A system of practical medicine. By American authors. Vol. 1 (part 8 of 8)

A system of practical medicine. By American authors. Vol. 1 (part 8 of 8)

CHOLERA, 715 Definition, 715 Synonyms, 715 History, 715 et seq. Etiology--predisposing causes, 720 Influence of high temperature in origin and spread, 720 Season, influence of, on causation, 720 Over-crowding and filth as causes, 720 Intemperance as a cause, 721 Contagiousness, 721 Modes of transmission, 721 Channels of entrance into system, 721 Propagation of, by fomites, 721 by drinking-water, 723 Cases illustrating spread of, by drinking-water, 724 Influence of height of subsoil-water on prevalence, 722 Humidity of soil as a cause, 722 Special fomites of, 723 Cases illustrating spread of, by fomites, 727 Cases illustrating contagiousness, 728 Objections to contagious nature, 729 Individual immunity, 730 Different grades of, from intensity of poison, 731 Specific origin, 747 Nature of poison, 748 Influence of bacteria in production, 748 Koch's investigations in regard to bacilli, 745, 749 Symptoms, 731 Mild forms, 732 "Cholerine" stage, 732 Number of stools in mild forms, 732 Character of stools in mild forms, 732 Grave forms, 733 Physiognomy in grave forms, 733 Stools in grave forms, 733 Typhoid state, 734 Stage of collapse, 734 Reaction, 734 Convalescence, 735 Temperature, 736 Difference between axillary, vaginal, and rectal temperature, 736 Special symptoms--Low temperature of mouth, 736 Condition of skin, 736 Color of skin, 737 Condition of heart and pulse, 737 Veins, 737 Vomiting, 738 Character of vomit, 738 Diarrhoea, 738 Results of diarrhoea, 738 Characters of stools, 739 Condition of urine, 739 Cramps, 740 Causes of cramps, 740 State of abdomen, 741 of nervous system, 741 Complications and sequelæ, 735 Complicated by diphtheritic exudations, 735 Inflammation of parotid and submaxillary glands, 735 Abscesses and ulcers, 735 Cutaneous eruptions, 735 Morbid anatomy--general appearance after death, 741 Cadaveric rigidity, 741 Muscular contractions after death, 741 Appearance, post-mortem, of abdominal cavity, 743 Changes in stomach, 743 Intestinal canal, 743 Intestinal mucous membrane, 743 Nature of exfoliation from intestinal canal, 744 Changes in isolated and agminated glands, 745 Capillaries and veins of intestinal canal, 745 Liver, 745 Gall-bladder, 746 Spleen, 746 Heart, 746 Pericardium, 747 Lungs, 746 Brain and spinal marrow, 746 Kidneys, 746 Blood, 747 Diagnosis--from cholera morbus, 750 from irritant poisoning, 752 Order of symptoms as a ground for, 753 Prognosis, 753 Symptoms indicating favorable and unfavorable, 754 Mortality--in different epidemics, 754 Influence of age, 754 Sex, 754 Social condition, 754 Treatment, 759 Preventive, 755 Disinfection, 758 Modes of applying disinfectants, 758 Importance of maintaining high degree of health during epidemics, 758 Quarantine and sanitary cordons for prevention, 755 et seq. Mode of carrying out quarantine, 757 Cases illustrating value of quarantine, 757 Use of drinking-water during epidemics, 759 General management, 760 Importance of early recognition, 732 Necessity of rest, 760 of prompt, 760 Diarrhoea, 760 Vomiting, 761 Hiccough, 762 Injection of sodium chloride into veins, 762 Stage of collapse, 763 Diet of stage of reaction, 763 For restoration of circulation in stage of collapse, 763 Stage of reaction, 763 Undue reaction, 764 Urinary suppression in stage of reaction, 764 Convalescence, 764 Use of venesection in, 764 Emetics, 765 Calomel, 766 Alcohol, 767 Opiates, 767 Mineral acids, 768 Camphor, 768 Chloroform, 768 Intravenous injections, 768 Hot applications, 769 Cold affusions, 769 Of cramps, 769 Necessity of cold water to allay thirst, 770 Use of antiseptic remedies, 770

Cholerine, 732

Chorea, following typhoid fever, 293

Chronic diseases, relation of, to rubeola, 561 forms of erysipelas, 634 of glanders, 915, 923

Cicatrix, condition during incubation of hydrophobia, 895 in hydrophobia, excision, 906-908 in vaccinia, description, 460

Classification of puerperal inflammations, 986

Cleanliness, importance of, in prevention of pyæmia, 980 in variola, 454

Climate, as a cause of disease, 185 definition of term, 185 influence of, on causation of influenza, 860 on causation of rabies and hydrophobia, 887 of rubeola, 560

Clinical history of influenza, 864

Clothing as a cause of disease, 198

Cloudy swelling, 72

Coagulation of exudations, 43

Cohnheim's theory of production of morbid growths, 106

Colchicum, use of, in dengue, 885

Cold as a cause of disease, 133 and damp, influence of, on causation of glanders, 912 bath, use of, in diphtheria, 702 in puerperal fever, 1034 in typhoid fever, 327 Contra-indications to use of, in diphtheria, 703 Use of, in algid form of pernicious malarial fever, 608 in cerebro-spinal meningitis, 830 in cholera, 769 in diphtheria, 702 in puerperal fever, 1033 in the hyperpyrexia of scarlet fever, 541 in scarlet fever, 542 in yellow fever, 651 water, intra-uterine injections of, in puerperal fever, 1034 mode of applying, in scarlet fever, 542

Cold stage of intermittent fever, 592 of intermittent fever, theory of cause, 593 treatment, 594 of yellow fever, treatment, 653

Cold water, use of, in typhus fever, 364

Collapse in cerebro-spinal meningitis, treatment, 831 in cholera, 734 treatment, 763 of lungs, complicating influenza, 869

Collections of water, influence on health of a community, 187

Colloid degeneration, 83 metamorphosis, 83

Color of skin, significance of, in general diagnosis, 159

Coma, in cerebro-spinal meningitis, 812 significance of, in general diagnosis, 166

Comatose form of pernicious malarial fever, 608 Diagnosis, 609 Symptoms, 609 Treatment, 609

Coma-vigil in typhus fever, 349

Compresses, hot water, use of, in variola, 453

Complications of cholera, 735 of erysipelas, 633 of idiopathic parotitis, 623 of influenza, 868 of pertussis, 843 of plague, 780 of relapsing fever, 396-410 of rötheln, 587 of rubeola, 570 causes, 570 of scarlet fever, 510 of typhoid fever, 292 treatment, 335 of vaccination, 468 of vaccinia, 464 of varicella, 483 of variola, 445

Confluent small-pox, 440

Conjunctiva, condition of, in human glanders, 921 symptoms of diphtheria of, 670

Conjunctival diphtheria, local treatment, 712

Conjunctivitis, diphtheritic, symptoms, 670

Consanguineous marriages, effects, 131

Constipation in cerebro-spinal meningitis, 814 in grave form of the plague, 779 in rubeola, treatment, 581 in typhoid fever, treatment, 333 in typhus fever, treatment, 367 significance of, in general diagnosis, 163

Constitutional infection, absence of, in vaccinia, 460 of syphilis, hereditary nature, 127 taints, conveyance of, by vaccination, 471 treatment of anthrax, 944 of pyæmia, 982

Contagion as a cause of disease, 135, 200 definition of, 200 of dengue, 884 of erysipelas, manner of propagation, 630 nature, 630 of influenza, 862 of relapsing fever, transmission, 373 of rabies and hydrophobia, 891 dissemination, 891 of rötheln, nature, 583 of rubeola, modes of dissemination, 558 mode of entering the body, 558 nature, 557 in typhus fever, nature, 343 modes of transmission, 344

Contagium of variola, duration of activity, 435 mode of entering body, 435 nature, 435 period of greatest activity, 435

Contagious diseases, characteristics, 137

Contagious nature of cholera, objections to, 729

Contagiousness of anthrax, 928 of cerebro-spinal meningitis, 803 of cholera, 721 of dengue, 884 of diphtheria, 678 of erysipelas, 630 of glanders, 911 of influenza, 862, 863 of leprosy, 788 of the plague, 776 of puerperal fever, 1017 of pyæmia, 960 of rabies and hydrophobia, 891 of scarlet fever, 494 of typhoid fever, 248 of typhus fever, 343 period of greatest, 345 of varicella, 481 of variola, 435

Convalescence, choice of diet, 206 in cerebro-spinal meningitis, 819 management, 835 in cholera, 735 management, 764 in chronic glanders in man, 922 in dengue, 882 in grave form of the plague, 779 in erysipelas, management, 639 in influenza, treatment, 875 in relapsing fever, 393 in scarlet fever, management, 544 in typhoid fever, management, 335 in typhus fever, management, 368

Convulsions during hot stage of intermittent fever, treatment, 597 in cerebro-spinal meningitis, 810 in relapsing fever, 384 complicating rubeola, 572 in prodromal stage of rubeola, 565 in rubeola, treatment, 581 in yellow fever, treatment, 653

Cooking, necessity of a physician's knowledge of, 196

Corpuscles, pus-, 43

Corrosive sublimate, use of, as antiseptic in puerperal fever, 1025, 1029

Coryza, chronic, following rubeola, 574 complicating scarlet fever, 520 of scarlet fever, treatment, 546

Cough, in rubeola, treatment, 581 significance of, in general diagnosis, 158

Counterirritants, use of, in pertussis, 848

Course of vaccinia, 458 irregularities, 460

Cow-pox, 456 spontaneous, 456

Cramps in beriberi, 1039 in cholera, 740 treatment, 769 causes, 740

Cretinism and goitre, hereditary nature, 128

Croup, respiration, 157

Croupous inflammation distinguished from croup, 49 of fauces, complicating scarlet fever, 516 membrane, 685 characters, 685 mode of formation, 685 metamorphosis, 80

Crust in vaccinia, composition, 464

Crusts, objections to use of, in vaccination, 476

Cubebs, use of, in diphtheria, 709

Cultivation of bacillus tuberculosis, 100

Curare, use of, in treatment of hydrophobia, 907

Cutaneous deposits in glanders, microscopic characters, 917 diphtheria, treatment, 713 lesions of glanders in man, 922 symptoms of glanders in man, 921

Cysts, definition, 115, 121

D.

Deaf-mutism following cerebro-spinal meningitis, 819

Deafness in cerebro-spinal meningitis, 811

Death, causes of, in cerebro-spinal meningitis, 818 in glanders, 915

Debility in cerebro-spinal meningitis, 813 in influenza, treatment, 876 influence of, in causation of glanders, 912 in relapsing fever, 386

Decline, stage of, in pertussis, 841

Decubitus, significance of, in general diagnosis, 150

Definition of anthrax, 926 of beriberi, 1038 of cerebro-spinal meningitis, 795 of cholera, 715 of contagion, 200 of cysts, 115, 121 of dengue, 880 of diphtheria, 656 of erysipelas, 629 of glanders, 909 of idiopathic parotitis, 620 of influenza, 851 of leprosy, 785 of pernicious malarial fever, 605 of pertussis, 836 of the plague, 771 of puerperal fever, 984 of pyæmia, 953 of rabies and hydrophobia, 886 of relapsing fever, 369 of remittent fever, 598 of rötheln, 582 of rubeola, 557 of septicæmia, 953 of simple continued fever, 231 of symptomatic parotitis, 625 of term "climate," 185 of typhoid fever, 237 of typho-malarial fever, 614 of vaccinia, 455 of varicella, 481 of variola, 434 of yellow fever, 640

Degeneration, 72 amyloid, 84 cheesy, 79 colloid, 83 fibrinous, 80 fatty, 74 granular, 72 hyaline, 80 lardaceous, 84 mucous, 82 of tubercle, 96 parenchymatous, 73 waxy, 84

Deglutition, difficult, in idiopathic parotitis, treatment, 624

Delirium in cerebro-spinal meningitis, 812 in erysipelas, treatment, 637 in idiopathic parotitis, treatment, 624 in pyæmia, 971 in relapsing fever, 384 in typhoid fever, 278 treatment, 334 in typhus fever, 348 treatment, 366 in yellow fever, treatment, 653 significance of, in general diagnosis, 166

Demonstration of bacillus of glanders, 914

DENGUE, 879 Synonyms, 879 History, 879 Definition, 880 Etiology, 883 Specific origin, 884 Contagiousness, 884 Symptoms--prodromal stage, 880 Mode of onset, 880 Temperature, 881 Pulse, 881 Delirium, 881 Facies, 881 State of gastro-intestinal tract, 881 State of tongue, 881 Stomach and bowels, 881 State of urine, 881 Eruptions, 881 Hemorrhages, 882 Prostration, 882 Convalescence, 882 Duration of, 882 Morbid anatomy, 882 Specific nature of, 882 Relation to acute articular rheumatism, 883 Changes in abdominal organs, 883 Diagnosis, 884 From acute articular rheumatism, 884 From yellow fever, 884 Prognosis, 885 Treatment, 885 Use of colchicum, 885 quinia, 885 opium, 885

Depletion, local, use of, in cerebro-spinal meningitis, 830

Depressing emotions, as a cause of typhoid fever, 245

Dermatitis, complicating vaccination, 468 vaccination, treatment, 469

Desquamation, date of, in mild scarlet fever, 506 in erysipelas, 633 in relapsing fever, 377

Desiccation in varicella, 482 in variola, 440

Diagnosis, general, 148 divisions of, 148 main direction of inquiries, 148 proper method of procedure, 150 significance of alteration of voice in, 158 of anthrax in animals, 936 in man, 942 of cerebro-spinal meningitis, 826 of cholera, 750 of comatose form of pernicious malarial fever, 609 of dengue, 884 of diphtheria, 689 of erysipelas, 635 of idiopathic parotitis, 624 of glanders in horse, 918 of glanders in man, 923 of influenza, 872 of intermittent fever, 594 of leprosy, 792 of the plague, 782 of pyæmia from septicæmia, 978, 979 of remittent fever, 600 of rabies and hydrophobia, 900 of relapsing fever, 418-422 of rötheln, 587 of rubeola, 575 of scarlet fever, 532 of simple continued fever, 234 of symptomatic parotitis, 627 of typhoid fever, 311-314 of typho-malarial fever, 616 of typhus fever, 358, 359 of vaccinia, 464 of varicella, 483 of variola, 447 of varioloid, 444 of yellow fever, 648

Diaphoretics, use of, in yellow fever, 649

Diarrhoea in cerebro-spinal meningitis, 814 in cholera, 738 results, 738 treatment, 760 in mild scarlet fever, 503 in pyæmia, 975 in relapsing fever, 405 in rubeola, treatment, 581 in septicæmia, 977 treatment, 983 in typhoid fever, 287 treatment, 331

Diarrhoeal diseases from impure water, 182

Diathesis, 127 hereditary, transmission, 130

Diet in anthrax, 944 in beriberi, 1042 in cerebro-spinal meningitis, 834 in cholera, 763 in convalescence, 206 in erysipelas, 639 in glanders, 924 in influenza, 874 in relapsing fever, 430 in pertussis, 848 in puerperal fever, 1036 in pyæmia, 982 in rubeola, 579 in typhoid fever, 323 in typho-malarial fever, 619 in typhus fever, 362 in yellow fever, 654 of convalescence, 206

Digestion, condition of, in cerebro-spinal meningitis, 814

Digestive tract, condition of, in glanders, 921 in idiopathic parotitis, 623

Digitalis, use of, in puerperal fever, 1033 in relapsing fever, 428 in scarlet fever, 543 in typhoid fever, 330 in yellow fever, 651

DIPHTHERIA, 656 Synonyms, 656 Definition, 656 History, 656 et seq. Panum's view regarding relation of bacteria to, 667 Etiology--Age, influence of, on causation, 680 Sex, influence of, on causation, 680 Causes of frequency of, in childhood, 680 Pharyngeal, buccal, and nasal catarrh a cause of, in children, 680 Physiological causes of, greater frequency in childhood, 681 Family predisposition, 681 Thermometric and barometric changes a cause, 682 Season as a cause, 682 Filth as a cause, 682 Polluted air as a cause, 682 water as a cause, 683 milk as a cause, 683 Contagiousness, 678 Modes of transmission of poison, 678 In the lower animals, 683 Transmission of, from lower animals to man, 683 Artificial production of membrane, 684 Invasion, 676 duration of incubation period, 679 Symptoms--Prodromal stage, 667 duration, 667 localized redness of mucous membranes, 667 Different manifestations of diphtheritic process, 668 Severe form, 668 appearance of membrane in severe form, 668 Gangrenous condition of membrane, 669 Swellings of glands at angle of jaw as sign of invasion of nasal cavities, 669, 670 Mode of invasion of nasal cavities, 669 Mode of spread to nasal cavities, 669 Nasal form, 669 Conjunctival form, 670 Aural form, 670 Laryngeal form, 671 Formation of membrane in larynx, 671 Tracheal and bronchial forms, 671 primary form, 672 Oral form, 672, 673 Intestinal form, 673 Of wounds, 673 Eruption of, 674 Vulvar and vaginal forms, 674 In puerperal women, 674 Vesical form, 674 Placental, 674 Liability of open wounds, 672, 679 Tendency to second attacks from chronic nasal and pharyngeal catarrh following, 670 Complications and sequelæ, 672 complicated by fibrinous pneumonia, 672 by broncho-pneumonia, 672 by erysipelas, 673 by urticaria and purpura, 674 by kidney affections, 674 by albuminuria, 674 by granular degeneration of blood, 675 by cardiac degeneration, 675 by symptoms of cardiac degeneration, 675 by embolism, 675 by acute endocarditis, 675 by leucocythæmia and Hodgkin's disease, 675 by nervous diseases, 675 by paralysis, 676 seat of, 676 date of appearance, 676 fatty degeneration and atrophy following, 676 sensory, 676 Secondary form, 671 Morbid anatomy--characters of the membrane, 685 Mode of formation of membrane, 685 Varieties of membrane in, 686 Rindfleisch's definition of diphtheritic inflammation, 686 Changes in the heart, 686 fatty and granular degeneration, 686 endocarditis, 687 cardiac thrombi, 687 Changes in lungs, 687 Spleen, 687 Liver, 687 Kidneys, 687 Muscles, 687 Lymphatic glands, 687 Mucous membranes, 688 Influence of different mucous membranes upon characters of false membrane, 688 epithelia upon growth and spread of false membrane, 688 Changes in intestines, 689 nervous system, 689 Diagnosis--significance of localized pharyngeal injection, 689 From muguet or thrush, 690 Follicular stomatitis, 690 Significance of glandular swelling, 690 lymphadenitis in nasal form, 690 Of laryngeal form, 691 Significance of absence of fever, 691 Of paralysis, 691 Prognosis--symptoms indicating favorable, 692 unfavorable, 692 Significance of glandular swelling, 692 In nasal, 692 Of fetid and putrid discharges, 693 Of epistaxis, 693 In laryngeal, 692 In tracheal, 692 Of tracheotomy, 692 significance of state of pulse after, 692 of dry respiration after, 692 of temperature-range after, 692 of character of membrane, 692 Influence of temperature, 693 state of pulse, 693 complications, 693 bronchitis and pneumonia, 693 endocarditis, 693 albuminuria, 693 affections of sensorium, 693 purpura, 693 icteric discoloration of skin, 693 Of relapses, 694 Treatment--hyperpyrexia, 694 Reflex symptoms, 694 Vomiting, 694 Futility of expectant, 694 Use of stimulants, 694 Amount of stimulants necessary, 695 Importance of general treatment, 695 Futility of venesection, 695 Prophylactic, 696 Danger of self-infection, 696 Prevention of self-infection, 696 Isolation, 696 Closure of schools and public places during epidemics, 697 Disinfection, 698 Special, 701 Local, 701, 709 by steam, 701 Use of water, 702 Ice and cold, 702 Cold baths, 702 Mode of applying cold, 702 Contra-indications to use of cold, 703 Solvents of pseudo-membrane, 703 Use of lime-water, 703 Slaking lime, 703 Lactic acid, 703 Pepsin, neurin, and chinolin, 703 Papayotin, 703 Pilocarpine, 704 objections to, 704 Turpentine inhalations, 704 Ammonium chloride, 704 Mercury, 705 Tincture of chloride of iron, 706 Carbolic acid, 707 Salicylic acid, 707 Quinia, 708 Bromine, 708 Boric acid, 709 Sodium salicylate, 709 Ozone, 709 Sulphur and cubebs, 709 Chlorate of potassium, 699 Dose of chlorate of potassium, 700 Danger in large doses of chlorate of potassium, 701 Mechanical removal of membrane, 709 Cauterization of membrane, 709 Glandular swellings, 710 Abscess of glands, 710 Of nasal form, 710 danger of permitting sleep in, 712 local applications, 710 Of conjunctival form, 712 Of laryngeal form, 712 use of emetics, 712 Of paralysis, 713 by strychnia, 713 by electricity, 713 artificial alimentation, 713 Of cutaneous form, 713

Diphtheria, complicating rubeola, 573 scarlet fever, 514 of genitalia in puerperal fever, 1002

Diphtheritic endometritis, 987 exudations, complicating rubeola, 735 membrane, cauterization, 709 mechanical removal, 709 conjunctivitis, 670 treatment, 712 inflammation, causes, 51 distinguished from diphtheria, 50 paralysis, treatment, 713 pock in vaccinia, 463

Disease, 35 Causes, 125, 175 arsenical poisoning, 193 climate, 185 cold, 133 contagion, 135, 200 epidemic influences, 135 errors of diet, 135 exciting, 125 exercise, abnormal, 134, 198 deficient, 135 functional, 134 habitation, 186 heat, 133 hereditary, 132 humidity of atmosphere, 133 improper clothing, 198 impure air, 177 ice, 185 water, 182 ingestive, 135 intemperance, 197 mental, 204 minute organisms, 141 predisposing, 125 pre-natal, 126, 175 poisons and misuse of medicines, 135 soil, condition of, 187 Definition of, 135 Elevation of site, influence of, 134 Means of discovery, 175 Abdominal, hot climate as a cause, 133 Respiratory, cold as a cause, 133 Prevention, 175 Respiration in, 156 Theory of--bioplastic, 140 chemical, 138, 140 fermentation, 138 germ, 138 points of objection, 142 undecided state, 147 Zymotic, table of, 136

Disinfectants, varieties, 202

Disinfection in anthrax, 937, 943 in cholera, 758 in diphtheria, 698 of glanders, 925 in the plague, 784 in puerperal fever, 1025, 1028 in pyæmia and septicæmia, 980 in scarlet fever, 201, 538 in typhus fever, 362 methods, 201 practical difficulties, 201 principles, 201

Dissecting poison, relation of, to causation of puerperal fever, 1018 wounds, relation of, to causation of septicæmia, 962

Dissemination of influenza, 863 in typhoid fever, 249 of puerperal fever by physicians, 1018

Diuretics, use of, in scarlet fever, 555 in wet beriberi, 1042

DRAINAGE AND SEWERAGE, 213 Back, ventilation of traps, 221 Disposal of liquid wastes by irrigation, 225 Frequency of leakage in waste-pipes, 222 Necessity of, in prevention of typhoid fever, 321 Of houses, 188 Necessity of abundant water-supply in, 220 Of soil, 226 Perfect, fundamental requirements, 213 Removal of human excrement, 215 of liquid household wastes, 220 Varieties of grease-traps, 221 Ventilation of waste-pipes, 223

Drainage-pipes, effects of large traps, 220 of too large bore, 220 of vertical position, 220

Drinking-water as a medium of disseminating typhoid fever, 248 propagation of cholera by, 723

Dropsies, 67-71

Drugs, use of, in the plague, 784

Dry form of beriberi, symptoms, 1040 treatment, 1043

Duration of cerebro-spinal meningitis, 818 of dengue, 882 of anthrax, 940, 941 of acute form of glanders in horses, 915 of chronic form of glanders in horses, 915 of acute form of glanders in man, 921 of chronic form of glanders in man, 922 of influenza, 865 of malignant scarlet fever, 508 of mild scarlet fever, 506 of prodromal stage of rubeola, 565 of remittent fever, 602 of rabies and hydrophobia, 900 of septicæmia lymphatica, 1012

Dysentery complicating relapsing fever, 406 typhus fever, 355

Dysphagia, significance of, in general diagnosis, 162

Dyspnoea, causes, 157

E.

Ear, affections of, in rubeola, treatment, 581 diseases of, complicating rubeola, 570 displacement of lobe in idiopathic parotitis, 624 internal, lesions of, in cerebro-spinal meningitis, 824 lesions of, in pyæmia, 967 in symptomatic parotitis, 626 middle, suppuration of, in cerebro-spinal meningitis, 811 symptoms of diphtheria, 670

Ears, significance of appearance of, in general diagnosis, 151

Early stages of yellow fever, treatment, 649

Earth-closets, 218

Effluvia, offensive, symptoms due to, 181

Effusions, 67 causes, 68-71 distinguished from exudations, 67

Elaterium, use of, in wet beriberi, 1042 in dry beriberi, 1043

Electricity, use of, in diphtheritic paralysis, 713

Elevated temperature as a cause of typhoid fever, 246

Emaciation, causes, 160 significance of, in diagnosis, 159

Emboli, action of, in production of metastatic abscesses in pyæmia, 967

Embolism, 62 complicating diphtheria, 675 from septic thrombus, 66 hemorrhagic results, 64, 65 in typhoid fever, treatment, 335 mechanical effects, 63 necrosis from, 64, 65 results, 64 softening, cerebral, from, 65 symptoms, 66

Embolus, 62 arterial, 63 venous, 63 terminations, 65

Emetics, use of, in cerebro-spinal meningitis, 830 in cholera, 765 during cold stage of intermittent fever, 595 in influenza, 876 in laryngeal diphtheria, 712 in pertussis, 845

Emphysema, aggravation of, by influenza, 870 significance of, in general diagnosis, 159

Endocarditis, acute, complicating diphtheria, 675 in diphtheria, 687 in puerperal fever, 990

Endo- and pericardium, lesions of, in septicæmia, 972

Endocolpitis in puerperal fever, 986, 1005

Endometritis in puerperal fever, 986

Enthetic febrile diseases, hereditary nature, 130

Epidemic causation of disease, 135

Epidemics of rubeola, frequency, 560 frequency in the new-born, 563

Epiglottis, symptoms of diphtheria, 671

Epistaxis in relapsing fever, 393 complicating rubeola, 570 in remittent fever, 602 in rubeola, treatment, 580 in typhoid fever, 273 treatment, 335

Epithelia, influence of different, in spread of diphtheritic membrane, 688

Ergot, use of, in cerebro-spinal meningitis, 833

Ergotine, use of, in pyæmia, 982

Eruption, absence of, in rubeola, 568 causes of absence of, in mild scarlet fever, 505 in cerebro-spinal meningitis, 816, 817 in dengue, 881 in diphtheria, 674 in influenza, 866 in malignant scarlet fever, 507 in mild scarlet fever, 504 in pyæmia, 974 in relapsing fever, 376 in rötheln, 585, 586 in rubeola, 566 peculiarities in character, 569 in seat, 509 relapses, 570 retrocession of, in rubeola, treatment, 580 in tubercular form of leprosy, 789 in typhoid fever, 273 in typhus fever, 351 in varicella, 487 in variola, 437 characters, 438 position, 438 in varioloid, 444

Eruptive stage of rubeola, duration of, 567 symptoms of, 565 of variola, treatment, 452

ERYSIPELAS, 629 Definition, 629 Synonyms, 629 Classification, 629 History, 629 Etiology, 629 Unity of the origin, 629 Age and sex as a cause, 630 Season as a cause, 630 Contagiousness, 630 Nature of contagion, 630 Manner of propagation, 630 Relation to childbed fever, 630 Symptoms--initial, 631 Characters of cutaneous lesions, 631 Course of cutaneous lesions, 631 Severe varieties of cutaneous lesions, 632 Migration of cutaneous lesions, 632 Swelling of integument, 632 Starting-point of cutaneous lesions, 632 Physiognomy, 632 Condition of tongue, 633 of fauces and buccal membrane, 633 General symptoms of grave form, 633 pulse, 633 temperature, 633 Occurrence of gangrene, 633 Resolution, 633 Desquamation, 633 Complications and sequelæ, 633 Complicated by lymphangitis and adenopathy, 634 By pneumonia, 634 By pleuritis, 634 By inflammation of joints, 634 By inflammations of serous membranes, 634 By pyæmia and septicæmia, 634 By eye diseases, 634 Followed by seborrhoea of scalp, 633 By loss of hair, 633 Modification of previous skin disorders, 634 Chronic forms, 634 Variety and nature of chronic forms, 634 Morbid anatomy, 635 Changes in skin, 635 Viscera, 635 Mucous surfaces, 635 Diagnosis, 635 From dermatitis, 636 From eczema, 636 From erythema, 636 From pemphigus, 636 From scarlet fever, 636 From urticaria, 636 Prognosis--symptoms indicating unfavorable, 636 Treatment--preventive, 636 Hygienic, 637 General, 637 Hyperpyrexia, 637 Delirium, 637 Local, 637 Value of abortive, 638 Surgical, 638 Mouth complications, 638 Nasal complications, 638 Abscesses, 638 Value of expectant, 639 Convalescence, 639 Diet, 639 Use of quinia, 637 tincture of the chloride of iron, 637

Erysipelas, complicating diphtheria, 673 typhus fever, 355 vaccination, 469 variola, 445 relation of, to puerperal fever, 1002

Etiology, general, 125 of anthrax in animals, 928 in man, 939 of beriberi, 1038 of cerebro-spinal meningitis, 801 of cholera, 720 of dengue, 883 of diphtheria, 680 of erysipelas, 629 of glanders in horse, 911 in man, 919 of idiopathic parotitis, 620 of influenza, 859 of leprosy, 787 of pertussis, 838 of the plague, 774 of puerperal fever, 1013 of pyæmia, 955 of rabies and hydrophobia, 887 of relapsing fever, 370 of remittent fever, 598 of rötheln, 583 of rubeola, 557 of scarlet fever, 487 of septicæmia, 960 of septo-pyæmia, 963 of simple continued fever, 232 of symptomatic parotitis, 625 of typhoid fever, 242 of typhus fever, 341 of varicella, 481 of variola, 435 of yellow fever, 640

Eucalyptus, use of, in typhoid fever, 331

Excision of cicatrix for prevention of hydrophobia, 908 of primary nucleus in anthrax, 943

Exciting cause, mechanical nature of, in symptomatic parotitis, 626 of the plague, 775 of typhoid fever, 248 of typhus fever, 343

Excrement, human, disposal of, by privy-vaults, 219 dry conservancy, 218 et seq. removal of, by water-carriage, 215

Exercise, abnormal, as a cause of disease, 134 amount necessary for health, 198 as a part of a systematic education, 199 deficiency of, a cause of disease, 135 Du Bois Reymond's definition, 198 importance of, in preservation of health, 198 relation of, to mental work, 199

Expectant treatment of erysipelas, value, 639

Expectoration, significance of, in diagnosis, 158

External anthrax, localized, 935

Exudation, distinction from transudation, 42 in inflammation, 42 in peri- and parametritis of puerperal fever, 1007 in pelvic peritonitis, 989

Eye, affections of, following cerebro-spinal meningitis, 819 in rubeola, treatment, 581 condition of, in cerebro-spinal meningitis, 810 diseases of, complicating erysipelas, 634 rubeola, 571 variola, 445 lesions of, in cerebro-spinal meningitis, 824 in pyæmia, 967

Eyes, appearance of, significance in general diagnosis, 151

F.

Face, appearance of, in typhus fever, 348

Family predisposition to diphtheria, 681

Faradization, use of, in rabies and hydrophobia, 907

Farcy, 909

Fatigue as a cause of typhus fever, 342

Fat, sources of, in the body, 74

Fatty degeneration, 74 causes, 78 following diphtheritic paralysis, 676 infiltration, 76 metamorphosis, 74, 79

Fauces, condition of, in cerebro-spinal meningitis, 814 in erysipelas, 633 in malignant scarlet fever, 508 in typhoid fever, 286 inflammation of, complicating rubeola, 571 significance of appearance of, in general diagnosis, 152

Faucial and nasal mucous membrane, condition of, in mild scarlet fever, 504

Febrifuge, use of, in relapsing fever, 428

Febrile stage of grave form of the plague, 778

Fermentation theory of disease, 138

Fever, agents producing heat in, 40, 41 definition, 38 inflammatory, 37 distinguished from idiopathic, 37 influence of vaso-motor system on production of heat in, 39 intermittent, 592 malarial, 589 pernicious malarial, 605 puerperal, 984 relapsing, 369 remittent, 598 sanitary effects, 41 scarlet, 486 secondary, in variola, 439 simple continued, 231 symptoms, 38 temperature, 38-40 traumatic, 37 typho-malarial, 614 typhoid, 237 typhus, 338 yellow, 640

Fibrinous degeneration, 80 inflammation, 49

Filtering power of soil, 187

Filth as a cause of cholera, 721 diphtheria, 682 the plague, 774 relapsing fever, 370

Foetus, effects of maternal impression upon, 131

Fomites, propagation of cholera by, 721 special, of cholera, 723

Food, adulterations, 197 appetite as a guide to necessary amount, 195 as a cause of disease, 195 infants, 196 patient's sensations as a guide to choice of, in disease, 205 popular errors in regard to, 195 to overeating, 195 preparation of, necessity of a physician's knowledge of, 196 proper, necessity of, in prevention of pyæmia and septicæmia, 980 transmission of anthrax by, 929

Formad on peculiarities of scrofulous habit, 101

Forms of anthrax in animals and man, 934, 940 of leprosy, 789 of the plague, 777 of rabies, 895 of relapsing fever, 395 of vaccine, 476

Fourth ventricle, lesions of, in cerebro-spinal meningitis, 824

Frænum linguæ, ulceration of, in pertussis, 841

Frequency of puerperal fever, 984 of typho-malarial fever, 616

Frictions, use of, in dry beriberi, 1043

Frontal pains in influenza, 867

Fruit, propagation of malaria by, 591

Fulminant form of the plague, 779

Furious form of rabies, 896

Furuncles, complicating variola, 445

G.

Gait, peculiarity of, in beriberi, 1039

Gall-bladder, lesions of, in cholera, 746 in typhoid fever, 266

Gangrene, 56 complicating vaccination, 468 following typhoid fever, 293 typhus fever, 355 in erysipelas, 633 in symptomatic parotitis, treatment of, 628 of neck, complicating scarlet fever, 512 pulmonary, complicating relapsing fever, 404

Gangrenous affections following rubeola, 574

Gastro-intestinal canal, condition of, in dengue, 881 condition of, in yellow fever, 644 lesions of, in anthrax, 936 in influenza, 872 in rabies and hydrophobia, 902 in relapsing fever, 413 symptoms in influenza, 866 in mild scarlet fever, 505 in malignant scarlet fever, 507 of septicæmia lymphatica, 1011

Gelsemium, use of, in yellow fever, 651

GENERAL ETIOLOGY, 125

General dropsies, 71 treatment of erysipelas, 639 of glanders in horse and man, 919, 920

Genitalia, gangrene of, complicating variola, 446

Geographical distribution of anthrax, 926 of beriberi, 1038 of glanders, 909 of rabies and hydrophobia, 886 of relapsing fever, 369 of typhoid fever, 241

Germ, specific, of glanders, nature of, 914 of rabies and hydrophobia, 892 point of election of, 892

Germ-theory of disease, 138 of scarlet fever, 488

Giddiness, significance of, in general diagnosis, 166

GLANDERS (FARCY), 909 Synonyms, 909 Definition, 909 History, 909 Geographical distribution, 909 Etiology--Contagiousness, 911 Specific nature, 911 Predisposing causes, 912 Ill-health, relation of, to causation, 912 Cold and damp stables, relation of, to causation, 912 Debility from chronic diseases, relation of, to causation, 912 Infection, channels of, 913 Particular nature of the germ, 914 Virulence of the germ, 914 Modes of culture of germ, 914 Demonstration of bacillus of, 914 Symptoms--in horses, 914 Acute form, 914 Incubation period, 914 Mode of onset, 914 Local lesions, 915 Appearance of nostrils, 915 of lymphatics, 915 Enlargement of joints, 915 Appearance of ulcers, 915 Mode of death in, 915 Chronic form, 915 Premonitory symptoms, 915 Condition of general health, 915 Local lesions, 915 Lymphatics, 915 Bronchial and pulmonary form, 916 Acute cutaneous form (farcy), 916 Local lesions, 916 Chronic cutaneous form (chronic farcy), 916 Local lesions, 916 Duration, 915 Morbid anatomy, 916 Nasal lesions, characters of, 917 Pulmonary lesions, characters of, 917 Cutaneous lesions, characters of, 917 Diffuse glanderous swellings, 917 of nose, 918 of lungs, 918 of muscles, 918 Diagnosis, 918 Value of inoculation in, 918 Prognosis, 918 Unfavorable nature of, 918 Treatment--in animals, 918 Not commendable, 918 Local, 918 General, 919 Diet in, 919 Preventive, 919 Extermination of disease in animals, 919

Glanders in Man, 919 History of, 919 Etiology, 919 Modes of infection, 919 immediate, 919 mediate, 920 Influence of occupation, 920 Influence of ill-health, 920 Symptoms--incubation period, 920 Appearance of wound, 920 General, 920 Mode of onset, 920 Character and seat of local lesions, 921 Appearance of sores, 921 Condition of nasal mucous membrane, 921 of submaxillary glands, 921 of conjunctiva, 921 Digestive tract, 921 Nervous system, 921 Temperature in, 921 Pulse in, 921 Chronic form, 921 General, 921 Local, 921 Cutaneous lesion, 922 Respiratory lesions, 922 Lymphatic glands, 922 Digestive tract, 922 Convalescence, 922 Duration of acute forms, 921 of chronic forms, 922 Morbid anatomy--changes in mucous membranes, 922 Lungs and pleuræ, 922 Gastro-intestinal tract, 922 Spleen and liver, 922 Joints, 922 Bones, 922 Brain and membranes, 923 Microscopy of lesions, 923 Diagnosis, 923 Pathognomonic signs in, 923 From rheumatic fever, 923 Chronic form, from pyæmia and septicæmia, 923 From syphilis, 924 From miliary tuberculosis, 924 Presence of bacillus not conclusive, 924 Value of inoculation in, 924 Prognosis--unfavorable nature of, 924 Treatment--External cases, 924 Erysipelatoid swellings, 924 Abscesses and tumors, 924 Nasal ulcers, 924 Importance of general treatment, 924 Use of antiseptics, 924 Diet, 924 Preventive, 925 Extinction of affection in animals, 925 Necessity of disinfection, 925

Glanderous swelling, diffuse, 917

Glands at angle of jaw, swelling of, symptomatic of nasal invasion, in diphtheria, 669, 670

Glandular abscesses in diphtheria, treatment, 710 degenerations, 72 swellings in diphtheria, treatment, 709

Glycosuria, complicating relapsing fever, 410

Gout, hereditary nature, 127

Granuloma, 120, 124

Grave forms of cholera, physiognomy, 734 stools, 733 symptoms, 732 of the plague, 777 of relapsing fever, 395

Grease-traps, varieties, 221

GROWTHS, MORBID, 105

Gums, significance of state of, in general diagnosis, 151

H.

Habits, depressing, as a cause of cerebro-spinal meningitis, 802

Hæmatemesis, significance of, in general diagnosis, 163 in relapsing fever, 390

Hæmatoidin, 91

Hæmatoma, 115, 122

Hæmaturia in relapsing fever, 390

Hæmoglobin, 90

Hæmophilia, hereditary nature, 129

Hæmoptysis, significance of, in general diagnosis, 163

Hæmostatics, use of, in yellow fever, 652

Hair, appearance of, in typhoid fever, 275 loss of, following erysipelas, 633

Headache in cerebro-spinal meningitis, 808 in idiopathic parotitis, 624 in influenza, 867 treatment, 874 in relapsing fever, 383 in typhoid fever, 277 treatment, 334 in typhus fever, 348 treatment, 366

Health, importance of exercise in preservation, 198

Health-resorts, disease from, 185

Hearing, impairment of, following cerebro-spinal meningitis, 819 disorders of, in relapsing fever, 400 modifications of, in typhoid fever, 279 significance of, in general diagnosis, 166

Heart, alterations of, in beriberi, 1041 condition of, in beriberi, 1040 in cholera, 737 in pyæmia, 976 in typhus fever, 351 disease, complicating influenza, 870 lesions of, in cholera, 746 in diphtheria, 686 in relapsing fever, 411 in septicæmia, 972 in typhoid fever, 267 in typhus fever, 357 and blood-vessels, lesions of, in rabies and hydrophobia, 902 palpitation of, in beriberi, 1039

Heart-clot, complicating relapsing fever, 402 rubeola, 672 scarlet fever, 523

Heat as a cause of disease, 133 use of, in cholera, 769

Hemorrhages in dengue, 882 in hemorrhagic form of pernicious malarial fever, treatment, 612 in remittent fever, treatment, 605 in yellow fever, 646 treatment, 651 intestinal, in typhoid fever, 287, 288 treatment, 332

Hemorrhagic form of pernicious malarial fever, 609 causes, 610 seat of hemorrhages, 610 symptoms, 611 treatment, 612 of scarlet fever, 509 of variola, treatment, 454 infarction, 64 rubeola, 569 small-pox, 442 variola, morbid anatomy of pock in, 447

Hepatic abscess following typhoid fever, 295

Heredity as a cause of disease, 175 influence of, on marriage, 176 relation of, to life insurance, 175 as a cause of leprosy, 787

Hereditary diathesis, transmutation, 130 nature of syphilis, 127 of non-malignant morbid growths, 129 of nervous diseases, 129 of organic disease, 129 of rickets, 128 predisposition to disease, 126

Herpes labialis, complicating influenza, 874

Hiccough in cholera, 762 in relapsing fever, 405 significance of, in general diagnosis, 158

Histoid tumors, 116

History of anthrax in animals and man, 926, 939 of beriberi, 1038 of cerebro-spinal meningitis, 796 of cholera, 715 of dengue, 879 of diphtheria, 656 of erysipelas, 629 of glanders in horses, 909 in man, 919 of influenza, 852 et seq. of pertussis, 836 of rabies and hydrophobia, 886 of relapsing fever, 369 of rötheln, 582 of rubeola, 557 of pyæmia and septicæmia, 945-952 of scarlet fever, 486 of simple continued fever, 231 of typhoid fever, 238 of typhus fever, 338 of vaccination, 465 of vaccinia, 456 of varicella, 481 of variola, 434

Hodgkin's disease, complicating diphtheria, 675

Horse-pock vaccine, 473

Hospitals for infectious diseases, necessity, 203

Hospital, maternity, advantages, 1021

Hot stage of intermittent fever, treatment, 595

House-drainage, 188 disconnection of, from sewer, 190 testing, 190

House-plumbing, 190

Houses, sanitary inspection, 187, 193

House-sewerage, 188 dangers to health from, 189, 191 examination of a system, 188 main points in a good system, 191 peppermint-test for defects, 190

Human excrement, removal of, by drainage, 215

Humanized and animal vaccine, relative merits, 473 vaccine, points of superiority, 473

Humidity of air as a cause of disease, 133

Hunger, influence of, on causation of rabies and hydrophobia, 888

Hyaline degeneration, 80

Hydro-bilirubin, 91

Hydrocephalus, following cerebro-spinal meningitis, 819

Hydrochloric acid, local use of, in puerperal fever, 1028

Hydrophobia, 886

Hygiene, 173 importance of perfect, in cholera epidemics, 758 in pertussis, 848 public, relation of physicians to, 207

Hygienic treatment of erysipelas, 637 of hydrophobia, 906 of scarlet fever, 539 of typhoid fever, 322 of yellow fever, 654

Hygroma, 116, 122

Hyperpyrexia in diphtheria, treatment, 694 in erysipelas, treatment, 637 in puerperal fever, treatment, 1032 in relapsing fever, treatment, 426 in rubeola, treatment, 579 in scarlet fever, treatment, 541 in typhoid fever, treatment, 327 in typhus fever, treatment, 364 in yellow fever, treatment, 651

Hypodermatic injection of anthrax swellings, 938, 943

I.

Ice, impure, as a cause of disease, 185 use of, in diphtheria, 702 in scarlet fever, 542

Idiopathic parotitis, 620

Idiosyncrasy as a cause of typhoid fever, 245 influence of, in causation of variola, 436

Ill-health, influence of, in causation of glanders, 912, 920

Impure air as a cause of disease, 177 evil effects of, 181 water, as a cause of disease, 182

Impurities of water, from living organisms, 184 nature, 184

Incubation of relapsing fever, 376 of scarlet fever, 492 of typhus fever, 346 of varicella, 481 of variola, 436 period of anthrax in animals, 934 in man, 940 of diphtheria, duration of, 679 of glanders in horse, 914 in man, 920 of influenza, 863 of intermittent fever, 592 of the plague, 777 of rabies and hydrophobia, 894 of rötheln, 585 of typhoid fever, 259 of yellow fever, 643 stage of idiopathic parotitis, duration, 621 of idiopathic parotitis, 621 of puerperal fever, 1004 of pyæmia, 973 of rubeola, 563

Indications for treatment of puerperal fever, 1028 of septicæmia, 982 of yellow fever, 649

Infants' food, 196

Infarction, hemorrhagic, 164

Infection, 200 channels of, in glanders, 913 modes of, in human anthrax, 939

Infiltration, albuminoid, 72 amyloid, 84 fatty, 76

INFLAMMATION, 37 Characteristics, 37 Heat, 37 Redness, 37 causes, 37 Pain, 41 causes, 41 Swelling, 41 causes, 41 Exudation, 42 Reuss on distinction of exudation from transudation, 42 Migration of white corpuscles, 42 Coagulation of exudation, 43 Changes in the blood-vessels, 43 Disturbance of functions, 44 Varieties of--hemorrhagic, 48 Diphtheritic, 50 Productive, 51 Catarrhal, 52 Phlegmonous, 52 Acute, 53 Chronic, 53 Interstitial, 53 Parenchymatous, 53 Termination, 54, 55, 56 Resolution, 54 New formations, 54 Cicatrization, 55 Abscesses, 56 Destruction of tissue, 56 Causes, toxic, 43 traumatic, 44 parasitic, 45 infectious, 45 constitutional, 46 trophic, 46 Course, 46 Sthenic and asthenic, 46 Serous, 47 Typhoidal, 47 symptoms, 47 Purulent, 48 Suppurative, relation of microbia, 48 Fibrinous, 49 of fauces, catarrhal and diphtheritic, complicating typhoid fever, 295 of neck, complicating parotitis, 511 simple, complicating vaccination, 468

Inflammations, serous, complicating typhus fever, 355

Inflammatory fevers, 37 form of typhus fever, 354 rubeola, 568

INFLUENZA--Definition, 851 Synonyms, 851 History, 852 et seq. Etiology, 859 Predisposing causes, 859 Age, relation of, to causation, 860 Social condition, relation of, to causation, 860 Sex, relation of, to causation, 860 Occupation, relation of, to causation, 860 Race, relation of, to causation, 860 Over-crowding and filth, relation of, to causation, 860 Season, relation of, to causation, 860 Climate, relation of, to causation, 860 Air, condition of, to causation, 860 Winds, relation of, to spread, 860 Mode of onset of epidemics, 860, 861 Duration of epidemics, 861 Exciting causes, 862 Specific poison, 863 Contagiousness, 862 Dissemination, 863 Relation of, to other epidemic diseases, 863 Incubation period, 863 Clinical history, 864 Variations in intensity of symptoms, 864 Symptoms of mild cases, 864 of severe cases, 864 Symptomatology, 865 Analysis of symptoms, 865 Fever, 865 Temperature, 865 Pulse, 866 Urine, 866 Skin, 866 Eruptions, 866 Gastro-intestinal system, 866 Nausea and vomiting, 866 Physiognomy, 866 Catarrhal symptoms, 866 Condition of mucous membrane, 866 Hoarseness, 867 Cough and dyspnoea, 867 Nervous system, 867 Headache, 867 Frontal pain, 867 Pains in limbs, 868 Pleurodynia, 868 Delirium, 868 Dizziness, 868 Sleeplessness, 868 Hebetude and torpor, 868 Muscular twitchings, 868 Mental condition, 868 Duration, 865 Complications and sequelæ, 868 Inflammations of lungs, 868 Bronchitis and capillary bronchitis, 868, 869 Catarrhal pneumonia, 869 Lobar pneumonia, 869 Localized pulmonary collapse, 869 Gangrene of lungs, 870 Pleurisy, 870 Pericarditis, 870 Laryngitis and chronic bronchitis, 870 Inflammation of middle ear, 870 Parotitis, 870 Herpes labialis, 870 Phthisis, 870 Emphysema, aggravation, 870 Old neuralgias, aggravation, 870 Heart disease, aggravation, 870 Bright's disease, aggravation, 870 Pregnancy, 870 Intermittent fever, 870 Morbid anatomy, 871 Essential lesions, 871 Appearance of respiratory tract, 871 Changes in gastro-intestinal tract, 872 Bronchial glands, 872 Lung tissue, 872 Pathology--Not a simple acute inflammation, 871 Specific character, 871 Diagnosis--From non-specific catarrhal affections, 872 From typhoid fever, 872 Prognosis--Influence of age, 872 pre-existing organic disease, 872 of character of epidemic, 872 Mortality, 872, 873 Variability in different epidemics, 873 Rate of, 873 Cause of death, 873 Treatment--preventive, 873 Mild forms, 874 Catarrh, 874 Headache, 874 Cough, 875 Use of quinine, 874 Opium, 874 Fat inunctions, 874 Diet, 874 Severe forms, 875 Indications for treatment, 875 High temperature, 875 Cough, 876 Sub-sternal and chest pains, 876 Use of diaphoretics, 875 Bloodletting, 875 Emetics, 876 Purgatives, 876 Quinine, 876 Mineral acids, 876 Expectorants, 877 Opium, 876 Alcohol, 877 Chloral, 877 Diarrhoea, 877 Debility, 877 Lung complications, 877 Diet in, 875 Convalescence, 878 Danger of depressing measures, 878

Inhalations, use of, in pertussis, 844

Initial stage of pertussis, 840 symptoms of yellow fever, 644

Injections, intravenous, use of, in cholera, 768 in hydrophobia, 908 in puerperal fever, 1029 vaginal, use of, in prevention of puerperal fever, 1026

Inoculation as a means of diagnosis in glanders, 918 in hydrophobia, 902 as a prophylactic in anthrax, 937 in rabies and hydrophobia, 905 in scarlet fever, 536 of leprosy, 788 of rubeola, 559 of small-pox, 465

Insects, propagation of anthrax by, 929

Insomnia in typhoid fever, treatment, 334 in typho-malarial fever, treatment, 619 in typhus fever, treatment, 366

Inspection of houses, sanitary, 187

Insusceptibility to rabies and hydrophobia, 894

Intellect, impairment of, following cerebro-spinal meningitis, 819 following typhoid fever, 292

Intellectual condition in typhus fever, 348

Intemperance as a cause of cholera, 721 of disease, 197 of relapsing fever, 370 of typhoid fever, 245 of typhus fever, 342

Intermission in intermittent fever, 594 in relapsing fever, 381

INTERMITTENT FEVER, 592 Incubation period, 592 Symptoms--prodromal stage, 592 Paroxysm, 592 Cold stage, 592 theory of cause of cold stage, 593 Hot stage, 593 duration of hot stage, 593 relation of type to duration of hot stage, 593 Sweating stage, 593 Nausea and vomiting during paroxysm, 593 Intermission, 594 Duration of intermission, 594 Relative frequency of different types, 594 Convertibility of different types, 594 Morbid anatomy, 594 Treatment--cold stage, 594 Use of quinia, 595 Opium, 595 Emetics, 595 Hot stage, 595 Use of opium, 595 Quinia, 596 Purgatives, 596 Of convulsions, 597 Sweating stage, 597 Use of quinia, 597 Causes of failure of quinia, 597 Adjuvants to quinia in preventing return of paroxysms, 598 Use of nitric acid to prevent return of paroxysms, 598

Internal anthrax in animals, 934

Interstitial inflammation, 53

Intestinal anthrax in man, 941 canal, lesions of, in cholera, 743 catarrh, chronic, following rubeola, 574 complicating rubeola, 572 tract, lesion of, in typhus fever, 357

Intestines, lesions of, in diphtheria, 689 symptoms of diphtheria of, 673

Intravenous injection of warm water in hydrophobia, 908

Inunction in scarlet fever, 541

Inunctions, use of, in rubeola, 580

Invasion of cerebro-spinal meningitis, 806 of diphtheria, 676 of variola, 438 stage of grave form of the plague, 777 of idiopathic parotitis, duration, 621 treatment, 624 of variola, treatment, 452 of varioloid, 443

Iodine as a specific in typhoid fever, 336, 337

Iodoform, intra-uterine use of, in puerperal fever, 1025

Iron, persulphate, local use of, in puerperal fever, 1028 tincture of the chloride, use of, in diphtheria, 706 in erysipelas, 637 in yellow fever, 652

Irregular forms of scarlet fever, 508

Irrigation, disposal of liquid wastes by, 225

Irritability of nervous system in hydrophobia, 899

Irritants, influence of, in production of morbid growths, 108

Isolated glands, lesions of, in cholera, 745

Isolation in anthrax, 937 in diphtheria, 696 in the plague, 783 in rubeola, 578 in scarlet fever, 536 necessity of, in typhus fever, 361 principles of, in disease, 203

J.

Jaborandi, use of, in scarlet fever, 552 in yellow fever, 650

Jaundice in relapsing fever, 391 in septicæmia venosa, 1012 complicating typhoid fever, 295 typhus fever, 356 in remittent fever, 601 in yellow fever, 646

Joints, chronic diseases of, following rubeola, 574 condition of, in glanders in man, 920 inflammation of, complicating erysipelas, 634 lesions of, in pyæmia, 967 purulent inflammation of, in puerperal fever, 990 suppuration of, in pyæmia, 976 swelling of, in cerebro-spinal meningitis, 814 in relapsing fever, 400

Jugular veins, pulsation of, significance in general diagnosis, 156

Juniper gin, use of, in wet beriberi, 1042

K.

Kibbie's fever-cot, use of, in puerperal fever, 1034, 1035

Kidney affections, complicating diphtheria, 676 complications in hemorrhagic form of pernicious malarial fever, treatment, 612

Kidneys, lesions of, in anthrax in animals, 937 in man, 942 in cholera, 746 in diphtheria, 687 in pyæmia, 969 in rabies and hydrophobia, 903 in relapsing fever, 414 in scarlet fever, 526 in septicæmia, 972 in typhoid fever, 268 in typhus fever, 357

Koch's investigation of bacillus tuberculosis, 99 of cholera bacilli, 745-749 of bacteria of puerperal fever, 997

L.

Lactic acid, use of, in diphtheria, 703

Lardaceous degeneration, 84

Laryngeal diphtheria, local treatment, 712 prognosis, 692

Laryngitis, complicating rubeola, 571 typhoid fever, 294

Larynx, inflammation of, complicating variola, 446 lesions of, in hydrophobia, 902 in relapsing fever, 413 in typhoid fever, 266 symptoms of diphtheria, 671

Latent form of typhoid fever, 300

Leeches, use of, in puerperal fever, 1031

LEPROSY, 785 Definition, 785 Synonyms, 785 History, 785 Etiology, 787 Heredity as a cause, 787, 788 Contagiousness, 788 Transmission, by inoculation, 788, 789 Sex as a cause, 789 Forms, 789 Symptoms--prodromal stage, 789 Duration of prodromal stage, 789 Tubercular form, 789 Local, 789 Eruptions, 789 Earlier eruptions, 790 Characteristic eruptions, 790 General, 790 Duration, 790 Anæsthetic form, 790 Local, 790 General, 791 Duration, 791 Morbid anatomy, 791 Changes in nerves, 791 Skin, 791 Bacteria, 792 Seat of bacteria, 792 Diagnosis, 792 Prognosis, 793 Treatment, 793 Futility of specific, in, 793 Indications, 793 Prophylaxis, 794 Segregation of afflicted, 794 Quarantine in, 794 Local, 794

Lesions characteristic of anthrax, 935

Lethargic form of rabies in dogs, 897

Leucocytes, death of, as a cause of thrombosis, 57 migration, 42

Leucocythæmia, complicating diphtheria, 675

Lime-water, use of, in diphtheria, 703

Limbs, significance of appearance in general diagnosis, 160

Listerine as a prophylactic in scarlet fever, 537

Liver, abscess of, following typhoid fever, 295 enlargement of, in pyæmia, 976 lesions of, in cholera, 745 in diphtheria, 687 in glanders, 918, 922 in pyæmia, 969 in remittent fever, 602 in relapsing fever, 414 in scarlet fever, 531 in typhoid fever, 265 in typhus fever, 357 in yellow fever, 649

Local dropsies, 71 lesions of glanders, 915, 921 symptoms of glanders in animals, 914 of glanders in man, 921 treatment of anthrax in animals, 938 of anthrax in man, 943 of diphtheria, 701, 709 of erysipelas, 637 of glanders in horse, 918 in man, 924 of pyæmia, 981 of septicæmia, 983

Lochial discharge, influence of, on causation of puerperal fever, 1015

Lung diseases, complicating influenza, 868 complicating influenza, treatment, 877

Lungs, gangrene of, in influenza, 870 hypostatic congestion of, in typhus fever, 353 lesions of, in cholera, 746 in diphtheria, 687 in glanders, 917, 922 in influenza, 872 in pyæmia, 968 in relapsing fever, 413 in septicæmia, 972 in typhoid fever, 266

Lymph, dried, use of, in vaccination, 477 of vaccinia, microscopical characters, 463 vaccine, proper time for collecting, 479

Lymphangitis, complicating erysipelas, 634 vaccination, 468

Lymphatic glands, condition of, in anthrax, 940 in glanders in horses, 915 in man, 921 in malignant scarlet fever, 508 in rötheln, 586 lesions of, in human anthrax, 942 in anthrax of lower animals, 935 in diphtheria, 687 in relapsing fever, 417 pigmentation of, 92

Lymphatics, as channel of entrance of poison of septicæmia, 963 lesions of, in symptomatic parotitis, 626

Lymphatic swellings, seat of, in grave form of the plague, 778 system, lesions of, in the plague, 781

Lymphoma, 120, 124

M.

Magnesium sulphate, use of, in wet beriberi, 1042

Malaria, 89 action of poison on system, 591 entrance into system, modes of, 591 communicability by drinking-water, 590 by fruit, 591 by milk, 590 conditions necessary to mature the poison, 589 duration of incubation of poison, 591 from impure water, 182 influence of moisture in production, 187 means of access of the poison, 590 nature of the poison, 589 non-interchangeableness of the poison, 591 ponderability of the poison, 590 production, 187 specific nature of poison, 591

MALARIAL FEVER, PERNICIOUS, 605 Definition, 605 Varieties, 606 Algid or congestive form, 606 Causes, 606 Frequency, 607 Cases illustrating clinical history, 606 Causes of death, 607 Mortality-rate, 607 Treatment, 607 General indications for treatment, 608 Use of ice and cold in treatment, 608 Opium, 608 Alcohol, 608 Comatose form, 608 Symptoms, 608 Previous condition of persons attacked, 609 Diagnosis from congestive form, 609 Treatment, 609 Hemorrhagic form of, 609 Causes, 610 Seat of hemorrhages, 610 Cases illustrating clinical history, 611 Treatment, 612 Indications for treatment, 612 Use of quinia, 612 Hemorrhages, 612 Renal complications, 613 Depurative, 613 Use of calomel and purgatives, 613

Malarial fevers, 589 definition, 589 nature of remittent fever, 598

Malignant anthrax oedema, 940 pustule, 926 tumors, 114

Mania following cerebro-spinal meningitis, 819

Maternity hospitals, advantages of, 1021

Marriages, influence of, hereditary, 176 of diseased persons, 176 transmission of hereditary proclivities by, 131

Marriages, consanguineous, 131

Marson's theory of multiple vaccination, 467

Masked forms of yellow fever, symptoms, 654

Maturation in variola, 439

Measles, 557 relations of, to idiopathic parotitis, 620

Mechanism of transudation, 68

Medical diagnosis, general, 148

Melanæmia, 92

Melanin, 92

Membrane, appearance of, in severe form of diphtheria, 668 diphtheritic, artificial production, 684 characters, 685 mode of formation, 685 varieties, 686 gangrenous condition of, in diphtheria, 669

MENINGITIS, EPIDEMIC CEREBRO-SPINAL, 795 Definition, 795 Synonyms, 795 History, 796 Etiology, 801 Seasons as a cause, 802 Meteorological agencies, 802 Localities, 802 Age, influence, 802 Sex, influence, 802 Depressing and debilitating habits, 803 Contagiousness, 803 Morbific principle, 803 Pandemic nature, 804 In the lower animals, 804 Types, 804 Forms, 805, 806 Symptoms--summary of, 806 Modes of onset, 806, 807 Individual, 808 Pain in the head, 808 spine, 808 Hyperæsthesia and anæsthesia of skin, 808 Spinal rigidity or opisthotonos, 809 duration of, 809 Convulsions, 809 Paralysis, 810 Aphasia, 810 Condition of eyes, 810 pupils, in, 810 strabismus, 810 blindness, 811 Deafness, 811 Suppurative inflammation of middle ear, 811 Physiognomy, 812 Delirium, 812 Coma, 812 Vertigo, 812 Debility, 813 Condition of tongue, 813 Nausea and vomiting, 813 Characters of matter vomited, 813 Appetite and digestion, 814 Thirst, 814 Constipation and diarrhoea, 814 Condition of fauces, 814 Urine, 814 Swelling of joints and limbs, 814 Respiration, 814 Pulse, 815 Temperature, 815 fluctuations of, 816 Eruptions, 816 irregularity of, 816, 817 petechiæ and ecchymoses, 816, 817 bullæ and pemphigus, 817 Cause of death, 818 Duration, 818 Convalescence, 819 characters, 819 cause of tardy, 819 Relapses, 820 frequency, 820 Sequelæ, 819 Followed by eye affections, 819 Impairment of hearing, 819 Deaf-mutism, 819 Impaired intellect and mania, 819 Hydrocephalus, 819 Paresis and paralysis, 819 Softening of brain, 820 Difficulty of speech, 820 Severe neuralgic pains, 820 Mortality of, 820, 828 variability of death-rate, 820, 828 influence of age upon, 828 Morbid anatomy, 820 General appearance of body after death, 820 Changes in the muscles, 821 in brain and membranes, 821 Changes due to congestion of brain and membranes, 821 to inflammation of meninges, 822 to softening of the brain, 823 Changes in pia mater, 821 in brain-tissue, 823 in spinal cord and membranes, 823 position of, 823 in internal and auditory apparatus, 824 Softening of fourth ventricle and auditory nerve, 824 Changes in eye and optic nerve, 824 in the viscera, 824 Absence of enlargement of spleen, 824 Changes in blood, 824 Amount of fibrine in blood before death, 825 after death, 825 Changes in blood-corpuscles, 825 Summary of pathology, 826 Diagnosis of, 826 From sporadic meningitis, 827 Functional and hysterical nervous affections, 827 Typhoid fever, 827 Typhus fever, 827 Prognosis of, 828 Symptoms indicating unfavorable, 829 favorable, 829 Imprudence of absolute, in, 829 Treatment, 829 Emetics, 830 Purgatives, 830 Futility of venesection, 830 Local depletion, 830 Cold applications, 830 Blisters, 830 Mode of using blisters, 831 Of coldness of skin, 831 Of collapse, 831 Use of alcohol, 831 Opium, 832 Value of opium, 833 Use of quinia, 833 Antipyretics, 833 Mercury, 833 Calabar bean, 834 Belladonna, 833 Ergot, 833 Potassium bromide, 834 Hydrate of chloral, 834 Potassium iodide, 834 Management of convalescence, 835 Diet in, 834

Meningitis, granular, following rubeola, 574

Menstrual disorders, complicating relapsing fever, 410 typhoid fever, 296

Menstruation, complicating typhus fever, 356 significance of abnormal, in general diagnosis, 165

Mental condition in hydrophobia, 899 in influenza, 868 in septicæmia lymphatica of puerperal fever, 1012 in typhoid fever, 277 disorders following the plague, 781 impressions, influence of, in causation of yellow fever, 643 overwork as a cause of typhus fever, 342 strain, symptoms due to, 205 work, relation of, to exercise, 199

Mercury, use of, in cerebro-spinal meningitis, 833 in diphtheria, 705

Metamorphosis, cheesy, 79 colloid, 83 croupous, 80 fatty, 74, 79 mucous, 82

Metastasis in idiopathic parotitis, 623, 624 treatment, 625 in pyæmia, pathology, 964 of tumors, 110

Methods of disinfection, 201 of vaccinating, 478

Metritis in puerperal fever, lesions, 987

Meteorism in typhoid fever, 286

Micro-organisms of puerperal fever, 1015 in pyæmia, blood-changes effected, 970

Microbes, as poison producers and carriers, 141 difficulty of separation of, from surrounding material, 146 liability to error from minuteness, 143

Microbia in inflammation, 45, 48

Micrococci, 141 in healthy bodies, 144

Microscopic organisms, classification, 141

Microscopy of glanderous lesions in man, 923

Migration of leucocytes, 42

Mild forms of cholera, 731 character of stools, 732 number of stools, 732 of influenza, treatment, 874 form of typhus fever, 354 of yellow fever, symptoms, 644

Milk, adulteration, 197 as a cause of disease, 197 as a medium of dissemination of anthrax, 929 of malaria, 590 of rabies and hydrophobia, 891 of scarlet fever, 491 of typhoid fever, 252 as a vehicle of bacillus tuberculosis, 105 polluted, as a cause of diphtheria, 683

Mind, state of, in relapsing fever, 384

Miscarriage, complicating typhus fever, 356

Modern conveniences questionable benefits, 215

Moral sense, perversion of, following typhoid fever, 292

Morbid anatomy, of anthrax in animals, 935 in man, 941 of beriberi, 1040 of cerebro-spinal meningitis, 820 of cholera, 741 of dengue, 882 of diphtheria, 685 of erysipelas, 635 of glanders in horses, 916 in man, 922 of idiopathic parotitis, 621 of influenza, 871 of intermittent fever, 594 of leprosy, 791 of pertussis, 843 of the plague, 781 of puerperal fever, 985 of pyæmia, 966 of pyæmia simplex, 970 of rabies and hydrophobia, 902 of relapsing fever, 413-417 of remittent fever, 602 of rubeola, 575 of scarlet fever, 530 of septicæmia, 971 of septo-pyæmia, 972 of simple continued fever, 235 of symptomatic parotitis, 626 of typhoid fever, 260 of typhus fever, 356 of vaccinal pock, 463 of varicella, 483 of variola, 446 of yellow fever, 649 growths, 105 classifications, 114, 122 Cohnheim's theory of origin, 106 influence of an irritant in production, 108 method of origin, 106 non-malignant, hereditary nature, 129 processes, 35

Morbific principle of cerebro-spinal meningitis, 803

Morphia, hypodermic use of, in beriberi, 1043 use of, in rabies and hydrophobia, 907

Mortality of anthrax in animals, 936 in man, 943 of cerebro-spinal meningitis, 820, 828 in cholera, 754 of glanders in man, 924 of influenza, 872 of pertussis, 841 of the plague, 780 of puerperal fever, 1020 of rabies and hydrophobia, 894 in relapsing fever, 422 of remittent fever, 599 of rubeola, 577 of scarlet fever, 534 of typhoid fever, 316-320 of typho-malarial fever, 616 of typhus fever, 360, 361 of yellow fever, 647, 648

Mouth, condition of, in idiopathic parotitis, 622 of mucous membrane of, in erysipelas, 633 complications in erysipelas, treatment, 638 symptoms of diphtheria, 672, 673

Mucous degeneration, 82 membranes of palate and fauces, appearance of, in prodromal stage of rubeola, 564 condition of, in confluent small-pox, 441 in rötheln, 586 eruptions of varicella on, 483 influence of different, upon the character of diphtheritic membrane, 688 lesions of, in diphtheria, 688 in glanders in man, 922 in rabies and hydrophobia, 902 in erysipelas, 635 localized redness of, symptomatic of prodromal stage of diphtheria, 667 variolous pustules upon, 439 metamorphosis, 82 softening, 82

Multiple tumors, 110

Mumps, 620

Murmurs, arterial, in beriberi, 1040 cardiac, in beriberi, 1040

Muscles, alteration of, in beriberi, 1041 lesions of, in cerebro-spinal meningitis, 821 in diphtheria, 687 in pyæmia, 966 in typhoid fever, 267 of neck, suppuration of, in symptomatic parotitis, 626 voluntary, lesions of, in relapsing fever, 410

Muscular pains in yellow fever, 644 paralysis in beriberi, 1039 rigidity after cholera, 741 spasm, in typhoid fever, 279 tenderness in beriberi, 1039 tremor in typhoid fever, 279 in typhus fever, 349

N.

Nævi, vaccination as a means of destroying, 468

Nails, appearance of, in typhoid fever, 275

Nasal cavities, condition of, in malignant scarlet fever, 508, 520 mode of invasion of, in diphtheria, 669 complications in erysipelas, treatment, 638 diphtheria, local treatment, 710 prognosis, 692 form of diphtheria, symptoms, 669 lesions in glanders, 917 mucous membrane, condition of, in influenza, 866

Nationality in relation to relapsing fever, 371

Nature of puerperal fever, views concerning, 990-1004 of vaccinia, 455

Nausea, during intermittent fever paroxysm, 593 in cerebro-spinal meningitis, 813 in influenza, 866 in relapsing fever, 390 in rubeola, treatment, 581 in typhoid fever, 285 in typhus fever, 350 in yellow fever, treatment, 652 significance of, in general treatment, 162

Negroes, insusceptibility of, to yellow fever, 644

Neck, significance of appearance of, in diagnosis, 152

Necrosis from embolism, 64, 65

Neoplasms, 105

Nephritis, complicating scarlet fever, 525 in scarlet fever, treatment, 550-555

Nerves, lesions of, in leprosy, 791 in symptomatic parotitis, 626

Nervous diseases, complicating diphtheria, 675, 676 hereditary nature of, 129 influence of, upon susceptibility to rubeola, 561 symptoms in relapsing fever, 383-385 complicating scarlet fever, 510 of dengue, 882 of influenza, 867 of malignant scarlet fever, 507

Nervous system, chronic diseases of, following rubeola, 574 condition of, in cholera, 741 in remittent fever, 602 lesion of, in diphtheria, 689 in septicæmia, 972

Neuralgia, following cerebro-spinal meningitis, 820 in yellow fever, 644

Neuralgias, old, aggravation of, in influenza, 870

Neurine, use of, in diphtheria, 703

Nitric acid, use of, to prevent the return of intermittent fever paroxysm, 598

Nitro-muriatic acid, use of, in anthrax, 938

Nodule, nasal, in glanders, 917

Nomenclature of pyæmia, 953 of septicæmia, 953

Nose, inflammation of, complicating variola, 445

Nostrils, condition of, in glanders in man, 921

Nourishment, necessity of, in typhus fever, 363

Nuisance, legal views as to what constitutes, 182

O.

Obesity, tendency to, following typhoid fever, 298

Obstetrical scarlatina, 498

Occupation, influence of, in causation of anthrax, 939 of glanders, 920 of influenza, 860 of typhoid fever, 244 of typhus fever, 343 relation of, to relapsing fever, 372

Odor of body, significance of, in general diagnosis, 159 of relapsing fever, 378

Oedema, 69 complicating relapsing fever, 400 scarlet fever, 529 typhoid fever, 297 from nervous influence, 71 of glottis, complicating scarlet fever, 512, 529 of lungs, Welch on cause of, 72 significance of, in general diagnosis, 159

Oesophagus, lesions of, in typhoid fever, 265

Offensive effluvia, symptoms due to, 181

Oil, inunctions of, in the plague, 784

Open wounds, liability of, to diphtheria, 679

Opisthotonos in cerebro-spinal meningitis, 809

Opium, use of, during cold stage of intermittent fever, 595 during hot stage of intermittent fever, 595 in algid form of pernicious malarial fever, 608 in cerebro-spinal meningitis, 832 in cholera, 767 in dengue, 885 in influenza, 874, 877 in puerperal fever, 1031 in relapsing fever, 429 in remittent fever, 604 in typhus fever, 366

Ophthalmia, chronic, following rubeola, 574

Optic nerve, lesions of, in cerebro-spinal meningitis, 824

Organic disease, hereditary nature of, 129

Organisms, microscopic, classification, 141 minute, convertibility, 145

Organoid tumors, 116

Origin of vaccinia, 457

Origins, specific, of the plague, 776

Ossification, 87

Otitis, chronic, following rubeola, 574 complicating scarlet fever, 520 in scarlet fever, results, 521 treatment, 547

Ovaries, lesions of, in septicæmia, 972 in pelvic peritonitis in puerperal fever, 989

Overcrowding as a cause of cholera, 721 of typhus fever, 341

Overwork as a cause of disease, 204 of the plague, 775

Ozone, use of, in diphtheria, 709

P.

Pain, in idiopathic parotitis, 623 in inflammation, 41 significance of, in general diagnosis, 165

Pains, muscular and joint, in relapsing fever, 385 of general peritonitis in puerperal fever, 1010 peritoneal, in para- and perimetritis of puerperal fever, 1007 rheumatic, in relapsing fever, 399

Palpitation of heart in beriberi, 1039

Pancreas, lesions of, in relapsing fever, 417

Pandemic nature of cerebro-spinal meningitis, 804

Panum's view of bacteria of diphtheria, 667

Papayotin, use of, in diphtheria, 703

Papule in variola, morbid anatomy, 446

Paralysis, complicating diphtheria, 676 variola, 445 diphtheritic, date of appearance, 676 seat, 676 treatment, 713 following cerebro-spinal meningitis, 819 typhoid fever, 293 in cerebro-spinal meningitis, 810 local, in relapsing fever, 398 motor, in relapsing fever, 385 muscular, in beriberi, 1039 sensory, in diphtheria, 676

Paralytic form of rabies in dogs, 896 stage of hydrophobia in man, 900

Parenchymatous inflammation, 53

Para- and perimetritis in puerperal fever, symptoms, 1005

Parametritis in puerperal fever, lesions, 987

Paresis following cerebro-spinal meningitis, 819

Parotid glands, lesions of, in idiopathic parotitis, 621 gland, lesions of, in symptomatic parotitis, 626 in pyæmia, 967 swelling, character of, in symptomatic parotitis, 627 complicating typhoid fever, 296

PAROTITIS, IDIOPATHIC, 620 Definition, 620 Nature, 620 Etiology--predisposing causes, 620 Age, influence, 620 Sex, influence, 620 Season, influence, 620 Relation to measles, diphtheria, and scarlet fever, 620 Peculiarities in mode of occurrence, 621 Anatomical appearance, 621 Changes in parotid gland, 621 Symptoms, 621 Duration of incubation stage, 621 Of invasion stage, 621 Actual attack, 621 Local, 621 Physiognomy, 622 Mouth and tongue, 622 Digestive tract, 622 Temperature and pulse, 623 Respiration, 623 Pain, 623 General, 623 Complications, 623 Metastasis, 623 Frequency, 623 Date of appearance, 623 Orchitis, 623 Symptoms, 624 Diagnosis, 624 Significance of outward displacement of lobe of ear, 624 Prognosis, 624 Result of metastatic orchitis, 624 Treatment, 624 Delirium and headache, 624 Difficult deglutition, 624 Sleeplessness, 625 Local, 625 Suppuration of gland, 625 Incomplete resolution, 625 Metastasis, 625 in females, 625 with depression, 625

PAROTITIS, SYMPTOMATIC or METASTATIC, 625 Definition, 625 Etiology, 625 Mechanical nature of exciting cause, 626 Altered blood as a cause, 626 Morbid anatomy, 626 Changes in parotid gland, 626 Suppuration of muscles of neck, 626 Changes in periosteum and cranial bones, 626 lymphatics, veins, and nerves, 626 in middle ear, 626 Thrombi of jugular veins, 626 Symptoms, 626 Characters of swelling, 627 Date of pointing of abscess, 627 Physiognomy, 627 Prognosis, 627 Of bilateral form, 627 Diagnosis--from idiopathic parotitis, 627 Treatment of, 627 Local, 628 Of incomplete resolution, 628 Of gangrene, 628

Parotitis, complicating cholera, 735 influenza, 870 relapsing fever, 404 typhus fever, 356 treatment, 367

Paroxysm of intermittent fever, 592 primary, of relapsing fever, 375, 378 of remittent fever, 599

Paroxysms of hydrophobia in man, 899 of pertussis, characters, 837 duration, 840 frequency, 840 of rabies in dogs, 896

Pasteur's experiments as to infectiveness of rabies, 892, 893 method of inoculation in anthrax, 937 for prevention of rabies and hydrophobia, 905

Pathognomonic lesions of rabies in dogs, 903

Pathology of glanders in man, 916, 918 of influenza, 871 of pyæmia, 963

Pearly distemper, relation of, to tuberculosis, 99

Pelvic abscesses in puerperal fever, treatment, 1036 cellulitis in puerperal fever, lesions, 988 exudations, treatment of, in puerperal fever, 1036 peritonitis, in puerperal fever, lesions, 988

Peppermint-test for defects in plumbing, 190

Pepsin, use of, in diphtheria, 703

Perforation, intestinal, in typhoid fever, 289, 290 in typhoid fever, treatment, 333

Pericarditis in relapsing fever, 402 complicating influenza, 870

Pericardium, lesions of, in cholera, 747 in pyæmia, 968

Peri-glandular lesions in the plague, 782

Periostitis, complicating typhoid fever, 297

Peritoneal effusions, encysted, in puerperal fever, treatment, 1036

Peritoneum, lesions of, in relapsing fever, 417

Peritonitis, complicating relapsing fever, 406 typhoid fever, 295 general, in puerperal fever lesions, 989 in puerperal fever, symptoms, 1010 pelvic and diffused, of puerperal fever, 988

Pernicious malarial fever, 605

Perspiration in pyæmia, 974 in yellow fever, 645

PERTUSSIS, 836 History, 836 Definition, 836 Etiology, 838 Specific poison, 838 seat, 838 period of greatest virulence, 838 inoculation of animals with, 839 Childhood, influence of, in occurrence, 839 Age at which most prevalent, 839 Sex, influence of, in causation, 839 Catarrhal affections as predisposing causes, 839 Symptoms, 840, 841 Initial stage, 840 Second stage, 840 Stage of decline, 841 Paroxysm, characters of, 837 duration, 840 frequency, 840 Frænum linguæ, ulceration, 841 Urine, condition, 841 Mortality, 841 Morbid anatomy, 843 Complications, 843 Prophylaxis, 843 Treatment, 844 Inhalations, 844 Emetics, 845 Potassium carbonate, 845 Alum, 845 Belladonna, 846 Ammonium bromide, 846 Chloral hydrate, 846 Quinia, 847 Pilocarpine muriate, 847 Sodium benzoate, 847 Caustic irritation, 848 Diet, 848 Hygiene, 848

Pertussis, following the plague, 781

Petechiæ, characters of, in grave form of the plague, 779

Petrifaction, 87

Peyer's patches, lesions of, in typhoid fever, 261

Pharyngeal spasm in rabies and hydrophobia, 899

Pharyngitis in scarlet fever, treatment, 545 and tonsillitis, complicating relapsing fever, 405

Pharynx, lesions of, in rabies and hydrophobia, 902 in relapsing fever, 413 in typhoid fever, 265

Phlebitis and phlebo-thrombosis, lesions of, in puerperal fever, 989

Phlegmonous inflammation, 52

Phthisis, complicating influenza, 870 following typhus fever, 355 from damp soil, 187 pulmonary, hereditary nature of, 128

Physicians as carriers of contagion in puerperal fever, 1017 mortality in, 207 relation of, to public hygiene, 207

Physiognomy of cerebro-spinal meningitis, 812 of dengue, 881 of erysipelas, 632 of hydrophobia, 899 of idiopathic parotitis, 622 of influenza, 866 of symptomatic parotitis, 627 of relapsing fever, 376 of typhoid fever, 272 of yellow fever, 644 significance of, in general diagnosis, 150, 151

Pigmentation, 90

Pilocarpine, use of, in diphtheria, 704 in rabies and hydrophobia, 907 muriate, use of, in pertussis, 847

Pitting, frequency of, in varicella, 482 prevention of, in variola, 452

Placenta, symptoms of diphtheria, 674

PLAGUE, THE, 771 Definition, 771 Synonyms, 771 Classification, 771 History, 772 Etiology--Predisposing causes of, 774 Poverty and filth, 774 Bodily and mental overwork, 775 Sex and age, influence, 775 Season, 775 Exciting causes, 775 Dissemination by bodies dead from, 775 Specific origin, 776 Contagiousness, 776 Nature of the poison, 776 Air as a medium of transmission, 776 Period of incubation, 777 Forms of, 777 Grave or ordinary form, 777 Fulminant form, 779 Abortive form, 780 Symptoms, 777 Grave form, different modes of onset, 779 Invasion stage, 777 Second stage, or stage of fever, 778 Stage of fully-developed local manifestations, 778 Seat of enlarged lymphatics, 778 of buboes, 778 Characters of bubonic swellings, 778 Date of appearance of buboes, 778 Seat and character of carbuncles, 778 of petechiæ, 779 Character of vomited matter, 779 Constipation, 779 Condition of urine, 779 Stage of convalescence, 779 Fulminant form, 779 duration, 779 Abortive form, 780 General duration of, 780 Complications and sequelæ, 780 Followed by catarrhal pneumonia, 781 Pertussis, 781 Mental troubles, 781 Ulcers and abscesses, 781 Morbid anatomy, 781 Changes in lymphatic system, 781 Appearance of buboes, 781 Peri-glandular tissue, 782 Abdominal viscera, 781 Diagnosis, 782 Prognosis, 780 Mortality, 780 Treatment, 782 Preventive, 782 Isolation, 783 Quarantine, 783 Disinfection, 784 Clinical, 784 Inunction of oil, 784 Buboes, 784 Drugs used, 784

Pleura, lesions of, in pyæmia, 968 in relapsing fever, 413 in septicæmia, 972

Pleurisy, complicating typhoid fever, 294 typhus fever, 355 in septicæmia lymphatica of puerperal fever, 1012

Pleuritis, complicating erysipelas, 634 influenza, 870 relapsing fever, 404 scarlet fever, 523 in scarlet fever, treatment, 556

Plumbing, examination of defects, 190 of houses, 188

Pneumonia, catarrhal, complicating influenza, 869 following the plague, 781 complicating erysipelas, 634 relapsing fever, 404 rubeola, 571 typhoid fever, 294 typhus fever, 355 fibrinous, complicating diphtheria, 672 in rubeola, treatment, 581 in typhoid fever, treatment, 335 lobar, complicating influenza, 869

Pneumonias, nature of, complicating influenza, 870

Pock of vaccinia, date of appearance, 459 depression, 459 desquamation, 460 development, 459 incrustation, 460 in variola, characters of mature, 439

Poison, diphtheritic, fixity, 678 transmission, 678 influence of intensity of, on severity of cholera, 730, 731 of anthrax, modes of transmission, 929 of cholera, nature, 749 of malaria, nature, 589, 591 of the plague, nature, 776 of yellow fever, birthplace, 641 characteristics, 641 influence of heat and cold on development, 641 transportability, 641 specific, of beriberi, 1038 of pertussis, 838

Polluted soil as a means of disseminating typhoid fever, 253

Potassium bromide, use of, in cerebro-spinal meningitis, 834 carbonate, use of, in pertussis, 845 chlorate, danger of large doses, 701 use of, in diphtheria, 699, 700 iodide, use of, in cerebro-spinal meningitis, 834

Poverty as a cause of typhus fever, 342

Predisposing causes of beriberi, 1042 of cholera, 720 of glanders in horse, 912 of idiopathic parotitis, 620 of the plague, 774 of typhoid fever, 242 of typhus fever, 341

Predisposition to disease, hereditary nature, 126

Predispositions, inherited, evidence, 132

Pregnancy, complicating influenza, 871 typhoid fever, 296

Preliminary papule of anthrax, treatment, 943

Premonitory symptoms of rabies and hydrophobia, 895 of scarlet fever, 502

Prevention of anthrax by inoculation, 937

Preventive treatment of anthrax in animals, 936 in man, 943 of cholera, 755 of erysipelas, 636 of glanders in horses, 919 in man, 925 of influenza, 873 of the plague, 782 of puerperal fever, 1021 of pyæmia and septicæmia, 979, 980, 983 of rabies and hydrophobia, 903 of scarlet fever, 536 of typhoid fever, 321 of typhus fever, 361

Previous attacks of variola, protection from, 436

Primary vaccine, 473

Privy vaults, contamination of water-supply by, 192 dangers from, 192

PROCESSES, GENERAL MORBID, 35

Prodromal stage of diphtheria, 667 of intermittent fever, 592 of leprosy, 789 of remittent fever, 599 of rötheln, 585 of rubeola, 564 of varicella, 482

Prognosis, general, 167 of anthrax in animals, 936 in man, 943 of beriberi, 1042 of cerebro-spinal meningitis, 828 of cholera, 753 of dengue, 885 of diphtheria, 692-694 of erysipelas, 636 of idiopathic parotitis, 624 of influenza, 872 of intermittent fever, 594 of glanders in horse, 918 in man, 924 of leprosy, 793 of the plague, 782 of relapsing fever, 422-425 of remittent fever, 602 of rötheln, 588 of scarlet fever, 533 of simple continued fever, 235 of symptomatic parotitis, 627 of typho-malarial fever, 616 of typhoid fever, 314-316 of typhus fever, 359, 360 of vaccinia, 464 of varicella, 484 of variola, 450 of varioloid, 444 in yellow fever, 646, 647 effect of constitution, 168 of nature of malady, 169 of present state of patient, 169 influence of nursing, 169 modifying effects of medicinal agents, 169

Prophylactic treatment of diphtheria, 696

Prophylaxis, individual, in contagious diseases, 206 of leprosy, 794 of pertussis, 843 of puerperal fever, 1021

Prostration in dengue, 882 in typhus fever, 348 treatment, 365

Protective power of vaccination, 466 duration of, 468 against pertussis, 468

Pseudo-membrane, solvents of, 703

Psoas abscess in puerperal fever, 1010

Psychical treatment of hydrophobia, 906

Public sewers, 224

PUERPERAL FEVER, 984 Definition, 984 Frequency, 984 Etiology, 1013 Atmosphere, impure, influence on causation, 1013, 1014 Malaria, nosocomial, influence on causation, 1013 Micro-organisms, influence on causation, 1013-1015 Lochial discharge, influence on causation, 1015 Atmosphere, peculiar states of, on causation, 1016 Direct inoculation, 1016 Contagiousness of, 1017 Contagion, physicians as carriers of, 1017 Dissecting poison, 1018 Self-inoculation, 1019 Morbid anatomy, 985 Spiegelberg's classification of puerperal inflammations, 986 Endocolpitis and endometritis, 986 Diphtheritic ulceration, 986 Metritis and parametritis, 987 Diphtheritic endometritis, 987 Pelvic cellulitis, 988 Cellulitis from specific infection, 988 Peritonitis, pelvic and diffused, 988 exudation in, 989 general, 989 appearance of abdominal cavity, 989 ovaries, 989 Phlebitis and phlebo-thrombosis, 989 Thrombi in uterine and pelvic veins, 989 Abscesses, 989 pulmonary, 989 Veins, inflammation, 989 Thrombi, growth, 990 Septicæmia, 990 Abscesses, metastatic, 990 Endocarditis, ulcerative, 990 Pleuritis, 990 Joints, purulent inflammation, 990 Earlier views concerning nature, 990 Modern view concerning nature, 992 Septic origin, 993-1003 Bacteria, relation to causation, 994 Koch's investigations of, 997 physical characters, 999 modes of entering the circulation, 1000 action of, upon the blood, 1000 Diphtheria of genitalia, characters, 1002 Relation of, to erysipelas, 1002 Inflammatory affections of non-specific origin, 1003 Symptoms, general, 1004 Incubation period, 1004 Chill, significance of, 1005 Of endometritis and endocolpitis, 1005 temperature, 1005 Parametritis and perimetritis, 1005 Incubation, 1006 Temperature, 1006 Pulse, 1006 Relapse, 1006 Headache, 1007 Pains, 1007 Vomiting, 1007 Duration, 1007 Exudation, 1007 Uterus fixity of, 1007 Tumors in iliac fossa, 1008 Abscesses, 1008 location, 1008 pointing of, 1008 Local peritonitis, 1009 Of psoas abscess, 1010 Of peritonitis, general, 1010 Pains, 1010 Abdomen, state, 1010 Respiration, 1010 Vomiting, 1010 Vomit, characters, 1010 Fever, 1010 Skin, 1010 Pulse, 1010 Pyæmic form, 1011 Of septicæmia lymphatica, 1011 Mode of onset, 1011 Temperature in, 1011 Abdomen, state, 1011 Skin, state, 1011 Vomiting, 1011 Tongue, condition, 1011 Pulse, condition, 1011 Respiration, 1012 Pleurisy in, 1012 Endocarditis, 1012 Mental condition, 1012 Joint affections in, 1012 Duration, 1012 Of septicæmia venosa, 1012 Chills in, 1012 Fever in, 1012 Temperature in, 1012 Pulse in, 1012 Abdomen, state of, 1012 Uterus in, 1012 Of pure septicæmia, 1013 Mortality, 1020 Relation of, to zymotic diseases, 1020 Prophylaxis, 1021 Maternity hospitals, advantages, 1021 Necessity of light and air, 1024 Antisepsis, value, 1024 methods, 1025 Sulphurous acid, use, 1025 Corrosive sublimate, use, 1025 Iodoform, use of, intra-uterine, 1025 Vaginal injections, carbolized, use, 1025 Tarnier's maternity pavilions for prevention, 1027 Treatment--indications, 1028 Disinfection, 1028 Local, 1028 Use of hydrochloric acid, 1028 Persulphate of iron, 1028 Intra-uterine injections, use, 1029 dangers of, 1029 methods, 1029 Corrosive sublimate, use, 1025, 1029 Pain, peritoneal, 1031 Use of opium, 1031 in pyæmic variety, 1031 Leeches, 1031 Turpentine stupes, 1032 Hyperpyrexia, 1032 Use of purgatives, 1032 Quinia, 1032 Sodium salicylate, 1032 Veratrum viride, 1033 Digitalis, 1033 Alcohol, 1033 Cold in, 1033 Cold, method of applying, 1034 Cold water, intra-uterine injections, 1034 Baths, cold, use, 1034 Kibbie's fever-cot, use, 1034, 1035 Coil, 1036 Diet, 1036 Encysted peritoneal effusions, 1036 Quinia, use, 1036 Pelvic exudations, 1036 Pelvic abscesses, 1036

Puerperal septicæmia, relations of, to obstetrical scarlatina, 499 women, general sepsis from diphtheria in, 674 symptoms of diphtheria in, 674

Pulmonary abscess in puerperal fever, 989 collapse, complicating influenza, 869 complications of typhus fever, treatment, 367 oedema, complicating rubeola, 572

Pulsation of jugular veins, significance of, in general diagnosis, 156

Pulse and temperature, relation of, in yellow fever, 644 average frequency in health and disease, 154 characters of, in erysipelas, 633 in idiopathic parotitis, 623 in general peritonitis of puerperal fever, 1010 in septicæmia, 977

Pulse, characters of, in septicæmia lymphatica of puerperal fever, 1011 venosa of puerperal fever, 1012 condition of, in acute glanders in man, 921 in beriberi, 1040 in cerebro-spinal meningitis, 815 in cholera, 737 in dengue, 881 in influenza, 866 in pyæmia, 975 in relapsing fever, 382 in typhus fever, 351 significance of, in general diagnosis, 152 in malignant scarlet fever, 507 in typhoid fever, 275 kinds of, 154 methods of examining, 153 relation to respiration, 154 temperature, relation of, in relapsing fever, 382

Pupil, significance of state of, in general diagnosis, 151

Pupils, condition of, in cerebro-spinal meningitis, 810

Pure septicæmia of puerperal fever, 1013

Purgatives, use of, during hot stage of intermittent fever, 596 in cerebro-spinal meningitis, 830 in hemorrhagic form of pernicious malarial fever, 613 in puerperal fever, 1032 in remittent fever, 604

Purity of water, standards of, 184

Purpura, complicating diphtheria, 674

Pus, 48 influence of, in production of pyæmia, 955 in stools, significance in diagnosis, 164

Pustule, malignant, 926

Putrefaction of cadaver, rapidity of, in puerperal fever, 971

Putrified flesh as a means of disseminating typhoid fever, 257

PYÆMIA AND SEPTICÆMIA, 945-955 History, 945-952 Nomenclature, 952 Pyæmia, 953 Definition, 953 Septicæmia, 953 Definition, 954 Etiology of pyæmia, 955 Theories concerning, 955 Pus, influence of, in production, 955 Character of production, 956 Thrombosis, relation of, to causation, 957, 958 Contamination of blood, influence of, in causation, 958 sources, 958 Germs, disease-, influence of, in causation, 958 Wounds, characters of, influence on causation, 958 Etiology of spontaneous pyæmia, 959 Wounds of alimentary canal and genito-urinary apparatus as cause, 959 Air, vitiated, influence of, on causation, 959 Spontaneous origin, 959 Contagiousness, 960 Chemical origin, 960 Living organisms, influence of, on causation, 958-960 Etiology of septicæmia, 960 Septic intoxication, relation of, to, 961 Traumatic fever, relation of, to, 962 Dissecting wounds, relation of, to causation, 962 Putrid substances, maximum toxic action of, on the body, 962 Lymphatics as channel of entrance of poison, 963 Etiology of septo-pyæmia, 963 Pathology, 963 Condition of blood, 963 in pyæmia simplex, 963 multiplex, 963 Metastasis, conditions, 964 Pus, mode of entering the circulation, 964 Metastatic abscesses, production, 964 from primary infection, 964 from secondary infection, 964 Emboli, action of, in production of metastatic abscesses, 964 Thrombi, action of, in production of metastatic abscesses, 965 Seat of pathological changes, 965 Fat emboli, influence of, in production, 966 Morbid anatomy, 966 Of pyæmia, 966 Appearance of body, 966 Rigor mortis, 966 Lesions of cellular tissue, 966 Muscles, 966 Brain and membrane, 966 Retina and choroid, 967 Cornea, 967 Ear, 967 Bones, 967 Joints, 967 Parotid gland, 967 Arteries and veins, 967 Blood, 968 Pericardium, 968 Pleuræ, 968 Lungs, 968 Liver, 969 Spleen, 969 Kidneys, 969 Micro-organism in blood, changes effected by, 970 Pyæmia simplex, 970 Absence of abscesses in, 970 Septicæmia, 971 Putrefaction of bodies, rapidity of, 971 Blood, lesions of, 971 Sepsin, nature, 971 Lesions, nervous system, 972 Endo- and pericardium, 972 Lungs, 972 Pleuræ, 972 Kidneys, 972 Spleen, 972 Uterus, 972 Ovaries, 972 Bladder, 972 Of septo-pyæmia, 972 Symptoms, 972 Of pyæmia, 972 Prodromal stage, 973 Chills, date of appearance, 973 frequency, 973 Temperature, 974 Perspiration, 974 Eruptions, 974 Pulse, 975 Tongue, condition of, 975 Vomiting, 975 Singultus, 975 Diarrhoea, 975 Stools, character of, 976 Heart, condition of, 976 Lungs, condition of, 976 Liver and spleen, enlargement, 976 Urine, 976 Joints, suppuration, 976 Abscesses, frequency, 976 Delirium, 976 Breath, odor of, 976 Wound, changes, 976 Of septicæmia, 976 General, 976 Wound, condition of, 977 Temperature, 977 Abdomen, state of, 977 Pulse, 977 Diarrhoea, 977 Vomiting, 977 Tongue, 977 Singultus, 977 Bronchitis in, 977 Of gangrene foudroyante, 977 Skin, condition, 977 Diagnosis, 978 Of pyæmia from septicæmia, table showing, 978, 979 Treatment, 979 In fully-developed cases unsuccessful, 980 Preventive, 979, 980 Cleanliness, necessity of, in prevention, 980 Atmosphere, pure, necessity of, in prevention, 980 Food and drink, proper, necessity of, in prevention, 980 Cheerful and pleasant surroundings, in prevention, 980 Antiseptics, use of, 980 Local, 981 Of wound, 981 Metastatic abscesses, 981 Constitutional, 982 Sulphites of magnesium, sodium, potassium, and lime, use of, 982 Use of alcohol, 982 Quinia, 982 Ergotine, 982 Diet, 982 Stimulants, 982 Of septicæmia, 982 Indications for, 982 Local, 983 Preventive, 983 Of wound, 983 Diarrhoea, 983 Antisepsis, 983 Sulphites and hyposulphites, use of, 983 Quinia, use of, 983 Of puerperal septicæmia, 983 complicating erysipelas, 634 typhoid fever, 295 typhus fever, 356

Pyæmic form of general peritonitis of puerperal fever, 1010

Q.

Quarantine in cholera, 204, 755 in leprosy, 794 in the plague, 783

Quinia, use of, in cerebro-spinal meningitis, 833 in dengue, 885 in diphtheria, 708, 712 in erysipelas, 637 in influenza, 874-876 during cold stage of intermittent fever, 595 hot stage of intermittent fever, 596 sweating stage of intermittent fever, 597 to prevent the return of intermittent fever, paroxysm, 598 in hemorrhagic form of pernicious malarial fever, 612 in pertussis, 847 in puerperal fever, 1032, 1036 in pyæmia, 982 in relapsing fever, 426 in remittent fever, 603 in rubeola, 580 in scarlet fever, 543 in septicæmia, 983 in typhoid fever, 330 in typho-malarial fever, 618 in typhus fever, 365 in yellow fever, 651 and opium, use of, in yellow fever, 651

R.

RABIES AND HYDROPHOBIA, 886 Synonyms, 886 Definition, 886 History, 886 Geographical distribution, 886 Etiology, 887 Climate, relation of, to causation, 887 Season, relation of, to causation, 887 Summer heats, relation of, to causation, 887 Hunger and thirst, relation of, to causation, 888 Improper food, relation of, to causation 888 Sex, relation of, to causation, 888 Liability of special breeds, 889 From skunk-bite, 889 Spontaneous origin, 890 Contagion, 891 Modes of dissemination, 891 Milk, propagation by, 891 Saliva, propagation by, 891 Specific germ, 892 Pasteur's experiments as to infectiousness, 892 Point of election of germ, 892 Antagonism between blood and germ, 892, 893 Localization of the virus in the wound, 893 Relation of successful inoculation to bites, 893 Insusceptibility to, 894 Incubation, 894 Duration of, in lower animals, 894 in man, 894 Condition of cicatrix during, 895 Symptoms, 895 In dogs, 895 Importance of recognizing premonitory, 895 Of prodromal stage, 895 Of furious form, 896 During paroxysms, 896 Between paroxysms, 896 Of paralytic form, 896, 897 Of lethargic form, 897 Popular fallacies regarding, 897 In horse and other animals, 897 In man, 898 Symptoms, 898 Prodromal stage, 898 Appearance of wound, 898, 899 Of paroxysms, 899 Duration, 899 Reflex irritability during, 899 Facies during, 899 Mental condition, 900 Delirium during, 900 Relative severity in men and women, 900 Paralytic stage, 900 duration, 900 Without paroxysms, 900 Diagnosis, 900 Pathognomonic features in, 900 From tetanus, 900 From diphtheria, 900 From pharyngeal anthrax, 900 From acute mania, 900 From epilepsy, 901 From hysteria, 901 From pseudo-hydrophobia, 901 Inoculation in doubtful cases, 902 Morbid anatomy, 902 Post-mortem appearance of body, 902 Changes in mucous membranes, 902 Bronchi and pharynx, 902 Lungs, 902 Heart and blood-vessels, 902 Gastro-intestinal tract, 902 Liver and spleen, 902 Kidneys, 902 Bladder, 902 Brain and spinal cord, 902 Pathognomonic changes in dogs, 903 Treatment, 903 Preventive, 903 Registration of dogs, 904 Modes of preventing diffusion, 904 Inoculation, 904 Pasteur's method, 905 Of bites, 905 Use of caustics, 905 Excision of cicatrix, 906, 908 Futility of eliminating measures, 906 Hygienic, 906 Psychical, importance of, 906 Therapeutic, 907 Use of chloroform, 907 Chloral, 907 Pilocarpine, 907 Curare, 907 Morphia, 907 Atropia and daturia, 907 Vaccine virus, 907 Warm baths, 907 Faradization, 907 Inhalation of oxygen, 907 Importance of rest and quiet, 907 Intravenous injections, 908 Venesection, 908

Race, influence of, in causation of variola, 436 protection as a preventive of small-pox, 130 relation of, as causation of rubeola, 561

Rachialgia in cerebro-spinal meningitis, 808

Rash of variola, date of appearance of, 437 significance of, 437 variolous, 437

Raspberry excrescence in vaccinia, 461

Reaction in cholera, 734 treatment, 763

Reflex irritability in hydrophobia, 899 symptoms in diphtheria, treatment, 694

Registration of dogs for prevention of rabies, 904

Relapse, in relapsing fever, 381

Relapses, cause of, in typhoid fever, 309 duration of, in typhoid fever, 304 frequency of, in typhoid fever, 302 in cerebro-spinal meningitis, 820 of diphtheria, prognosis of, 694 in rubeola, 563

RELAPSING FEVER, 369 Definition, 369 Synonyms, 369 History and geographical distribution, 369 Etiology, 370 Destitution and filth as causes, 370 Intemperance as a cause, 370 Starvation and over-crowding as a cause, 371 Age, relation of, to causation, 371 Sex, relation of, to causation, 371 Nationality, relation of, to causation, 371 Season, relation of, to causation, 371 Occupation, relation of, to causation, 372 Specific origin, 370, 372 Contagious nature, 372 Transmission of contagion, 373 Area of contagious atmosphere, 373 Spirillum, 373 Mode of detecting, 373 Inoculation, 374 Incubation period, 376 General clinical description, 374 Invasion, 376 Special symptoms, 376 Odor, 378 Physiognomy, 376 Bronzing of face, 376 Eruptions, 377 Hepatic eruptions, 377 Sudamina, 377 Desquamation, 377 Primary paroxysms, duration, 378 Temperature, 378 at crisis, 378 peculiarities, 382 Relapse, 381 Duration, 381 Absence, 380 Frequency, 382 Later relapses, 381 Cases illustrating frequency of relapses, 394 Average duration of paroxysms, 381 Intermission, duration, 381 Pulse, 382 Relation of pulse to temperature, 382 Character of pulse during paroxysm, 383 Pulse at crisis, 382 During intermission, 383 Character of heart-sounds, 383 Convulsions, 384 Mental condition, 384 Headache, 383 Wakefulness, 384 Vertigo, 384 Delirium, 384 General tremor, 384 Muscular rigidity, 384 Muscular and joint pains, 385 Cause of muscular and joint pains, 385 Seat of muscular and joint pains, 385 Motor paralysis, 385 Debility, 386 Perversion of special senses, 386 Respiration, 386 Relation of respiration, temperature, and pulse, 386 Bronchitis and pneumonia, 387 Condition of urine, 387 Urine of paroxysm, 388 of intermission, 388 Thirst, 389 Anorexia, 389 Condition of tongue, 389 Nausea and vomiting, 390 Hæmatemesis, 390 Condition of bowels, 390 of abdomen, 390 Spleen, enlargement, 391 Liver, enlargement, 391 Jaundice, significance of, 391 Epistaxis, 393 Hemorrhages, 393 Convalescence, 393 Varieties, 395 Grave form, 395 Multiple or protracted form, 395 Abortive form, 395 Case illustrating subintrant form, 396 Complications, 396 Peculiarities of temperature, 397 Mental hebetude, 398 Local palsies, 398 Severe rheumatic pains, 399 Disorders of vision, 399 Ophthalmia, 399 Disorders of hearing, 400 Otorrhoea, 400 Swellings and effusions of joints, 400 Bed-sores, 400 Gangrene, 400 Abscesses, 400 Anæmia, 400 Oedema, 400 Sudden collapse and syncope, 401 Hemorrhages from mucous surfaces, 401 Pericarditis, 402 Heart-clot, 402 Thrombosis and embolism, 402 Laryngitis, 403 Bronchitis, 403 Splenic enlargement, 403 Rupture of spleen, 403 Parotitis, 404 Pleurisy, 404 Pneumonia, 404 Pulmonary gangrene, 404 Metastatic abscesses of lungs, 404 Pharyngitis and tonsillitis, 405 Hiccough, 405 Diarrhoea, 405 Dysentery, 406 stools, 406 Suppuration of mesenteric glands, 406 General and local peritonitis, 406 Emaciation, 407 Renal disorders, 408 Albuminuria, 407 Suppression of urine, 407 Incontinence of urine, 407 Hæmaturia, 409 Glycosuria, 410 Metastatic inflammation of kidneys, 410 Disorders of menstruation, 410 Pregnancy, 410 Sequelæ, 398 Local palsies, 398 Acute miliary tuberculosis, 404 Dyspepsia, 406 Anæmia, 400 Morbid anatomy, 410 Post-mortem appearance of body, 410 Changes in voluntary muscles, 410 Blood, 411 Granule-cells of blood, 412 Changes in pericardium, 411 Heat, 411 Gastro-intestinal canal, 412 Solitary and agminated glands, 413 Mesenteric glands, 413 Larynx and pharynx, 413 Pleura, 413 Lungs, 413 Brain and membranes, 413 Liver, 414 Bile-ducts and gall-bladder, 415 Spleen and capsule, 416 Pancreas, 417 Peritoneum, 417 Kidneys, 414 Bladder, 414 Lymphatic glands, 417 Marrow of bones, 417 Diagnosis, 418 Presence of spirillum as a means, 418 From typhus fever, 418 From typhoid fever, 419 Grave form of, from typhoid fever, 420 From bilious remittent fever, 420 Yellow fever, 420 Small-pox, 421 Acute gastro-hepatic catarrh, 421 Simple febricula, 421 Rheumatic fever, 421 Acute yellow atrophy of liver, 422 Parotitis, 422 Cerebral diseases, 422 Prognosis, 422 Symptoms indicating unfavorable, 424 Influence of variations of temperature, 424 Cerebral symptoms, 424 Character of eruption, 425 Hiccough upon, 425 Epistaxis, 425 Cough upon, 425 Heart complications on, 425 Hepatic enlargement upon, 425 Splenic enlargement upon, 425 Jaundice upon, 425 Albuminuria, 425 Mortality--bilious typhoid form, 422 Influence of type of disease, 423 Stage of disease, 423 Season, 423 Habits and previous health, 424 Sex, 424 Age, 424 Race, 424 Cause of death in, 426 Treatment--indications for treatment in regular cases, 426 Hyperpyrexia, 426 Cause of failure of antipyretics, 429 Insomnia, 429 Headache, 429 Nausea and vomiting, 430 Constipation, 430 Jaundice, 431 Muscular tremor, 432 soreness and pains, 432 At critical fall of temperature, 432 Renal complications, 432 Epistaxis, 432 Collapse, 433 Necessity of absolute rest in, 432 Résumé of treatment, 432 Diet, 430 Special remedies, 431 Use of antiperiodics, 428 Arsenic, 427 Atropia, 429 Bromide and chloral, 430 Blisters, 431 Chloroform, 431 Cold baths, 428 Digitalis and other antipyretics, 428 Hyposulphite of sodium, 428 Opium, 429 Quinia, 426 Salicylic acid and salicylates, 428 Simple febrifuges, 428 Stimulants, 430 Venesection, 431

REMITTENT FEVER, 598 Definition, 598 Malarial nature, 598 Etiology, 598, 599 Relation of, to intermittent fever, 599 Symptoms, 599 Prodromal stage, 599 Paroxysm, 599 Temperature, 599 Epistaxis, 602 State of tongue, 600 Stomach, 602 Bowels, 602 Urine, 602 Jaundice, 600 cause, 600 Nervous symptoms, 602 Physiognomy, 600 Pulse in, 602 Duration of, 602 Diagnosis, 600 From intermittent fever, 600 From typhoid fever, 600 From yellow fever, 600 Prognosis, 602 Mortality, 599 Morbid anatomy, 602 Changes in skin, 603 Liver, 602 Spleen, 602 Treatment, 603 Main indications, 603 Use of quinia, 603 Amount of quinia, 603 Causes of failure of quinia, 604 Adjuvants to quinia, 604 Use of depuratives, 604 Purgatives, 604 Opium, 604 Of hemorrhage, 605 Of tympanites, 605 Of vomiting, 605

Renal disease, complicating relapsing fever, 408 scarlet fever, 525

Residence, change of, in treatment of beriberi, 1042

Resolution, incomplete, in idiopathic parotitis, treatment, 625 of symptomatic parotitis, treatment, 628 of erysipelas, 633 of inflammation, 54

Respiration in cerebro-spinal meningitis, 814 characters of, in idiopathic parotitis, 623 in general peritonitis of puerperal fever, 1010 in mild scarlet fever, 504 in relapsing fever, 386 in septicæmia lymphatica, 1012 in typhoid fever, 276 in typhus fever, 352 in croup, 157 in disease, 156 kinds of, 156 significance of, in general diagnosis, 156

Respiratory diseases, relation of, to rubeola, 561 organs, lesions of, in typhus fever, 356 spread of diphtheria into, 671 tract, alterations of, in scarlet fever, 531

Rest, necessity of, in cholera, 760 in rabies and hydrophobia, 907 in relapsing fever, 432 in yellow fever, 654

Retention-cysts, 116, 122

Retro-vaccine, 473

Re-vaccination, time of, 467

Rheumatic and cardiac inflammation in scarlet fever, treatment, 556

Rheumatism, complicating scarlet fever, 521

Rickets, hereditary nature, 128

Rigidity, muscular, in relapsing fever, 384

Rindfleisch's definition of diphtheritic inflammation, 686

RÖTHELN, 582 Definition, 582 Synonyms, 582 History, 582 Etiology, 583 Age as a cause, 583 Sex as a cause, 583 Specific origin, 583 Nature of contagion, 583 Modes of transmission, 583 Period of greatest contagiousness, 583 Distinct nature, 584 Frequency of second attacks, 584 Relapses, 584 Symptoms, 585 Incubation period, 583, 585 Duration of incubation period, 583 Prodromal stage, 585 Eruption, 585 Duration of eruption, 585 Characters of eruption, 586 Types of eruption, 586 Condition of mucous membranes, 586 Swelling of lymphatic glands, 586 Temperature, 587 Complications and sequelæ, 587 Diagnosis, 587 From measles, 587 From scarlet fever, 587 From symptomatic skin eruptions, 588 Prognosis of, 588 Treatment of, 588

RUBEOLA, 557 Definition, 557 Synonyms, 557 History, 557 Etiology, 557 Nature of contagion, 558 Relation of straw fungus, 558 Mode of entrance into body, 558 Modes of dissemination of contagion, 559 Inoculation, 559 Stage when most easily propagated, 560 Race, influence of, 561 Age, influence of, 561 Sex, influence of, 562 Climate as a cause, 560 Pregnancy and parturition as a cause, 561 Scrofula as a cause, 561 Diseases of respiratory organs as a cause, 561 Relation of, to acute diseases, 561 to chronic diseases, 561 to whooping cough, 561 Influence of nervous diseases upon susceptibility, 561 Frequency of epidemics, 560 in new-born, 562 second attacks, 563 Relapses in, 563 Symptoms, 563 Incubation stage, 563 Duration of incubation stage, 560 Prodromal stage, 564 Temperature, 564 Catarrhal symptoms, 564 Punctated appearance of palatal and faucial mucous membrane, 564 Convulsions, 565 Duration of, 565 Eruptive stage, 565 Temperature of, 566 Character and seat of eruption, 566 General symptoms, 567 Symptoms at decline, 567 Temperature at decline, 567 Duration of eruptive stage, 567 Varieties of, 568 Inflammatory or synochal, 568 Hemorrhagic (rubeola nigra), 569 Without eruption, 568 catarrh, 568 Deviations from ordinary course, 569 Peculiarities in seat of eruption, 569 in character of eruption, 569 Relapses of eruption, 570 Complications, 570 Causes, 570 Complicated with epistaxis, 570 Skin disorders, 570 Pemphigoid eruptions, 571 Ear diseases, 570 Eye diseases, 571 Faucial inflammation, 571 Laryngitis, 571 Bronchitis and capillary bronchitis, 571 Pneumonia, 571 Pulmonary oedema, 572 Acute miliary tuberculosis, 572 Heart-clot, 572 Intestinal catarrh, 572 Convulsions, 572 Diphtheria, 573 Sequelæ, 573 Followed by general miliary tuberculosis, 574 Chronic pulmonary tuberculosis, 573 Coryza, 574 Ophthalmia, 574 Otitis, 574 Intestinal catarrh, 574 Cutaneous diseases, 574 Bone and joint disease, 574 Nervous affections, 574 Granular meningitis, 574 Albuminuria, 574 Gangrenous affections, 574 Morbid anatomy, 575 Changes in skin, 575 Diagnosis, 575 Value of punctated appearance of palatal and faucial mucous membranes, 575 Salient points in diagnosis, 575 From rötheln, 576 Scarlet fever, 576 Variola, 576 Roseola and erythema, 577 Typhus, 577 Roseola syphilitica, 577 Prognosis, 577 Factors to be considered in making, 577 Influence of hygienic surroundings, 577 previous health, 578 complications, 578 Mortality, 578 Influence of stage of disease, 578 of age, 578 Treatment, 578 Preventive, 578 Isolation, 578 Hygienic, 579 Diet, 579 Uncomplicated cases, 579 Results, 579 Hyperpyrexia, 580 Retrocession of eruption, 580 Epistaxis, 580 Diarrhoea, 581 Nausea and vomiting, 581 Constipation, 581 Cough, 581 Eye complications, 581 Aural complications, 581 Bronchitis and pneumonia, 581 Convulsions, 581 Use of aconite, 580 Inunctions, 580 Quinia, 580 Stimulants, 580

S.

Salicylic acid, use of, in diphtheria, 707 in relapsing fever, 428

Saliva, propagation of rabies and hydrophobia by, 891

Salivary glands, lesions of, in typhoid fever, 268

Sanitary inspection of houses, 187

Sarcoma, 118

SCARLET FEVER, 486 History, 486 Etiology--Specific origin, 487 Germ theory, 488 Microbes, 488 Modes of cultivation of microbes, 488 Modes of entering the system, 490 Modes of communication, 490 Dissemination of, by milk, 491 Fixity of the poison, 491 Solid nature of the poison, 492 Duration of incubation, 492, 493 Contagiousness, 494 Area of contagiousness, 494 Age, influence of, in causation, 500 Variations in type, 494 Surgical, 495 distinguished from septicæmic efflorescence, 497 effect of poison upon inflammation of wounds, 498 Obstetrical, 498 liability of parturient women to, 498 relation of, to puerperal septicæmia, 499 Immunity of infants, 500 Clinical facts regarding, 501 Relapses in, 501 Frequency of second attacks, 501 Sympathetic sore throat in, 502 albuminuria in, 502 Symptoms, 502 Ordinary form, 502 Premonitory, 502 Nervous system, 503 Vomiting in, significance, 503 Diarrhoea, 503 Condition of tongue, 504 of faucial and nasal membranes, 504 Respiratory, 504 Efflorescence, 504 Seat of greatest intensity of eruption, 504 Cause of absence of eruption, 505 Date of desquamation, 506 Temperature, 505 Digestive system, 505 Urine, characters, 505 Duration, 506 Malignant or grave form, 507 Digestive system, 507 Pulse, 507 Eruption, 507 Temperature, 507 Nervous symptoms, 507 Condition of fauces, 508 Of throat, 508 Nasal cavities, 508 Lymphatic glands, 508 Duration, 508 Irregular form, 508 Causes, 508 Absence of eruption, 508 Hemorrhagic form, 509 Anginose form, 510 Complications and sequelæ, 510 Complicated by severe nervous symptoms 510 Throat symptoms, 511 Adenitis, 511 Inflammation of neck, 511 Gangrene of neck, 512 Oedema of glottis, 512 Diphtheria, 514 course of diphtheria, complicating, 516 Croupous inflammation of fauces, 516 Coryza, 520 Otitis, 520 course of otitis, complicating, 520 results of otitis, complicating, 521 By rheumatism, 521 By cardiac inflammations, 522 By dilatation of heart, 523 By heart-clot, 523 By pleuritis, 523 By nephritis, 525 By glomerulo-nephritis, 527 By albuminuria, 525 By anasarca and oedema, 529 Order and date of appearance of anasarca, 529 By head symptoms due to uræmia, 530 Morbid anatomy, 530 Changes in the blood, 530 Respiratory tract, 531 Abdominal organs, 531 Post-mortem appearance of eruption, 532 Changes in the kidneys, 526 hyaline degeneration of kidneys, 527 intestinal nephritis, 528 parenchymatous nephritis, 526 Changes in the liver, 531 Diagnosis, 532 From measles, 532 From erythema, 533 From rötheln, 533 From diphtheria, 533 Prognosis, 533 Influence of complications upon, 533, 535 type upon, 534 age upon, 534 Of grave cases, 535 Mortality, 534 Treatment, 536 Preventive, 536 Isolation in, 537 Inoculation as a prophylactic, 536 Belladonna as a prophylactic, 536 Sodium sulpho-carbolate as a prophylactic, 537 Listerine as a prophylactic, 537 Boric acid as a prophylactic, 537 Disinfection in, 201, 538 Hygienic, 539 Therapeutic, 539 Mild cases, 540 Inunction in, 541 Hyperpyrexia, 541 by cold, 541 Mode of applying cold, 542 Antiseptic, 545 Complications and sequelæ, 545 Pharyngitis, 545 local, 546 Coryza, 546 local, 547 Otitis, 547 local, 549 paracentesis of tympanum, 548 Nephritis and albuminuria, 550 modes of producing diaphoresis, 551 local, 555 Convulsions, 556 Rheumatic and cardiac inflammation, 556 Pleuritis, 556 Convalescence, 544 Use of aconite and veratrum viride, 543 Alcohol, 544 Ammonium carbonate, 544 Carbolic acid, 545 Cathartics, 554 Diuretics, 555 Digitalis, 543, 555 Ice, 542 Jaborandi and pilocarpine, 552 Sodium salicylate, 543 Quinia, 543

Scarlet fever, relation of, to idiopathic parotitis, 620

Scarlatina, disinfection in, 201, 538

Schools, closure of, for prevention of disease, 203

Scrofula, relation of, to causation of rubeola, 561 relation to tuberculosis, 96, 101

Scrofulosis, hereditary disposition to, 127

Scrofulous habit, peculiarities of tissue, 101

Scurvy, complicating typhus fever, 355

Season, influence of, on causation of anthrax, 931, 940 of cerebro-spinal meningitis, 802 of diphtheria, 682 of typhoid fever, 245 of erysipelas, 630 of idiopathic parotitis, 620 of influenza, 860 of the plague, 775 of rabies and hydrophobia, 887 of relapsing fever, 371 of typhus fever, 343 of variola, 435 on cholera, 720 proper, for vaccination, 477

Seborrhoea, following erysipelas, 633

Second attack of rubeola, frequency of, 563 stage of pertussis, 840

Secondary form of diphtheria, 671

Segregation of lepers, 794

Self-infection, danger of, in treating diphtheria, 696 prevention of, in treating diphtheria, 696

Sensibility, altered, significance of, in general diagnosis, 161 modifications of, in typhoid fever, 279

Sepsin, 971

Septicæmia, 945 complicating erysipelas, 634 distinguished from pyæmia, 978, 979 lymphatica of puerperal fever, 1011 venosa, 1012

Sequelæ of cerebro-spinal meningitis, 819 of cholera, 735 of erysipelas, 633 of grave form of the plague, 780, 781 of influenza, 868 of relapsing fever, 396 of rötheln, 587 of rubeola, 573 treatment, 580 of scarlet fever, 510 of vaccinia, 464 of variola, 445

Serous inflammation, 47 inflammations complicating erysipelas, 634

Severe form of diphtheria, symptoms, 668 of influenza, treatment, 875 of typhus fever, 354

Sewerage, 213

Sewer- and soil-pipes, importance of position, 188

Sewer-gas, 189 diseases produced by, 190 symptoms due to, 189

Sewers, characters of efficient, 224 public, 224 ventilation of, 224

Sewer-traps, test as to their efficiency, 190 varieties, 191

Sex, influence of, on causation of cerebro-spinal meningitis, 802 of diphtheria, 680 of erysipelas, 630 of idiopathic parotitis, 620 of influenza, 860 of leprosy, 789 of pertussis, 839 of the plague, 775 of rabies and hydrophobia, 880 of relapsing fever, 371 of rötheln, 583 of variola, 436 typhoid fever, 243 relation of, to causation of rubeola, 563

Silver nitrate, use of, in typhoid fever, 332

Simon's triangles, 437

SIMPLE CONTINUED FEVER, 231 Definition, 231 Synonyms, 231 History, 231 Etiology, 232 Symptoms, 233 Asthenic form, 233 Morbid anatomy, 235 Diagnosis, 234 From typhoid fever, 234 From typhus fever, 234 From relapsing fever, 235 From tubercular meningitis, 235 Prognosis, 235 Treatment, 236

Simple form of yellow fever, treatment, 649

Singultus in pyæmia, 975 in septicæmia, 977 significance of, in general diagnosis, 158

Skin, alterations in sensibility of, in cerebro-spinal meningitis, 808 anæsthesia of, in beriberi, 1039 appearance of, in typhoid fever, 273 character of lesions in erysipelas, 631 chronic diseases of, following rubeola, 574 color of, in cholera, 737 condition of, in cholera, 736 in influenza, 866 in septicæmia, 977 coolness of, in cerebro-spinal meningitis, treatment, 831 diseases of, complicating vaccination, 471 effects on course of erysipelas, 634 following vaccination, 471 disorders of, complicating rubeola, 570 eruptions of, complicating cholera, 735 in pyæmia, 974 erysipelas of, migration, 632 hyperæsthesia of, in typhus fever, 352 lesions of, in erysipelas, 635 course of, 631 in leprosy, 791 in remittent fever, 603 in rubeola, 575 morbid anatomy of lesions of, in variola, 446 odor of, in typhoid fever, 273 in typhus fever, 352 significance of color of, in general diagnosis, 159 swelling of, in erysipelas, 632

Skunk-bites as cause of rabies and hydrophobia, 889

Slaking lime, use of, in diphtheria, 703

Sleep, danger of prolonged, in nasal diphtheria, 712

Sleeplessness in idiopathic parotitis, treatment, 625

Small-pox, 434 black, 442 freedom of liability to, from race-protection, 130

Sodium benzoate, use of, in pertussis, 847 chloride, venous injection of, in cholera, 762, 768 hyposulphite, use of, in relapsing fever, 428 salicylate, use of, in diphtheria, 707 in puerperal fever, 1032 in scarlet fever, 543 in typhoid fever, 330 sulpho-carbolate as a prophylactic in scarlet fever, 537

Softening, cerebral, from embolism, 65 mucous, 82

Soil, character of, as cause of disease, 187 composition of, 187 diminished dryness of, a cause of phthisis, 187 drainage of, for prevention of anthrax, 937 of disease, 226 examination, 188 filtering power, 187 humidity of, as a cause of cholera, 722

Soils, alkaline, relation of, to causation of anthrax, 930

Soil-pipes, importance of position of, 188 tests as to their efficiency, 190 ventilation of, 189

Solitary glands, lesions of, in typhoid fever, 261

Spasm of pharyngeal and respiratory muscles in hydrophobia, 899

Special senses, perversion of, in relapsing fever, 386 in typhus fever, 349

Specific origin of anthrax, 720, 726 of cholera, 727 of glanders, 911 of rötheln, 583 of yellow fever, 640

Speech, impairment of, following cerebro-spinal meningitis, 820

Spinal cord, lesions of, in cerebro-spinal meningitis, 823 marrow, lesions of, in cholera, 746 rigidity in cerebro-spinal meningitis, 809

Spirillum, 142 of relapsing fever, 373

Spleen, condition of, in relapsing fever, 391 enlargement of, in pyæmia, 976 lesions of, in anthrax in animals, 935 in man, 942 in cholera, 746 in diphtheria, 687 in glanders, 922 in hydrophobia, 903 in pyæmia, 969 in relapsing fever, 416 in remittent fever, 602 in septicæmia, 972 in typhoid fever, 264 in typhus fever, 357 rupture of, in relapsing fever, 403

Spontaneous cow-pox, 456 origin of pyæmia, 959 of typhoid fever, 254

Stages of yellow fever, 645

Standards of purity of water, 184

Starvation and over-crowding as causes of relapsing fever, 370

Steam, use of, in diphtheria, 701

Sthenic inflammation, 46

Stimulants, use of, in diphtheria, 695 in relapsing fever, 431 in rubeola, 580 in variola, 453

Stomach, lesions of, in cholera, 743 state of, in remittent fever, 602

Stools, as a medium of disseminating typhoid fever, 249 character of, in cholera, 739 in pyæmia, 976 in typhoid fever, 287 in typho-malarial fever, necessity of disinfecting, 619 necessity of disinfection in prevention of typhoid fever, 321 significance of, in general diagnosis, 163

Strabismus in cerebro-spinal meningitis, 810

Straw-fungus, relation of, to rubeola, 558

Strychnia, use of, in diphtheritic paralysis, 713 in dry beriberi, 1043

Stupor in typhoid fever, treatment, 334 in typhus fever, treatment, 366

Subsoil-water, level of, 188

Sudamina in typhoid fever, 274 in typhus fever, 352

Sulphites and hyposulphites, use of, in pyæmia, 982 in septicæmia, 983

Sulphur, use of, in diphtheria, 709

Summer heats, relation of, to causation of rabies and hydrophobia, 887

Suppuration in idiopathic parotitis, treatment, 625 influence of minute organisms in production of, 144

Suppurative stage of variola, 439

Surgical scarlatina, 495 treatment of erysipelas, 638

Swelling of parotid glands in cerebro-spinal meningitis, 814

Swellings, significance of, in diagnosis, 159

Sweating stage of intermittent fever, 593 of intermittent fever, treatment, 597

Symptomatic parotitis, 625

Symptomatology, general, 148

Symptoms at decline of eruptive stage of rubeola, 567 constitutional, of vaccinia, 459 due to sewer-gas, 189 general, of idiopathic parotitis, 623 of anæsthetic form of leprosy, 791 of tubercular form of leprosy, 790 of confluent small-pox, 441 local, of anthrax, 935, 940 of idiopathic parotitis, 621 anæsthetic form of leprosy, 790 of glanders, 914, 915, 921 of tubercular form of leprosy, 789 nervous, in mild scarlet fever, 503 in typhus fever, 348 special, in typhus fever, 347 of anthrax in animals, 934 in man, 940 angina, 941 intestinalis, 941 of malignant anthrax, 940 of beriberi, 1039 of cerebro-spinal meningitis, 806 of cholera, 731 of comatose form of pernicious malarial fever, 608 of dengue, 884 of diphtheria, 667 of endometritis and endocolpitis of puerperal fever, 1005 of erysipelas, 631 of glanders in horses, 914 in man, 920 of hydrophobia, in man, 898 of influenza, 865 of idiopathic parotitis, 621 of intermittent fever, 592 of gangrene foudroyante, 977 of general peritonitis of puerperal fever, 1010 of leprosy, 789 of malignant scarlet fever, 507 of para- and perimetritis in puerperal fever, 1005 of pertussis, 840 of the plague, 777 of puerperal fever, 1004 of pyæmia, 972 of rabies and hydrophobia in dogs, 895 of relapsing fever, 374 of remittent fever, 599 of rötheln, 585 of rubeola, 563 of scarlet fever, 502 of septicæmia, 976 lymphatica of puerperal fever, 1011 venosa of puerperal fever, 1012 of simple continued fever, 233 of symptomatic parotitis, 626 of typho-malarial fever, 615 of typhoid fever, 268 of typhus fever, 346 of vaccinia, 458 of varicella, 481 of variola, 436 of varioloid, 443 of yellow fever, 644

Synonyms of anthrax, 926 of cerebro-spinal meningitis, 795 of cholera, 715 of dengue, 879 of diphtheria, 656 of erysipelas, 629 of glanders, 909 of influenza, 851 of leprosy, 785 of the plague, 771 of rabies and hydrophobia, 886 of relapsing fever, 369 of rötheln, 582 of rubeola, 557 of simple continued fever, 231 of typhoid fever, 237 of typhus fever, 338 of vaccinia, 455 of vaccination, 465 of varicella, 481 of variola, 434 of yellow fever, 640

Syphilis, complicating vaccination, 469 modes of preventing, 470 treatment of, 471 constitutional, hereditary nature of, 127

T.

Tâches bleuâtres in typhoid fever, 275 in typhus fever, 352

Tarnier's maternity pavilions for prevention of puerperal fever, 1028

Taste, modifications of, in typhoid fever, 280 significance of modification, in general diagnosis, 162

Technics of vaccination, 472

Teeth, significance of condition, in diagnosis, 152

Temperature in anthrax in man, 940 at decline of eruptive stage of rubeola, 567 elevated, influence of, in origin and spread of cholera, 720 in cerebro-spinal meningitis, 815 in cholera, 736 in dengue, 881 in eruptive stage of rubeola, 565 in erysipelas, 633 in fevers, 38-40 in general peritonitis of puerperal fever, 1010 in idiopathic parotitis, 623 in influenza, 864 in malignant scarlet fever, 507 in mild scarlet fever, 505 in para- and perimetritis in puerperal fever, 1006 in prodromal stage of rubeola, 564 in pyæmia, 974 in relapsing fever, 378, 382 in remittent fever, 599 in rötheln, 587 in septicæmia, 977 venosa of puerperal fever, 1012 in typhoid fever, 280 in typhus fever, 349 significance of, in general diagnosis, 158 respiration and pulse, relations of, in relapsing fever, 386

Tenderness, muscular, in beriberi, 1039

Teratoid tumors, 124

Test, peppermint, for defects in plumbing, 198

Tests as to efficiency of soil-pipes, 190

The plague, 771

Thermometer, use of, in typhoid fever, 284

Thirst in cerebro-spinal meningitis, 814 in rabies and hydrophobia, 899 in relapsing fever, 389 in typhoid fever, 285 in typhus fever, 350 treatment, 367 significance of, in general diagnosis, 162 treatment of, in cholera, 770

Throat symptoms, complicating scarlet fever, 511

Thoracic duct, obstruction of, as cause of dropsy, 69

Thrombi, action of, in production of metastatic abscesses in pyæmia, 965 calcification of, 60, 89 in uterine pelvic veins, 989 growth of, in puerperal fever, 989

Thrombosis, 56 relation of, to causation of pyæmia, 957 and embolism, 56 causes, 57 symptoms, 66 in relapsing fever, 402 in typhoid fever, treatment, 335

THROMBUS, 56 Calcification, 60, 88 Characteristics, 59 Changes, 60 Composition, 56 Distinguished from thrombosis, 56 From compression, 58 From death of leucocytes, 57 From dilatation, 58 From marasmus, 59 From traumatism, 58 Mechanical effects, 62 Organization, 60 Softening, 61 Varieties, 57, 58

Tongue, condition of, in cerebro-spinal meningitis, 813 in dengue, 881 in erysipelas, 633 in idiopathic parotitis, 622 in mild scarlet fever, 504 in typhus fever, 350 in yellow fever, 644 state of, in pyæmia, 975 in relapsing fever, 389 in remittent fever, 600 in septicæmia, 977 in typhoid fever, 285 signification of state of, in diagnosis, 152

Tracheal diphtheria, prognosis of, 692

Trachea, formation of diphtheritic membrane in, 671

Tracheotomy in diphtheria, prognosis of, 692

Transmission of cholera, 721, 723 of variola, 435

Transudation, 68 causes, 69 mechanism, 68

Traps, ventilation, 221

Traumatic fever, relation of, to septicæmia, 961 fevers, 37

Treatment of anthrax in animals, 938 in man, 943 preventive, of anthrax, 936, 943 of beriberi, 1042 of cerebro-spinal meningitis, 829 of cholera, 759 of dengue, 885 of diphtheria, 694 general, importance of, in diphtheria, 695 of erysipelas, 636 of idiopathic parotitis, 624 local, of idiopathic parotitis, 625 of intermittent fever, 594 of leprosy, 793 local, of leprosy, 794 of comatose form of pernicious malarial fever, 609 of glanders in horse, 918 in man, 924 preventive, in horse, 919 in man, 925 of influenza, 873 of pertussis, 844 of the plague, 782 of puerperal fever, 1028 of septicæmia, 983 of pyæmia, 979 of rabies and hydrophobia, 903 preventive, 903 of relapsing fever, 426-433 of remittent fever, 603 of rötheln, 587 of rubeola, 578 hygienic, of rubeola, 579 preventive, of rubeola, 578 of scarlet fever, 536 of septicæmia, 982 of simple continued fever, 236 of symptomatic parotitis, 627 local, of symptomatic parotitis, 628 of typhoid fever, 320 of typho-malarial fever, 618 of typhus fever, 361 of variola, 451 hygienic, of variola, 451 of variola, preventive, 451 of varioloid, 451 of yellow fever, 649

Treeak farook, use of, in wet beriberi, 1042

TUBERCLE, 94 Calcification, 96 Cheesy degeneration, 96 Fibrous transformation, 96 Histology, 95 Horn-like change, 96 Infectious origin, 97 Inoculability, 97 Miliary and gray, cause of infectious qualities, 99 Origin of, from absorption of cheesy products, 97

Tubercular form of leprosy, 789

TUBERCULOSIS, 94 Bacilli of, 99, 100 et seq. Dissemination, 103 Hereditary nature, 101 Primary seat, 104 Relation of, to pearly distemper, 99 to scrofula, 101

Tuberculosis, acute miliary, complicating rubeola, 572 chronic pulmonary, following rubeola, 573 general miliary, following relapsing fever, 404 following rubeola, 574 relation of, to pearly distemper, 99 to scrofula, 96, 101

TUMORS, 105 Method of origin, 106 Cohnheim's theory of origin, 106 Influence of irritants in producing, 108 Growth, 109 concentric, 109 continuous, 109 eccentric, 109 influence of seat, 109 rapidity, 109 Primary, 110, 111 Secondary, 110, 112 Metastasis, 110 Multiple, 110 Recurrence, 110 Transplantation, 110 Embolic nature, 112 Changes occurring, 113 inflammatory, 113 Analogy of structure in primary and secondary, 113 Benignant, 114 Cachexia, 114 Malignant, 114 Resemblance of, to normal tissue of body, 115 Histoid, 116 Organoid, 116 Relation of, to each other, 117 Connective tissue, 118, 122 Cystic, 115, 116, 121 Influence of age upon development, 119 Classification, 114, 121 Infective group, 120, 124 Epithelial group, 123 Congenital, 124

Turpentine inhalations in diphtheria, 704 stupes, use of, in puerperal fever, 1032 use of, in typhoid fever, 326

Tympanites in remittent fever, treatment, 605 in typhoid fever, 286 treatment of, 332 in typho-malarial fever, treatment, 619 in typhus fever, 350

Tympanum, paracentesis of, in scarlet fever, 548

Types of cerebro-spinal meningitis, 804 of intermittent fever, 594 of scarlet fever, 494 of varioloid, 444

TYPHOID FEVER, 237 Synonyms, 237 Definitions, 237 History, 238 Geographical distribution, 241 Etiology, 242 Predisposing causes, 242 Age, influence of, 242 Sex, influence of, 243 Occupation, influence of, 244 Change of residence, influence of, 244 Idiosyncrasy, influence of, 245 Depressing emotions, influence of, 245 Intemperance, influence of, 245 Previous ill-health, influence of, 245 Season, influence of, 245 Elevated temperature, influence of, 246 Rise and fall of subsoil-water, influence of, 247 Exciting causes, 248 Contagiousness, 248 Dissemination, 249 Cases illustrating modes of dissemination, 250 Dissemination of, by drinking-water, 248 By stools, 249 By milk, 252 By atmosphere, 252 By bed-linen, etc., 253 By polluted soil, 253 By putrefied flesh, 257 Spontaneous origin, 254 Duration of virulence of germs, 256 Bacillus typhosus, 258 Incubation period, 259 Morbid anatomy, 260 Lesions peculiar to, 261 Changes in Peyer's patches, 261 Solitary glands, 261 Softening of Peyer's patches and solitary glands, 263 Cicatrization of Peyer's patches and solitary glands, 263 Changes in cæcum and colon, 263 Spleen, 264 Abdominal glands, 264 Lesions not peculiar to, 265 Changes in liver and gall-bladder, 265 Pharynx and oesophagus, 265 Larynx and lungs, 266 Brain and membranes, 266 Muscles, 267 Heart and blood-vessels, 267 Blood, 268 Salivary glands, 268 Kidneys, 268 Symptoms, 268 Clinical description, 268 Physiognomy, 272 Epistaxis, 273 Condition of skin, 273 Odor, 273 Eruption, 273 Sudamina, 274 Tâches bleuâtres, 275 Condition of hair and nails, 275 Pulse, 275 Heart-sounds, 276 Respiration, 276 Frequency of bronchitis, 277 Mental condition, 277 Headache, 277 Delirium, 278 Muscular spasm, 279 tremor, 279 Modifications of sensibility, 279 Hearing, 280 Vision, 280 Taste, 280 Temperature, 280 State of tongue, 285 Fauces, 286 Nausea and vomiting, 285 Anorexia, 285 Thirst, 285 Gurgling, 286 Meteorism or tympanites, 286 Diarrhoea, 287 Character of stools, 287 Intestinal hemorrhage, 287 frequency, 288 causes, 288 importance, 288 Intestinal perforation, 289 frequency, 290 causes, 290 date of appearance, 290 importance, 289 Condition of urine, 291 amount of solids, 291 presence of albumen, 292 Complications and sequelæ, 292 Complicated by pyæmia, 294 Laryngitis, 294 Bronchitis and pneumonia, 294 Pleurisy, 294 Jaundice, 295 Peritonitis, 295 Catarrhal and diphtheritic inflammation of fauces, 295 Parotid swelling, 296 Menstrual disorders, 296 Pregnancy, 296 Suppuration of Bartholini's glands, 296 Periostitis, 297 Oedema, 297 Bed-sores, 297 Followed by impaired intellect, 292 Perversion of the moral sense, 292 Paralysis and chorea, 293 Cardiac degeneration, 293 Arterial thrombosis, 293 Venous thrombosis, 294 Gangrene of vulva and vagina, 293 Hepatic abscess, 295 Tendency to stoutness, 298 Varieties of, 298 Abortive form, 298 Latent form, 300 In children, 301 In aged persons, 302 Relapses in, 302 frequency, 302 course, 303 cases illustrating, 304 causes, 308 Duration, 310 Diagnosis, 311 From typhus, 311 From influenza, 312 From relapsing fever, 312 From epidemic cerebro-spinal meningitis, 313 From simple continued fever, 313 From remittent fever, 312 From the eruptive fevers, 313 From acute tuberculosis, 313 From trichinosis, 314 From the specific inflammations, 314 From acute tubercular meningitis, 314 Prognosis, 314 Symptoms indicating unfavorable, 314 favorable, 316 Influence of hyperpyrexia upon, 314 Nervous symptoms, 315 Heart symptoms, 316 Condition of pulse, 316 Abdominal symptoms upon, 316 Mortality, 316 Tables showing, 317, 318 Influence of season, 318 Sex, 319 Age, 319 Treatment, 319 Habits, 320 Social condition, 320 Recent residence, 320 Corpulence, 320 Organic disease, 320 Childhood, 320 Treatment, 320 Preventive, 321 Necessity of proper drainage in prevention, 321 Disinfection of stools, 321 Hygienic, 322 Importance of ventilation, 323 administering water, 325 Diet, 323 Mild cases, 326 Hyperpyrexia, 327 by cold baths, 327-329 Typho-malarial form, 331 Vomiting, 331 Diarrhoea, 331 Tympanites, 332 Intestinal hemorrhage, 332 perforation, 333 Constipation, 333 Headache, 334 Insomnia, 334 Stupor, 334 Delirium, 334 Albuminuria, 334 Complications, 335 Epistaxis, 335 Pneumonia, 335 Hypostatic congestion of lungs, 335 Thrombosis and embolism, 335 Bed-sores, 335 Convalescence, 335 Use of alcohol, 324 Digitalis, 330 Eucalyptus, 331 Quinia, 330 Silver nitrate, 332 Sodium salicylate, 330 Turpentine, 326 Specific, 336 By calomel, 336 By iodine, 336, 337 Use of thermometer, 284

Typhoidal inflammation, 47

Typhoid state of cholera, 734 following variola, 445

TYPHO-MALARIAL FEVERS, 614 Definition, 614 Frequency, 616 Symptoms, 615 Diagnosis, 616 Prognosis, 616 Mortality, 616 relative mortality of white and black races, 616 Treatment, 618 Of typhoidal element, 618 Of malarial element, 618 Use of quinia, 618 Depurative treatment, 618 Necessity of disinfection of stools, 619 Of tympanites, 619 Of insomnia, 619 Diet, 619

Typho-malarial form of typhoid fever, treatment, 331

TYPHUS FEVER, 338 Synonyms, 338 History, 338 Etiology--Predisposing causes, 341 Over-crowding as a cause, 341 Age, influence of, 342 Debility and fatigue, influence of, 342 Mental and physical overwork, 342 Intemperance, 342 Poverty, 342 Barometric and thermometric variations, 343 Season, 343 Occupation, 343 Individual susceptibility to, 343 Exciting causes, 343 Contagiousness, 343 Nature of contagion, 343 Modes of transmission of contagion, 344 Communication of, by fomites, 345 Period of contagiousness, 345 Spontaneous origin, 345 Period of incubation, 346 Symptoms--Clinical description, 346 Special symptoms, 347 Prostration, 348 Nervous symptoms, 348 Appearance of face, 348 Intellectual condition, 348 Headache, 348 Delirium, 348 Wakefulness, 349 Coma vigil, 349 Perversion of special senses, 349 Muscular tremor, 349 Temperature, 349 Condition of tongue, 350 Anorexia, 350 Thirst, 350 Nausea and vomiting, 350 Condition of bowels, 350 Tympanites, 350 Gurgling, 350 Eruption, 351 Duration of eruption, 351 Tâches bleuâtres, 352 Sudamina, 352 Hyperæsthesia of skin, 352 Odor, 352 Condition of pulse, 351 of heart, 351 Respiration, 352 Pneumonia, 353, 355 Bronchitis, 353, 355 Odor of breath, 353 Hypostatic congestion of lungs, 353 Changes in urine, 353 Varieties of, 353 Mild form, 354 Severe form, 354 Ataxic form, 354 Adynamic form, 354 Ataxo-adynamic form, 354 Inflammatory form, 354 Walking form, 354 Abortive form, 354 Complications and sequelæ, 354 Complicated by erysipelas, 355 Cardiac degeneration, 355 Bronchitis and pneumonia, 353, 355 Pleurisy, 355 Albuminuria, 355 Bed-sores, 355 Scurvy, 355 Dysentery, 355 Jaundice, 356 Parotitis, 356 Serous inflammations, 356 Pyæmia, 356 Disorders of menstruation, 356 Miscarriage, 356 Followed by pulmonary gangrene and phthisis, 355 Morbid anatomy, 356 Alteration of blood, 356 Changes in respiratory organs, 356 Heart and membranes, 357 Liver and kidneys, 357 Spleen, 357 Intestinal tract, 357 Brain and membranes, 358 Diagnosis, 358 From typhoid fever, 358 From meningitis, 358 From measles, 358 From typhoid pneumonia, 359 From delirium tremens, 359 From purpura, 359 Prognosis of, 359 Symptoms indicating favorable, 360 unfavorable, 360 Influence of age, 359 Sex, 359 Former habits, 359 Convalescence from previous illness, 359 Obesity, 359 Mental and physical overwork, 360 Social condition, 360 Race, 360 Mortality, 360 Difference of, in hospital and private cases, 361 Treatment, 361 Preventive, 361 Necessity of isolation, 361 Disinfection, 362 Diet, 362 Quantity of nourishment necessary, 363 Futility of abortive treatment, 363 General treatment, 364 Mild cases, 364 Hyperpyrexia, 364 By cold water, 364 By cold baths, 364 Mode of using cold bath, 364 Prostration, 365 Headache, 366 Delirium, 366 Insomnia, 366 Stupor, 366 Urinary complications, 366 Thirst, 367 Vomiting, 367 Constipation, 367 Parotitis, 367 Pulmonary complications, 367 Use of alcohol in, 366 Opium in, 366 Quinia in, 365 Of convalescence, 368 Necessity of continuing stimulants during convalescence, 368

Tyrosis, 79

U.

Ulceration, complicating vaccination, 468

Ulcers, complicating cholera, 735 following the plague, 781

Umbilication in vaccinia, mechanism of, 464 in varicella, 482 in variola, 438 cause of, 447

Uræmia in scarlet fever, 530

Urinary complications in typhus fever, treatment, 366

Urine, analysis of, importance in general diagnosis, 165 condition of, in cerebro-spinal meningitis, 814 in cholera, 739 in dengue, 881 in influenza, 866 in mild scarlet fever, 506 in grave form of the plague, 779 in pertussis, 841 in pyæmia, 976 in relapsing fever, 387 in remittent fever, 602 in typhoid fever, 291, 292 in yellow fever, 644 suppression of, complicating relapsing fever, 407 in cholera, treatment, 764 in yellow fever, treatment, 653

Urination, difficult, significance of, in diagnosis, 164

Urobilin, 91

Urticaria, complicating diphtheria, 674

Uterus, fixity of, in para- and perimetritis of puerperal fever, 1007 lesions of, in septicæmia, 972

V.

VACCINIA, 455 Definition, 455 Synonyms, 455 History, 458 Etiology, 458 Nature, 455 Variolous origin, 457 Meteorological conditions as a cause, 458 Symptoms, 458 General course, 458 Constitutional, 459 Development of pock, 459 Date of appearance of pock, 459 incrustation of pock, 460 falling off of crust, 460 Description of cicatrix, 460 Irregularities in course, 460 Raspberry excrescence of pock, 461 Lack of elevation in pock, 461 Absence of a constitutional infection, 460 Bryce's test for determining constitutional infection, 461 Diphtheritic pock, 463 Catarrhal pock, 463 Morbid anatomy, 462 Pock, 463 Microspheres and vaccinals of lymph, 463 Microscopical characters of the lymph, 463 Mechanism of umbilication, 464 Composition of crust, 464 Complications and sequelæ, 464

VACCINATION, 465 Synonyms, 465 History of, 465 Protective power of, 461 theories regarding, 461 duration of, 468 against pertussis, 468 Marson's theory of multiple insertions, 467 Time of revaccination, 467 As a means of destroying nævi, 468 Complications, 468 Simple inflammatory, 468 Complicated by dermatitis, 468 Treatment of dermatitis, 469 Complicated by lymphangitis and adenitis, 468 By ulceration and gangrene, 468 Erysipelas, 469 treatment, 469 Complicated by syphilis, 469 treatment, 471 Modes of preventing transmission of syphilis, 470 Complicated by skin diseases, 471 by eczema, 472 Impetigo contagiosa, its relations to, 472 Followed by cutaneous affections, 471 by eczema, 472 Conveyance of constitutional taints in, 471 Technics of, 472 Varieties of virus, 472 Primary vaccine, 473 Horse-pox vaccine, 473 Retro-vaccine, 473 Bovine vaccine, 473 Variola vaccine, 473 So-called points of superiority of humanized vaccine, 473 Relative merits of animal and humanized vaccine, 473 Advantages of animal over humanized virus, 475 Forms of vaccine, 476 Objections to use of crust, 476 Use of dried lymph, 477 liquid or tube lymph, 476 Proper season, 477 Age, 477 Part of body most suitable for, 477 Modes of operating, 478 applying the virus, 478 Storage and preservation of virus, 479 Proper time of collecting lymph for storage, 479 Proper manner of transporting, 480

Vaccination, neglect of, as a cause of variola, 436

Vaccine virus, varieties of, 472 use of, in treatment of rabies and hydrophobia, 907

Vagina, symptoms of diphtheria of, 674

Vaginal injections, use of, for prevention of puerperal fever, 1025

Variations, barometric, influence of, upon course of diseases, 134

VARICELLA, 481 Definition, 481 Synonyms, 481 History, 481 Etiology, 481 Contagiousness, 481 Symptoms, 481 Period of incubation, 482 General, 482 Prodromal stage, 482 Eruption, 482 Umbilication of eruption, 482 Date of appearance of desiccation, 482 Frequency of scarring, 482 Appearance of vesicles on mucous membrane, 483 Morbid anatomy, 483 Complications, 483 Diagnosis, 483 From variola and varioloid, 484 From vaccinia, 484 From impetigo, 483 contagiosum, 483 From eczema pustulosum, 483 Prognosis, 484 Treatment, 485

Varicella Prurigo, nature, 484

Varieties of beriberi, 1039 of grease-traps, 221 of pernicious malarial fever, 606 of rubeola, 568 of sewer-traps, 191 of typhoid fever, 298

VARIOLA, 434 Definition, 434 Synonyms, 434 History, 434 Etiology, 435 Contagiousness, 435 Nature of contagium, 435 Mode of entrance of contagium, 435 Duration of activity of contagium, 435 Period of greatest activity of contagium, 435 Modes of transmission, 435 Race, influence of, 436 Season, influence of, 436 Sex, influence of, 436 Neglect of vaccination as a cause, 436 Individual idiosyncrasy, 436 Protection from, by previous attacks, 436 Effect of pre-existing skin disorders, 436 Symptoms, 436 Stage of incubation, 436 Invasion, 436 Variolous rash, 437 date of appearance, 437 significance, 437 Simon's triangle, 437 Stage of invasion, 438 Eruptive stage, 438 Characters of eruption, 438 Position of eruption, 438 Stage of vesication, 438 Umbilication, 438 Maturation, 439 Characters of mature pock, 439 Condition of patient in suppuration stage, 439 Pustules on mucous surfaces, 439 Stage of desiccation, 439 General, during desiccation, 440 Secondary fever, 439 Date of appearance of secondary fever, 439 Confluent variety, 440 Seat of lesion, 441 Condition of mucous surfaces in confluent, 441 General condition in confluent, 441 Hemorrhagic variety, 442 First form, 442 Second form, 443 Lesions of, 443 Variolic purpura, 442 Complications and sequelæ, 445 Complicated by eye diseases, 445 Erysipelas, 445 Nasal inflammation, 445 Furuncles and abscesses, 445 Muscular paralysis and hemiplegic attacks, 445 Laryngitis, 446 Gangrene of genitalia, 446 Followed by a typhoid state, 445 Pathology and morbid anatomy, 446 Cutaneous lesions, 446 Formation of papule, 446 Vesicle, 446 Cause of umbilication, 447 Repair of pock, 447 Hemorrhagic variety, 447 Changes of viscera, 447 Diagnosis, 447 From measles, 448 From scarlatina, 449 From pustular skin diseases, 449 From dermatitis medicamentosa, 449 From syphiloderm, 449 From acneform disease, 449 From typhoid fever, 450 From typhus fever, 450 Prognosis, 450 Symptoms indicating unfavorable, 450 Influence of sudden defervescence of eruption, 450 Pregnancy and childbed, 450 Fatality of, in the unvaccinated, 450 Influence of vaccination after development, 451 Treatment, 451 Preventive, 451 Hygienic, 451 Necessity of cleanliness, 454 Invasion stage, 452 Eruption, 452 Exclusion of sunlight for prevention of pitting, 452 Use of warm baths, 453 Hot water compresses, 453 Stimulants, 454 Hemorrhagic form, 454 Disposition of clothes and body after death, 454

Variola of vaccine, 473

Variolic purpura, 442

VARIOLOID, 443 Symptoms, 443 Invasion stage, 443 Eruption, 444 Types of, 444 Identity with variola, 444 Treatment, 451

Veins, condition of, in cholera, 737 intestinal, lesions of, in cholera, 745 jugular, thrombi of, in symptomatic parotitis, 626 lesions of, in pyæmia, 967 in symptomatic parotitis, 626

Venesection in cholera, 764 in rabies and hydrophobia, 908 in relapsing fever, 431 futility of, in cerebro-spinal meningitis, 830

VENTILATION, 177 et seq. Defects, 179 Distribution of air, 180 Estimation of carbonic acid in air, 178 Insufficient, evil effects, 181 Importance of, in treatment of typhoid fever, 323 Methods of calculating amount of air-supply, 179 Modes of investigating merits of a plan, 179 Of waste-pipes in drainage, 223 Of soil-pipes, 189 Proper size of flues and registers, 179 Relation of, to heating apparatus, 180 Varieties of ventilators, 180 Velocity of air, 180

Ventilators, varieties, 180

Venous emboli, 63 thrombosis, following typhoid fever, 294

Veratrum viride, use of, in puerperal fever, 1033 in scarlet fever, 543 in yellow fever, 651

Vertigo in cerebro-spinal meningitis, 812 in relapsing fever, 384 significance of, in general diagnosis, 158

Vesication in variola, 438

Vesicle in variola, morbid anatomy of, 446

Views, earlier, concerning nature of puerperal fever, 990 modern, concerning nature of puerperal fever, 992

Virus of anthrax, period of greatest virulence, 928 of rabies, localization of, in wound, 893 of vaccination, varieties of, 472 vaccine, manner of transporting, 480 storage, 479

Viscera, lesions of abdominal, in the plague, 781 in cerebro-spinal meningitis, 824 in erysipelas, 635 in variola, 447

Vision, modifications of, in relapsing fever, 399 in typhoid fever, 280

Vital statistics, registration, 208

Voice, alteration of, in diagnosis, 158

Vomit, character of, in cerebro-spinal meningitis, 813 in cholera, 738 in grave form of the plague, 779

Vomiting during intermittent fever paroxysm, 593 in cerebro-spinal meningitis, 813 in cholera, 738 treatment, 761 in diphtheria, treatment, 694 in general peritonitis of puerperal fever, 1010 in mild scarlet fever, 503 in para- and perimetritis of puerperal fever, 1007 in pyæmia, 975 in remittent fever, treatment, 605 in rubeola, treatment, 581 in septicæmia, 977 in typhoid fever, 285 treatment, 331 in typhus fever, 350 treatment, 367 in yellow fever, 644 treatment, 652 significance of, in general diagnosis, 162

Vulva, symptoms of diphtheria, 674

W.

Wakefulness in relapsing fever, 384 in typhus fever, 349

Walk, significance of, in diagnosis, 161

Walking form of typhus fever, 354 of yellow fever, symptoms, 654

Washstands, stationary, dangers from, 216

Waste-pipes, effects of large bore in, 220 leakage in, 222 tests for, 222 ventilation, 223

Water, collections of, effect upon public health, 187 fear of, in rabies and hydrophobia, 899 height of subsoil, influence of, on prevalence of cholera, 722 importance of, in treatment of typhoid fever, 325 impure, microscopic characters of, 184 diarrhoeal affections from, 182 disease from, 182 chemical examination of, 183, 184 value of chemical examination of, 183, 184 impurity of, from metallic salts, 182 from organisms, 184 nature of impurities, 182 polluted, as a cause of diphtheria, 683 stagnant, production of malaria by, 187 standards of purity, 184 subsoil, level of, 188 supply, contamination of, from privy-vaults, 192 cess-pools, 192 chloride test for detecting impurities in, 192 tables of analyses, 184 use of, in diphtheria, 702

Water-closets, defects of, 217 location, 218 varieties, 191 ventilation, 192, 217

Waxy degeneration, 84

Welch on cause of oedema of lungs, 72

Wet form of beriberi, symptoms, 1040 treatment, 1042

Whooping cough, 836 relation of, to rubeola, 561

Winds, influence of, on spread of influenza, 860

Wound, appearance of, in rabies and hydrophobia, 895, 899 changes in, in pyæmia, 976 condition of, in septicæmia, 977 influence of characters of, in causation of pyæmia, 958 treatment of, in pyæmia, 981 in septicæmia, 983

Wounds, diphtheria of, 673

Y.

YELLOW FEVER, 640 Synonyms, 640 Definition, 640 Etiology, 640 Specific origin, 640 Poison of, inconvertibility, 840 Birthplace, 641 Characteristics, 641 Ponderability, 641 Vitality, 641 Influence of heat and cold on development, 641 Impossibility of transportation of, by air, 641 Transportability of, by fomites, etc., 641 Nature of fomites, 641, 642 Fixity of, 643 Slowness of extension, 643 Medium of admission to system, 642 Localization of epidemics by atmospheric impregnation, 642 Anxiety, grief, and fatigue as causes, 643 Insusceptibility, in negroes, 644 from idiosyncrasy, 643 Protective power of previous attacks, 643 Duration of incubation period, 643 Symptoms, 644 Mild cases, 644 Initial, 644 Physiognomy, 644 Neuralgia and muscular pains, 644 Cerebral, 644 Condition of tongue, 644 Gastro-intestinal canal, 644 Vomiting, 644 Character of matters vomited, 644 Condition of urine, 644 Pulse, 644 Relation of pulse to temperature, 645 Perspiration, 645 Stages, 645 Masked forms, 653 Walking forms, 654 Paroxysmal stage, 645 Calm stage, 645 Hemorrhages and jaundice, 646 Prognosis, 646 Symptoms indicating unfavorable, 646 Influence of crowding the sick, 646 Pregnancy and parturition, 647 Condition of patient at time of attack, 647 Temperature, 647 In hospital cases, 647 Mortality, 647 Variableness, 647 Difference in hospital and private cases, 648 Diagnosis, 648 Significance of physiognomy, 648 State of pulse, 648 Albuminous urine, 648 Hemorrhagic tendency, 648 Yellow discoloration of skin, 648 Morbid anatomy, 649 Changes in liver, 649 Treatment, 649 Futility of abortive, 649 Importance of early, 649 Indications for, 649 Simple form, 649 Early stages, 649 Diaphoresis, 650 Jaborandi, 650 Neuralgias and muscular pains, 651 Hyperpyrexia, 651 by cold, 651 Hemorrhages, 651 by tincture of iron, 652 Nausea and vomiting, 652 Urinary suppression, 652 Failure of reaction from cold stage, 653 Convulsions and delirium, 653 Use of digitalis, 651 Aconite, 651 Veratrum viride, 651 Gelsemium, 651 Hæmostatics, 652 Quinia, 650, 651 Quinia and opium in combination, 651 Hygienic, 654 Necessity of absolute rest, 654 Diet, 654 Children, 655 Typhoid cases, 655 Time of return to solid food, 655

Z.

Zymosis, meaning of term, 137

Zymotic diseases, relation of, to puerperal fever, 1020 table, 136

END OF VOL. I.

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