The Wheeling daily intelligencer. [volume] (Wheeling, W. Va.) 1865-1903, 1878-08-26
Remarks on the Form and Contagious
ness OF Yellow Fever.

Remarks on the Form md Contagious
ness OF Yellow Fever. o..
Louisville Medical News.
Robert Lawson, Inspector General oil
Hospitals, in the London Lancet, says:
Observation-Disclosures estrikinginthemod-
crn literature Of yellow fever than the lit
tie advance it displays on the lineof invest
igation and the mode of treatment follow
cd by the numerous writers who recorded
their experience and views at the begin
ming OF tAe-eeBtury. Now, as then, one
body ofmedical practitioncsreg yellow
fever as presenting various forms, as aris-
ing from local causes and not from contag-
ion, and rs frequcntlyappearing sporadical-
" as well us from time to time in the form
Of severe epidemic. Another body con-
siders TINT yellow fever always arises from
poison given of by person already labor
ing under it, as being continued fever
and never presenting a renting or inter
hitting form, and as never appearing
sporadically, or arising without commune
cation, either directly or mediately with
a previous case; while they relcgate the
spondic cases every West Indian and
many American practitioners arc famil-
lar with, and the frequent occurrance OF
which can not be ignored, to what has
been variously designated "remittent" or
@malarial yellow fever"-a form said to
present very close resemblance to true
yellow fever, including the ycllowness OF
the surface and black vomit, but which
may be distinguished from yellow fever by
the non-oCcurrence OF albumen in the
urine, II is worthy OF observation that
tho great majority OF the members OF the
profession Wild have resided someyears in
the tropics, and had constant experience OF
yellow fever, entertain the first opinion,
and it is only among those who have met
the disease occasionally, orwho have never
been brought into contact with 1t, that the
second is generally received.
Yellow fever is a febrile disease, usually
terminating in convalcscene or death from
the fourth to the seventh day, but either
may occur ms early MS the second day,
or not before the tenth or twelfth, or even
later. Thereisgenerally yellowness OF the
surface, commencing at various periods in
different individuals or epidemics Upon
the evening OF the third day, or the morn
ing Of the fourth, the urine usually con-
tains traces OF albumen, and on the latter
considerable sediment appears in 1t,
almost wholly consisting of tho scaly
cpitheium from the bladder; this is sue
ceeded by nm equally eopiOus ono on the
morning OF the fifth day, which consists
almost exclusively of granular tuDe-casts
from the kidneys, with scarce trace OF
epithelium from the bladder. By this time
the albumen has usually become consider
able, the chloridcs have been gradually re-
duced, and the urine US n whole Is usually
scanty, and may even g. IN TO complete
suppression. 1fthere be much yellowness,
the urine may contain u variable quantity
OF the coloring matter OF the pie. Inc
alvinc discharges IRE devoid o. inc natural
feculent appearance, especially from the
third day onward till tue disease gives way.
As the alvine and urinary secretions Us.
sumo these pecullaritics, there Is great
tendency to black vomit or discharges oil
similar matter from the bowels, or to the
so-called hemorhages from the various
mucous surfaces, or even In some, cases
from the skin; and alter dealii sucn may
often be found in the stomach or intes-
tines when not manifested during life;
Such are the distinctive features oianormal
case OF yellow fever, but in some the oc'
cnrrence OF the urinary symptoms may take
place earlier than here mentioned, and in
others they seem to be delayed for day
or two; but whenever watched from day
to day, and properly examined, it is found
TINT lie changes in the urine not only en-
brace the presence Of albumen, but tndi-
cate ,lesquamation Of the bladder and kid
ncys us regular features OF the disease. It
is important to bear this In mind, for in
some varitics Of intermittent albumen has
been found in the urine; but in such cases
It occurred during the cold stage only, aud
went Off us the fever came on, and was