Pathological and practical observations on diseases of the abdomen : comprising those of the stomach and other parts of the alimentary canal, oesophagus, caecum, intestines and peritoneum / by S.O. Habershon.

Date:
1862
Catalogue details

Licence: Public Domain Mark

Credit: Pathological and practical observations on diseases of the abdomen : comprising those of the stomach and other parts of the alimentary canal, oesophagus, caecum, intestines and peritoneum / by S.O. Habershon. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

    51/668 (page 17)
    becomes extreme, the respiration impeded, and, on examining the neck, we find either erysipelatous redness of tbe skin, or a fulness and tenseness among the infra-hyoid muscles, impeding the free movement of tlie parts concerned in deglutition. The examination of the neck will generally enable us to distinguish the dyspnoea arising from this cause, from that produced by disease of the larynx, or trachea, as well as from that consequent on pressure or injury of the nerves of respiration. In my notes I find the following case, a very interesting one of the kind, occurring in 1847 :— Case I. Diffused Inflammation of the Throat.—Abraham S , set. 36, a sailor, of intemperate habits, was admitted into Guy’s Hospital, October 13th, 1847. On the 5th, whilst unloading coals, he received a blow on the back of the hand, and on the following day rigors ensued, with pain in the axilla, but the skin of the arm did not become inflamed. On admission, on the 13 th, be presented the appearance of a man suffering from typhoid fever; there was delirium at night; the pulse was very soft, 106 ; the tongue was moist, and the respiration was much oppressed ; no fluctuation could be found under the pectoral muscle, nor any suppuration detected in the neck ; the wound on the hand was dry. Stimulants and opium were administered. On the 15th, the respiration was difficult and laboured, 42 per minute; there was evident obstruction of the larynx, and some tenderness about it, but scarcely any swelling; and neither fluctuation nor suppuration could be detected on very careful examination; there was also great difficulty in swallowing. On the 16th, the respiration and deglutition were somewhat easier, but the skin was clammy, and the tongue dry. He died on the fol- lowing day, after vomiting some blood. On inspection, the whole of the cellular tissue surrounding the muscles of the neck was found infiltrated with pus, but there was no suppuration below the pectoral muscles. Case II. Diffused Inflammation of the Throat. Ulceration of the Pharynx.— In this case, which was admitted in May, 1847, a woman, aged 66, had sore throat, with pyrexia, quickly followed by typhoid symptoms, and death on the fifth day. On inspection, suppuration was found among the muscles of the neck, which extended round the oesophagus, as low as the root of the lung. In the pharnyx there were several superficial ulcers ; and one opposite the arytenoid cartilage had extended into the cellular tissue. These diseases appear to be an erysipelatous form of inflam- mation, and are generally of such an aggravated kind as to be quite beyond the reach of remedial measures. Hot fomenta- tions should be used, and ammonia with stimulants adminis- tered ; it is rare, however, that the suppuration in these cases is sufficiently localized to admit of relief by incisions 2