Observations on the present epidemic of typhus / by Robert Perry, M.D.

  • Perry, Robert, active 1866.
Date:
1866
Catalogue details

Licence: Public Domain Mark

Credit: Observations on the present epidemic of typhus / by Robert Perry, M.D. Source: Wellcome Collection.

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

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    strengtli. Bowels confined. There was very decided opistho- tonos, so that the boy was unable to sit up in bed, and when assistance was given to raise him, the whole body was found to be rigid and curved backwards to a slight extent. The left foot was swollen and oedematous, and the oedema extended in a less degree over the whole leg and thigh, with some hardness, and a degree of tenderness upon pressure in the course of the femoral vein. On the dorsum of the foot an erysipelatous redness was observed, which extended upwards to about the ankle. The patient was quite sensible, did not complain of much pain any- where, and took food with avidity. A purge of calomel and rhubarb was given, and sinapisms were applied to the nape of the neck and in the course of the spinal column. The foot was poulticed for two days, when a small abscess was opened, and exit given to a little pus, after w^hich the poultices were changed for water dressing and the whole limb bandaged. The opisthotonos gradually passed off. The swelling of the thigh, however, increased, and extended upwards to the abdomen, evi- dently in the course of the iliac veins. No decided fluctuation could be made out in the thigh, and the abdominal swelling increased very much up till the time of the boy's death. Wine, brandy, and beef tea were freely administered, and greedily taken till shortly before death, the patient continuing sensible all the time, with the exception of slight fits of raving on awaking from sleep during the night. On the 16th day of his illness this patient died. On post-mortem examination, a large quantity of very ofl'ensive and grumous pus was found burrowing deeply amongst the muscles of the thigh, and extending in the line of the iliac vessels through the pelvis, and into tlie lumbar region behind the peri- toneum. I had not time to make a particular examination of the body personally; and the stench from the purulent matter was so intolerably offensive, that the pathologist and his assistants were very glad to have the body removed as speedily as possible, without making any more detailed inspection of the case. Dr. Gairdner, in his communication upon fever in the Glasgow Medical Journal^ No. 48, January, 1865, gives the history of one fatal case of typhus, with secondary inflammation of the femoral vein. I have met with a considerable number of cases in which phlegmasia dolens, or white leg, occurred during convalescence from typhus, and in three or four of them, at least, the femoral vein was felt like a hard cord, and was very tender and painful upon pressure. I have also had one death from general pygemia, with the formation of numerous abscesses in various parts of the body. There appears to be little doubt that, in the case just mentioned, the abscess on the dorsum of the foot was the exciting cause of the phlegmasia b