Volume 1

A system of medicine / edited by J. Russell Reynolds.

Date:
1866-1879
Catalogue details

Licence: Public Domain Mark

Credit: A system of medicine / edited by J. Russell Reynolds. Source: Wellcome Collection.

    115/976 (page 95)
    or indifferent. • In general there is not much or any pain; the charac- teristic feature being that of painless, emaciating, exhausting Diarrhoea. In the advanced stages the temper becomes irritable, the pulse thready but not always quick, sometimes indeed slow; the skin generally harsh and dry, parchment-like, or in others soft and silky, and very often brownish or darkish in hue, or the tint of the brownish skins deepened. With all this, emaciation progresses as does failure of bochly strength. Great anaemia follows, as shown by the pearly eye and bloodless conjunctiva, the pallor and the dropsical swellings. Articular pains without swelling, and scorbutic patches, occasionally appear, and in the natives of India ulcerations of the cornea. The patients die with more or less anasarca, creamy exudations on the tongue and inside of mouth; sometimes with coma or convulsion, and occasionally from syncope during slight exertion. When recovery takes place there is great risk of relapse under exposure or other exciting causes. It is difficult to tell the exact mortality of this disease. It is con- siderable in the confirmed cases. The paleness of the discharges has obtained for this disease the name of white flux, though probably the term Diarrhoea alba has been differently applied by different authors. This paleness has led many to think that the exciting cause of the disease is the state of the liver secretion. It is probable that too much importance has been attached to this as a cause of the flux, and that the liver derangement is merely a part of the great general disease which gave rise to blood changes. Without doubt, an absence of bile in the upper part of the canal interferes greatly with the digestive processes, and thus the Diarrhoea may be aggravated in the same way as it is when the stomach diges- tion is imperfect, and therefore it is of importance that the biliary secretion should be. restored. We must remember, however, that in judging of the action of the liver the colouring matter is not the certain measure of the quantity of biliary acids secreted, and we should, in estimating the quantity of colouring matter, recollect the quantity of liquid and the colour of the secretions with which it may be diluted or mixed. There can be little doubt, however, that the/e is a deficiency of the colouring matter of the bile. It may be noticed that m all forms of chronic Diarrhoea there is a tendency to paleness ot stools as the disease advances. It is not improbable that there may be more than one form of chronic constitutional Diarrhoea in India and elsewhere, but in the majonty of cases it will be found that they are secondary to scurvy recognisable malarious disease, &c. J •y’ Ihll Diarrhoea,—Under the name of this, and of Diarrhoea alba passing into^Diarrhoea cum.cachexia, or cum amemia, Sur4o?Maioi’ Alexander Grant has described the disease of the Indian Hill stations which resembles in so many particulars the white Cofthfp£’ This valuable paper is to be found in the first vnll^ni « f 1 Annals, and should be carefully pemsed. IncUan