An essay on the present type and character of disease, as contrasted with its general features in the early part of the present century : read before the Nineteenth Annual General Meeting of the Provincial Medical and Surgical Association, held at Brighton, August 13 & 14, 1851 / by Caleb Williams.

  • Williams, Caleb, 1798-1871.
Date:
1851
Catalogue details

Licence: Public Domain Mark

Credit: An essay on the present type and character of disease, as contrasted with its general features in the early part of the present century : read before the Nineteenth Annual General Meeting of the Provincial Medical and Surgical Association, held at Brighton, August 13 & 14, 1851 / by Caleb Williams. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    G* been similarly affected. From facts of this kind, it has been supposed that hereditary predisposition, a vitiated atmosphere, changeable temperature, certain occupations, humidity, particular localities, absence of light, and so on, predispose to phthisis. Very frequently several of these are found united, so that it is diffi- cult to ascertain the influence of each. When they so operate, how- ever, they invariably produce, in the first place, more or less disorder of the nutritive functions, and are associated with dyspepsia, or other signs of mal-assimilation of food. Cases analogous to the following are exceedingly common. Case II.—An Irish girl left her own country, at the age of seventeen, to work as a field labourer in Scotland. In Ireland she lived on potatoes and sweet milk, and once a week had fish or a little meat. The quantity was abundant. In Scotland she lived on coarse oatmeal porridge and dry bread, with butter milk, and did not taste fish or meat once a month. Under this diet her health gradually became affected, and she entered the Royal Infirmary at the age of twenty-one, with all the symptoms and signs of advanced phthisis. Case III.—A lad, aged sixteen, of robust health, whose parents and relations were equally healthy, committed a theft. He was imprisoned in goal for three months, confined in a damp stone cell, and lived on the ordinary prison fare. His health insensibly declined. On being liberated he could not obtain employ- ment, and found that his strength had greatly diminished. Two months after- wards he applied at the Royal Dispensary, labouring under phthisis pulmonalis jn its advanced stage. •' Case IV.—A woman, aged twenty-six, applied at the Royal Infirmary in 1843, who was greatly emaciated, and complained of harrassing cough and expecto- ration. On examining the chest, perfect dulness existed under the right cla- vicle, with loud mucous rale, and imperfect pectoriloquy. The apex of the left lung was healthy. She had a son, aged six years, a perfect picture of health, and an infant at the breast, seven months old, also quite healthy. The mother died in 1844; both children are living, and are quite healthy, for the father, having good wages, is enabled to give them plenty of food. It is unnecessary to multiply cases of this description. The more they are examined into, the more do I feel persuaded it will appear that the causes of phthisis are not hereditary influences, vitiated at- mosphere, &c. &c., although these may co-operate, but almost inva- riably such circumstances as induce impoverished nutrition resulting from an improper quantity, quality, or assimilation of food. From a study of the symptoms, causes, morbid anatomy, and his- tology of phthisis pulmonalis, we are, therefore, led to the conclusion, that it is a disease of the primary digestion, causing, 1st, impoverish- ment of the blood; 2d, local exudations into the lung, which present the characters of tubercular exudation ; and, 3d, owing to the succes- sive formation and softening of these, and the ulcerations which follow in the pulmonary or other tissues, the destructive results which dis- tinguish it. Further observation shows, that circumstances which remove the mal-assimilation of food frequently check further tuber- cular exudations, while those which previously existed become abor- tive, and that occasionally more extensive excavations in the pulmonary tissue may, owing to like circumstances, heal up and cicatrize.