Tubercular fever and its relation to enteric fever / by John Harley.

  • Harley, John, 1833-1921.
Date:
[1872]
Catalogue details

Licence: Public Domain Mark

Credit: Tubercular fever and its relation to enteric fever / by John Harley. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    Case 4. — Acute tubercular pleuro-pneumonia; severe a?id persistent diarrhoea ; slight deposit of tubercle in the ileal glands ; death on the thirtieth day, the event being accelerated by epilepsy. Kate Newman, ajt. 18, was admitted on the seventh day of a febrile attack, which began with headache, shivering, and looseness of the bowels. 7th day.—Pulse 120; skin hot and di-y; tongue white and moist, but inclining to dry; respiration 30; lower lobe of right lung dull, with fine crepitation; a dry cough; bowels loose. 9th day.—Sharp pleuritic pain beneath the right nipple; bowels very loose, stools light coloured. 10th day.—Pulse 132; resp. 36; cough still dry; free perspiration. 12th day.—Crepitant rales over the whole of the right lung, very crisp at the apex; scanty muco-purulent expectoration; left lung normal. The bowels had acted once a day only during the last three days. 15th day.—Had an epileptic fit (to which she was liable) to-day. 16th day.—Signs of increasing consolidation of the right lung, crepitation becoming general in the left. Pulse 120; cheeks flushed; return of diarrhoea. 18th to 21st day.—The diarrhoea j_was checked to-day. Pulse 132; resp. 48; cough very troublesome, with scanty expectoration of frothy mucus. 24th day.—Tongue white and moist; temp. 103° Fahr.; much flushing. The whole of the right chest dull, with fine, dry, crepitant inspiration, most marked at the apex, and bronchial breathing, wheezing, and crepitation, in the left apex; cough short, dry, and troublesome. 25th day, 9 a.m.—Temp. 104°; 9 p.m. 103-4°. 26th day, 9 a.m.—Temp. 102-4°. 27th day, 9 a.m.—Temp. 103°, 9 p.m. 102-6°; pulse 144, thready; resp. very short, frequent. The cough was still very troublesome, and at times she now expectorated an ounce of frothy, nearly clear bronchial sputum. This began to excite vomiting, and her strength was rapidly failing. On the 30th day she was seized with another epileptic fit, which lasted ten minutes, and terminated in death. She continued bright and intelligent up to the time of this convulsive attack. The body was slender and somewhat emaciated. The right lung was adherent to the chest-wall and diaphragm by new and tender dryish membrane; it weighed forty-two ounces. The whole lung was disseminated with rather coarse granules of yellow tubercle, which were separated by very short intervals of bright red, half-consolidated lung-tissue. The apex was quite solid, the tubercles being nearly confluent. The left luvg weighed fourteen and a half ounces; it was partially adherent at both base and apex. The apex was slightly WTinkled, back and front, and beneath the puckcrings were masses of fine granular tubercle. The lower lobe, particularly the posterior part, was strewn with yellow tubercle, but more sparsely than the right. The spleen and mesenteric glands were normal. The small intestine contained slimy, semifluid, gamboge-coloured frocal matter. Ex.