The modern practice of physic, exhibiting the character, causes, symptoms, prognostics, morbid appearances, and improved method of treating the diseases of all climates / By Robert Thomas.

  • Thomas, Robert, 1753-1835
Date:
1828
Catalogue details

Licence: Public Domain Mark

Credit: The modern practice of physic, exhibiting the character, causes, symptoms, prognostics, morbid appearances, and improved method of treating the diseases of all climates / By Robert Thomas. Source: Wellcome Collection.

    169/1018 (page 149)
    desquamation. As in other eruptive fevers, the eruption in this sometimes suddenly recedes, and an alarming train of symptoms arise. The patient becomes dropsical, the countenance assumes a cadaverous appearance, and convulsions supervene, which ter- minate in death. The same consequence has ensued on the eruption suddenly assuming a very pale or livid appearance. A florid colour of the eruption, with a uniform diffusion of it over the body, and a copious desquamation, afford a favourable prognosis. From dissections, it appears, that in this disease the fauces are inflamed, suppurated, and often gangrenous; and that the trachea and larynx are likewise in a state of inflammation, and lined with a viscid fetid matter. In many instances the inflammatory affection extends to the lungs themselves. Large swellings of the lymphatic glands about the neck, occasioned by an absorption of the acrid matter poured out in the fauces, are now and then to be found. The same morbid appearances which are to be met with in typhus gravior present themselves in other parts of the body. Cynanche maligna, as it differs very much in its nature and appearance from cynanche tonsillaris, differs also very much in its treatment; and this difference depends upon the former being attended with a fever of the typhoid nature, and a strong dis- position to gangrene in the ulcerated parts, which prohibit the employment of those antiphlogistic remedies which we find proper and necessary in the latter, and call for others of a very opposite nature. In the treatment of cynanche maligna, we should abstain from all kinds of bleeding, either topical or general, as it would infallibly prove injurious, by increasing the uritability, and likewise the debility, which naturally are very great. The same precaution is necessary with respect to the employment of active purgatives ; and we are sufficiently deterred indeed from the use of them, by observing that a diarrhea, arising even spontaneously, always does harm, and often proves fatal. The regular expulsion of the feeces 1s therefore to be solicited by gentle aperients and clysters, and even these are only to be had recourse to when nature is defective. It has often happened in this complaint, that from a want of due attention to this precaution, a cathartic has been followed by a retrocession of the eruption, and a train of the most alarming symptoms. If active cathartics are ever admissible in cynanche maligna, they can only be so at its very commencement, or at the termination of those cases, where, although there is a healthy appearance in the throat, with an abatement of all the febrile symptoms, still the abdomen becomes swelled from a eol- lection of putrid colluvies; or glandular obstructions are formed. In such instances, a few grains of hydrargyri submurias with rhubarb may be administered with caution. It has been proposed by Dr. Currie to extinguish the disease in the beginning (as in the first twelve or sixteen hours of its attack)