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Table No. 8.
ness. Livid face, frothy saliva escapes, eye- Face flushed, or complexion unaltered,
lids half open, eyeballs rolling, no froth on lips, eyelids closed, teeth grinding, tongue biting; more eyeballs fixed, no grinding of teeth, or less insensibility of pupils to or biting of tongue; pupils react light.
readily. Countenance is distorted.
Is not. Patient shows no feeling.
Sighs, or laughs, or sobs. Aura epileptica.
Globus hystericus. Short paroxysm, followed by heavy Longer paroxysm, not sleepy, but comatose sleep and dull intellect. usually wakeful and depressed
in spirits. Frequently occurs at night.
Rarely occurs at night. Not necessarily of uterine connection, Often connected with uterine or men
though a paroxysm often occurs at strual disorders, the menstrual period.
Table No. 9.
the metatarsal joint of the great toe. From 35-50 years; rarely before Generally in young adults.
puberty. Most frequent in men, and result of Affects both sexes equally, and
idle, intemperate and luxurious life. equally the poor and the rich. Is strongly hereditary.
But slightly so. Chalk stones (urate of soda) in ext. Not so.
ear, on tops of fingers, or elsewhere. Uric acid in the blood, absent from Lactic acid in the blood.
urine. A fit often affords temporary relief. Quite the contrary. Is confined to temperate zone, | Is ubiquitous-prevails in all climates,
Table No. 10.
dark color, and is vomited, | generally coughed up. Often mixed with food, not froth. Generally frothy, mixed with sputa. Preceded by nausea and stomach dis- Preceded by pain in the chest and tress, and blood is passed with the dyspnea. No blood in the stools. stools,
Table No. 11.
Pneumonia. Sharp pain, friction sound, dry cough, Dull pain, crepitant rale, cough fol. impaired chest motion.
lowed by expectoration. In stage of effusion, obliteration of in. In stage of hepatization none of these
tercostal spaces, enlargement of the signs are present.
side, viscera displaced. Dulness, with enfeebled or absent res. Dulness, with marked bronchial respiration, voice, and fremitus.
piration, distinct thoracic voice, in
creased vocal fremitus. Sputa frothy, rarely any râles. Sputa rusty color, rales common. Febrile symptoms slight usually. Febrile symptoms severe. Temperature irregular, rarely high. Sudden elevations and falls, high tem
1 perature not uncommon.
Table No. 12.
or some other acute disease. No exciting cause apparent.
Is referable to some exciting cause, as
cold, inflammation, or inhaling of
heavy dust. Hereditary cases are of this class. Not hereditary. Frequently preceded by enlarged or No evidence of scrofula.
suppurating glands, or other evi
dence of scrofula Voice changes from tubercular deposit. No change of voice.
Table No. 13.
Small-por. Incubation 1 day to Incubation, 7-14 days. Incubation, 6-20 days. weeks.
Average 10. Fever, great heat of skin, Same fever rather in- Fever often violent,
and frequent pulse, creased by eruption. bounding pulse, pain unabated during erup
in loins, greatly retion.
lieved by eruption. Brilliant stare.
Liquid watery eye. Eruption on second On fourth day, on face, At end of third or on
day, not rough, first rough, spreads gradu. fourth day on lips on neck and chest, ally, streak lasts short and forehead. spreads rapidly, white time. streak on pressure with nail.
Small-pox. Uniform, or large Crescentic patches, last | Papular, then vesicular,
patches, interspersed | about 5 days, then finally pustular; pusraised spots and some partial desquamation, tules maturate on 8th vesicles, rash scarlet, scales very fine. day of eruption. on its seventh day very complete desquamation in large patches. Sore throat, rarely Coryza and bronchitis Sore throat often and dry coryza or bronchitis. very constant, rarely cough.
sore throat. “ Raspberry” tongue, Tongue coated, may be Coated and swollen, red.
red at edges.
I may be red at edges. Cerebral symptoms fre- Not so.
Cerebral symptoms are quent and grave.
frequent. Temperature may be 1030-106° before erup- Before eruption often
1050-112° to roth day, ' tion, remains high for 106°, then rapidly subsides gradually, 1-2 days after, then sinks to 100° in 36 falls on 5th, Ioth, and falls suddenly.
hours ; rises during 15th days.
secondary fever. No secondary fever. None.
Always secondary fever. Pneumonia rare, pleu. Pneumonia a frequent Pneumonia not a very risy more frequent. complication.
frequent complication. Sequelæ: Bright's dis- Sequelæ: chronic bron- Sequelæ: chronic diar
ease, dropsy, deafness, chitis, phthisis, con. rhæa, glandular enconjunctivitis, phthi. | junctivitis.
largements, various sis, chronic diarrhæa;
eye diseases. glandular enlargements,
Table No. 14.
Typhus and Typhoid. Typhus Fever. I Typhoid (Enteric) Fever. Attacks quickly, incubation 9 days. Commences slowly, incubation about
13 days. Occurs at any age.
Most common in youth and child.
hood, rarely after 40. Rare among the higher classes, except As common among rich as the poor.
those exposed. Mulberry eruption on 4th or 5th day, Rose eruption, few, on abdomen, and on extremities, lasts till close. in successive crops, which fade and
disappear. Brain chiefly affected ; bowels are Bowels chiefly affected, evacuations
often but little so; abdomen ochre-color and watery, sometimes natural, evacuations dark, but | hemorrhage, or even ulceration, abnever bloody (these are occasion domen tumid.
ally reversed). Contracted pupils, dusky face. | Dilated pupils, cheeks flushed.
Typhoid (Enteric) Fever. Pulse and temperature rise to 120 and Pulse and temperature rise and fall
1050 till 3d day, high for 6 days, independently, and without unithen fall.
formity, but both are usually high
to 15th day. Lasts 2-3 weeks.
Lasts 4-6 or more weeks. Relapses rare.
Relapses frequent. Death from coma, or congestion of Death from asthenia, pneumonia, lungs, in Ist or 2d week.
hemorrhage, or perforation of in
testine, in or after 3d week. Arises from destitution, over-crowd. Bad drainage, poisoned drinking
ing, bad ventilation, is contagious, water, putrid animal matter, want and generally epidemic.
of ozone, certain electrical condi. tions; is not contagious, osten
sporadic. Post-mortem : not constant, most fre- Post-mortem : morbid Peyer's patches,
quent are dark blood and enlarged enlarged mesenteric glands, ulcer. spleen, soft heart.
ated mucous coat of intestines; enlarged and soft spleen, ulcerated pharynx.
Table No. 15.
Incubation may extend to months. A disease of one paroxysm, termi. A disease of several paroxysms, with
nating in recovery or collapse. intervening remissions. Very severe nausea and vomiting, These symptoms not so severe nor so early epigastric tenderness.
early. Black vomit.
Bilious vomiting. Hemorrhages from various parts. No hemorrhagic tendency. Tongue clean, or slightly coated. Tongue heavily coated. Pulse variable, slow at end.
Pulse quick to convalescence, Injected and humid eye.
Eye natural. Supra-orbital pain, pain in back and Headache, sense of fulness in head, in calves of legs.
often no loin or leg pains. Rarely delirious, mind clear gener. Delirium frequent, mind dull.
ally. Urine albuminous, usually sup- Not so.
pressed. Rapid convalescence, no sequelæ. Slow convalescence, tedious sequela. Little muscular prostration.
Greater muscular prostration. High mortality, epidemic.
Slight mortality, endemic. Treatment unsatisfactory.
Very amenable to treatment. Autopsy: inflamed or congested Autopsy: stomach congested, rarely
stomach, enlarged yellow liver, inflamed, liver olive or bronze hue, filled with oil globules, muscular not fatty. fibres of heart are often disintegrated.
Table No. 16.
Gastric or Hepatic.
tinues aster stomach is emptied. I when food is taken.' No tenderness on pressure over the Liver and stomach are tender, pressure liver or stomach.
produces inclination to vomit. Pulse infrequent and hard.
Pulse frequent and weak. Tongue clean, breath sweet, conjunc- Tongue furred, breath offensive, con
tivæ normal or injected, and head. junctivæ often yellowish, and headache primary.
ache secondary as to time. Generally obstinate constipation. Griping abdominal pain, diarrhea and
clay-colored stools. No salivation.
NOTES ON TEMPERATURE IN DISEASE.
Temperature, average normal, of adults, 98.6° F.; of children, 99°; of the aged, 98.8°. Diurnal variation 1° to 1.5° F., highest in the evening. Above 1080 F. is a fatal sign, which issue may be averted by cold baths, reduced by ice from 96° to about 60° F. (A.). The clinical thermometer placed in the mouth, axilla or rectum, and retained in situ for five minutes, should go hand in hand with Aconite in the treatment of inflammations (R.). For antipyretics see the articles FEVER, INFLAMMATION, in Part III, also the list of these agents on page 421.]
Clinical Thermometry is one of the principal means of positive diagnosis. The thermometer should be self-registering, certified, and accurately marked according to the Fahrenheit scale. The most reliable temperature is that in recto, or in the vagina; less so in the axilla and folds of skin, and still less reliable in the mouth. A correct reading of the thermometer cannot be obtained in less time than five to seven minutes. (Da Costa.)
The Average Normal Temperature of the body is 98.6°; which, like the pulse, will vary somewhat in individual cases; as a general practical result, it is agreed that in temperate regions the normal temperature at completely sheltered parts of the surface of the human body amounts to 98.4° Fahr., or a few tenths more or less; and a rising above 99.5°, or a depression below 97.3° F., are sure indications of some kind of disease, if the increase or depression is persistent. The temperature is increased at the prime of life, is raised and depressed temporarily by the influence of diet, stimulants, exercise, etc. The minimum diurnal temp. is observed at 2 A.M., the maximum at 4 to 6 P.M. Any rise above 99.5°, or fall below 97-3°, if persistent, indicates disease; on the other hand, a normal temperature does not always indicate good health. The greatest recorded range of temperature in disease is 33.4°; the minimum is 89.6°, the maximum 123°. In severe and fatal cases it rarely exceeds 1079. It may rise 3°-4° after death, as observed in a case of typhoid fever in which death occurred with a temperature of 107°, which increased shortly afterwards