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. 123

mum hypochondriaca sinistra conspexi duas maculas virides et sugillationibus simillimas, quae ovi columbini magnitu dinem aequabant.' That these were of the fame nature,ithwhat occurred in greater number in urpatient, cannot be doubted And there caneveni litile roundior hesitation in pro nouncin that the were the effect of ese fused blood For here a disposition to the rupture os esset manifested iis et in vari ous ways. Besore the patient Was admitte lunderisu care, he had ostener than once pontaneous ieedin at he gum and that too without an evident sign os spong texture or locat affection. .on ta-kin purgative also, he had been observe lio disicharge considerable quantities of blood by tool.

Aster me came unde ou care there

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H MEDICA L CASEA

c, an haemorrhagi esseri for ei therwas there quicknes nor hardnes of pulse, norinny other symptorii usuali attendingilia state of body. These were the only morbid symptomsevident in his case oris,hicli ou patient complaine aster comin under urcare. Atine time, indeed, me complainedo somelneasines and welliniat hercitomach. Probably, hoWever, these symp- toms were rather the consequence of the remedie iue ad taken or arisin fromsome ther accidental circumstance, hanconnected with the diseasse. At an rate, it was a complaint of ut mort duration, and givingui ille uneasines s.

At another time, he disicharged by

shool, a large orm of the lumbricolas hind. was, however, inclinexto magine that this had n connection,ith the primar assection. Worm in the alimentar cana are indeed the cause of a reat variet os symptoms, ut Ι do notano that he have eve been allege Ilo inducesuch a the present an a disicharge of the

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AN OBSERVATION S. et

them froni the alimentar canat s by nomeans an unfrequent conse=ence of other affectionS. This, Pan dispos exto imagine, as insonae degree, the case illitur patient anct would consideriae pelechia eruption, the lolches, fugillations o vibices, ana disposition to hemorrhagy, a constitutingine affection for hicli sit came unde our

care.

place o,hicli I an properi reducerit in an nosological fystem. y some nos logists, indeed, petechia isel is made a genus o diseas, but stili his nam is gi ven tothos cases here pelechiae are combinenwith febrile assections. To uch, then, me canno refer the present instance. of the sympionis here present, there arenone hicli do not, at times, occur in the ea-scurvy. ut that affection is characterised by many other marks no herepresent. Nor, in his instance, a there

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12M MEDICA L CASE s

h an means the fame progress as in in curvy. No fetor of the breath, pungystate of the unas, prostrationis strength,

ulcerations, edematous wellings, o the

like here too place No could the patientie subjected to thos causes, Ver generalty is no always, induciniit There wouldae an vident impropriety there' fore, in referriniit to this head It isnOt, hoWeVer, improbabie, that in iis

and in his a the pracstitioners of urdays have sed more Deedom than allthei predecessors, we might Pthin calicit Petechian os that is, a dis eas characte riged by Petechiae. But whether his appellationi prope or not it ili litti affect our de of it nature. In his case, Pown fron ali circumstances alien together, I shouldie api tofus pect a particula morbi state of the fluids;

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AN OBSERVATION S 129

suid. and that too without an disease of the other paris of the system, ither assimple or a livin soli is . At east, onthis round I apprehend that the symp-

toms may most rea lily be explained Thatthe soli is areio affected appear evident infrona the natural state os ever function. That the fluid are in suci a stare a tmahe their a through passages no natural to them, appear both rom hemorrhag and cxtravasation for on his cause, must considerioth the petechiae and lividitotches to depend. The former, indeed, in evers of a putrid nature, resonaetimes echoned ather critica than symptomatical: ut in ali probabilit Withou any good reason. The alter manifest the fame appearanceas occur in X travasation rom other causes There cant, no hesitation, herefore, in referringit to this ource and Pwould conclude, that he texture of the blood, probabi of the rei globules, is in sonae meastare destroyed. In his respect then, e may Presume, that the present discas has no in consi-

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rgo MEDICA L CASEA

considerable analog to curvy, in Whichthere is every evidence of a simila destruction os texture Stili, however, the casema be materiali disserent. The experi ments of M Hewson, adeson blood ta-hen rom the livinibody throw ne lighton this subjecit. Me has inown that he figure of the globula particles is connected illi a certain Rate of the fluid, in

whicli they wim. His experiment de monstrate, that by the increasse of saline impregnation, the are iuri velle and broken inward, and that by the increasse of the water pari, the are distended and broken utwards And, o ali han is, itis allowed that by putrefaction, the exture is destroyed, ithou any hange of the menstruum, acleast illi respexi iis proportioni saline alter. That ait these causes,ill, o ome de-gree, operate in the living ody, is notto e doubted and perhaps, more frequently they operate in combination hanseparalely. There is, howe ver a Presemption, frona the circumstances indu-

cing

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AN OBSERVATION S. 131

cinis ea-scurvy that the first more particulari operates in that affection and thelas is perhaps, a cause of dissolutionconnected with his putrescent tendenCy. To,hicli of these causes the dissolutiono the re particles here occurriniis obe referred Lam sonaewhat doubiful Andon his subjecit litile round of conjectureis afforded by the alledged remote cause, the eatini quantity of beatas. It is not, howeVer, improbabie, that these, si om their quantit merely may have induce thesucccedinis ever, and the eve may have given ris to this state of the fluids. Fromthis tew, Ilam ather disposed to refer itto the putrescent tendency than to an over- proportion os saline matter and accordingio his de the reatinent was conducted. O the prognosis here, observations areno precluded from the diseas havingterminate favourabis it ma naturally,

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ra MEDICA L CASEA

forme facts or, here these are an

ing, romanowledge of the nature of the discase have atready observed that thisis the sirs instance of the kines have met

mila favourabie termination, and that too in no long pace of time. Besides his, toward the en of histreatisse, he has collected severa instances, somewhat analogous, fro different ou ces, particularly froin the Acta Academiae Natura Curiosorum. In these likewiseth distias lia a favourabie termination. Uponthe whole theres ore, there is, perhaps,

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AN OBSERVATION S. 33

mould rechon it imprope to te illas of qitti account anil, illes e corrected by future experierace, I would again e dis possedo follo the fame plan os curenwhicli, although iti no precisely, is atteast early similarito that whicli succeededwithi Graas Supposing the sumptonis to aris fro adestructis of ome of the globules in consequence of a putrescent tendency, imagined that his ought tot combate lb antiseptics, and a suci Pemployed herethe Peruvianiar an elixi os vitriol. Asthe symptoms eremo urgent, I wis hedrathe to throw in the Peruvianiar gradually than in suci quantities a to en-dange any uneasmes at ille stomach. In his way, corio ed with in vitriolacid it was continue for nea the paceo a forinight and aesthe en of that period the appearancein the furface, Whichlia undergone disserent changes, but illia gradua tendency to decreasse, Was almostentiret gone.

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13 MEDICA L CASEA

the alimentar canal, hicha conjecture lmight be the effect of the medicines. directed thei belli discontinued and atthe fame time, ordei ed purgatives, o di charge the content of the boweis Bythes means the wellin in the stomachwas removed; ut probably the gave occasion to the dis charge of the worm observe after the sirst purgative. Although conclude his to e accidental, et was edo suspect that here might bemore,orms, andri thought it a leas prope to ake ome trials illi his iew.From more active anthelminiics I ashere, in ome meas ure, recluded by theide of the forme diseasse. It was his circumstance that determine 1 me to rustio theio de of camomite flowers. But, after continuiniit for sonae days, and after repeating the purgative, a there

Patient as, in very ther respect in health, Prechonexit tinnecessar that saemould continue her attendanc here. At

the fame time, I insul notae su rised

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