The modern practice of physic, which points out the characters ... and improved method of treating the diseases of all climates / [Robert Thomas].

  • Thomas, Robert, 1753-1835
Date:
1821
Catalogue details

Licence: Public Domain Mark

Credit: The modern practice of physic, which points out the characters ... and improved method of treating the diseases of all climates / [Robert Thomas]. Source: Wellcome Collection.

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    in every part, with some slight degree of swelling in the tonsils, which, however, is by no means so great as to impede either respiration or deglutition. The inflammation, after a short time, takes a peculiar termina¬ tion ; for, upon a further inspection into the throat, a number of sloughs of a shade between a light ash colour and a dark brown are to be observed on the tonsils, velum pendulum palati, and uvula; the breath is highly offensive; the tongue is covered with a thick brown fur; and the inside of the lips is beset with vesicles, containing an acrid matter, which falling on the comers of the mouth and other parts, occasions excoriations. With these symp¬ toms there is likewise a coryza, which pours out a thin acrid matter, excoriating the nostrils. A purging often attends also, particularly in infants, and a thin acrid matter flows from the anus, excoriating this and the neighbouring parts. From the first attack of the complaint there is a considerable degree of fever, with a small, frequent, and irregular pulse; and every evening there occurs a manifest exacerbation, and in the morning some slight remission, together with debility and general loss of strength. In some cases the brain is affected with delirium of the low muttering kind, or coma. About the second or third day, large patches of a dark red colour make their appearance about the face and neck, which by degrees become dispersed over every part of the body, even to the extremities of the fingers, which feel swelled and stiff. These eruptions, after continuing for about four days, depart without producing any remission of the symptoms. The inflammation, as in the cynanche tonsillaris, sometimes spreads along the Eustachian tube to the internal ear, occasioning ulceration, and sometimes wholly destroying its structure. In other cases it extends to the parotid, maxillary, and other glands of the fauces, which become swelled and painful. The whole neck, indeed, sometimes swells, and assumes a dark red colour. As the sloughs spread, they generally become of a darker colour, the interstices at the same time assuming a purple hue; new specks arise, and the whole internal fauces are at length covered with thick sloughs, which, when they fall off, discover ulcers sometimes very deeply seated. In the worst cases, the fauces appear quite black, the sloughs corrode deeper and deeper, and spread throughout the whole of the alimentary tube, so as to terminate at last in gangrene; and the symptoms of irritation continuing to increase, together with a severe purging coming on, the patient is cut off; which event happens usually before the seventh day, and, in some cases, so early as on the third. Where there is a great increase of the evening paroxysm of fbver, with vast debility, depression or irregularity in the pulse, early delirium, coma, much vomiting, diarrhoea or subsultus tendi- num, and these are accompanied with considerable swelling of the