The Cleveland leader. [volume] (Cleveland [Ohio]) 1865-1865, 1865-05-08
THE RUSSIAN rPTBEMIC.
,OmeIaI RePsrt ON tt. origin ana CHAR
acters -

official report upon the bussian epidemic.
The information embodied in this report |
was obtained by correspondence with the |
officers of the Russian Government /; and |
the character of the disease is now distinct |
" defined. It is arelspsing fever, appear
iHR in two forms-the simple and the bill |
lious-and its greatest raVsges are among |
the poorer clssses. Like typhus fever in |
general, It is contagious contact with the |
nersons attack or with their wearing sp-
uareI Of those attacked in st. Petersburg |
one in seven have died. The total number |
of cases admitted into the hospital up to |
March l. was IA, 722 of which 2,O34 proved |
fatal.
Its emphatically stated, however, that
the disease presents no features new 10
medical science. It is an aggravated form
Of the typhus and typhoid fevers which
ravsge'St. Petersburg almost every year In |
the autumn, and decrease about the month
of November, at which period q large num-
Der of workmen leave the csPitsl. Towards
the months of March and April following
during Easter time), at the breaking up OF
The ice when the journeynen artisans re-
turn to St. Petersburg these feVers sgsin
make their appearance, The typhus st
present raging only differs from these levers
by 8 greater extension and inter sity OF the
characteristic symptoms. -,
The following descriptions Of the pre-
monitory symptoms of the epidemic, and
the different stages of its progress are val
usble,in Visw of its possible entrance here:
"Those contracting this mslady are
seized with shivering fits, sometimes in two
attacks within short intervals one of the
other, and at other times in one continued
attack. When the shivering fits are over,
the patient feels great prostration, intense
thirst, pain in the heart, and want of ap-
petite Sometimes the sufferer vOmits, and
he is generally constipsted. His prostrs-
tion then increases, aud he is seized with
peculiar pains in his extremites. There
symptoms last mentioned sometimes cease
or disappear after short lapse Of time;
they are neither permanent nor continuous.
This preliminary period is usually short
one, often after tWeaty four hours only the
disease clearly mADifests itself. The face
becomes changed, the features sunken, the
complexion sometimes red, and st others of
grey ysllOWish hue, ofttimes icterical, the
skin is hot and parcted, the head heavy
and burning. If thermometer be placed
uuder tie armpit of the patient, The result
is 30, 40 to Al degrees CELSIUS, and this tenn
perature is slmoet the same throughout sll
the other parts of the body. The tongue
is generally moist-never quite dry, red on
the side and the tip, and turred at the root.
In most cases the respiration is free, but in
some the patient coughs little, without
emitting much CLAIRE. Although not swol-
len, the abdomen gives way TO the touch,
particularly if the left hypochondris be
slightly pressed
"The liver is much larger than in its
pstursl state, for it often developes itself
IS far as the umbilicus, and occupies the
whole of the left hypochondrisc region.
The spleen is always very much swollen.
The sufferer does not eat, feeling even dis
gust for every kind of food: but experien-
| ces the most intense thirst; he has easy
passages in the bowels, and bis excavations
| present nothing unusual, being moreover,
rather liquid than consistent, and the urine,
which is voided without difficulty, is slight
lY acid, somewhat slbUmiuOus. The pa
tient, who is much prostrated, is seized with
dizziness, and Is unable TO keep himself 10
an upright position. The pulse is weak
and slow; it b ats loo minute st first and
afterwards altains rs many IS l3O to lao
during that space of time. Delirium very
rarely ensues. The state we have just de-
| seribed lasts from. seven and even ten days;
after wards the patient begins TO perspire
protusely; and tLis persplrAtioD, which is
accompanied by considerable decrease in
| the intensity of the symptoms, continues
sometimes from twelve TO thirty-siH hours,
| but the lprostrstion does not diminish the
twichings in the muscles.
"rhe state of comparative immunity
from suffering is prolonged for several days,
when suddenly fresh access occurs, the
shiVering fits next ensue, being followed
by q renewal of all the symptoms before
mentioned, which sffiict the sufferer for q
| further space of several DAYS However,
| in general, this second attack is neither so
violent nor does it last so long as the first,
and then the first stage of convslescence
! sets in, although its progress is very slow.
| 1t is also very common occurrence for the
| person attacked to have one or two relapses,
! apparently less violent than the first &C.
cesses, but still leaving the sufferer in ex-
treme prostration. In few isolated cases
| death ensues in the first psroxysm, that is,
before the second Access Of cold, in conse-
queuce of cerebral or pulmonary hemOrr-
| hage, inflammation OF the meninges, or par
Alysis of the heart, (Dr. Hermann, of the
! Aboukhoff hOspitsL) But if death does
not take place till later, it is caused by in
fiammation of the lungs or rather by q
stoppsge in the lungs, sbeess in the spleen
and loins, intestinal cstsrrh, and dropsy.
.'In the woIkiDgman's hospital phleg-
mons have been observed fmuch diffused)
starting from the trunk and lower ex-
| Su A.,
! tion of the parotis and inguinal glands
Latterly we have frequently observed fss
mentioned sbove) that the bilious relsps-
| ing fever becomes transformed during tho
second psro1ysm into typhus or typhoid
fever. The second form of the mslady,
which is the bilious relspsing fever, may
arise from the first just spoken of; but
sometimes it appears ut the very first.
| Prom the first day the sufferer presents
every appearance of being in an ictoricsl
condition he has frequent fits of vomiting,
and is afflicted with insuPportsble psins III
the head; he is also deliriJus and greatly
prostraied. This condition, although al
ways dangerous, does not in every case
end fatally, but the progress TO convales-
ceDce is always slow.
"Post mertem examinations have always
| proved the seat OF this mAlady to be in the
organs of the abdomen, particularly the
spleen and liver, which Sre always much
enlarged and completely changed in sppes-
rance( constituting parenchymatous inasm-
mation); sometimes the groin also is
attacked with this Inflammation; catarrhal
affections of the mucus of the stomach snd
intestines have also been observed, extend
ing in some cases to the mucous mem
brsnes of the hillary ducts, eccssioning
ictericsl phe during life. More
over, in cases of complication, are to be
found the results of Inflammation on the
lungs, suppurAtive PeEicarditis and hemor=
rhoIdsl foci in the tissue of the spleen, and
even rupture of that organ. Men are more
| subject TO it than women. Those OF the
working classes who are addicted 70 drink
ing are also most likely to be attacked"
The treatment is thus directed:- e''
tNo uniform method of treatment for
every case has as yet been found, but those
physicians are most successful who attend
particularly to the fever and the state of
the abdominal organs. Mineral acids
(Hsliers acid elixir and chlorine are most
adopted. Symptomstic and palliative
treatments, according to the local compi-
cations. are recommended, such IS lsxs-