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II. Or the new dissimilar disease is the stronger. In this case the disease under which the patient originally labored, being the weaker, will be kept back and suspended by the accession of the stronger one, until the latter shall have run its course or been cured, and then the old one reappears uncured. Two children affected with a kind of epilepsy remained free from epileptic attacks after infection with ringworm (tinea) but as soon as the eruption on the head was gone the epilepsy returned just as before, as Tulpius1 observed. The itch, as Schopf2 saw, disappeared on the occurrence of the scurvy, but after the cure of the latter it again broke out. So, also the pulmonary phthisis remained stationary when the patient was attacked by a violent typhus, but went on again after the latter had run its course.3 If mania occur in a consumptive patient, the phthisis with all its symptoms is removed by the former; but if that go off, the phthisis returns immediately and proves fatal.4 When measles and smallpox are prevalent at the same time, and both attack the same child, the measles that had already broken out is generally checked by the smallpox that came somewhat later; nor does the measles resume its course until after the cure of the smallpox; but it not infrequently happens that the inoculated smallpox is suspended for four days by the supervention of the measles, as observed by Manget,5 after the desquamation of which the smallpox completes its course. Even when the inoculation of the smallpox had taken effect for six days, and the measles then broke out, the inflammation of the inoculation remained stationary and the smallpox did not ensue until the measles had completed its regular course of seven days.6 In an epidemic of measles, that disease attacked many individuals on the fourth or fifth day after the inoculation of smallpox and prevented the development of the smallpox until it had completed its own course, whereupon the smallpox appeared and proceeded regularly to its termination.7 The true, smooth, erysipelatous-looking scarlatina of Sydenham, with sore throat, was checked on the fourth day by the eruption of cow-pox, which ran its regular course, and not till it was ended did the scarlatina again establish itself; but on another occasion, as both diseases seem to be of equal strength, the cow-pox was suspended on the eighth day by the supervention of the true, smooth scarlatina of Sydenham,8 and the red areola of the former disappeared until the scarlatina was gone, wherein the cow-pox immediately resumed its course, and went on its regular termination.9 The measles suspended the cow-pox; on the eighth day, when the cow-pox had nearly attained its climax, the measles broke out; the cow-pox now remained stationary, and did not resume and complete its course until the desquamation of the measles, had taken place, so that on the sixteenth day it presented the appearance it otherwise would have shown on the tenth day, as Kortum10 observed.

Even after the measles had broken out the cow-pox inoculation took effect, but did not run its course until these measles had disappeared, as Kortum likewise witnessed.11

I myself saw the mumps (angina parotidea) immediately disappear when the cow-pox inoculation had taken effect and had nearly attained its height; it was not until the complete termination of the cow-pox and the disappearance of its red areola that this febrile tumefaction of the parotid and submaxillary glands, that is caused by a peculiar miasm, reappeared and ran its regular course of seven days.

And thus it is with all dissimilar disease; the stronger suspends the weaker (when they do not complicate one another, which is seldom the case with acute disease), but they never cure one another.

1 Obs., lib. I, obs. 8.

2 In Hufeland’s Journal, xv, 2.

3 Chevalier, in Hufeland’s Neuesten Annalen der franzosichen Heikunde, ii, p.192.

4 Mania phthisi superveniens eam cum omnibus suis phaenomenis auffert, verum mox redit phthisis et occidit, abeunte mania. Reil Memorab., fasc. iii, v, p.171.

5 In the Edinb. Med. Comment., pt. i, 1.

6 John Hunter, On the veneral Disease, p.5.

7 Rainey, in the Edinb. Med. Comment., iii, p.480.

8 Very accurately described by Withering and Plenciz, but differing greatly from the purpura (or Roodvonk), which is often erroneously denominated scarlet fever. It is only of late year that the two, which were originally very different diseases, have come to resemble each other in their symptoms.

9 Jenner, in Medicinische Annalen, August, 1800, p.747.

10 In Hufeland’s Journal der praktischen Arzneikunde, xx, 3, p.50.

11 Loc. cit.

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