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en:ahr:wells-pp-typhoid-fever-158-10665 [2013/02/28 19:57]
195.80.163.82
en:ahr:wells-pp-typhoid-fever-158-10665 [2013/02/28 21:11]
195.80.163.82
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 {{anchor:​s109}}We will suppose the case to be in the first stage of the attack, what symptoms shall we be likely to meet? {{anchor:​s110}}We will present, presently, the group given by Prof. {{anchor:​s111}}Griesinger,​ of Tubingen, in Virchow'​s <span grade2>​Handbuch der Speciellen Pathologie und Therapie,</​span>​ 2te Band, 2te Abtheil., s. 130, as one of the latest and best pictures, from the writers of the old school of the phenomena of this stage. {{anchor:​s112}}We do this, not because it is, perfect for the purpose of a homoeopathic prescription,​ but as, when taken in connection with translated symptoms of our Materia Medica, furnishing a convenient opportunity to answer, in part, the often repeated declaration of opponents of our school, that the phenomena of diseased action do not find a parallel in those of drug action. {{anchor:​s113}}In this statement of the symptoms of the first stage of typhoid fever the author had no reference to any record of our Materia Medica, he simply intended to give a representative picture of the disease; the parallel symptoms of the Materia Medica were on the record long before Griesinger wrote. {{anchor:​s114}}There was therefore no collusion. {{anchor:​s115}}It is given also because of its <span grade2>​representative character, i. e.,</​span>​ it presents the symptoms the most important, as the author understands them; and the most frequently met in his practice, <span grade2>​i. e.,</​span>​ belonging to the greatest number of cases, thus furnishing a convenient opportunity,​ not only to present an answer to an oft repeated and groundless objection, but also the proper method of dealing with a record of symptoms where a prescription is to be made. {{anchor:​s116}}It also demonstrates the truth of the principle, already stated, when having to speak of Acon., that remedies related to depressed vital force are those from which we shall find our curative, even in this first stage. {{anchor:​s117}}Of these Ars. is certainly one of the chief. {{anchor:​s118}}It is rare that a record of symptoms in practice can afford an opportunity for a more perfect compliance with the demands of the law of cure than these of Griesinger, when met by Ars.* [For the parallel of Griesinger and Ars., see the symptoms of An. in a future number of the Review.] {{anchor:​s109}}We will suppose the case to be in the first stage of the attack, what symptoms shall we be likely to meet? {{anchor:​s110}}We will present, presently, the group given by Prof. {{anchor:​s111}}Griesinger,​ of Tubingen, in Virchow'​s <span grade2>​Handbuch der Speciellen Pathologie und Therapie,</​span>​ 2te Band, 2te Abtheil., s. 130, as one of the latest and best pictures, from the writers of the old school of the phenomena of this stage. {{anchor:​s112}}We do this, not because it is, perfect for the purpose of a homoeopathic prescription,​ but as, when taken in connection with translated symptoms of our Materia Medica, furnishing a convenient opportunity to answer, in part, the often repeated declaration of opponents of our school, that the phenomena of diseased action do not find a parallel in those of drug action. {{anchor:​s113}}In this statement of the symptoms of the first stage of typhoid fever the author had no reference to any record of our Materia Medica, he simply intended to give a representative picture of the disease; the parallel symptoms of the Materia Medica were on the record long before Griesinger wrote. {{anchor:​s114}}There was therefore no collusion. {{anchor:​s115}}It is given also because of its <span grade2>​representative character, i. e.,</​span>​ it presents the symptoms the most important, as the author understands them; and the most frequently met in his practice, <span grade2>​i. e.,</​span>​ belonging to the greatest number of cases, thus furnishing a convenient opportunity,​ not only to present an answer to an oft repeated and groundless objection, but also the proper method of dealing with a record of symptoms where a prescription is to be made. {{anchor:​s116}}It also demonstrates the truth of the principle, already stated, when having to speak of Acon., that remedies related to depressed vital force are those from which we shall find our curative, even in this first stage. {{anchor:​s117}}Of these Ars. is certainly one of the chief. {{anchor:​s118}}It is rare that a record of symptoms in practice can afford an opportunity for a more perfect compliance with the demands of the law of cure than these of Griesinger, when met by Ars.* [For the parallel of Griesinger and Ars., see the symptoms of An. in a future number of the Review.]
  
-{{anchor:​s119}}But cases in practice are not constituted according to the models of the text books. {{anchor:​s120}}The symptoms of each case, while presenting generalities sufficiently like these, show also special symptoms or combinations,​ by which it is characterized,​ and which constitute it an individuality. {{anchor:​s121}}And in this individuality the case must be studied, and to this the remedy adapted by the law of similars. {{anchor:​s122}}Typhoid fever, in its earliest existence, chiefly attacks and modifies the functions of the brain, and of the organs of the digestive apparatus. {{anchor:​s123}}In its early stage these modifications are the proper objects of most careful study. {{anchor:​s124}}It is in the functions of these organs that the fever, for the most part, makes its existence known, and in these it is to be combated. {{anchor:​s125}}In the study of cases at the bed side, it will be found, that early in the history of the attack, a preponderance of important symptoms has shown itself in one or the other of these spheres, which marks the first step in the analysis of the case,, and that which decides whether the remedy is to be found in the class of drugs which attack the brain by preference, of which Belladonna may, for convenience,​ be received as the representative;​ or in the class which by similar preference attacks the digestive apparatus, represented by Arsenicum; or if the case be mixed, <span grade2>​i</​span>​. <span grade2>​e.,</​span>​ the two systems about equally affected, in the class of drugs equally related to both, of which Bryonia may stand as a type. {{anchor:​s126}}Where cases are marked with strong cerebral or abdominal preponderance,​ this classification may help some-what ​to find the right remedy. {{anchor:​s127}}But as cases in practice will not make themselves up in models for our convenience,​ it is to be understood that in this analysis we only contemplate <span grade2>​preponderance,</​span>​ all cases being more or less mixed, in their cerebral and abdominal manifestations.+{{anchor:​s119}}But cases in practice are not constituted according to the models of the text books. {{anchor:​s120}}The symptoms of each case, while presenting generalities sufficiently like these, show also special symptoms or combinations,​ by which it is characterized,​ and which constitute it an individuality. {{anchor:​s121}}And in this individuality the case must be studied, and to this the remedy adapted by the law of similars. {{anchor:​s122}}Typhoid fever, in its earliest existence, chiefly attacks and modifies the functions of the brain, and of the organs of the digestive apparatus. {{anchor:​s123}}In its early stage these modifications are the proper objects of most careful study. {{anchor:​s124}}It is in the functions of these organs that the fever, for the most part, makes its existence known, and in these it is to be combated. {{anchor:​s125}}In the study of cases at the bed side, it will be found, that early in the history of the attack, a preponderance of important symptoms has shown itself in one or the other of these spheres, which marks the first step in the analysis of the case,, and that which decides whether the remedy is to be found in the class of drugs which attack the brain by preference, of which Belladonna may, for convenience,​ be received as the representative;​ or in the class which by similar preference attacks the digestive apparatus, represented by Arsenicum; or if the case be mixed, <span grade2>​i</​span>​. <span grade2>​e.,</​span>​ the two systems about equally affected, in the class of drugs equally related to both, of which Bryonia may stand as a type. {{anchor:​s126}}Where cases are marked with strong cerebral or abdominal preponderance,​ this classification may help somewhat ​to find the right remedy. {{anchor:​s127}}But as cases in practice will not make themselves up in models for our convenience,​ it is to be understood that in this analysis we only contemplate <span grade2>​preponderance,</​span>​ all cases being more or less mixed, in their cerebral and abdominal manifestations.
  
 {{anchor:​s128}}In this paper, we propose to examine the relations of Bell., Hyos., Lach., Opium and Stram. to typhoid fevers with predominant cerebral symptoms. {{anchor:​s129}}After the symptoms have been presented in groups, it will be easy for the student to perceive the resemblances and differences of the different groups, and from these differences to decide on the selection of either which may be appropriate to his case. {{anchor:​s128}}In this paper, we propose to examine the relations of Bell., Hyos., Lach., Opium and Stram. to typhoid fevers with predominant cerebral symptoms. {{anchor:​s129}}After the symptoms have been presented in groups, it will be easy for the student to perceive the resemblances and differences of the different groups, and from these differences to decide on the selection of either which may be appropriate to his case.
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 | {{anchor:​s244}}Dull pain in the forehead, occiput in the whole head; confusion in the head, vertigo, humming in the ears, intolerance of light. | {{anchor:​s245}}Great heaviness in the head, with humming in the ears; stupefying pain in the forehead. {{anchor:​s246}}Great intolerance of light; vertigo with headache. | | {{anchor:​s244}}Dull pain in the forehead, occiput in the whole head; confusion in the head, vertigo, humming in the ears, intolerance of light. | {{anchor:​s245}}Great heaviness in the head, with humming in the ears; stupefying pain in the forehead. {{anchor:​s246}}Great intolerance of light; vertigo with headache. |
 | {{anchor:​s247}}Sleeplessness,​ or sleep disturbed by heavy dreams. | {{anchor:​s248}}Sleeplessness with restlessness and tossing. {{anchor:​s249}}Many heavy dreams; frightful and anxious dreams. | | {{anchor:​s247}}Sleeplessness,​ or sleep disturbed by heavy dreams. | {{anchor:​s248}}Sleeplessness with restlessness and tossing. {{anchor:​s249}}Many heavy dreams; frightful and anxious dreams. |
-| {{anchor:​s250}}Complete loss of appetite, with thirst and bad taste in the month, pappy and bitter; the tongue is coated and red at the point and edges. | {{anchor:​s251}}Complete loss of appetite with severe thirst; bitter, salt, sour, and putrid taste in the mouth; tongue coated white, or red and dry, brown or blackish. {{anchor:​s252}}(A later stage) Constipation with pain in the abdomen. {{anchor:​s253}}Watery and slimy diarrhea, with great weakness. | +| {{anchor:​s250}}Complete loss of appetite, with thirst and bad taste in the month, pappy and bitter; the tongue is coated and red at the point and edges. | {{anchor:​s251}}Complete loss of appetite with severe thirst; bitter, salt, sour, and putrid taste in the mouth; tongue coated white, or red and dry, brown or blackish. ​
-| {{anchor:s254}}In the first days there is for the most part constipation,​ though cases occur where there are fluid stools from the beginning. ​| {{anchor:​s255}}Pains of the severest kind in the epigastrium,​ with great sensibility to pressure. | +| {{anchor:​s254}}In the first days there is for the most part constipation,​ though cases occur where there are fluid stools from the beginning. | {{anchor:​s252}}(A later stage) Constipation with pain in the abdomen. {{anchor:​s253}}Watery and slimy diarrhea, with great weakness. | 
-| {{anchor:s256}}Pains in the abdomen arein this stage for the most part in the epigastrium ​| {{anchor:​s257}}Pulse quick, frequent, weak, and intermitting. | +| {{anchor:s256}}Pains in the abdomen are, in this stage for the most part in the epigastrium ​| {{anchor:​s255}}Pains of the severest kind in the epigastrium,​ with great sensibility to pressure. | 
-| {{anchor:s258}}Pulse frequent, full and softand sometimes undulating. | {{anchor:​s259}}Heat of skin for the most part dry and burning. {{anchor:​s260}}Anxious,​ nocturnal heat, also dry and without thirst. | +| {{anchor:s258}}Pulse frequentfull and soft, and sometimes undulating. ​| {{anchor:​s257}}Pulse quick, frequent, weak, and intermitting. | 
-| {{anchor:s261}}The skin hot and drysweating is the exception in this stage. | {{anchor:​s262}}Urine diminished, with burning. | +| {{anchor:s261}}The skin hot and drysweating is the exception in this stage. | {{anchor:​s259}}Heat of skin for the most part dry and burning. {{anchor:​s260}}Anxious,​ nocturnal heat, also dry and without thirst. | 
-| {{anchor:s263}}Urine scanty, dark. | {{anchor:​s264}}Copious bleedings from the nose. | +| {{anchor:s263}}Urine scantydark. | {{anchor:​s262}}Urine diminished, with burning. | 
-| {{anchor:s265}}Single or repeated bleedings from the nose. | {{anchor:​s266}}Spleen swollen and painful (also in fever). {{anchor:​s267}}Dryness and burning in the larynx; cough short, dry, deep, fatiguing, with dry excoriation in chest. and expectoration scanty, frothy and difficult. {{anchor:​s268}}[A tolerable picture of acute bronchial catarrh."​] ​+| {{anchor:s265}}Single or repeated bleedings from the nose. | {{anchor:​s264}}Copious bleedings from the nose. | 
-| {{anchor:​s269}}An increased volume of the spleen is easily detected. {{anchor:​s270}}Cough and symptoms of bronchial catarrh in many cases. | {{anchor:​s271}}Loss of sensation, consciousness and speech. {{anchor:​s272}}He lies senseless, voice stammering and inarticulate. {{anchor:​s273}}Dullness and weakness of the understanding and senses.. ​+| {{anchor:s269}}An increased volume of the spleen is easily detected. {{anchor:​s270}}Cough and symptoms of bronchial catarrh in many cases. | {{anchor:​s266}}Spleen swollen and painful (also in fever). {{anchor:​s267}}Dryness and burning in the larynx; cough short, dry, deep, fatiguing, with dry excoriation in chest. and expectoration scanty, frothy and difficult. {{anchor:​s268}}[A tolerable picture of acute bronchial catarrh."​] | 
-| {{anchor:​s274}}[The above are Griesinger'​s symptoms of the <span grade2>​first week,</​span>​ in the order in which they occur on his page. {{anchor:​s275}}He proceeds to say that the fever increases in intensity, the second week, and the above symptoms are mostly aggravated.] | {{anchor:​s276}}Speech hesitating and slow. +| {{anchor:​s274}}[The above are Griesinger'​s symptoms of the <span grade2>​first week,</​span>​ in the order in which they occur on his page. {{anchor:​s275}}He proceeds to say that the fever increases in intensity, the second week, and the above symptoms are mostly aggravated.] |  
-| {{anchor:​s277}}The confusion of the head (<span grade2>​eingenommenheit</​span>​) is increased till it becomes now a peculiar stupidity. | {{anchor:s278}}Difficult hearing as if the ears were stopped. | +| {{anchor:​s277}}The confusion of the head (<span grade2>​eingenommenheit</​span>​) is increased till it becomes now a peculiar stupidity. | {{anchor:s271}}Loss of sensation, consciousness and speech. {{anchor:​s272}}He lies senseless, voice stammering and inarticulate. {{anchor:​s273}}Dullness and weakness of the understanding and senses. | 
-| {{anchor:​s279}}Speech hesitating and difficult. | {{anchor:s280}}Night in bed, restless ​and tossing, with heat, and extravagant,​ delirious imaginations. | +| {{anchor:​s279}}Speech hesitating and difficult. | {{anchor:s276}}Speech hesitating ​and slow. | 
-| {{anchor:​s281}}Hearing somewhat weakened. | {{anchor:s282}}Great dryness and dry sensation of the mouth and also of the tongue{{anchor:​s283}}Tongue brown or blackish ​+| {{anchor:​s281}}Hearing somewhat weakened. | {{anchor:s278}}Difficult hearing as if the ears were stopped. | 
-| {{anchor:​s284}}The evening exacerbation brings great restlessness;​ the night, a moderate delirium. | {{anchor:s285}}Miliary rash. {{anchor:​s286}}Red scorbutic spots. | +| {{anchor:​s284}}The evening exacerbation brings great restlessness;​ the night, a moderate delirium. | {{anchor:s280}}Night in bed, restless and tossing, with heat, and extravagant,​ delirious imaginations. | 
-| {{anchor:​s287}}The mouth and tongue become dry, the latter brown coated. | | +| {{anchor:​s287}}The mouth and tongue become dry, the latter brown coated. | {{anchor:​s282}}Great dryness and dry sensation of the mouth and also of the tongue. {{anchor:​s283}}Tongue brown or blackish ​
-| {{anchor:​s288}}Rose red spots, towards the close of the second week, on the chest and abdomen. | |+| {{anchor:​s288}}Rose red spots, towards the close of the second week, on the chest and abdomen. | {{anchor:​s285}}Miliary rash. {{anchor:​s286}}Red scorbutic spots. ​|
  
 {{anchor:​s289}}From the above symptoms and their counterpart it will be seen that Ars. has no second place of importance in the list of the curatives of this fever, especially in its first stage. {{anchor:​s290}}This will be still more apparent after a careful study of the following: {{anchor:​s289}}From the above symptoms and their counterpart it will be seen that Ars. has no second place of importance in the list of the curatives of this fever, especially in its first stage. {{anchor:​s290}}This will be still more apparent after a careful study of the following:
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 {{anchor:​s464}}In illustration of the action of these two remedies, the following case, which occurred in the practice of the writer some years since, may serve. {{anchor:​s465}}The patient was a girl, ten years of age, light complexion, Slender form, temperament mixed nervous and lymphatic, the mother of whom had suffered from often repeated attacks of facial erysipelas, While the father would be at once classed with the scrofulous, by those who use the term. {{anchor:​s466}}There was in the early stage no notable characteristic,​ except the great rapidity with which the case reached the state usually met in the last stage of the severer forms of the fever. {{anchor:​s467}}On the sixth day, through an uninterrupted downward coarse, the patient had come to utter insensibility;​ constant profound coma, or lying with staring eyes; involuntary and unnoticed evacuations into the bed, of both urine and feces; subsultus; when the eyes were open, reaching after objects in the air and picking at the bed clothes; entire loss of hearing, and apparently of sight; intestinal evacuations liquid, brownish, and extremely offensive; pulse small, weak, quick and 130 per minute. {{anchor:​s468}}In this alarming state of things, in accordance with the advice of my friend, Dr. A, F. Haynel, the patient got four globules of Psorin<​sup>​30</​sup>​. {{anchor:​s469}}In twelve hours, having had no other dose, and no other medicine, she answered questions loudly put, the diarrhea was less frequent, pulse 120 per minute. {{anchor:​s470}}The dose was permitted to act and the improvement to progress till the end of forty-eight hours, when she fell again into insensibility and involuntary evacuations,​ with an increase of the other remaining symptoms though they were slighter than before the dose of Psor. was taken. {{anchor:​s471}}She now got Sulphur, third trituration,​ half grain. {{anchor:​s472}}The amendment which followed was prompt, the convalescence rapid and complete. {{anchor:​s473}}The patient required and got no other dose and no other medicine. {{anchor:​s474}}There can hardly be a doubt that in this case, if there had been a continued reliance on and use of what seemed to be the appropriate remedy in this case, regardless of the psoric complication,​ it would have speedily reached a fatal termination. {{anchor:​s475}}Whether the cure is to be referred to the action of these two drugs solely, or whether by extinguishing the psoric element, the case became amenable to, and came under the power of, the remedies previously employed, is a question on which opinions may differ. {{anchor:​s476}}The recovery was rapid, complete and unexpected. {{anchor:​s464}}In illustration of the action of these two remedies, the following case, which occurred in the practice of the writer some years since, may serve. {{anchor:​s465}}The patient was a girl, ten years of age, light complexion, Slender form, temperament mixed nervous and lymphatic, the mother of whom had suffered from often repeated attacks of facial erysipelas, While the father would be at once classed with the scrofulous, by those who use the term. {{anchor:​s466}}There was in the early stage no notable characteristic,​ except the great rapidity with which the case reached the state usually met in the last stage of the severer forms of the fever. {{anchor:​s467}}On the sixth day, through an uninterrupted downward coarse, the patient had come to utter insensibility;​ constant profound coma, or lying with staring eyes; involuntary and unnoticed evacuations into the bed, of both urine and feces; subsultus; when the eyes were open, reaching after objects in the air and picking at the bed clothes; entire loss of hearing, and apparently of sight; intestinal evacuations liquid, brownish, and extremely offensive; pulse small, weak, quick and 130 per minute. {{anchor:​s468}}In this alarming state of things, in accordance with the advice of my friend, Dr. A, F. Haynel, the patient got four globules of Psorin<​sup>​30</​sup>​. {{anchor:​s469}}In twelve hours, having had no other dose, and no other medicine, she answered questions loudly put, the diarrhea was less frequent, pulse 120 per minute. {{anchor:​s470}}The dose was permitted to act and the improvement to progress till the end of forty-eight hours, when she fell again into insensibility and involuntary evacuations,​ with an increase of the other remaining symptoms though they were slighter than before the dose of Psor. was taken. {{anchor:​s471}}She now got Sulphur, third trituration,​ half grain. {{anchor:​s472}}The amendment which followed was prompt, the convalescence rapid and complete. {{anchor:​s473}}The patient required and got no other dose and no other medicine. {{anchor:​s474}}There can hardly be a doubt that in this case, if there had been a continued reliance on and use of what seemed to be the appropriate remedy in this case, regardless of the psoric complication,​ it would have speedily reached a fatal termination. {{anchor:​s475}}Whether the cure is to be referred to the action of these two drugs solely, or whether by extinguishing the psoric element, the case became amenable to, and came under the power of, the remedies previously employed, is a question on which opinions may differ. {{anchor:​s476}}The recovery was rapid, complete and unexpected.
  
-{{anchor:​s477}}The third variety of typhoid fever, that in which neither the cerebral nor abdominal symptoms can be said to preponderate much, and of which we have presented Bryonia as the drug representative,​ may require Arn., Bry., Calc., Nux vomica, Pulsatilla, Rhus tox.; or Verat. {{anchor:​s478}}The following are symptoms of these drags, the likeness of which may be met in our practical dealing with this class of cases:+{{anchor:​s477}}The third variety of typhoid fever, that in which neither the cerebral nor abdominal symptoms can be said to preponderate much, and of which we have presented Bryonia as the drug representative,​ may require Arn., Bry., Calc., Nux vomica, Pulsatilla, Rhus tox.; or Verat. {{anchor:​s478}}The following are symptoms of these drugs, the likeness of which may be met in our practical dealing with this class of cases:
  
 <span grade2>​{{anchor:​s479}}Arnica.</​span>​ {{anchor:​s480}}Great heaviness of the limbs as if from extreme fatigue; weakness, weariness, and bruised soreness which compels to lie down; lassitude and sluggishness in the whole body; general sinking of the forces. {{anchor:​s481}}Sleep unrefreshing and full of dreams. {{anchor:​s482}}In sleep, whimpering, loud talking, loud blowing (schniebendes) in-and expirations;​ involuntary evacuations of feces and urine; anxious and heavy dreams from the evening into the night, which much affect the body; frightful dreams. {{anchor:​s483}}Sits as if in thought, yet thinks of nothing, like a waking dream; forgets the word while speaking; loss of consciousness;​ delirium; stupefying confusion of the head, like a heaviness in the forehead; vertigo while raising or moving the head. {{anchor:​s484}}Pupils contracted, with beclouding of the head. {{anchor:​s485}}Bleeding from the nose. {{anchor:​s486}}Lips dry as if parched by thirst. {{anchor:​s487}}Dryness of the mouth, with great thirst. {{anchor:​s488}}Putrid smell from the mouth. {{anchor:​s489}}Distention and hardness of the abdomen. {{anchor:​s490}}Brown or white diarrhea; diarrhea at night, with pressure in the abdomen as if from gas; with distension of the abdomen before the stool; with rumbling in the abdomen during the stool. <span grade2>​{{anchor:​s479}}Arnica.</​span>​ {{anchor:​s480}}Great heaviness of the limbs as if from extreme fatigue; weakness, weariness, and bruised soreness which compels to lie down; lassitude and sluggishness in the whole body; general sinking of the forces. {{anchor:​s481}}Sleep unrefreshing and full of dreams. {{anchor:​s482}}In sleep, whimpering, loud talking, loud blowing (schniebendes) in-and expirations;​ involuntary evacuations of feces and urine; anxious and heavy dreams from the evening into the night, which much affect the body; frightful dreams. {{anchor:​s483}}Sits as if in thought, yet thinks of nothing, like a waking dream; forgets the word while speaking; loss of consciousness;​ delirium; stupefying confusion of the head, like a heaviness in the forehead; vertigo while raising or moving the head. {{anchor:​s484}}Pupils contracted, with beclouding of the head. {{anchor:​s485}}Bleeding from the nose. {{anchor:​s486}}Lips dry as if parched by thirst. {{anchor:​s487}}Dryness of the mouth, with great thirst. {{anchor:​s488}}Putrid smell from the mouth. {{anchor:​s489}}Distention and hardness of the abdomen. {{anchor:​s490}}Brown or white diarrhea; diarrhea at night, with pressure in the abdomen as if from gas; with distension of the abdomen before the stool; with rumbling in the abdomen during the stool.
en/ahr/wells-pp-typhoid-fever-158-10665.txt · Last modified: 2013/02/28 21:11 by 195.80.163.82