Four hundred cases of phthisis / by F.M. Sandwith.

  • Sandwith, Fleming Mant, 1853-1918.
Date:
1892
Catalogue details

Licence: Public Domain Mark

Credit: Four hundred cases of phthisis / by F.M. Sandwith. 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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    Stomach.—One Nubian had tubercles on the outer surface of the stomach. I only mention it because of its rarity. Intestines.—After the lungs, the ileum was the most com- mon seat of tubercle or ulcers, but, unlike phthisis in Europe, ulceration was also very common below the ileo- csecal valve, and sometimes was present in the upper colon when no ulcers could be discovered in the small intestine. Among Egyptians 43 per cent, had ulcers in the ileum, and 18 per cent, below the valve. Among the Soudanese as many as 77 per cent, had ulcers in the lower part of the ileum, besides 6 per cent, with tubercle on mucous or serous surface, and a further 10 per cent, with ulcers below the valve. Three negroes also had dysenteric ulcers in colon and rectum. Again, 72 per cent, of Nubians had ileac ulcers, 12 per cent, tubercles, and as many as 42 per cent, of these had ulceration below the valve, while two patients had chronic dysentery. One man, besides much tubercle in the upper lobes of lungs and two large ulcers in the trachea, had 130 separate ulcers extending from the begin- ning of the jejunum, and becoming more numerous towards the valve, and ending with three ulcers in the upper colon. In this patient the mesenteric and bronchial glands were not affected, and I often noticed that where there were many intestinal ulcers there were often no gland changes. In another Nubian, who had large cavities at both apices, caseous centres all over the lungs, greatly thickened pleurae, and no obvious change in the glands, there were vei’y small tubercular ulcers, which could be traced to the duodenal side of pylorus, where there were three small ones. In the ileum itself there were very few ulcers, but much small tubercle on the mucous membrane ; immediately above and below the valve there were several large ulcers, and in the rectum there were a few dysenteric ulcers. Peritoneum.—Tubercle of the peritoneum varied from small miliary points to a thick caseous mass an inch thick, matting together all the contents of the pelvis and lower abdomen. Among the Egyptians tubercle was present in 19 per cent., in the Soudanese 29 per cent., and my notes of Nubians only mention 9 per cent. Glands.—Bronchial glands were enlarged and cheesy in