Volume 1

A dictionary of practical medicine : comprising general pathology, the nature and treatment of diseases [...] with numerous prescriptions [...] a classification of diseases [...] a copious bibliography with references, and an appendix of approved formulæ [...] / by James Copland.

  • Copland, James, 1791-1870.
Date:
1858
Catalogue details

Licence: Public Domain Mark

Credit: A dictionary of practical medicine : comprising general pathology, the nature and treatment of diseases [...] with numerous prescriptions [...] a classification of diseases [...] a copious bibliography with references, and an appendix of approved formulæ [...] / by James Copland. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    the calls to stool became remarkably great; a watery yellowish fluid resembling saliva being voided. The deep-seated pain above the umbi- licus prevented the patient from lying on her back and left side; and was increased by a full inspiration. Some days of relief followed, after which a violent increase of fever appeared, with a return of the diarrhoea, an acute pain at the epigastrium, and cough and orthopncea. Blood- letting was prescribed. The following morning the parotids were hot and painful; the mouth was burning, the pulse small, and the stools were suppressed. Mercury, camphor, and opium were ordered, and leeches, blisters, &c, to the parotids. Towards evening, the breathing be- came stertorous, the anxiety extreme, the pulse thready and intermittent, the extremities cold, and the face Hippocratic. She expired in the night. The pancreas was found red, swollen, and somewhat more consistent than natural. It weighed eight ounces; and blood ran freely from it upon dividing it. The duct was dilated. The parotids were also inflamed. 22. iii. The Treatment of pancreatitis differs but little from that of other inflammations of an acute and sthenic character. General or local blood- letting, or both, according to the state of the pulse and vascular system generally, and to the condition of the patient; warm baths, fomentations, and diluents; cooling diaphoretics and sedatives, are the most appropriate means. If diarrhoea be present, it merely should be moderated, by ab- sorbents and opiates, or small doses of Dover's powder; and the circulation determined to the surface of the body by promoting a copious per- spiration. A large blister, sinapisms, or warm turpentine embrocations, placed over the epi- gastrium, will generally alleviate the deep-seated pains, as well as the vomiting, when these symp- toms are present. If the disease appears to have passed into a chronic state, these external deriva- tives may be rendered more permanent by repe- tition, or by procuring a discharge from the blistered or inflamed surface; and, if indications of suppuration of the gland occur, the consti- tutional powers should be supported, and ab- sorption promoted by prescribing the iodide of potassium, and liquor potassae with sarsaparilla and tonic vegetable infusions or decoctions; a discharge from the external surface being also procured. The pale and ana:mial state of some patients in whom I have had reason to suspect the existence of inflammation of the pancreas, seems to contra-indicate the propriety of general, and even of local bloodletting, and to suggest very different, if not opposite means of cure; and in a very few instances I have prescribed the sulphate of iron with camphor and opium ; sulphate of quinine with camphor and hyos- cyamus, or conium, or extract of hops; the trisnitrate of bismuth with ipecacuanha and either of these narcotics, and similar medicines with marked benefit; but more or less doubt existed as to the exact seat and nature of the malady. III. Structural lesions of the pancreas not NECESSARILY DEPENDENT ON INFLAMMATION, Classif. — IV. Class. I. Order (Author). 23. The organic lesions of the pancreas, as those of other organs, have been chiefly referred to diseased nutrition, when they appear to differ from the more obvious consequences of inflammation. Still this diseased nutrition, varying as it does in character* form, and results, must itself depend upon some pre-existing morbid state or states, originating either in the organic nerves of the part, or in the capillary vessels, or in the secreting apparatus of the part, or in these collectively—in the vitality, in short, of the organ. Modern pathologists, in grappling with this and several other subjects which have long been matters of discussion, have had recourse to new names and terms, believing that they afford explanations, even if they do not actually constitute discoveries. But the reader will soon be enabled to estimate the true value of terms or epithets when he reflects upon their meaning, and their applicability to visible phe- nomena and changes, — to deviations from the healthy condition, which are never stationary or exactly identical with one another, but varied in form, character, appearances, associations, morbid relations and results, to an extent that precludes the possibility of description ; and he will readily detect what portion of sense and precise inform- ation may be concealed beneath the rubbish of phraseology, and the affected use of novel terms. Still terms and names of some kind are conven- tionalities that must be resorted to, in order to convey accurate ideas of certain morbid con- ditions, and their probable results; but these should not be multiplied beyond the necessity of the occasion; nor be used when generally re- ceived and well understood words are altogether applicable. 24. i. Atrophy or wasting of the pancreas some- times occurs, according to Siebold and Lob- stein at an advanced age. It is occasionally also the result of disease, either of itself or of adjoining organs. Dr. Lobstein records an in- stance of the pancreas being atrophied and some- what indurated, independently of lesion of any other organ. Most frequently, however, the wasting is connected with organic disease of the liver, duodenum, stomach, or of the mesenteric glands or consequent upon tumours developed in its vicinity, as scirrhous enlargement of the pylorus, aneurisms of the aorta, &c. Dr. Hull found the pancreas wasted owing to the pressure caused by a scirrhous tumour in the mesentery. M. Guerin observed this lesion produced by a similar cause; Moroagni by a tumour in the liver; M. Berjaud by aneurism in the aorta; and M. Mondiere by scirrhous pylorus. In this last case, it is supposed that the atrophy of the pancreas is the result rather of inter- rupted or diminished function, owing to the small quantity of chyme passed into the duodenum, than of any pressure produced by the thickened pylorus. M. Darcy has adduced a case of rabies, in which the pancreas was remarkably small. In a case recorded by Dr. Wolf of a person who had complained of nausea, vomitings of bilious and mucous fluids, of a burning sensa- tion along the oesophagus, of alternations of constipation and diarrhoea, and ultimately of ex- cessive emaciation, the pancreas was found very small, indurated, of a greyish colour ; its arteries being ossified, and its duct obstructed. 25. ii. Hypertrophy or enlargement is the most frequent lesion observed in the pancreas; but it is rarely seen without some change in the struc- ture of the organ. Chronic inflammatory action, and the consequent deposition of albuminous