VOLUME I. PATHOLOGY AND GENERAL DISEASES.

PHILADELPHIA:

LEA BROTHERS & CO.

1885.

Entered according to Act of Congress, in the year 1885, by LEA BROTHERS & CO., in the Office of the Librarian of Congress. All rights reserved.

WESTCOTT & THOMSON, _Stereotypers and Electrotypers, Philada._

WILLIAM J. DORNAN, _Printer, Philada._

PREFACE.

The present work has been undertaken in the belief that by obtaining the co-operation of a considerable number of physicians of acknowledged authority, who should treat subjects selected by themselves, there could be secured an amount of practical information and teaching not otherwise accessible. It was determined to restrict the selection of authors to those of this country--including Canada--not from any want of recognition of the importance of the studies of certain special subjects by European investigators, but because it was felt that the proper time had arrived for the presentation of the whole field of medicine as it is actually taught and practised by its best representatives in America.

It is a matter of importance also that a comprehensive study shall be made of the various forms of disease as occurring among our highly composite population and under our varied and peculiar climatic influences. Of course, in the present work comparative studies of this kind must occupy a subordinate position; yet it cannot fail to enhance both its interest and its value to have the various forms of disease as they occur in this country discussed by those among us who are confessedly the most competent and experienced.

The force of these observations must have been felt by the distinguished men to whom I made application, for with scarcely an exception they joined cordially in the laborious undertaking. I take the greatest pleasure in testifying to the courtesy which has marked all our relations, and which has lessened materially the labor and strain inevitable in the production of such a work.

To ensure greater accuracy in the revision of the large amount of proof-sheets, as well as to relieve me of some of the details connected with the editorial work, I associated with myself Dr. THOMAS HOLMES CATHCART, and, after sudden illness had cut short his very promising career, I was fortunate in securing the assistance of Dr. LOUIS STARR for the same purpose.

In order to render the work as valuable as possible to the general practitioner, its scope has been made as comprehensive as could be done without exceeding the limits prescribed by the nature of the undertaking. This will be particularly noted in the section on Gynæcology, where is presented a series of articles by eminent specialists upon the subjects of chief importance to the general practitioner, written with special reference to their constitutional relations and their bearings on associated morbid conditions, while, among the general diseases, a full article on puerperal fever has properly been included. Important articles will also be found on Tracheotomy, the Diseases of the Rectum and the Anus, and those of the Bladder and the male sexual organs. Comprehensive sections have further been provided, from the pens of distinguished specialists, upon medical ophthalmology, medical otology, and on skin diseases, presenting these large and complicated subjects in a clear and practical light and with special reference to their relations to general medical practice. In the presentation of such subjects as hydrophobia, glanders, and anthrax care has been taken to ensure the full discussion of these affections, not only as occurring in man, but also in the lower animals, since it is highly important to provide the physician with authoritative information on at least such points of Veterinary Science as have a direct practical bearing on morbid processes in man.

In view of the intimate relations of all questions of hygiene to the causation and prevention of disease, in regard to which medical men are constantly consulted, and are, indeed, often obliged to assume weighty responsibilities, interesting articles on Drainage and Hygiene have been provided.

In order to avoid repetition and confusion, and at the same time to secure a comprehensive presentation of the subjects of General Pathology and of General Etiology, Symptomatology, and Diagnosis, considerable space has been devoted to their full discussion. The chapter on General Morbid Processes will be found to convey distinct and conservative teaching on all points included under that comprehensive title, and will thus supply a solid basis for the subsequent discussions of special morbid conditions. In any work on General Medicine at the present day frequent allusion must be made to the relations of various low organisms to morbid processes. This question--or rather the series of questions which arise in connection with this subject, and which at present form the most fruitful topic of discussion and of investigation--will be found treated by different authors in various places and from various standpoints. No attempt has been made to secure uniformity of views upon a matter which is still _sub judice_, and which demands much more skilful and critical investigation before its true scientific position has been finally determined. It has even been felt to be desirable to allow a certain amount of repetition, which has naturally resulted from the introduction of this discussion, not only in the chapter on General Etiology, but in connection with the causation of scarlatina, diphtheria, hydrophobia, pyæmia, puerperal fever, and phthisis.

Throughout the work the chief purpose of the editor and of his collaborators, to furnish a concise and thoroughly practical system of medicine, has compelled the omission of bibliographical lists, of numerous references, and of extended discussions of theoretical views or of controverted questions, in order that more space might be devoted to clear descriptions of disease and to a full presentation of the subjects of diagnosis and treatment. If it should seem, in consequence, that inadequate recognition has been made of the labors of others, it must be borne in mind that ample quotations and numerous references were inadmissible in such a work as the present.

* * * * *

The classification and nomenclature which have been adopted are those recommended by the Royal College of Physicians of England and by the American Medical Association. Charts and tables have been inserted wherever they were needed to elucidate the text, but after mature reflection it was felt necessary to omit all illustrations that were not imperatively required, although many original drawings and paintings of high value were offered with the articles.

THE EDITOR.

OCTOBER, 1884.

CONTENTS OF VOL. I.

PAGE PREFACE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

GENERAL PATHOLOGY AND SANITARY SCIENCE.

GENERAL MORBID PROCESSES. By REGINALD H. FITZ, M.D. . . . . . . . 35

GENERAL ETIOLOGY, MEDICAL DIAGNOSIS, AND PROGNOSIS. By HENRY HARTSHORNE, M.D., LL.D. . . . . . . . . . . . . . . . . . . . . 125

HYGIENE. By JOHN S. BILLINGS, A.M., M.D., LL.D. (Edin.) . . . . . 173

DRAINAGE AND SEWERAGE IN THEIR HYGIENIC RELATIONS. By GEORGE E. WARING, JR., M. Inst. C.E. . . . . . . . . . . . . . . . . . . 213

GENERAL DISEASES.

SIMPLE CONTINUED FEVER. By JAMES H. HUTCHINSON, M.D. . . . . . . 231

TYPHOID FEVER. By JAMES H. HUTCHINSON, M.D. . . . . . . . . . . . 237

TYPHUS FEVER. By JAMES H. HUTCHINSON, M.D. . . . . . . . . . . . 338

RELAPSING FEVER. By WILLIAM PEPPER, M.D., LL.D. . . . . . . . . . 369

VARIOLA. By JAMES NEVINS HYDE, M.D. . . . . . . . . . . . . . . . 434

VACCINIA. By FRANK P. FOSTER, M.D. . . . . . . . . . . . . . . . 455

VARICELLA. By JAMES NEVINS HYDE, M.D. . . . . . . . . . . . . . . 481

SCARLET FEVER. By J. LEWIS SMITH, M.D. . . . . . . . . . . . . . 486

RUBEOLA. By W. A. HARDAWAY, A.M., M.D. . . . . . . . . . . . . . 557

RÖTHELN. By W. A. HARDAWAY, A.M., M.D. . . . . . . . . . . . . . 582

MALARIAL FEVERS. By SAMUEL M. BEMISS, M.D. . . . . . . . . . . . 589

PAROTITIS. By JOHN M. KEATING, M.D. . . . . . . . . . . . . . . . 620

ERYSIPELAS. By JAMES NEVINS HYDE, M.D. . . . . . . . . . . . . . 629

YELLOW FEVER. By SAMUEL M. BEMISS, M.D. . . . . . . . . . . . . . 640

DIPHTHERIA. By ABRAHAM JACOBI, M.D. . . . . . . . . . . . . . . . 656

CHOLERA. By ALFRED STILLÉ, M.D., LL.D. . . . . . . . . . . . . . 715

PLAGUE. By JAMES C. WILSON, A.M., M.D. . . . . . . . . . . . . . 771

LEPROSY. By JAMES C. WHITE, M.D. . . . . . . . . . . . . . . . . 785

EPIDEMIC CEREBRO-SPINAL MENINGITIS. By A. STILLÉ, M.D., LL.D. . . 795

PERTUSSIS. By JOHN M. KEATING, M.D. . . . . . . . . . . . . . . . 836

INFLUENZA. By JAMES C. WILSON, A.M., M.D. . . . . . . . . . . . . 851

DENGUE. By H. D. SCHMIDT, M.D. . . . . . . . . . . . . . . . . . 879

RABIES AND HYDROPHOBIA. By JAMES LAW, F.R.C.V.S. . . . . . . . . 886

GLANDERS AND FARCY. By JAMES LAW, F.R.C.V.S. . . . . . . . . . . 909

ANTHRAX (MALIGNANT PUSTULE). By JAMES LAW, F.R.C.V.S. . . . . . . 926

PYÆMIA AND SEPTICÆMIA. By B. A. WATSON, A.M., M.D. . . . . . . . 945

PUERPERAL FEVER. By WILLIAM T. LUSK, M.D. . . . . . . . . . . . . 984

BERIBERI. By DUANE B. SIMMONS, M.D. . . . . . . . . . . . . . . . 1038

INDEX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1045

CONTRIBUTORS TO VOL. I.

BEMISS, SAMUEL M., M.D., Professor of Theory and Practice of Medicine and Clinical Medicine in the University of Louisiana, New Orleans.

BILLINGS, JOHN S., A.M., M.D., LL.D. (Edin.), Surgeon U.S. Army, Washington.

FITZ, REGINALD H., M.D., Shattuck Professor of Pathological Anatomy in Harvard University, Boston.

FOSTER, FRANK P., M.D., New York.

HARDAWAY, W. A., A.M., M.D., Professor of Diseases of the Skin in the St. Louis Post-Graduate School of Medicine and in the Missouri Medical College, St. Louis; President of the American Dermatological Association.

HARTSHORNE, HENRY, M.D., LL.D., Late Professor of Hygiene in the University of Pennsylvania, Philadelphia.

HUTCHINSON, JAMES H., M.D., Physician to the Pennsylvania Hospital and to the Children's Hospital, Philadelphia.

HYDE, JAMES NEVINS, M.D., Professor of Skin and Venereal Diseases in the Rush Medical College, Chicago.

JACOBI, ABRAHAM, M.D., Clinical Professor of Diseases of Children in the College of Physicians and Surgeons, New York, etc.

KEATING, JOHN M., M.D., Visiting Obstetrician and Lecturer on Diseases of Women and Children to the Philadelphia (Blockley) Hospital; Surgeon to the Maternity Hospital; Physician to St. Joseph's Hospital, Philadelphia.

LAW, JAMES, F.R.C.V.S., Professor of Veterinary Science in Cornell University, Ithaca, N.Y.

LUSK, WILLIAM T., M.D., Professor of Obstetrics and Diseases of Women and Children in the Bellevue Hospital Medical College, New York.

PEPPER, WILLIAM, M.D., LL.D., Provost and Professor of the Theory and Practice of Medicine and of Clinical Medicine in the University of Pennsylvania, Philadelphia.

SCHMIDT, H. D., M.D., Pathologist to the Charity Hospital, New Orleans.

SIMMONS, DUANE B., M.D., Yokohama, Japan, Late Director, Physician, and Surgeon-in-Chief of the Government Hospital, also Consulting Surgeon to Prison and Police Hospitals at Yokohama, Japan.

SMITH, J. LEWIS, M.D., Clinical Professor of Diseases of Children in the Bellevue Hospital Medical College, New York.

STILLÉ, ALFRED, M.D., LL.D., Emeritus Professor of Theory and Practice of Medicine in the University of Pennsylvania, Philadelphia.

WARING, GEORGE E., JR., M. Inst. C.E., Engineer of Sanitary Drainage, Newport, R.I.

WATSON, B. A., A.M., M.D., Surgeon to the Jersey City Charity, St. Francis, and Christ Hospitals, Jersey City, N.J.

WHITE, JAMES C., M.D., Professor of Dermatology in Harvard University, Boston.

WILSON, JAMES C., A.M., M.D., Physician to the Jefferson Medical College Hospital and to the Philadelphia Hospital, Philadelphia.

ILLUSTRATIONS.

FIGURE PAGE 1. MICROCOCCI . . . . . . . . . . . . . . . . . . . . . . . . . 142

2. BACTERIA . . . . . . . . . . . . . . . . . . . . . . . . . . 142

3. BACILLUS MALARIÆ . . . . . . . . . . . . . . . . . . . . . . 143

4. BACTERIA FROM GELATIN SOLUTION . . . . . . . . . . . . . . . 143

5. VIBRIOS IN GELATIN CULTURE-FLUID . . . . . . . . . . . . . . 144

6. PROTOCOCCUS FROM SLIDES EXPOSED OVER SWAMP-MUD . . . . . . . 144

7. BACILLI FROM SWAMP-MUD . . . . . . . . . . . . . . . . . . . 145

8. BACILLI FROM SEPTICÆMIC RABBIT . . . . . . . . . . . . . . . 145

9. BACILLI FROM HUMAN SALIVA . . . . . . . . . . . . . . . . . . 146

10. BACILLUS ANTHRACIS . . . . . . . . . . . . . . . . . . . . . 146

11. BACILLUS TUBERCULOSIS . . . . . . . . . . . . . . . . . . . . 147

12. CHART OF TYPICAL RANGE OF TEMPERATURE IN TYPHOID FEVER, AFTER WUNDERLICH . . . . . . . . . . . . . . . . . . . . . . . . 282

13. CHART SHOWING RECRUDESCENCE OF FEVER FROM INDISCRETION OF DIET. . . . . . . . . . . . . . . . . . . . . . . . . . . . 283

14. CHART SHOWING FALL OF TEMPERATURE FROM INTESTINAL HEMORRHAGE IN TYPHOID FEVER . . . . . . . . . . . . . . . . . . . . . 284

15. PULSE-TRACING IN RELAPSES OF TYPHOID FEVER . . . . . . . . . 304

16. CHART OF TEMPERATURE IN TYPHOID FEVER WITH RELAPSE.--ORIGINAL ATTACK . . . . . . . . . . . . . . . . . . . . . . . . . . 306

17. CHART OF TEMPERATURE IN TYPHOID FEVER WITH RELAPSE.--RELAPSE 306

18. TEMPERATURE CHART OF TYPHOID FEVER.--ABORTIVE ATTACK, FOLLOWED BY TYPICAL ATTACK . . . . . . . . . . . . . . . . 308

19. SPIRILLUM FROM THE BLOOD IN A CASE OF RELAPSING FEVER . . . . 374

20. TEMPERATURE CHART OF TYPICAL CASE OF RELAPSING FEVER, WITH THREE RELAPSES TERMINATING IN RECOVERY . . . . . . . . . . 379

21. TEMPERATURE CHART OF TYPICAL CASE OF RELAPSING FEVER, TERMINATING IN RECOVERY . . . . . . . . . . . . . . . . . . 380

22. TEMPERATURE CHART FROM A CASE OF THE BILIOUS TYPHOID OR GRAVE SUBINTRANT FORM OF RELAPSING FEVER . . . . . . . . . . . . 397

23. TEMPERATURE CHART SHOWING THE LAPSE OF A REMITTENT FEVER INTO AN INTERMITTENT . . . . . . . . . . . . . . . . . . . . . . 600

24. CHARTS SHOWING THE TEMPERATURE CURVE IN TYPHO-MALARIAL FEVER: