A treatise on relapsing or famine fever / by R.T. Lyons.

  • Lyons, R. T.
Date:
1872
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on relapsing or famine fever / by R.T. Lyons. Source: Wellcome Collection.

    125/408 (page 109)
    epidemic in the jail at Dera Grhazee Klian in 1855, in -wliich diarrhoea was general. Abdominal pain and tenderness are very often observed in some one or more parts; bnt only in exceptional cases are they of a severe character. Hunter noted pain in the bowels and in the region of the stomach, with hardness and fulness of the painful parts, on board the Mornington; Spencer states that pain was not admitted by the sick, but much pressure could not be borne on the epigastre; Guthrie remarked that in the protracted stages of the disease there was painful tension in the epigastric and hepatic regions, and the abdomen was hard, tumid, and sore on pressure; Beattie, LyeU, Farquhar, Hugh Clark, and Gray, have all observed tenderness of the epigastrium and upper portion of the abdomen. Tenderness of the hypochondrium is far more common on the right side, over the liver, than on the left side over the spleen ; so much so that in the earher stages of an epidemic it might be taken as an aid in diagnosis. Gray, who had the advantage of observing at least three epidemics, remarks that a quick pulse, from 120 to 140, and the general existence of pain in the region of the hver demand attention as assisting in the diagnosis. Sometimes pain and tenderness occur simultaneously in both hypochondria, sometimes on right or left side only, and sometimes in neither. Besides pain and tenderness, some authors have noticed a sensation of burning or heat, more or less severe, referred sometimes to the abdomen, but more commonly to the stomach. McDonell and MacNab especially speak of this symptom. Hunter and Edward Goodeve mention pain in the bowels and griping, with looseness; the latter author likewise met with some cases in which cohc occurred for two or three days. In examples comphcated with dysentery, pain in the ihac regions is naturally to be expected, as was noted by Lyell in the Eusufzai epidemic; but when dysentery docs not exist in the course of the disease, pain is not usually felt in these parts ; its occurrence might thus, in fact, be con- sidered diagnostic of dysentery in most cases. 8. Enlargement of the liver and spleen.—In the disease as it occurs in Europe, the spleen often becomes enlarged, in