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.

    174/976 (page 154)
    ciglit or ten horn’s there is hope of regular convalescence ; but when it goes beyond this—-say eighteen or twenty-four, or more—we must, in the event of reaction, expect a much larger proportion of secondary risks. It seems that in the earlier known epidemics in India the propor- tion of cases with healthy reaction and of rapid recoveries to those of consecutive disease was greater than it is in the present day. In the great epidemic ot 1861, about 22 per cent, of the fatal cases died in the reaction stages. In England the opinion is prevalent that con- secutive risks are less common in India than in Europe. Dr. More- head shows that this is a mistake, and says that the practitioners in India are as familiar as those of Europe with all the diseases of the reaction stages. I think that most of the surgeons in Lower Bengal will confirm this opinion. Dr. J. Macpherson, in a paper on the Indian Annals, shows that for a period of ten years one-fifth of the fatal cases of Cholera in the Calcutta General Hospital died after the stage of collapse was over. Whatever may have been the case formerly, I can bear testimony to the large proportion of secondary affections which are now met with in Calcutta, both among Europeans and natives. I regret that writing this paper in England, away from my own hospital records, I cannot now avail myself of them to prove this and many other points by figures. In the Beport of the General Board of Health for the Cholera epidemic of 1853-54, it appears that in 1,777 deaths, 249, or about 14 per cent, died of consecutive fever. Dr. Gull states that probably not more than one-tenth died of it in 1848-49. In the North-West Provinces of India in 1861, as before said, the proportion was 22 per cent, which is larger than it was in England. I have, therefore, little doubt that in India, or at all events in Lower Bengal, the diseases following reaction are quite as frequently seen as in England. The diseases succeeding to collapse may be ar- ranged under the following heads :— 1st.—Imperfect reaction, relapse and occasional deviations from normal convalescence. 2d.—Complicated reaction ending in uraemia, low fevers, gastro- enteritis, diarrhoeas, and various asthenic sequelae. Eelapse after the circulation has been fairly restored, is not very common, but it is met with now and then. There is a return of vomiting, purging, exhaustion, and death in a few hours or two or three days. In one case known to me it occurred after the adminis- tration of a very mild dose of a resinous purgative. Dr. Johnson mentions a case of relapse after some pears had been eaten. In the