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Related post: holds true as regards sequels. As a rule, important sequels
do not occur. A peculiar form of oplithalmia, which was
described as following the cases reported by Dr. A. Dubois, of
this city, in 1848, is an exception to the rule. It lias been
repeatedly observed as a sequel of relapsing fever. The pecu-
liarities of the ophthalmia are described in works whicli treat
of the diseases of Purchase Arjuna the eye. Buy Arjuna This sequel, however, has not
occurred in any of the cases which I have observed. Relaps-
ing fever, when it attacks pregnant women, ahnost always
leads to miscarriage or abortion. The mother almost invaria-
bly recovers, but the child, no matter how near nuiy be the
end of gestation, as a rule, is eitlier stillborn, or dies shortly
after birth. Order Arjuna
There are no constant lesions found after death which are
distinctive of this disease. The spleen is uniformlj more or
less enlarged and softened ; but this occurs in typhus and
typhoid fever. The liver is, also, more or less enlarged, but
without any special appearance or structural change. Changes
in other organs, which may be found, are due either to com-
plications or to antecedent disease. It is a negative point of
distinction in contrast with malarial fevers and with typhoid
fever, that relapsing fever is devoid of any known anatomical
What are the grounds for Arjuna Online considering this disease as a
distinct species of fever? Is relapsing fever a special form
of disease ; in other words, is it a distinct species of fever ? I
think facts warrant a positive answer to this question in the
aiSrmative. Let us consider briefly the grounds for this opin-
ion :
In the tirst place, the laws Order Arjuna Online of relapsing fever, as regards
the primary paroxysm, the intermission and the relapse, or
relapses, are very striking and peculiar. The clinical history, in
these respects, has but a remote analogy to the different types
of intermittent fever, and to the very rare instances in which a
relapse of either typhus or typhoid fever is observed. In re-
spect of the distinctive points now referred to, relapsing fever
differs essentially from any other form of fever; it stands
alone. Moreover, as we have just seen, there are other dis-
tinctive points in its clinical history. That it is a distinct
species of fever is a fair inference from the peculiarities per-
taining to its phenomena and laws.
In the second place, if it be not a distinct disease, it must Buy Arjuna Online
be a variety of periodical, that is, malarial fever, or of either
typhus or typhoid fever. Now, it may be clearly shown to
lack certain characters which are essential to Purchase Arjuna Online the fevers just
named. To prove that it is not a form of periodical or mala-
rial fever, it is sufficient to say that it has prevailed repeat-
edly in situations where the si^ecial cause of intermittent and
remittent fever, that is, malaria, does not exist ; that it is un-
doubtedly a contagious disease, and tliat it is not controlled
by anti-periodic remedies. The proof involved in these facts
is so conclusive that it is unnecessary to cite further evidence.
That it is not a variety of typhoid fever is shown conclusively
by the absence of the anatomical characteristics of the latter
disease, the so-called typhoid lesions of the small intestine;
and also by the absence of the essential features pertaining to
the clinical history of ty|3hoid fever. The grounds for the
non-identity of relapsing fever and typhoid fever are certainly
stronger than for the non-identity of typhoid and t^-phus fever.
The essential points of difference, indeed, are more strongly
marked than those which distinguish measles from scarlet
fever — diseases which were once considered as identical.
To establish the opinion that relapsing fever is a distinct
disease, it is then only necessary to shoAV that it is not a va-
riety of typhus. It is certainly a distinct species of fever, if
its non-identity with typhus be proven. The points of differ-
ence in the clinical history of relapsing fever and typhus are
very marked. A relapse of typhus is exceedingly rare ; and,
when it occurs, the duration of the primary career of fever
exceeds the average duration of the first paroxysm of re-
lapsing fever. On the other hand, the occm'rence of a relapse
in relapsing fever is the rule, the exceptions to which are as
rare as is the occurrence of a relapse of typhus. The charac-
teristic eruption which is nearly constant in typhus never oc-
curs in relapsing fever. The physiognomy and the mental
condition in the two diseases present wide points of difference.
The fatality, which is considerable in typhus, is comparatively
insignificant in relapsing fever. But the conclusive proof is
that relapsing fever affords no protection against typhus. Pa-
tients who have passed through the former have repeatedly
contracted, by contagion, the latter. Murchison cites an
abundance of facts exemplifying the correctness of this state-
ment. Hence it is wrong to transfer patients affected with
relapsing fever to hospital wards containing cases of typhus.
There are no facts showing that the contagion of typhus ever
gives rise to relapsing fever. The conclusion is, that each of
these two diseases has its o^^^l special poison or miasm, by
means of which it alone is reproduced ; tliat is, neither of these
two diseases is capable of communicating the other. Tliis fact

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