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.

    173/976 (page 153)
    thirsty, and jactitation and anxiety give way to calm ; lie dozes quietly with easy respiration, and this is of most favourable mipoi . pulse at the wrist flickers, we are in doubt if we do not feel some movement, then are we certain that we do, then this beat is unnns- takeably established, the superficial veins show themselves filling at the back of the hands, the surface is less cold, the countenance assumes more and more its natural character, and even becomes flushed, respiration is quiet and regular, temperature rises, and reaction may be considered certain. Stage of Reaction— The patient has now passed through the col- lapse, and is, in many instances, nearly himself again. In some persons recovery is as rapid as decline. The secretions are readily performed, the strength returns, and health is the speedy issue. Twining mentions the rapidity with which many Cholera patients recover, and that it is not uncommon to see a man well on the third day after an attack of the worst symptoms. Mr. Grainger says, “ I have seen a man stand at his door on Wednesday, who on Monday was in a perfect collapse.” Such cases were common in India in Twining’s day. They are not so common in Calcutta now. When the collapse has passed away our anxiety is not at an end. The perfect establish- ment of the secretions is our next desire. As said before, during collapse all secretions are stopped, but after reaction has come on they should reappear. The first indications of change is in the colour and character of the alvine evacuations. Independently of the in- fluence of drugs, such as lead, mercury, &c. we find that they become sometimes milky or whitish, then greyish, then darker or muddy, and at last brown. We find that the liver is acting, at all events as far as colouring matter is concerned. We also look anxiously for the passing of urine. We may have to wait ten, twelve, or thirty hours, or even more. At first it comes scantily, high coloured, acid, an ounce or two with a strong and peculiar animal smell, deficient in urea perhaps, but not in all animal principles, generally albuminous with many transparent casts. The albumen or allied compound when present is not always detected by nitric acid, though often by heat, giving a deposit not dissolved by nitric acid when the nitric acid test alone failed to detect it. The urine often turns pinkish with nitric acid. After the first, the secretion becomes copious, and probably by this time all the functions of the system will have become natural. The above description applies to the well-marked evacuation and algide stages of severe ordinary cases met with in the present day in India. It is not to be supposed that all these symptoms occur in everv instance, or that thevare a,lwa,vs p.nn a.llvwpll rlpvolmior! Tl 1