Part 10 (1/2)
IV.
_General Considerations on the Ox-Typhus, and the Recapitulation of the Symptoms._
We have seen the causes, the symptoms, and the cadaveric alterations of the Bovine typhus, and we may therefore apply ourselves at present to the consideration of its pathogenia and its nature. Only, the limits of this book will not admit of a complete discussion of every point of this important question of pathology; for if we desired to show in what respect the typhus differs from, and in what respect it resembles, such and such a morbid ent.i.ty, febrile, infectious and contagious like it, such a dissertation would require a whole volume for itself; we are therefore obliged to keep within certain limits.
Like every watchful physician who has applied himself to the study of comparative pathology, we entertained our own preconceived opinions as to the nature of this _Cattle Plague_. Arguing _a priori_ from what we knew, from the laws of the pathogenia of those exanthematic diseases which we have alluded to in a former chapter; from the ident.i.ty of variola in various animals; from the preventive treatment to which this ident.i.ty has led; believing that animals and man have each their typhoid fever, as they have their variola or small-pox; considering with the Ecole de Tours, typhoid fever as a variola of the intestinal mucous membrane, and having proposed, in 1855,[Q] to adopt inoculation as a preventive treatment, drawing an easy comparison between the typhus we are now observing and the typhoid fever in man; hoping, we may say, indeed, to find in this typhus the inoculative and preventive virus which is required for our typhoid fever, all will understand with what eager and vivid curiosity we have examined the entrails of the victims struck down by this epizootia. For, if this typhus had been a genuine typhoid fever, the bovine species which has already provided the preventive virus for small-pox, would equally have afforded us the preventive virus for typhoid fever. In this hypothesis, our proposal to inoculate the typhoid fever, which up to this time has been tried on horses only, and in experiments badly conducted, by pupils of the Veterinary School of Lyons, was perhaps on the eve of being realised.
But we regret to say, we have been forced to submit to evidence, and to acknowledge that the present infectious typhus is not the one we require to provide us with the anti-typhoid virus.
In the same manner as pathologists disagree as to the question, whether the typhus and typhoid fever in man are one and the same disease, so should we long debate, without coming to an agreement, as to that which relates to the typhus and typhoid fever of the ox. We cannot pretend to produce a reconciliation between these dissentient schools; all we desire, is to sum up what observation has suggested to us, on account of the practical and therapeutic interest belonging to the subject.
For ourselves, the typhus and the typhoid fever of the ox are two diseases of the same order, but nevertheless distinct; and the reasons upon which we ground our opinion are suggested to us by the nature of the intestinal lesions, the symptoms, and causes of these distempers.
As we have already seen, the contagious typhus of the ox, at least that of the present epizootia, is an infectious disease, which varies in the intensity of the functional disorders and the cadaveric lesions to which it gives rise. The typhoid fever, we mean the real one,--for there are other intestinal exanthematic fevers which simulate it,--always localize on the small intestines a pustulous exanthem, and in the typhus of the ox, this pustulous exanthem and the ulcerations by which it is succeeded, are frequently wanting.
The real typhoid fever springs up in every country under the influence of local causes, and is not in the same degree infectious and contagious as the typhus proper. In fine, the typhoid fever smites many species of animals--the horse, the pig, etc., without transmitting its contagion with the same intensity.
The contagious typhus of the ox appears to be more especially proper to that animal; for in those lat.i.tudes where it developes itself other animals are not affected by it.
For these reasons, then, to which we could easily add many others, we consider the typhus of the present epizootia a special and distinct type of typhic diseases, and differing from the typhoid fever: it is the highest expression of its cla.s.s, and occupies the first degree in the scale of infectious typhic diseases. Next to it we should place the typhoid fever, which we admit is not often found in the ox. But veterinary pathology is still less understood than human pathology, and typhoid fever may perhaps be recognised in those diseases which the former science has described under the names of _adynamic_ and _ataxic fevers_. Besides, a persistent research among the veterinary memorials and reports might possibly enable us to discover some instances in which the real typhoid fever in the ox had been traced, apart from the epizootic conditions. Here is an instance of it:--
Gelle, in vol. i. page 245 of the _Pathologie Bovine_, quotes the following abstract which had been forwarded to him by one of his brethren, on the dissection of an ox, which was made on the 10th of May, 1824:--
”_Duodenum._--Uniform redness of the mucous membrane, with thickening, softening, and petechial spots. In the middle portion were discovered some of Peyer's glands, small round pustules, whitish at the top, with a reddish circ.u.mference. In some parts contiguous to these pustules lay ulcerations somewhat extensive, which seemed to be the result of the softening of the pustules which had preceded them. A dark pus issued from these ulcerations. The inflammation by which they were attended was diffused in some places, whilst in others it was circ.u.mscribed. In some parts the intestinal mucous membrane was utterly destroyed. The mesenteric glands were red and soft.”
Gelle adds:--”I have recorded this interesting narrative, as it may perhaps serve hereafter to throw light on a point of doctrine.”
The intention which Gelle nurtured at the time, is, we see, now fulfilled conformably with his object.
The contagious typhus of the ox not being a real typhoid fever, we shall not, consequently, be able to borrow from it the preventive virus for that disease in man. But if these diseases differ, and if it is difficult, in the present state of science, to a.s.sign to them such distinct characters as to produce a perfect agreement among all medical writers, we must, however, admit, that to designate the ox-typhus now before us by the generic name of PLAGUE, after the Germans, who have given it the name of RINDERPEST, would carry us too far back.
Let us acknowledge also, that the denomination of _contagious typhus_, adopted by the French veterinary doctors, is not, any more than the designation of TYPHUS FEVER, applied to it by English physicians, totally free from objection.
In truth, the various species of typhus whose characteristics we have already given (see p. 73), are all of them febrile and contagious.
Whoever uses the word _typhus_, speaks of a contagious and febrile malady, inasmuch as we cannot conceive typhus without its accompaniments, fever and contagion. But as the prevailing characteristic of this infectious disease is, above all, its _contagion_, we have preferred to adopt the name of _contagious typhus_, without, however, deceiving ourselves as to the value of the denomination. The final elucidation has not yet been found for these diseases; at some future day they will be methodically divided and arranged, and each of them will then receive a special t.i.tle, which will remove from the mind that vague uncertainty which at present we regret.
But if some faults of doctrine are open to debate, no doubt whatever can exist in the mind as to the morbid individuality of ox-typhus, or the general conditions of its pathogenia; and we are able to deduce from the preceding explanation, the following conclusions as so many propositions definitively settled:--
1st. The typhus of the ox is a disease essentially infectious, which is produced by the absorption of the morbigenous miasma in the air.
2nd. This typhic miasma is absorbed and engendered by the ox, under the influence of a number of special deleterious causes.
3rd. When the miasma has been absorbed and incubation produced, the disease itself is but a supreme effort of nature--a struggle between the vital forces and the morbid evolution of the poison, in order to guard and defend life against the danger which threatens it.
4th. A malady essentially general, _totius substantiae_, it directs its action, in different degrees, over the whole structure, but chiefly on the nervous centres, on the organs of respiration, and on the digestive apparatus.
5th. Its progress is regular; to the latest period of incubation it succeeds that of the general poisoning of the blood--that of the pyrexia of general fever--which for a time stops up all the secretions. Then, the morbid flux is localized according to particular predispositions: either on the nervous centres, when the animal is struck down at the outbreak; or on the lungs, when the respiratory derangements become the leading symptoms; or on the digestive channels, when the train of typhoid phenomena is observable.
6th. The period of acute inflammation, which had dried up the sources of secretion, gives place to that of the depurative and critical exhalations or secretions; from every mucous membrane, from every outlet, there issues a mucous discharge, which at first is thin and clear, but afterwards becomes thick and purulent, and endowed with the most infectious properties. The intestinal mucous membrane, smitten with a particular lesion, becomes the seat of a flux extremely copious and intolerably fetid. Gases, and occasionally purulent deposits, are developed in the cellular tissue beneath the skin.
7th. The organism or physical frame, disturbed in the very centres of life, undergoes a general transformation, a kind of organic decomposition beforehand, and all the symptoms of reaction are followed by a period of wasting atony and adynamia, which usher in dissolution or life's extinction.