Observations on the characters of endemic fever in the island of Dominica : preceded by an account of the physical peculiarities of the island, so far as they influence the formation and intensity of disease / by John Imray.

  • Imray, John.
Date:
1848
Catalogue details

Licence: Public Domain Mark

Credit: Observations on the characters of endemic fever in the island of Dominica : preceded by an account of the physical peculiarities of the island, so far as they influence the formation and intensity of disease / by John Imray. 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.

    19/36 (page 19)
    pressible pulse. The arms from the elbows downwards cold, and covered with profuse cold perspirations. The lower extremities are cold and^clammy. The general surface above the natural temperature, and dry. Face flushed. Great increase of heat about the head, with free perspiration anteriorly, requiring to be constantly wipedj away ; posteriorly, no perspiration. Says he has had no headach, but had pains in his limbs. Tongue moist and coated. He has vomited everything for the last two days. Great thirst. Bowels at first open, but not moved for twenty-four hours. Restless and hurried in his manner. Twelve grains of calomel and a grain and a half of opium to be formed in three pills. One every third hour, followed by senna draught (in small quantity). To sit in hot water, in which the arms are to be immersed. 10 p. m. Two pills and the draughts have been taken and re- tained. Wanders at times; but when spoken to, answers sensibly. The great heat about the head continues, while the general strength is giving way. Pulse weak and quick. Partial perspiration and cold extremities continue. The perspiration almost runs from the forehead without diminishing the heat. Extremely restless. Cupped on the nape of the neck to the extent of eight ounces of blood ; blister to be afterwards applied. Cold affusion over the head. Sinapisms to be applied to the arms. Warmth to the feet. Three grains of calomel every two hours, followed by small doses of infusion of senna with sulphate of magnesia, till the bowels are acted on. 19^. The patient has been very restless, talking incoherently all night, though when asked a question he answers rationally. Surface generally warm and dry. The great heat about the head is unabated. Pulse and strength failing. Urinary secretion scanty. A table-spoonful of saline mixture ordered every two hours. The cold applications to the head and warmth to the ex- tremities to be continued. If he continue to sink, add wine to the arrow-root. The purgative medicine operated freely. Noon. The patient is still sinking. The intense heat about the head is only kept in check by the constant application of cold water. He can scarcely keep his attention fixed for a few minutes. He is extremely restless. The sinking symptoms increased, not- withstanding every means used to rouse the system and relieve the head, and he expired calmly in the evening. In this case, as in most others of the same type, the balance of the circulation was upset, and the brain surcharged with blood. The head symptoms were rendered more formidable and obstinate in consequence of hereditary predisposition to cerebral congestion ; several of the same family having died under somewhat similar circumstances.