conviction that the
had reached my patient, and that in due
time the eruption would make its appear-
ance. This opinion correfponded exa&ly
^'ith the fubfequent facts; for, in a few
days, he was covered with the mealies.
On this occafion the mode of treatment
gave me much unealinefs. By the fever he
;vas reduced to the moft extreme degree of

Ability. Cordials, tonics, &-c. were there-

fore indicated. The difeafe which I had
then combat, required
to a regimen of a

contrary tendency.
I marked cautioufly the progrefs of the
difeafe before me, and I found, that inftead
recurring antiphlogiftic mode of
to the

treatment, fo very judicioully recommend-

ed in cafes of meafles,
fupporting the
ftrength by means of broths, bark, wine,
k-c. was the only likely method of reftoring
1Tly patient to health.
Vol. II. U In
3o6 ANNALS OF

In the profecution of thisplan, I was fuo

cefsful, and had the happinefs to fee ai\

amiable boy in a itate of convalefcence,
which fpeedily terminated in the moft com-
pleterecovery. t

From the hiftory of this cafe fome curious'

queries arife. When was the contagion

of the mealies communicated to my patient?
If he received it from the two children who
had the difeafe atarrival, and who were
his
foon after removed, as I have already ftated?
it muft have remained in his fyftem in a
Hate of ina&ion, during the progrefs of the
If this be true, How far is
typhus fever*
the hypothefis confiftent with that dodtrine,
which maintains, that contagions of an op-

pofite nature cannot exift in the fame fub-

jedt, and at the fame time ??Again, If lt
be true that the poifon of the mealies was
in an inert ftate, during the continuance ot
the fever; was its adlivity, at laft, in an^

degree conducive to the recovery of my P:l"

tient ? Is this laft fuppofition compatibfc
with the commonly received opinions re"

fpe&ing the action of contagion ?

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