CASE 118.—Remittent fever followed by
typhoid.—Private A. Whipple, Co. A, 4th Mich.
Vols.; age 19; was admitted Oct. 30, 1861,
as a case of remittent fever. On October 8 he had chills and
fever which continued a week, with weakness, anorexia,
nausea and vomiting, and during this period he felt better
in the morning than in the evening. He was treated with
quinine, rhubarb and capsicum. On admission his cheeks were
slightly flushed, countenance calm, eyes bright,
conjunctivæ yellow, pulse 99, full and strong, skin
yellow, warm, dry, soft and without eruption or sudamina,
tongue moist, red at the tip and coated grayish in the
centre, appetite deficient; the bowels were moved five
times, and there was abdominal tenderness with slight
gurgling but no meteorism. Calomel and full doses of quinine
were prescribed. During the night the patient was delirious
at times, and on the following day he had some deafness and
tinnitus aurium. The quinine was continued and the calomel
omitted. On November 1 the tongue was moist, pale and coated
somewhat in the centre and at the base. Next day two
rose-colored spots were noticed and sordes appeared on the
teeth. Milk-punch, beef-essence and turpentine emulsion were
prescribed. On the 4th the patient's condition was
unchanged; he was very delirious, his face much flushed,
pulse 98 and strong, skin very hot and showing some
rose-colored spots, tongue dry in the centre but moist at
the edges; he had no cough, but mucous and sibilant rales
were heard in some parts of the chest; the bowels were moved
by an enema of castor oil and turpentine and the tympanites
which had been present was thereby reduced. He was dull and
stupid on the 5th and had subsultus tendinum. Next day some
petechial spots appeared. No further details are given. The
patient was transferred to Annapolis, Md., on the 18th.