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.

    26/594 (page 12)
    do, tho relative mortality is increased. During Irish epidemics, from one to ten, to ono in three, died among the wealthy sick, whereas, of the sick poor, not moro tlian ono in thirty. Tlie loss, at first, was greater among males than females; subsequently, the ratio became more equal. Pregnancy and childbearing were dangerous complications, but, at other times, as Hildenbrand has remarked, women withstood the assaults of typhus better than men. Professional persons, physicians, and clergy- men, often suffer severely. In ordinary years the mortality varies, but the causes are not apparent. During those months, says Welsh, in which tho mildest cases were received at Queensbury house, the worst eases and most numerous deaths occurred at the Infirmary, and, con- versely, though- patients were carried indiscriminately to both, and the hospitals scarcely eight hundred yards apart. Irish practitioners take the average mortality in both sexes, and at all ages, epidemics apart, at about one in ten, to one in fourteen; but, if children be excluded, the rate is higher. This proportion nearly agrees with that assigned by Cowan in Glasgow. Similar, and sometimes much worse returns have been made in England and the continent; yet, out of one hundred and forty cases mentioned by Mackintosh, and sixty-three by Williams, they severally relate but one death. Other circumstances alike, the mortality varies with the vital powers as influenced by hereditary constitution, previous habits, and by-gone disease. Few adults are affected in whom the integrity of some leading viscus has not been impaired, and on which, therefore, the malady is apt to exhaust itself. Even character has its influence, as shewn by the partial immunity of infants and children, and the good effects of that cheerfulness which anticipates a favourable issue, but is not afraid of the worst. A multitude of signs, whether for good or for ill, are not peculiar to the disease, but extend to the febrile exanthemata and different inflammations. The number and intensity of the complications are a special point in the prognosis. Pneumonia in the lobular form, even, is a serious addition; still more so, if conjoined with intestinal ulceration or cerebral determination. Its accidental supervention, however, has proved the means of saving fife by causing revulsion from the head. The latency of some affections, as pneumonia, sloughing and ulceration of the glands of Peyer and Brunner, softening and enlarge- ment of the mesenteric glands and spleen, enhances the difficulty of the prognosis—critical evacuations, as they are termed, indicate altera- tions, if any, that are consentaneous with the discharge. Warm genial moisture over the surface, indeed, clear urine, and a soft clean tongue, are precursors of recovery. The lateritious sediment, as Lettsom remarks, has been known to precede death. Abscesses do not possess the critical value once ascribed to them. Diarrhoea, towards the close, has been considered favourable. The blood, in the course of fever, undergoes certain changes to which the terms watery, dissolved, and putrid, have been applied. A living fluid, like the blood, cannot become putrid, but alterations do occur, which exercise much influence on tho disease. Petechia) and vibices, eschars and intestinal hemorrages, are all more or less connected with the condition of the circulating fluid. Superficial sloughing retards convalescence, but irritation, exhaustion, and death, as I have more than once had occasion to witness, are induced by extensive eschars.