An account of the epidemic fever of 1847-48, more especially as deduced from the statistical records of the extra accommodation of the Royal Infirmary : with a suggestion and plan for improved and more economical temporary erections for future occasions / by Robert Paterson, M.D.

  • Paterson, Robert, 1814-1889.
Date:
[1848?]
Catalogue details

Licence: Public Domain Mark

Credit: An account of the epidemic fever of 1847-48, more especially as deduced from the statistical records of the extra accommodation of the Royal Infirmary : with a suggestion and plan for improved and more economical temporary erections for future occasions / by Robert Paterson, M.D. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    a period of longer or shorter duration, generally upon the fifth, or from five to seven days, during which time the patient has been lying in a state much the same as described, he begins to expe- rience a gradual remission of his sufferings. The skin becomes by degrees moister, until it is covered with copious perspira- tion. This diaphoresis is in general critical; sometimes it is ushered in by a severe rigor, while, at other times, it comes on more suddenly. It continues for a time most abundant, be- dewing the face and hands with large drops of moisture, and sa- turating the bed-clothes, after which the patient feels quite relieved. The most common duration of this diaphoretic crisis is from three to six hours, sometimes much longer. I have seen it in some cases continue for upwards of forty-eight hours. Another manner in which this disease terminates, is, after an imperfect attempt at diaphoresis, the febrile symptoms become shortly renewed, and it passes on to synochus or typhus. I have else- where remarks to make upon the eruptions which have occurred during this epidemic. I may here mention that petechial spots, often with central puncta, were frequent during this short disease, but were not noticed in the relapses which followed. The pulse, on the occurrence of this critical diaphoresis, undergoes a remark- able reduction—from 140 to 160 ; it sometimes falls in a few hours to 45; in two cases it fell as low as 40, and 50 is a very common number. Along with this reduction of the pulse, the heat of skin vanishes, and it is soon left in a natural state. The critical evacuation has generally been by perspiration ; but we have had cases in which it proved critical by epistaxis, by diuresis, by diarrhoBa, and by menorrhagia. This evacuation in general leaves the patient much exhausted, sometimes to such a dangerous degree as to prove fatal. Aftep >: recovering from this evacuation, however, he feels himself perfectly well; his appetite returns, his skin and pulse are natural, and he is soon able to get out of bed and go about the ward. This state of matters rarely continues for any length of time; in one or two instances, a gradual recovery of strength and perfect convalescence followed ; but, in the great bulk of the cases, after a longer or shorter period of good health, a slight rigor or chilliness, followed by loss of appetite, heat of skin, quick pulse, and general sore- ness, denoted a relapse of the disease. This relapse, in the ma- jority of the cases, occurred on the fourteenth day from the first seizure, and terminated in a similar way generally upon the third day from the commencement of the relapse. A second and even third relapse occurred in a small number of instances. Considerable difference of opinion seems to exist about the nature of this disease. It is clearly distinct from typhus. It is equally dis- tinct from continued fever. But is it synocha ? It may be said to