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.

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    pear to have been in most instances in a morbid state previ- ous to the choleric attack ; and as this morbid state appears to consist in an unusual accumulation of blood in the vessels, indi- cated by the enlarged appearance, and perhaps in some increas- ed degree of excitement, it is not improbable that it may have acted as a predisposing circumstance. It is remarkable that the follicles of the colic mucous mem- brane were by no means very commonly or frequently enlarged ; and, excepting in four or five cases, though diligently looked for, they were not recognized otherwise than in very minute orbicular areolcc or disci, not elevated above the surrounding membrane, and chiefly cognizable by the minute central aperture or excre- tory pore. I have indeed seen these follicles more distinctly in dropsical subjects than I have done in those cut off' by cholera. The other morbid appearances proper to cholera, and observ- ed chiefly in the stage of collapse, though occurring in a great variety of organs, were all nevertheless confined to the vascular system of these organs. I shall therefore begin first with the vascular system itself. The heart generally presented round its base at the junction of the auricles and ventricles, and along the acute or right mar- gin, a train of dark-coloured ecchymotic spots, irregular in shape, and varying in size from the area of a small vetch to that of a split pea, or even larger. These spots were in the subserous tissue beneath the cardiac pericardium, and were in some instan- ces largest and most numerous along the course of the vessels. Connected with this the surface of the aorta and pulmonary artery, but especially the former, was traversed by numerous minute communicating vessels, very much injected, and forming a complete vascular net-work, encompassing the proper tunics of the vessels. In one or two subjects, but especially in the body of the woman M‘Gurke, inspected on the 23d October in the presence of Dr Henderson of Aberdeen, there were distinct ecchymotic patches in the filamentous tissue above the proper coat of the aorta, and which could not be removed by mere im- mersion in water. The right auricle and ventricle invariably contained a large mass of semi-coagulated dark-coloured grumous blood, implicat- ed more or less firmly with the musculi pectinati and walls of the former, and the columnece cameos and walls of the latter; and from these a large eoagulum, generally fibrinous, extended into the pulmonary artery. The left auricle contained a small quantity of semi-coagulated dark-coloured gore ; and a small quantity of the same was very generally found in the left ven- tricle, the walls of which were always firm and hard, and the capacity very small, asif it had been much and forcibly contracted.