On the occurrence and significance of intestinal haemorrhage in typhoid fever : a thesis for an act for the degree of M.B. in the University of Cambridge / by William Collingridge.

  • Collingridge, William.
Date:
1879
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Licence: Public Domain Mark

Credit: On the occurrence and significance of intestinal haemorrhage in typhoid fever : a thesis for an act for the degree of M.B. in the University of Cambridge / by William Collingridge. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    io Jenner, 1S49 (2). Hudson, 1867, p. 290. In illustration of this I shall quote a typical case below. Murchison states that out of 60 cases of haemor- rhage occurring in his practice 32 proved fatal ; that of these 32 the cause of death was peritonitis in 11 ; of the 21 remaining cases 14 died within three days of the bleeding, and 8 out of these 14 within a few hours. Again, in 60 deaths from perforation, in no less than 11 cases there had been previous haemorrhage. As a general rule haemorrhage, more especially when profuse, only occurs in those cases in which there has been severe antecedent diarrhoea ; but to this rule there are many exceptions. In 18 out of 60 cases of haemorrhage (Murchison) the symptoms had been mild, while in 8 (6 of which were fatal) there had been constipation. Jenner and Hudson also both mention cases in which fatal haemorrhage occurred after constipation. Haemorrhage very often occurs quire suddenly and unexpectedly, and apparently without having given any warning of its approach. As a rule, however, if the temperature be carefully and constantly taken, it will generally be found to present a sudden fall previously. If coincidently with this fall there be increased frequency of pulse, haemorrhage may often be strongly suspected when as yet there is no other indication of the coming danger, and the patient seems to be rapidly progressing to convalescence. When the blood escapes externally, of course the diagnosis presents no difficulty, but unfortunately