, 1875-06-02

ing. Sometimes the patient breads the light
(photophobia), the pupils are sometimes dila-
ted, sometimes contracted, at all events in
constant; he often feels a tingling in the ears,
is extremely sensitive to noise, becomes hard
of hearing OF completely deaf. In some cases
there is complete. sleeplesSnesS, delirium, ankle
ty in others somnolency, stupor and coma.
A frequent but not invariable symptom is
Vomiting, which, when it occurs, takes place
at an early stage of the disease; and usually
there is Costivemess, but seldom diarrhea.
A characteristic symptom also is the general
Hyperesthes,G of the skin. This extreme
sensibility of the skin is sometimes so great
that the slightest contact or movement is pain
full. As for the limbs, they are sometimes
attacked with spasms, or tonic contraotions,
at other times with lameness, which again
diminishes. Sometimes partial paralysis of
the facial muscles (PtosiS, squirting, etc.
occur sometimes the urine is made Spontane-
ously, at other times not at all.
characteristic is also in many cases the
breaking out Of small vesicles in the face, less
frequently on the body, or of red spots, Urtica-
ria E" mad bloody or Of dark discolored spots
containing blood (PetechiH(, which last gave
the name Of spotted fever" TO the disease
in America.
The disease may also begin by a bleeding
of the nOse.-As 10 Fcrer ii is, as rule, never
wanting, but it is often met with only at the
commencement of the disease, or consists
merely in a single shiveriDg fit and ensuing heat
and sweat, thus disappointingly resembling a
common ague. In cases resulting fatally, The
fever frequently lasts during the whole disor-
der (even as long as 6 wepks), it is at it's
highest on The day Of death, bat disappears
suddenly during the last agonies. Or the
whole, the fever shows a very changeable and
incOnstant cOulse, but is, as a rule, never very
strong, but Of mean degree.
The Pulse, finally, is now quick, row slow.
It can scorAe down TO 40 beats a minute. AT
the moment Of death it ca0, however, reach
100. And strange e~n0ugh-tbe pulse and
the fever do not always correspond, so that the
fever is cften strong while She pulse is weak, and
vice. versa
We'have thus seen that there are symptoms
enough to choose between and variety likoHi5e.
Some Of these symptoms are, however, less
subject to change than others, to which,
consequently, all attention must be directed,
as I shall endeavOur to do below.
In now turning 10 the question of the treat
ment of this disease, it may perhaps be thought
that the discussion Of this matter would be less
in its place in this brief sketch. But in the
first place, it is absolutely necessary TO the
completeness of the picture l intend to give,
and in the second place, it may be Of great
consequence for people TO know in what direc-
ton the treatment must be conducted, until the
arrival Of the physician, especially in more re-
mote places to which he cannot always come
acknowledgements so in this busy time-apd
inally it can do no harm To endeavour to set
clearly before our eyes the principles Of the
treatm ent.
The p}even ion OF the disease, w,ichs accord
ing to the adage is better than the cure, is. it
must be fairly acknowledged, as good as impos-
sibla.
Pre;ent the disease we cannot, there is no
remedy at disposal, although che has been
eagerly sought, and endeayours have been
made to find means to that end. Fresh ar,
cleanliness, ana good food, must be recommend
ed here as everywhere, although it must be &C
knowIedged that here and elsewhere where
those conditions have been present, they have
not, as experience shows, been able to prevent
the outbreak Of the disease.
The disease is, as we have seen, according
to it's nature, an intense and acute infamma-
ton of the membranes of the brain and the
spinal chord, that is to say, there is a great
aflux of blood to those parts, The blood vessels
being dilGted, followed by exudation and sup
duration. Attention was therefore in the first
instance directed to the remedies known to
subdue or abate infammations and prevent the
af1ux of blood. Besides those a quantity Of
others have been employed, which is not to be
wondered at, when it is remembered how hume.