Clinical illustrations of fever : comprising a report of the cases treated at the London fever hospital, 1828-1829 / by Alexander Tweedie.

  • Tweedie, Alexander, 1794-1884.
Date:
1831
Catalogue details

Licence: Public Domain Mark

Credit: Clinical illustrations of fever : comprising a report of the cases treated at the London fever hospital, 1828-1829 / by Alexander Tweedie. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    mencement, could be adopted with safety and advantage, small local bleedings, blisters, and cold lotions, were resorted to. Such cases often required much consideration in the treat- ment, on the one hand, to subdue the low degree of inflamma- tion in the brain, and on the other, to husband the powers of the system for a probably protracted disease. There is another point connected with the state of the brain in fever, to which I wish to call more particularly the attention of those whose opportunities of treating the disease are limited ; viz., that when some other organ becomes inflamed in the course of the febrile action, the symptoms are more or less obscured by the cerebral affection. It is in this way that symptoms in the chest, for example, may be entirely overlooked, and in the absence of cough, and of any disorder in the respiration, there is nothing to lead even to the suspicion that there is mischief going on. The condition of the brain is the cause of this obscurity, and it is in such cases of latent pulmonary disease, that the stethoscope is of unquestiona- ble diagnostic value. I shall allude to this subject more par- ticularly when I come to mention the state of the lungs in fever. From the frequent occurrence of symptomatic inflammation of the brain in the more acute, as well as chronic forms, I have been often surprised that palsy so rarely follows. I have only seen it in one instance among the cases which form the subject of this report. This occurred in a man who suddenly lost the use of the right arm, after the more urgent symptoms in the brain had disappeared ; he gradually recovered, and completely regained the use of the arm before he left the Hospital. Retention of urine may be ranked among the paralytic affec- tions, depending on the condition of the brain in fever. It is a matter of common observation, that in some diseases of the head the bowels are with difficulty stimulated by ordinary aperients, and therefore the more active kinds are required. From an inactive state of the muscles concerned in the ex- pulsion of the urine, accumulation in the bladder often takes place; so that in all cases of severe sensorial disturbance, the region of the bladder should be examined at each visit, as I have often seen great additional irritation arise from this cause. I have known a practitioner thrown off his guard completely, by the patient passing small quantities of urine unconsciously, which not unfrequently happens when the bladder is over distended, 4