Hematemesis and Hemoptysis. Hematemesis. Hemoptysis. If from the stomach, the blood is of a dark If from the lungs, it is bright red, and color, and is vomited. Often mixed with food, not froth. Preceded by nausea and stomach distress, and blood is passed with the stools. generally coughed up. Generally frothy, mixed with sputa. Preceded by pain in the chest and dyspnoea. No blood in the stools. Tongue coated, may be red Coated and swollen, may be at edges. Not so. 103°-106° before eruption, remains high for 1-2 days after, then falls suddenly. None. Sequela: chronic bronchitis, red at edges. Cerebral symptoms are frequent. Before eruption often 106°, then rapidly sinks to 100° in 36 hours; rises during secondary fever. Always secondary fever. Pneumonia not a very frequent complication. Sequela: chronic diarrhoea, glandular enlargements, various eye diseases. Typhus and Typhoid. Typhus Fever. Attacks quickly, incubation 9 days. Occurs at any age. Rare among the higher classes, except those exposed. Mulberry eruption on 4th or 5th day, on extremities, lasts till close. Brain chiefly affected; bowels are often but little so; abdomen natural, evacuations dark, but never bloody (these are occasionally reversed). Contracted pupils, dusky face. Pulse and temperature rise to 120 and 105° till 3d day, high for 6 days, then fall. Lasts 2-3 weeks. Relapses rare. Death from coma, or congestion of the lungs, in 1st or 2d week. Arises from destitution, over-crowding, bad ventilation, is contagious, and generally epidemic. Post-mortem: not constant, most frequent are dark blood and enlarged spleen, soft heart. Typhoid (Enteric) Fever. Commences slowly, incubation about 13 days. Most common in youth and childhood, rarely after 40. As common among rich as the poor. Rose eruption, few, on abdomen, and in successive crops, which fade and disap appear. Bowels chiefly affected, evacuations ochrecolor and watery, sometimes hemorrhage, or even ulceration, abdomen tumid. Dilated pupils, cheeks flushed. Pulse and temperature rise and fall independently, and without uniformity, but both are usually high to 15th day. Lasts 4-6 or more weeks. Relapses frequent. Death from asthenia, pneumonia, hemorrhage, or perforation of intestine, in or after 3d week. Bad drainage, poisoned drinking water, putrid animal matter, want of ozone, certain electrical conditions; is not contagious, often sporadic. Post-mortem morbid Peyer's patches, en. larged mesenteric glands, ulcerated mucous coat of intestines; enlarged and soft spleen, ulcerated pharynx. NOTES ON TEMPERATURE IN DISEASE. Temperature, average normal, of adults, 98.6° F.; of children, 99°; of the aged, 98.8°. Diurnal variation 1° to 1.5° F., highest from 9 A. M. to 2 P. M. Above 108° F. is a fatal sign, which issue may be averted by cold baths, reduced by ice from 96° to about 60° F. (A.). The clinical thermometer placed in the mouth, axilla or rectum, and retained in situ for five minutes, should go hand in hand with Aconite in the treatment of inflammations (R.). [For antipyretics see the articles FEver, InflammatION, in Part III, also the list of these agents on page 42.] Clinical Thermometry is one of the principal means of positive diagnosis. The thermometer should be self-registering, certified, and accurately marked according to the Fahrenheit scale. The most reliable temperature is that in recto, or in the vagina; less so in the axilla and folds of skin, and still less reliable in the mouth. A correct reading of the thermometer cannot be obtained in less time than five to seven minutes. (DaCosta.) The Average Normal Temperature of the body is 98.6°; which, like the pulse, will |