The clinique médicale; or, reports of medical cases / Condensed and translated, with observations ... from ... medical authors: by D. Spillan.

  • Andral, G. (Gabriel), 1797-1876
Date:
1836
Catalogue details

Licence: Public Domain Mark

Credit: The clinique médicale; or, reports of medical cases / Condensed and translated, with observations ... from ... medical authors: by D. Spillan. Source: Wellcome Collection.

    44/1050 (page 22)
    system, ''rhe profound sadness of the patient then, that air of dejection, and dis- position to conceal his head under the bed clothes, as if to avoid our look and questions, his reluctance to answer, &c., were certain indications of a commencing’ cerebral affection. This state of the patient prevented us, unfortunately, from procuring any information as to what he had suffered before he came to the hospital—as, for instance, w'hether he had had pain of head. The tongue was constantly natural ; not so in the preceding case ; and yet the primæ vise were here affected ; for at different times, and especially on entering the hospital, he complained of acute pain in the abdomen, and had most obstinate constipation. Had he the beginning of lead colic? We must not lose sight of the bright red appearance found in a great portion of the large intestine, and the accumulation of fæces in the sigmoid flexure, which a circular contraction of the commencement of the rectum prevented from passing into the latter intestine. This contraction depended on no organic lesion ; it appeared to be the result of a spasmodic affec- tion of the muscular coat. Case 19.—Serous effusion into cerebral ventricles—Pain of head at the commence- ment—Subsequently coma—Acceleration of the pidse some hours only before death. A mason, twenty-three years of age, had been complaining for several days of violent pain of head, when he entered the hospital. Tongue white ; pulse not frequent; no other ailment than the headach. Two grains of tartar emetic were given him. He vomited twice very copiously, and had two stools. The following day the state of the patient underw'ent a remarkable change. His intelligence very much diminished ; he answered questions slowly and with difficulty. Still complained of the headach ; pulse and tongue natural. (Twelve leeches behind each ear.) On the 17th. Great stupor. On being very much solicited, he opened his eyes slowly, and looked around him with the most vacant stare. On being asked how he found himself, he answered, that he was doing very well. Pupils did not contract on the approach of a very strong light; they were not much dilated, the right a little less so than the left. State of pulse and skin natural. (Six leeches to each mastoid process; a pint of w^hey, with the addition of a grain of tartar emetic, and four drachms of sulphate of soda ; two blisters to the thighs ; frictions with linim : volat : cantharid : to the extremities.) 18th. Stupor continues ; utters some unmeaning words; puts out his tongue wdien asked; pupils more dilated than on the preceding day, and equally so ; pulse has acquired some frequency; tongue dry; bladder very much distended.—(a pint of whey, with a grain of tartar emetic, and an ounce of sulphate of soda; frictions with linim. ammon.). During the day the coma increased, and he died during the night. Post mortem.—The two lateral ventricles were found to be very much distended with limpid serum ; some was also found in the third ventricle. Nothing remark- able was observed in the other cavities. Peniarks.—The symptoms here did not differ much from those in the seventeenth and eighteenth cases, in which pus was found to fill the ventricles. There was no febrile excitement at all in the course of the disease, and it w^as only a few hours before death that the pulse became accelerated. Case 20.—Copious serous effusion into the lateral ventricles—Destruction of the fornix and sepitum lucidum—Symptoms of apoplexy. A man, fifty years of age, entered the La Charité with considerable anasarca and ascites ; no local sign of organic disease of the heart ; respiration free ; states that he never felt any pain in the right hypochondrium ; the dropsical effusion took place three months previously, but we could not learn from him w’here it commenced ; digestion w’cll performed ; no new symptom presented for the fifteen days following. One morning, on approaching his bed, w’e found him in a state