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.

    135/976 (page 115)
    in general cold arid clammy, and immense discharges of blood often take place from the bowels, determining the fatal issue, and also nom the mouth and nostrils. . . . , Scorbutic Dysentery is met with when the conditions which induce that cachexy* are superadded to any type of dysentery. I had an opportunity of seeing the ravages worked by this form of the disease during the first occupation of Chusan in 1840, one of the most dis- graceful episodes in our military history. Here we have the usual sirrns of tlio scorbutic cachexy—pallor, emaciation, extreme lassitude, pains in the loins and limbs, a spongy condition of the gums, which bleed on the slightest pressure. Soon livid and purple-coloured spots appear on the legs, and ulcers of a weak and unhealthy kind follow the least injury to the surface, the pulse is feeble, the appetite bad, and the debility extreme. To the above are added the. symptoms of dysentery, only the evacuations are, from the first, fluid, bloody and nearly as offensive as in the malignant form. Scorbutic Dysentery does not run so rapid a course as the sthenic or malignant (typhoid) form, rarely proving fatal in less than three weeks, and, in the more chronic form, it may extend over as many months. Diagnosis.—This ought not to present any difficulty. In acute cases the tormina, tenesmus, muciform and bloody stools, and above all, their peculiar odour, will distinguish Dysentery from diarrhoea. If seen in a more advanced stage when the stools have become more fluid, the history of the case, the nervous depression, the blood in the discharges, and once more, their cadaveric odour, will establish the diagnosis. The author once saw a case in which a grave error in diagnosis had been made. A lad between thirteen and fourteen years of age, the son of European parents in India, was seized with frequent calls to stool, with much gastric irritation, nausea, vomiting, restlessness, and oppression. The practitioner who first saw the case, seeing that the stools were scanty and muciform, without feculence, and passed with griping, pronounced the case to be one of Dysentery, and proceeded to treat it with calomel and opium. Under this treatment the stools, still presenting the same characteristic appearances, became of a greenish colour, and the gastric symptoms were aggravated. Seeing the patient at this stage, the first thing he noticed was the entire absence of the peculiar dysenteric odour in the evacuations. On inquiry, it was found that before the appearance of the so-called dysenteric symp- toms,, the patient, after slight febrile and catarrhal symptoms, had an eruption on his skin, which, after imprudent exposure to a cool sea- breeze, suddenly receded, the recession of the eruption being followed by the symptoms mistaken for those of Dysentery. The patient was placed at once in a hot bath; soon the characteristic rash of measles appeared, nausea and vomiting subsided. Under simple treatment the I disease ran a mild course, and the lad soon recovered.