Page 117 - My FlipBook

system ; a depression ; a stupor with a peculiar wakefulness ;;
the patient isn't asleep, and yet he is apparently half asleep
often with disturbance of the mental functions as well. This
is known to physicians as the typhoid condition. This is
brought about slowly. The presence of the micro-organisms
seems not to be the important factor. The effect upon the
small intestines, Peyer's patches, or the mesentery glands
in the neighborhood is often of considerable importance, be-
cause these swell, their function is interfered with and often
sloughing occurs that is serious. But still this is not the
principal factor, this local lesion, in this disease. Some years
ago I was called in consultation with a physician in a case in
which he was somewhat in doubt as to the diagnosis, but
felt that his patient was in a somewhat critical condition.
The patient was in the second week of his illness, and whether
it was a malarial fever or a typhoid fever or what not, the
physician was in some doubt. After looking over the case I
found a profound depression of the nervous system, such as
to induce me to give a very unfavorable prognosis, and yet
there was no very considerable fever ; it didn't rise above
103, and otherwise than the pronounced depression there
were no serious symptoms. The case was not apparently a
very well marked one in its symptomatology. We watched
the case for two or three days as best we could. The patient
died too early for patients to die usually with typhoid fever.
But we know very well that there are some of those walking
cases of typhoid fever in which the patient is up and about,
not feeling very well, and it is possible that he may have had
typhoid fever for some time before he took to bed. I made
a post-mortem and found a perfectly developed typhoid fever
intestine that was not beyond the second week; Peyer's
patches were swollen, very considerably so ; the mesentery
glands in the neighborhood were enlarged. There was no
sloughing, no very considerable inflammation anywhere than
this swelling and enlargement of the glands, and upon cut-
ting sections of these we found the typhoid fever bacillus
abundantly. There was no lesion anywhere that would seem
sufficient to kill. The man was dead of the action upon his
nervous system of the poisons produced by the growth of
these micro-organisms in the tissues and juices of the body.
Take the case of anthrax, one that has run a fatal course

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