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. 3

ease; ut that he Will, a formerly continue to e more or les affected illi itduring the winter-season. I liope, OweVer, that, unde proper reaiment, his complaint manat east be alleviated par ticulari is his siluationis home e such

In his affection, in generat, I imagine, that the reat object whieli is to belaimedat in the cure, is to restore the secretion, by the lungs, o iis natural states and thebe way of effecting this, is by diminis hin the determinatio of the loodio the lungs Henc it ecomes no esse necessarycio avoid cause promoting determination here, than to usi suci means asHil increas the low of lood to ther paris. Os ali cause determining blood tolli viscera in generat, perhaps the most considerable is the application os colit to thes ursace of theiody an hencerit is that the dis eas of hicli, no treat is universali allowe to e ori during the winter-monilis. An it is ne of those

affections in hicli it is of the ighest utility

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96 MEDICA L CASES

utilit totas the inter in a arm climate. With patienis,here that mode fcur is unattainable coli is particularlyto b guarded against by prope cloathingand conafortabie lodging, as by these means unifori circulation is hieflycio e supporte t.

But besides his, the determination totheireast ill also e diminished by allthos meas ures hicli increas the flow of bloo to eighbourin part and withthis vlew, nothin has a better, o more permanent effect than om drain froni theiody unde the formis siue orieton. With nearly a simila intention also emetic are osten useful These have particula influence in giving powersu determi nation to the surface: et it must be alialowed that this determination is no per manent; and in his diseasse thesare per-haps stili farther serviceabie rom another principie. The distressing sympionis hicli here tali place although ultimately the

consequence of an increased secretion ofmUCUS, re et tot considere Das imme

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AN OBSERVATION S. 7

diatet proceedinis rona the accumulationos his mucus in hos canals and receptacles hicli are provide trio air Hence considerable relies may be derived rom allthos means os cure hicli serve immediatet to unload the bi east by promotingexpectoration and with his intention, there is perhaps no remed more service- able than emeticS. Emetics, however, at the ulmost, cante repeated oni at certain intervals hence, it ouldi ou endeavou to obtain relies frona somethin productive of the sameesseest, heis of hicli cani more uniformi persiste in. Mith his vidis, is therei in realit any remedies hicli, byentering the circulation, and in this man- ne reachin the lungs, produce a tendenC to excretion, e mould naturallythin os employing these Some, indeed, are disposed to den that an suci medicines exist buta musaeown thatu cannothelimentertaining on his subjecit, a very different opinion can se no more dif

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s MEDICA L CASE s

emeens os a remedy, entering the circulation, thould appea a the eXcretor o secretoryorgans by the breast than by the kidneysor salivary lan is That an action on the two alter ahes place, is undeniabies and , for my Wia part am convinced that with respect to the forme also it is con firmedi observation his effect is particularly observabie ro in the use of many of thos very substances hicli, after their introduction into the circulation, ho thei influenc on the kidneys such, forinstance, as squilis. Such remedies, in-deed, may in the present affection, be sup- posed to have aia effecit, a far a theyten Ito increas secretion ut this is morethan counterbalanced by their ivinianadditiona stimulus to excretion, and by this means unloading the lungs. While these medicines aid expectoration, they seem ais to produc a change ori thestate of the matter expectoraled for after their use, it manifesti appears of a consis ence les visci l and esse tenacious hant,efore. his probably, is no the effect

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AND OBSERVATION S. 99

os an alteration on the state of the mucus, ascit is secreteil; ut it happens mere ly rom eYcretion occurring before the mucus has in consequence of stagnation, C-quired an great viscidi ty. Thus, then, although fuch remedies an e considere lagia vingi ut litile tendencycio produce aradica cure, et the are os considerable service a alleviatin the diseasse. On these genera principies I have begun, an mean to conducit, oia practice, in thecas before us and the observations hichliave o been ossered, ill fuit explain t yoti the intentions hicha have inite in avita recoui se to an issue, to the squill-pilis, and to repea ted emetics. In the se of the wo former, mean uniformi to persistrior sonae tength of time; but the alter,illie used only occasionalty When, rom much dissiculi os breath-ing there is reason to suspees that a considerable quantit o mucus is accumulate in the bi east. I liope, heres ore, thatis the other remedies have the essedi tolewissiet for these ill e les necessary.

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1oo MEDICA L CASES

In the future management of this case, e

drain to a disserent siluation ora a disserent forni and with the squilis, me mayconjoin asia foetida But suci changes excepted me ill probabi make n other alteration in the reaiment of this case, inles from circumstances of the diseasemith hich e are at present unacquainted.

ing the use of the quill-pilis, heiecamemuch affected mitti costiveness, which was obviated by the use of cream os tartar. ut although by these meas ures the severit os his dis eas was allevialed, et it continuedio distres him much during the wholeminter and about the end of AJay, hen

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AN OBSERVATION S. o i

curia MedicInes.

his age, admitted November 2 O. 776, is by trade a chairman, an naturalisos a robust mahe. In the right hypochon-drium, a considerable rumou may be eit, extendinito the umbilica region Thistumour ives him litti uneasiness, eveno pressure butae is affected illi constant ichling cough, and his respiration issonaewhat dissiculi. He has ome hirst; his appetite is considerably impatred an the eeps ill on account of the ough.

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1oa MEDICA L CASE s

and moin urine naturat, both in colourand quantity. About two ears ago the welling assirs perceived, and it has since graduallyincreasse l. illi the ough he has been affected oriearly the same tengilii time. In une las he was ei ed illi a vomitingo blood whicli est him, after continuingabout a monili. Heias dis charge lilood hy sto it for above two ear past, at inrtervals of two or three monilis and abolita ea ago he was Tected illi severegri pingialias in his boweis: these, howCVer, ere et leved by the vomitin ofblood hich oon fierward succee led, and of late the have been much es se

vere.

He an signis cause se his dis. easse he has sed an medicines illi litile relies Some time ago, he drankthe purgative minerat,ater a Pitcathly, Whicli, e says, in sonae meas ure relieved the patia in his boweis.

Unguenti mercurialis unciam linam, Camphorae grana cccM.

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AN OBSERVATION S. 1Ο3

Terantur optimebimul, ut sal unguentum.

Hoc inunguatur tumor abdominis inmnocte, etsingulis viciis, scrupulus unetlsis Gibeatur. November a 3 He thinks that the tumour

in his abdomen is tessiainsul to the ouch since helegan the oiniment. Me has liadno bl dy disicharge by tool ut his other symptom continue early in rhesiam state a before, and the cough is very

'dragrari granum unum, Conservae fructus Ino at drachmam di midiam. Treantur optime simul ad perfectam globulorum extinctionem, ut a bolus fora somni sumendus. Repetatur risis alternis noctibus. November go. me has continued theoiniment, and ahen three bolus es, without thei producing any inconvenience. Hestili hinks thelain of the tumour sonae what diminiined, and he has had n re- turn of the blood stools Continuetur tinguentum, et repetatur bolus tertia quaque nocte.

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December . He has ahen his medicines a directed, and has fel somelight forenes in his unis for these three Jayspast. He thiniis that the ain rom thetia mour in his abdomen is stili les than for- mei ly, ut the welliniis nothini liminis hed. Omittantur boli, continuetur unguentum, e capiat salutarum thebaicarum grana decem alternis noctibus .

December in He thinhs his coughsomewhat aue since e egan the pilis andine has ad n farther retur of theblood disicharge by tool. The patia in his abdomen continues easter, and he hinks that the welliniis omewhat fallen. Continuentur medicamenta et repetatur holus ut antea, alterna quaque nocte. December et i He is again aestimes en

sibi os a copper ast in his mouili sincethe boluses mere repeated hut withou anys pitting. His cough, and the difficult of breathing, have been very uneas for ome

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