Volume 2

The Clinique médicale, or, Reports of medical cases / by G. Andral ... Condensed and tr., with observations extracted from the writings of the most distinguished 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 / by G. Andral ... Condensed and tr., with observations extracted from the writings of the most distinguished medical authors: by D. Spillan. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    niodicine as with several other branches of human knowledge, where a small number of principles being given, nothing remains but to apply them to all the particular cases. In medicine, on the contrary, where a fact is never pre- cisely similar to the facts already observed, it is necessary continually to in- dividualise, if I may say so ; in that consists the entire art of diagnosis, and thence it is that the well-instructed physician who has seen most, must also see best. r I ' CHAPTER I. ACUTE PERICARDITIS. 3. The following cases are of three kinds : the first will point out inflammation of the pericardium announced by local symptoms, which render its diagnosis sufficiently easy. We shall then give other cases, in which there was no other local symptom than greater or less dyspnoea ; so that it was only by a process of exclusion* that the existence of pericarditis could be recognised. Finally, in a third class, will be found cases of a rarer description, in which the acute peri- carditis was not even announced by dyspnoea, and in which it produced no other symptom than great acceleration of the pulse, nervous phenomena of a severe kind, sudden prostration of strength, and death. :i 0 I n ARTICLE I. CASES OF ACUTE PERICARDITIS WITH CHARACTERISTIC SYMPTOMS. Case Acute articular rheumatism—Suddenly a sharjj pain in the region of the heart—Speedy death—Purident exudation on the internal surface of the peri- cardium. A baker, thirty-one years of age, entered the La Charite in the eourse of the ^ month of August, 1822. For the last fifteen days he had been affeeted with ^ acute pains, which ran through different articulations, and which at the time of his j admission were seated in the artieulations of the elbow and wrist of the left side, the right knee and foot of the same side. All these parts w'ere swollen and red. Several times since the attack of this rheumatism he had severe headachs ; the |j fever was intense ; the tongue was red and a little dry ; the epigastrium sensible to pressure. Two bleedings of tw'elve ounces each were resorted to the first j. twenty-four hours. The coagulum of blood was covered with a thick huffy coat. The next day there was no perceptible amendment; a third bleeding was ordered, ,, which was buffed as the preceding ; the knee and foot of the right side ceased to .■ be painful, but at the same time the left knee swelled ; the elbow and wrist of the + left side were less swollen, and were free from pain in the state of rest, but the ■: least motion excited acute pains in them. (Bled a fourth time to twelve ounces ; ^ eataplasms, &c.; blood buffed.) On the fourth day after his admission, and not- W'ithstanding his having been bled four times in three days, the elbow, wrist, and knee of the left side were swollen and very painful ; the tongue lost its redness ; f * i. e. Negatively, or hy remotion.—Tr. I