A treatise on the diseases of the chest and on mediate auscultation / by R.T.H. Laennec ; translated from the latest French edition, with notes and a sketch of the author's life, by John Forbes.

  • Laennec, R. T. H. (René Théophile Hyacinthe), 1781-1826.
Date:
1832
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on the diseases of the chest and on mediate auscultation / by R.T.H. Laennec ; translated from the latest French edition, with notes and a sketch of the author's life, by John Forbes. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

    134/774 (page 106)
    nary catarrh is equally constant, and most commonly in them it is manifest. In measles it is well known always to be so; and it continues often for a long time after this disorder is cured. The same thing occasionally takes place after sim- ple continued fevers ; but in these, I have also had frequent occasion to observe, that when a crisis takes place, at the very time when the lateritious sediment shews itself in the urine, every sign (even stethoscopic) of perhaps a very intense and extended, catarrh disappears at once, with the coma, tympa- nitic aflection, quick pulse, heat, and earthy character of the skin. During the paroxysms of intermittent fevers, the stethoscope detects, in like manner, symptoms of catarrh, for the most part dry and latent, and of which some traces remain in the intervals. Even the fevers which are most decidedly symptomatic, for instance, those arising from a wound, very commonly present the same phenomena. It would, therefore, seem that the first effect of febrile action is to produce a con- gestion in the mucous membrane of the bronchia: and this eiFect is readily conceived on taking into consideration the energy of the actions of concentration and expansion which constitute fever*. The inflammatory fever of nosologists, * Cet effet se confoit facilement d'apres I'enei-gie de mouvements de concentra- tion et d'expansion qui constituent lafievre. Although I have translated this para- graph, I cannot say tliat I understand it. The statement of facts immediately pre- ceding it, is very intelligible, and of extreme importance, both in a pathological and practical point of view. The reader will not fail to observe, in many parts of this work, a very marked hostility to the doctrines of M. Broussais ; and no doubt this discovery of tlie constant affection of the bronchial membrane in fever, is considered by our author as militating most powerfully against the exclusive doctrine of thSt pa- thologist. In a practical point of view, liowever, I only see in it a cause for extending the general principle of treatment advocated by Broussais. I would be disposed to look upon Laennec's demonstration of the universal pre- sence of bronchial congestion in fever as an additional argument in favour of the existence of a similar state of tlie mucous membrantfe of the stomach and intestines, and would deduce tlie practical conclusion from it, that we sliould also endeavour to relieve the former as well as the latter, by topical applications and tlie religious avoid- ance of all stimuli. The opinion of our author, that the congestion of tlie mucous membrane is the effect and not tlie cause of the first febrile movement, is certainly more tenable than the reverse ; but tlie admission of its being the effect of the first movements, is almost equivalent, in a practical point of view, to the admission of its being the cause of these. The investigations of the French pathologists leave no doubt as to the very frequent affection of the gastro-intestinal mucous membrane in fever ; the facts just stated by Laennec equally demonstrate the affection of the mucous membrane of the lungs; may we not, therefore, presume that many other parts of the system are in an analogous