Medical cases, selected from the records of the Public Dispensary at Edinburgh : with remarks and observations

발행: 1784년

분량: 452페이지

출처: archive.org

분류: 미분류

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AN OBSERVATION S. s

employed the elixi guriacirium volatile but, mould another case simila to this occur torus I intendiomewhat o vary the prescription and in place of the volatile, to us the simple elixir B this, maybe abieci determine ho far the powers of the medicine are tot ascribe est theguaiacum iiself fores mus observe, that I conside large doses of the present for mula a liable to sonae objections. Fromilie heat an pungency of the menstruum, me cannot Venture to emplo it undiluted; and when an watery addition is made, a precipitatio of the guaiacum is the ne cessar consequence With the simpleelixir, the menstruum, hicli is rectified spirit, ould no require dilution evenwhen given to a reater extent than halfan unce and the guaiacum itfel maybe supposed tot in nearly the fame condition in his as in the volatile elixir.

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86MEDICA L CASES

B- a hoemaher, in the 48thyear of his age, admitte 1 November II. 1776, complain os frequent an ltroublessem cough, attended illi copious and viscid expectoration, speciali in themorning He has a sense of eight and coidnes in the praecordia his respirationis omewhat difficuli longue lean annmoisae appetite natural bell bound si in cool pulses

This cough first came on aliout twelve years ago; and during the winter eason, it has been generalty aggravated. Heknows no particular cause to hicli his dis eas can e ascribed. Heias used se-Verat remedies, particulari sonte quill- pilis; hichaad the effecti opening hisbelly, and relieving the dissiculi os reath- proe

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AN OBSERVATION S. 8

Capiat hora septima vespertina su eris pe-

cacuan scrupulum unum; nec non omni nocte,

δε horam fmni, sitularum scissilibarum grana quinque sumat. December . The vomit operated weli; but he wasio sensibli haesit had any influence, ither in relievin his cough ordissiculi ostreathing. e continued the pilis regularly for a considerable time after the were ordered, and the had the effecto rendering both his cough and breathingessier; ut he has alien non of the pilis for soni daysiast, since whicli time these 4 symP .

In the xili edition of the Edilaburgh Pharmaco poeta there a no formula sor the preparation ofsquill-pilis These here used the refore, ere prepared in the followin manner, accordin to the fifth edi

tion.

R. Gummi ammoniaci, Scilla recentis, ana semunciam. Contunde simul in mortario marmorio dein adde Cardamomi minoris triti femunciam,

visa massa pitularis, addendo, si pus es, Balsam C aibae q. s. In the evenili edition o ou pharmacopoeia be-sides ther alterations the powder os dry squilis isnoru substitute to the recent root whicli unquestion-αhly urnis hes a more te ad and efficaci ous medicine.

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88MEDICA L CASES

symptoriis are again more severe. Contiantientur pilulae scilliticae ut antea, et applicetur Uescatorium nuchi, deinde imponatur unguen

tum p pa, icum ut sat fonticulus. December I . His cough was omewhateaster for a se day after the applicationos the bl ister, rom hicli there as a very copioris discli arge; ut it has been rathermore troubles me to in since the disse charge has been omewhat diminimed.

Continuentur fonticulus et pilatis ut antea. December i. There has been a copious

discli arge rom thecis sue since last repori, and his cough and reathin have been

Tu dis eas to hicli this patient is subjected is ver distic'ly marhed and a thesiam timeri is an assection hicli is noties frequent in his country than it istro ubles me and obstinate. As existingwith different degrees of severity there is solue variet in the appearance of it; andi rom

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AND OBSERVATION S. 89

from his circumstanc it has obtaineddifferent nam es, notini among the vulgar, but also among men os science Thus, there are sonae ho ould refer the diseaseos our present patientdo the head of cough; for by the reateri par o nosological

writers tum is Considere as a properceniis of diseasse There are ther who,

froin the dissiculi os reathing hicli here talae place, ould refer it to the genus offasthina, particularly to that species whichris terme the humid asthma By third se it,ouldi referrexto the head Os dyspnoea, and would e considere asan example of that species hichi Cullentias termed Tonstra catarrhatis. In myopinion, however, ait these appellationsare improper and Pimagine that his, and similar cases of hicli,e have at present severat underisu care, are to e referred to the genus os catarrh.

It mus incleed e allowed that thesymptonas of the case efore us do notcorrespon to the definition os catarrh asgive by severat authors, and particularly

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9 MEDICA L CASES

by thos vilio refer catarrh to the generalcias of pyrexiae, o febrile assections. cannot help hinking, however, that this arrangemen is exceptionabie. And is e conside the orderi profluvia a constitu- ted merely by a morbid increasse of natural disicharge froni theiody the for an association o diseases, among whicli inereis a great natura amnity. In his sense,

the profluvia ither may or a no beattended illi ever. When, however ver does occur it is no to e considerenas an essentiat, but meret as an accidental

symptoto To the orde os profluvia thus defined I ould refer catarrh, as ei nianassection, the essentia par of hicli consili scin an increasse of the mucous discliargefroni the gland o follicles siluated in the membrana mucosa Schneideri, particularly in that par of it,hicli lines the lungs. There is indeed ne diseas commonlyrechoned aspecies of catarrh.whichisa be considere Mas a strong objection to this definition and methodis arranginiit. What allude to is that contagious assection

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AN OBSERVATION S. 1

known by the ille of the influenga orepidemica catarrh, hicli, at severat different periods, has been observe to e Propagated ove ali Europe. O that disse eas sever is probahi a necessar pari. It is however, an affection, hicli in iis

natur has no essentia agreement illi

catarrh frona coid. It certaini dependsupo a peculia febrile infection andought tot confiderexas havinino more analog With catarrh rom colit, than the

Havin premi sed these observation respecting the nosolog of catarrh, it follows,

that on the vie no gi venis it me may, withou hesitation, refer the case of ur present patient to that genus. In the caset,efore us, the diseas is sufficienti characterised by the copious visci expectoration. For there an e litile oubi that thetroubles me cough is meret the conse- ence of the accumulationis this matterin

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0 MEDICA L CASES

in the ramifications and vesicles of thebronchia.

sist o disserent species, and o whicli ofthes species the present case is tole refer-xed. I mus own that jam ne of those who rechon the multiplication of the species comprehended unde genera o bebothinnecessar and improper It is in-deed triae, that the cure applicabie to any particula genus, si no means vitexto alliae species falliniunde it but neitherHil the cure os species alway anfwer forine reatinent of varieties and in actualpractice, the cure employed in any particular case ought tot adaptedo it peculiarities. I apprehend therefore, that genera oughtini tot subdivide&whenthere is a manifest and considerable disser- ence, particulari in eachin medicine. In the present affection, here are Wo condition belween whicli a distinction is requisit. that is, hether the diseas oc

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AND BSERVATION S. 3

cursis an acute o chronica assection. In

the fir st of these cases, it appears a thealmos immediate effectis a particula accident it is attended illi considerable fe-Ver and in no long time, it terminates ei-ther in healthir in ome other assection Osai assections the mos common sequeis ofit are, ither phthisis pulmonalis o chro nica catarrh. An observations on theforme of these diseases ouldie here ovios place; ut the caseiefore us naturallyleadsis to the considerationis the lalter. B chroni catarrh Lunders and an increa ed secretion o mucus in the lungs, without sever, and mos commoni mill out an degre os inflammation Thisdisea1e, a Pliave atready observed is both common and troubles me and as eingsuch, it has naturali claimed the attentionis practica writers. The have com

moni distigui med it by the ille os catarrhus senilis and in defence of the propriety of the name, it cannot e dente lilia it is hiest a diseas of old people;

Tet, ascit sonaetime occursint an early period

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9 MEDICA L CASE s

rio os life conside thesterni chroni tobe es exceptionable: and indeed, it could hardi With propriet be termed - 1ulis even with ou present patient, a mannot et fift years of age. It is froin thesedisserent considerations then, that to thediseas of this patient I give the nam os

chroni catarrh.

This affectio is ne of thos whichias

osten a fatal termination; ut for themost pari, tris no sud leni fatal andi rather induces death by earing out theconstitution than in an other manner; although in soni instances, indeed, a tients are ut ossi it from immediate suffocation. 'ith our present patient, ithas no gone to such a height a to ive much reason to apprehend this and ourpatient' strengili istut litile impatred Toali his e may add that he has not et arrive at a very advanced periodis life ;henc there are ome round forinoping

abie entirelycio rid ou patient of his disse

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