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.

    169/976 (page 149)
    cause of sanitary science in India, either ^ standing position about those high in power, or by their officiai stantog or appointments, Kenneth, Mackmnon, Martin Bedford, Oheveis, Parkes Balfour, Moreliead, Eogers, Bonnier, Maclean, Alexander Grant/Forsyth, Hugh Macpherson, Ewart, Maclennan, Leith, Mouat, and P. Walker may be mentioned with special hononr. Symptoms.—The typical cases of well-developed Cholera present well-defined symptoms. The descriptions in the following paragraphs apply to the ordinary forms of epidemic Cholera. In the beginning of an attack, the most prominent symptoms are disturbances ot the stomach and bowels. Then, in swift succession, though not necessarily in that order, the circulatory, respiratory, muscular, and nervous systems suffer. Then, in severe cases, ensues _ extreme depression of all the functions of life, which often terminates in death. The symptoms are naturally divided into periods or stages, which may be called those of Invasion, Development, Collapse, and Reaction. Stage of Invasion.—We have not very often to deal practically with more than one or two sets of symptoms in this stage; viz. preliminary disturbances of the bowels. There are doubtless other preliminary signs which are sometimes felt for a few hours, or even days, _ by patients, before passing into the well-marked stages. Twining, Annesley, Orton, and others mention among these preliminary symp- toms a feeling of malaise, oppression of epigastrium, depression of spirits, pallid, anxious, and sorrowful cast ot countenance, sense of exhaustion, vertigo, noise in the ears, headache, tremor, and sense of debility. Annesley gives the following statement of the sensations of a patient, related by himself to his surgeon, Mr. Colledge : “ I must knock off work, I feel unable to do more, but do not know what is the matter; I have only a little pain in the stomach and rumbling in the guts.” Mr. Colledge says, sighing, peevishness, and uneasiness accompanied these complaints. Annesley relates a case in which, from the countenance of the patient, he suspected the approach of Cholera, and in wdiicli he contented himself with merely watching him. Nine hours elapsed after the establishment of his suspicions from premonitory signs, before vomiting, purging, and spasm appeared. Without douht, after making due allowances for the fancies and terror of people during Cholera epidemics, preliminary disturbances of the nervous system have occurred, and should not be made light of. But it must be acknowledged that in the majority of cases no such fore- warnings are perceived. A premonitory symptom for w'hich medical mrl IQ n'ffon rlnrmrr rHirvInva oru rlrmTiPC! to rliovvlTmn rPl-»H ^ ~ ~