Miscellaneous contributions to the study of pathology / by John W. Ogle, M.D.

  • Ogle, John W. (John William), 1824-1905.
Date:
[1868], [©1868]
Catalogue details

Licence: Public Domain Mark

Credit: Miscellaneous contributions to the study of pathology / by John W. Ogle, M.D. Source: Wellcome Collection.

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

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    symptoms of chorea, with twitching of the muscles of the face and upper limbs. Catamenia absent ever since. She had ascarides. There had been no previous attack of chorea. On admission the face was flushed, the movements very trouble- some ; the heart's sounds were natural, but its action was quick ; breathing natural but hurried. Iron and purgatives were given, and morphia subsequently to procure sleep. A swelling existed on one of the wrist-joints from frequent move- ments, and there was soreness of the back and limbs. The symp- toms of chorea were almost instantly relieved by a water-bed follow- ing a warm bath, but she complained of a “ pricking pain at the heart, and a loud bruit came on with both cardiac sounds—at the apex loudest with the first sound, loudest at the base and downwards towards the aortic valves with the second sound. Calomel and opium, and afterwards quinia and belladonna, were administered. October 31st.—It was noted that the chorea had almost ceased, the chest symptoms increasing. Dyspnoea was oppressive; there was short cough, and expectoration; the pulse was irregular and quick; the fingers almost constantly flexed, thumbs drawn into the palms. November 3rd.—So weak as to require stimulants. 5th.—The heart's bruit had disappeared, but the left side of the chest was dull, and not rising on inspiration. She became worse and dyspnoea increased. 7th.—Erysipelas of the ankle set in, and she became weaker until she died; a slight return of chorea came on two days before death, which occurred November 12th. Post-mortem examination.—Sloughs on the surface, and erysipelas. Thorax.—-An abscess was found in the anterior mediastinum, and pus in the left pleural sac. The lungs were compressed, and without air. The heart was healthy in all respects. Cranium.—The brain was natural. Spinal column.—Much fluid existed in the arachnoid cavity of the spinal cord; otherwise the cord was natural. A small abscess existed in connection with an intervertebral cartilage just below the diaphragm. Remarks.—Notice in this case the fright as the assigned cause, and absence of catamenia since the commencement of the attack. The abscess of the mediastinum and the empyema were probably of pysemic origin, and connected with the bed-sores. Unfortunately, the wrist-joints were not examined after death. The disappearance of the cardiac murmurs must not be disregarded (261).