Manual of pathology and practice of medicine / by Samuel Henry Dickson.

  • Dickson, Samuel Henry, 1798-1872.
Date:
1850
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Licence: Public Domain Mark

Credit: Manual of pathology and practice of medicine / by Samuel Henry Dickson. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    upon the local sensibility of the part affected ; it is also modified both in kind and degree by the nature of the case, so that it bears no regu- lar proportion to the danger of the attack. The loss of sensibility, whether local or general, must augur unfavorably. Permanent dilatation of the pupil of the eye is untoward, as being probably occasioned by compression of the brain ; permanent contrac- tion by meningeal inflammation. Insensibility to light, as evinced by a fixed state of the pupil, is also unfavorable. Hallucinations of va- rious kinds, amounting to delirium and insanity, are more to be dread- ed when low and gloomy than if cheerful or violent. V. Of the Motory System.—Great muscular prostration is always to be dreaded. Relaxation of the various sphincters indicates a high de- gree of danger. Paralysis is still more unfortunate, whether of one half the body, transversely divided, paraplegia, usually affecting the lower limbs, or hemiplegia, which is confined to the right or left side, and both extremities. Trembling of the head, a common circumstance in the debility of old age ; of the hands and tongue, often from intemperance. Cramps or tonic contractions of particular mus- cles, result from many various irritations—are often connected with digestive disorder and uterine irritation. Convulsions and spasms, more common in childhood, derived from numerous causes ; in gene- ral more alarming than imminently dangerous. Convulsion is an affection of the true spinal or excito-motory sys- tem of nerves. It is centric or eccentric, the former most dangerous generally. A striking exception is found in tetanus, which may be excited either centrically or eccentrically ; the former not very dan- gerous, the latter or traumatic tetanus is fatal in large proportion. VI. Of the Excretory System.—It is very difficult to assign any ra- tionale of the coldness and corrugation of the skin in ague, or the gen- eration of so much cutaneous heat in certain fevers—most observable in scarlatina and yellow fever. Rush makes the remark, which is confirmed by my own experience, that a cool moist state of the skin in the disease last mentioned is indicative of great danger. Inordinate sweating was the principal circumstance noted in the ancient fatal epi- demic called sudor Anglicanus, as supposed to affect almost exclusive- ly the people of England. The perspiration undergoes changes of quality as well as of quantity, assuming a yellow or brownish hue, becoming acid and offensive in smell. The skin itself suffers changes of color, being yellow as in jaundice ; pale, white, and semi-transpa- rent, as in dropsy; orange, in yellow and bilious fevers, and hepatic disorders, and from intemperance; and livid, mottled and spotted in petechial fevers.