Observations, pathological and therapeutic, on the epidemic cholera as it has prevailed in Edinburgh and its vicinity / by David Craigie.

Date:
[1833?]
Catalogue details

Licence: Public Domain Mark

Credit: Observations, pathological and therapeutic, on the epidemic cholera as it has prevailed in Edinburgh and its vicinity / by David Craigie. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

    12/54 (page 12)
    they were closely and carefully inspected, they proved to be merely the individual componentfollicles of the cluster, very much enlarged and swelled. In the bodies of children, the isolated glands were, on the contrary, not nearly so well marked, and were often totally imperceptible. Conversely, in adults the solitary glands were always very much developed, and acquired in some instances the size of mil- let seeds, so as to be distinctly seen to render the ileal mucous surface rough and irregular. In one case (Thomas Philips,) in which there had been wine-lee stools with reddish granular bodies discharged per anum, similar to gooseberry seeds, not only were the isolated ileal glands enlarged, and prominent, and reddened, but the whole ileal membrane was of a pale or light red colour from vascular injection. In the majority of adult subjects, however, the agminated glands were developed, in the strict sense of the word, that is to say, they were rendered more distinctly visible, and they were not only more enlarged than natural, but they were redder, and, when held between the eye and the light, the patches which they formed were more opaque than the rest of the membrane. To give some idea of the prevalence of these appearances in the bodies of those cut off by cholera, I must mention, that, among the 26 cases inspected, 22 presented enlargement and ir- regularity of the agminated glands; and 21 more or less distinct developement of the isolated glands. Though I have stated these among the appearances proper to cholera, yet I am not prepared to assert that enlargement of the intestinal glands is not found in other diseases. We know, indeed, that the agminated glands are occasionally enlarged in continued fever, and frequently in diarrhoea and dysentery, and almost in- variably in the diarrhoea of infants and children, constituting the disease distinguished by the name of dothinenteritis. The isolated glands also are liable to become prominent and swelled, in various intestinal disorders; and only on the 6th November, I inspected in the Royal Infirmary the body of a man cut off by meningeal apoplexy, in which the isolated glands of the lower extremity of the ileum were so enlarged, reddened, and pro- minent, that they looked not unlike small-pox pustules scatter- ed over the ileal mucous membrane. While, therefore, it must be admitted that this enlarged and developed condition of the intestinal glands is the most frequent and uniform morbid appearance of the intestinal mucous mem- brane in cholera, it would perhaps be too precipitate to infer that it is either the cause of the profuse discharges, or the effect of the choleric action, whatever that may be. These glands ap-