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Relapsing Fever.

Problems:

Attention was called last Winter to a fever having some of the characteristics of the English "relapsing fever." It had not all the symptoms, it was true, but it had the unpleasant one—the relapse. This year we have seen the same tendency in a few cases, and have had it reported from several sections. Possibly our civilization has so far advanced that we may have this "famine fever," in addition to all our other blessings.

To renew the acquaintance of the reader with it, I give the diagnosis, as found in Robert's Practice of Medicine, noticed in this number.

"At first it may be difficult to distinguish between relapsing fever and other affections of a pyrexial character, but the only two which call for special notice are typhus fever and yellow fever.

Relapsing fever is distinguished from typhus by—

1. Its mode of onset and peculiar course

2. The symptoms which are prominent in each, and which may be thus arranged:

Relapsing Fever.

a. Very frequent pulse at an early period, with a high temperature.
b. Severe pains in the limbs and joints.
c. Jaundice, not uncommon.
d. Vomiting and pain in epigastrium.
e. Tenderness and much enlargement of liver and spleen.
f. Not great prostration as a rule.
g. Epistaxis and other hemorrhages common.
h. Anaemic cardiac murmur is frequently observed.

Typhus Fever.

a. Pulse less frequent, very feeble.
b. Sense of great weakness.
c. Peculiar eruption on the skin.
d. Severe nervous symptoms arc common.
e. Dusky appearance of the face, and signs of prostration.
f. Signs of softening of the heart.

3. The difference in the mortality.

4. The complications and sequelae, especially abortion and ophthalmia.

From yellow fever it differs in its course; in attacking especially the poor and destitute; in the rarity of black vomit, and comparatively infreqnent occurrence of jaundice; and in being rarely fatal."


The Eclectic Medical Journal, Vol. XXXIV, 1874, was edited by John M. Scudder, M.D.



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