Foreign Department

Abstract

asserted by Louis to be characteristic of typhoid fever in its acute form, and of phthisis in the chronic, cannot, I think, be considered as strictly pathognomonic, as I once met with a fatal case of ulceration of the glands and perforations of the intestines in an infant only eight dAys old. In this instance, after the meconium had been passed, there was jaundice, tympanitis, and obtipation; and after death there was found peritonitis, from effusion of yellow faeces through a perforation of an agminate gland, just above the ceecum, which was also ulcerated, as well as the other Peyerian glands, for some distance up the ileum. Neither Drs. Graves, Watson, nor Copland, make any distinction in the lesions of adults and children from continued fever, though the latter, like Louis, asserts that typhoid fever is most common between the ages of 15 and 40 years. None of these authors, however, speak decidedly and expressly upon this point, and therefore I have ventured to make the foregoing remarks as the result of my own experience, with the hope that if they meet the eye of Dr. Merei he may be induced to favour your readers, in a future lecture, with the conclusions he has drawn upon the morbid anatomy of infantile fevers, whether continued or remittent, from the extensive field of observation he has enjoyed at the Childrens' Hospital in Pesth. I do not mean to assert that continued fever in adults is always attended with ulceration of Peyer's glands, for Andral, Dr. Watson, and others, have met with cases in which no lesion of the kind could be discovered, and Dr. Lombard, of Geneva, has attempted to draw a distinction betwee the typhoid fever, thus characterised, and the Irih typhus, attended with petechim and vibices, a distinction, however, not admitted by Dr. Graves; but having invariably found ulcerton of the intestines in infantile continued fever, Which is always attended with more or less diarrhoea, indicative of the progress of the disorganization, it appears to be a most important proof in regard to treatmt, to establish as a rule, that whenever other affections may complicate the course of continued fever in children, inflammation of the glandulb agminate always co-exists, and requires our closest attention to gad against its consequences. I am, Sir, your obedient Servant, T. OGIER WARD. Kensington, August 30, 1852.