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.

    48/54 (page 48)
    and the cold affusion evidently abated the symptoms of cercbro- meningcal affection. But the circumstance of other individuals of the same family having died of symptoms of hydrencephalus, showed that little could be expected from any remedies. The result of these cases, nevertheless, shows that some means may, with reasonable hopes of success, be employed to oppose this formidable symptom. While I cannot hold it up as a remedy that will in all instances remove the renal congestion and restore the natural secretion, I think that in the majority of cases,—that is, ten out of twelve,—in which the system pos- sesses sufficient energy to rally spontaneously, and yet not enough to resist alone the overwhelming congestion of the cere- bro-meningeal and pneumo-bronchial vessels, this local deple- tion may always be used with the hope of restoring the urinary secretion. It was remarkable, indeed, that when it succeeded in this, the head was always less oppressed, and the respiration became more free ; and, if the healthy action continued, or was not interrupted, the circulation soon resumed its natural course. To the employment of this mode of attempting the re-esta- blishment of the urinary secretion, I have already stated, I was led by reflecting on the appearance of the kidneys and their vessels in those who died during reaction, combined with the analogical condition of the vascular system in all the organs. I have also mentioned, that the papillae of the tubular cones always emitted when pressed a thick, milky, opaque fluid, and in one case a bloody fluid. In illustration of the nature of this fluid, and of the pathological state of the urinary secretion, it is highly interesting to remark, that my friend Dr Christison had previously ascertained, that the urine first voided by patients in choleric reaction, is much less dense than natural, and always contains more or less albuminous matter, and that in some in- stances urea is found in the serum. On mentioning to him some time ago the effects of the local depletion and counter- irritation, he communicated to me the experiments by which he had determined this point; and, though these experiments are not so complete as I well know they would have been, had they not been interrupted by a severe and tedious fit of sickness, and afterwards by circumstances over which Dr Christison had no control, they are so precise and satisfactory, so far as they go, that a short abstract of their results cannot fail to be interesting. Dr Christison examined the density of the serum of the blood in nine cases of patients, three of whom were bled before col- lapse, two in that state, (John McDonald and William Mel- rose,) in one case (James Keir,) after reaction had commenced, and in three in which it is not specified. In all the cases in which blood was drawn during violent symptoms, the density of the serum varied from 1038, which is the lowest, to 104.5.5,