A dictionary of practical medicine : comprising general pathology, the nature and treatment of diseases ... with numerous prescriptions ... a classification of diseases ... a copious bibliography, with references; and an appendix of approved formulae / ... By James Copland.

James Copland

Date:: 1844-58

Credit: A dictionary of practical medicine : comprising general pathology, the nature and treatment of diseases ... with numerous prescriptions ... a classification of diseases ... a copious bibliography, with references; and an appendix of approved formulae / ... By James Copland. Source: Wellcome Collection.

Provider: This material has been provided by the University of Massachusetts Medical School, Lamar Soutter Library, through the Medical Heritage Library. The original may be consulted at the Lamar Soutter Library at the University of Massachusetts Medical School.

1000/1070 (page 992)

$ation, tlie crepitating rattle, or a blowing noise in some of the lobes of the lungs, diminished sono- rousness of the chest, a full andfrequent pulse, and bloody expectoration or h.-emoptysis, indicat- ing inflammation or inflammatory congestion of the respiratory organs. Wlien the digestive organs are predominantly diseased, the patient complains of an acute constrictive pain in the epigastrium, with urgent anxiety, frequent sigh- ing, a sense of suflfbcation, or of weight in the chest, and an unusual pulsation in the region of the stomach. These appear from the commence- ment, aie exacerbated at intervals, and are most severe just before the eruption. In others, the symptoms indicate affection of the bowels, with constipation ; and in some, severe pains are felt in the hypogastrium, with scanty, high coloured urine, and difliculty in voiding it. — 'I'his violent form of the disease may prove fatal in twenty-four or forty-eight hours, or in three or four days ; but it commonly runs its course in from one to two weeks in favourable cases ; sometimes, however, extending beyond three weeks. During con- valescence, debility is its chief consequence, secondary affections being rare. Those that do occur, are gastro-intestinal disorders, and the eruption of boils. 422. c. I'he alterations^/ structure have been imperfectly observed.—When a fatal result has been preceded by anxiety, pain, or burning in the epigastrium, the mucous coat of the stomach and duodenum has been found much injected. In the cerebral complication, the brain has been found congested, the membranes injected, and the ventricles filled with serum. In the pul- monary complication, congestion of the lungs, and hepatization of portions of it, have been re- marked. Although epidemic visitations of this disease in France have been frequent in modern times, and fatal cases very numerous, yet its pa- thological anatomy has been very imperfectly investigated. It is evident that death is caused chiefly by the severity of the complications ac- companying it. 423. iii. Diagnosis.—The constant, the profuse, and the peculiar sweat attending the disease from the tiine of its development, not only characterises it, but distinguishes it from all other fevers. The severity of the complications in the intense form, especially at the time of attack, and upon the appearance of the eruption, the character of the eruption, the epidemic prevalence of the malady, and its infectious nature, further serve to distin- guish it. The descriptions of the sweating sick- 7iess by C'aius, Wii.i.is, and others prove tliat it was a more intense form of this disease than has been lately observed. The cliaracteristic symp- toms of the former all exist in the latter; and, although the eruption is not mentioned in the sweating sickness, this appears not to have been a general symptom in recent epidemics. J\I. J{avfu states it to have been wanting in a great number of cases, in the epidemic of 1821 ; and M. Mlnikui; makes a similar lemaik as to that of 1832. 424. iv. PiiooNOSis.— Sweating fever, as ob- served in modern times, is a mild disease in its simple form. l'redon)inanl afl'ection of any inter- na! organ will remler the prognosis unfavourable, accr)rdiiig to the severity of such afl'eclion. I low- ever alarming the symptoms, if tliey decline upon the appearance of the eruption, a favourable issue may be anticipated. M. Rayer states that, in 1821, the eruption was independent of irri- tation of the stomach ; that it was confluent with- out violent previous pain in the epigastrium or nausea ; that it did nor always succeed the most profuse and incessant sweat; and that it did not invariably appear in cases where the gastro-in- testinal disorder was the most remarkable. Death was often sudden — more unexpected than in the common eruptive fevers, — and often followed upon shrivelling of the vesicles. The greatest number of deaths occurred in 1821, between the ages of 23 and 33. The mortality in males was one in thirteen ; and among females, one in twenty-eight. In the earlier epidemics observed in Picardy, the mortality was very much greater than this. It was greatest at the beginning and decline of the epidemic ; and among bakers, smiths, and farriers: but was variable in different townships. The epidemic of 1832 was in many instances followed by pestilential cholera. The latter malady often followed the decline of, or convalescence from, the former, and even occa- sionally appeared in its course ; the mortality being thereby much increased. 425. V. Causes. — The theatre of the epidemic of 1821, was bounded by extensive forests. M, Rayer states, that the disease is endemic in some situations ; and that it may occur sporadically where it has prevailed epidemically. It has been observed only between 43° and 60° North latitude. IMoist and shady places, excessive heat, and an atmosphere surcharged with electricity, seem to favour its irruption. No age gives immunity from an attack; but adults and females are most obnoxious to it. M. Meniere states, that many of those who had the disease in 1821 were again attacked, and died of it in the epidemic of 1832, When once engendered, it spreads by infection, in the same manner as typhus, scarlatina, and measles. Unhealthy situations, and the poor in the vicinity of the place where it firstappeared, suftered in proportion to their proximity, during these two epidemics, M, Meniere ren^arks that, of the nu- merous epidemics which have occurred in France, and in other countries, since 1718, to the pre- sent time, there is none which shows its origin, either in marsh exhalations, or in unwholesome food. 426. vi. Treatment.— Isolation, temporary migration, and avoidance of the afl^ected, aie the only preservative means that can be depended upon in this malady. — The ?)n7(/ s((i(ei-reijuire but little aid ; and it is doubtful if medical treat- ment will either shorten or iilleviate the attack. In the severer farms, and wliere some inteinal organ is especially affected, appropriate remedies ought to be em])loyed to guard it from danger. If the affection of the head, or of the chest, or of the digestive organs, be slight, lucal dejiletions will give relief. If the local complication be severe, general hlocdlellings, with powerful external and internal derivatives, as blisters, sinapisms, purg- atives, &c., will be occasionally used with suc- cess. But i\l. IIaveu remarks that the cerebral afl'ection, when severe, is often rapidly fatal, not- withstanding the repealed abstraction of blood : and that the nervous phenomena are occasionally independent of actual inflammation. — After the eruption, bloodletting is always injurious; and if$