On diseases of the lungs and air-passages : their pathology, physical diagnosis, symptoms and treatment / by Henry William Fuller.

  • Fuller, Henry William, 1820-1873.
Date:
1867
Catalogue details

Licence: Public Domain Mark

Credit: On diseases of the lungs and air-passages : their pathology, physical diagnosis, symptoms and treatment / by Henry William Fuller. Source: Wellcome Collection.

    455/596 (page 437)
    becomes more oppressed, aphthous ulceration occurs in the mouth and throat, the appetite fails, and the patient sinks. In many instances these symptoms are found associated with amyloid de- generation of the tissues. In another class of cases the symptoms at first do not differ materially from those just described, but after a time severe ab- dominal pain occurs, accompanied by sickness and irregularity of the bowels; there is gradually increasing distension of the belly, caused partly by the effusion of lymph and serum into the ab- dominal cavity, and partly by flatulent distension of the bowels; and there are great tenderness on pressure and severe febrile excitement. Those symptoms, which are due to ulceration of the glandular structure of the intestines,, and a tuberculous condition of the peritoneum with chronic peritoneal inflammation consequent thereupon, may be brought more or less under the influence of treatment, and thus may run a longer or shorter course; but their occurrence is commonly the sign for the commencement of un- controllable diarrhoea, rapid emaciation, hectic fever, and other symptoms which bring the patient rapidly to the grave. In yet another class of cases the symptoms resemble those above described, except in the occurrence of fistula in ano. The cough is just as slight, the nervous and physical depression as great, and emaciation is also well marked; but diarrhoea is a far less prominent feature, and appears to be replaced by the discharge' from the fistula. Sometimes, indeed, a harassing cough or a troublesome diarrhoea may coexist with a fistula in ano j but, in the cases of latent phthisis now under consideration, neither the cough nor the diarrhoea assume any importance unless the dis- charge from the fistula is checked. Nor need they do so even then; for if the patient's health and strength be improved, and the tendency to further mischief arrested, the discharge may be stopped and the fistula cured without any fear of untoward con- sequences : but if, on the contrary, the discharge be checked while the constitutional disorder is still progressing, severe cough or pro- fuse sweating will be excited, or diarrhoea will set in, and the malady will assume the more ordinary features of pulmonary consumption. In some instances of latent phthisis there is almost entire