Methodus medendi, or, The description and treatment of the principal diseases incident to the human frame / Henry M'Cormac.

Date:
1842
Catalogue details

Licence: Public Domain Mark

Credit: Methodus medendi, or, The description and treatment of the principal diseases incident to the human frame / Henry M'Cormac. 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.

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    its point and margins, clean. For a few days, perhaps, these favorable changes will only be seen in the mornings. The urine deposits a sedi- ment, the skin turns moist and clean, the eyes bright, hearing, appetite, and intelligence are restored, and the sopor is replaced by sound refreshing sleep. The patient, indeed, often seems to obtain a new lease of existence, and enjoys it with a relish proportioned to the transition. After prolonged and dangerous attacks, the convalescence is tedious and painful; phthisis, dropsy, paralysis, and other chronic complaints, may ensue. Often, the hair falls off, and there is desqua- mation of the cuticle. Some complain of singing in their ears, and a few display a temporary insanity, fisyaXov vovGrifiarog Xvtfig. Lesions after death are not constant; I have often not discovered any, or any adequate to the production of death. Of those dying of what are termed essential fevers, observes Andral, the small, and, more frequently, the large intestines, are exempt from every change. Louis, Dahnas, Cayol, Martinet, and Bouillaud, all record fatal instances without any local affection. The mucous membrane of the small intestines, writes Louis in one instance, likewise the elliptic plates of the ileum, were free from all traces of alteration. Bouillaud and Chomel, and others, aver that the digestive tube was perfectly healthy; and Alison, Neumann, Gerhard, and Lombard, make similar admissions. Marks of gastric disease are far less frequent than the affirmations of Broussais, Bouisseau, Roche, Stokes, and others, would imply. Com- monly, there is no departure from the healthy state; sometimes, there is slight discoloration, occasionally, softening and ulceration of the inner surface; alterations, however, not confined to fever, and very equivocal indications of inflammatiou. Softening, in particular, would seem merely a cadaveric change, and was often detected by Andral without the least evidence during life of its existence. In the twenty-first case of Chomel's Clinique, all three coats of the stomach were ready to slough out; and a pupil having placed his finger on the black spot, an aperture through which fluid passed, quickly ensued. In four instances by Louis, the ulcers did not penetrate the mucous coat, and were frorn two, to three fines in diameter. Alterations, not follicular, of the large and small intestines, are not numerous. A reddish tinge confined to the mucous membrane, or extending to the three coats, is occasionally visible, even through the peritoneum; Chomel speaks of sanguineous infiltration with thickening, from a few inches, to as many feet, confined to the mucous coat. The hue varies from a rose colour to a reddish black, and fluid may be expressed by the handle of the scalpel. Blood, however, may be exhaled apart from ulceration or erosion. Softening and discoloration are not confined to the vicinity of the altered plates. The abnormal development of the mucous follicles of Peyer and Brunner, along with enlargement, induration, or softening of the corresponding mesenteric glands, are frequent occurrences in fever. These glands have been seen large as a pigeon's egg, perhaps soft and tending to suppuration, of a red, violet, or blackish aspect. Louis tound one near the coecum, which had undergone purulent conversion oy the forty-ninth day; and the parieties were so thin, that rupture and efiusion, had the patient lived, could not have been remote. The glands '•nnti-uous to the altered plates, are those principally affected. Sarcone, Roederer and Wagler, Frost, Broussais, Petit and Scrrcs, Andral,