Bèri-bèri : its etiology,symptoms, treatment, and pathology, with an appendix, containing a detailed clinical account of 52 cases, and the morbid appearance seen in 19 post-mortem examinations, with characteristic illustrations of the disease, being a thesis submitted for the M.D. degree of the University ofEdinburgh in 1889 / by Arthur J.M. Bentley.

  • Bentley, Arthur J. M.
Date:
1893
Catalogue details

Licence: Public Domain Mark

Credit: Bèri-bèri : its etiology,symptoms, treatment, and pathology, with an appendix, containing a detailed clinical account of 52 cases, and the morbid appearance seen in 19 post-mortem examinations, with characteristic illustrations of the disease, being a thesis submitted for the M.D. degree of the University ofEdinburgh in 1889 / by Arthur J.M. Bentley. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    bluish line and ulcerated edges, bleeding on pressure. Teeth covered with a yellowish film (sordes). Tongue tremulous, flabby, indented at the edges, and covered with a slight yellowish fur on the dorsum, tip and edges red. Temperature 98. Pulse 84, small, com- pressible, regular. Neck thin, no fulness. Arterial pulsation seen above the sternum and in the carotids is very marked. No venous fulness. Thorax well formed, surface normal. Ribs easily seen, intercostal spaces do not move with the respirations, which are regular—24 in .a minute. Respiration easy, not painful. There is a numb feeling over the epigastrium on deep respiration. Resistance on palpation wooden. Vocal vibrations distinct. Cardiac impulse cannot be felt, but a slight tremor can be seen between the 5th, 6th, and 7th spaces, one inch below and to inside of nipple. On pressure over the spaces, patient says they are numb all over, but there is no pain except between the 1st and 2nd intercostals, and between the 7th and 8th ribs on both sides (insertion of the diaphragm and pectoralis muscles). He cannot bear pressure on these spaces, even slight pressure causing pain. There is no increased irritability of the muscles. Percussion note boxy. Cardiac area decreased. Heart—first sound is dull. There is a systolic murmur at the apex, but heard more plainly at the base over the pulmonary area. Second sound accentuated, distinctly dicrotous over the pulmonary area, but not so over the aortic area, where it is only accentuated. Heart's rhythm normal. Lungs—Inspiration harsh, slightly jerky ; Expiration short, harsh, no superadded sounds, no cough, vocal resonance normal. Voice—there is a decided loss of voice, he is unable to call aloud, it is husky, hoarse, and cracked (he speaks as if he had a hoarseness, not in a whisper). He loses his breath if he speaks or makes any exertion. If told to count numbers, his whole chest moves in a laboured, circular stolid manner. He commences one, two, three, with an inspiration and with expiration, says one as if it were forced out by the weight of the thorax descending. He takes a fresh inspiration for each number, but he can get three or four words quickly spoken into one expiration, when he loses his breath. Abdomen thin, receding, and very flat. Skin has a brawny scurf on it ; it is dry, and the abdominal pulsation is distinctly visible. Palpation—on rubbing the finger gently over the surface the patient makes grimaces of pain, and puts on a very distressed ex- pression. He says it causes great irritation of a tickling character. G 2