Excerpt from Albany Medical Annals, 1890, Vol. 11: Published Monthly
What is the nature of the disease constituting this extra ordinary outbreak? This question, which is the one of pri mary interest, to which an altogether satisfactory solution has not been proposed, is to be answered by a study of its clinical history, and by its etiological surroundings, so far as they can be discovered.
Early in the epidemic I found, on inquiry among physi cians having cases in charge, that there was considerable conﬂict of opinion regarding its nature. The majority, how ever, were inclined to look upon it as a fever of malarial origin, and the existence of symptoms referable to this, particularly as to the occurrence of chills, were especially emphasized. None, however, reported these chills as having any regular periodicity of recurrence, nor that cases con. Formed to any established type of malarial fever. In fact, it seemed to be the general impression that the fever was a continued fever, but the malarial character of the sickness was what appeared to receive especial emphasis in the minds of these observers early in their observation of it. It is evi dent there was confusion in the minds of the observers as to the nature of the fever, and that cases as they presented themselves individually exhibited symptoms that were some what unusual, the only thing certain being that it was an acute febrile disease.
My own experience was limited to a few cases, who were employed in the various shops and about the yards, and as there was considerable uniformity in the symptoms, and variation only as to intensity, I may best give a summary of my individual observation.
The onset of the sickness was gradual, and was character ized by simple malaise, growing in intensity for several days. I found the patients, when first seen, having pretty marked weakness, amounting, in severer cases, to prostration. This was more noticeable than is common early in typhoid or other autumnal fevers, and was a feature throughout. Then, there was very considerable gastro-hepatic derangement. The tongue was heavily coated with thick, whitish fur; there was complete anorexia, and there was uniformly constipation. This continued and did not yield readily to treatment.
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