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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AND OBSERVATION S.

causes induc in inflammation, a natural

tioner are so much convincedi filiis that the rechon medicines in his dis eas inne- Cedary, o meret direct fuch as a pleaseand amus the patient nam far,'OweVer, from contendiniso the propriet of this practice to iis ulmos extent. hold theu se of so me remedies tot in many cases of the ulmos consequence But stili tmusti allowed that in ther cases theyma be neglected without an great dan-ge' and in generat, the neglectris productive of n other essect than that ostendering the present symptorias more ian ea sy, and more tedious here can, here fore, hei dispute, that, a far a respectis the progress of the affections the phenomena of the dis eas es are essentiali different. seconi circumstanc froni the phenomen of the dis ea se marhedi ut a demon stratini disse reiace, is that he infectio usinat ter of syphili uniformi produces yphilis, and the infectious matter of on Or- rhoea a constanti produces ora Orrhina.

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have atready indeed, observed that w hregard to the matter iv in infection inordinar cases, e re in genera in thedarh. 4e are ool-hardy enough to ex- pos theniselves Where the are certain os the existence of either disease But hereth complaints of the person iving thedis eas are asterward known it is very generali observed that whether itie yphilis o gonorrhoea, the person infected receives the fame complaint Boer-haave has positivel asserted that he neverkne any one illi the gon rhoea alone

as accurate an observe on his subjectissany one either beseret since his time. In generat, it is a certain, thacone onorrhoea is the consequence of another, a that s mall-pox ives the mall-pox. onemas ver infected illi a gon rhoea romcuttinia finger on pening a bubo noon was ver infecsted illi a gonorrhoea

froni ucklinian infant assected illi syphilis. iesides, in no instance here thegonorrhoea a received by innoculation,

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AN OBSERVATION S. 81

or the intentiona application of the matterto theloint of the urethra, by way of experiment, has an sympioni o syphilis everappeared. It would seem, heia that aclidis eas is an uniform consequence of a Particular infectious alter and wheneverme are certain o what natur that is, ema also e certain f the disease hichwil folio . A third particular rom the phenomena confirming the differetice hetween thematte in the w diseases, is drawn romthe diseases remaininis frequently separate. t must, indeed, e allo ed that the are in many instances conjoined; et, in by much the reater number os cases, each runs it course, Without the least appearance of the other. It has indeed ome- times been said that onorrhoe has been converte into syphilisci ut it has neverevenire alleged that the syphilis has been

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α8 MEDICA L CASES

naturali expect that he the matteris the syphili acts o almost every other partos the system, it ould by an action onthe penis, induce a running This, however, is no observexto appen. Hence, while here is si great reason or belle ving that it is applied we are texto infer, that in iis nature it is disserent rom thalgiviniris to a gonorrhoea. I has, indeed, been alleged that in some instance gonorrhoe gives ris to syphilist have, however, potnted ut severa circumstances ea lingo ambiguit in his respect and it is at least certain that hereare eventu se instanc , in hicli it cant, pretended that this happens; speciallyis, mali a prope distinction et ceni ea syphi litic symptoins, and those, such as1welling of the testicles, and the like, whichare the mere consequences of an obstructed discliarge, and whiclitare in no degre venereat. ivt were the infectious matte in the w diseases of the fame nature, instances of the one arisinifroni the ther could iaci ther e rare nor mbiguous. Arad,

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AN OBSERVATION S. 283

1lance of gonorrhoea infectioris matte is necessarii applied to an innumerable multitude os lymphatic absorbent on the glans penis It is certain, however, that in bymuch the reater number os cases, there isno inconvenience rom hences and inninely-nine a least os an hundred instances, there is no appearence of syphilis. ecanini suppos this to happen, ho ever, in consequence of one of two circumstances : ither his matte is incapable of be

in absorbe&; or, although absorbed, it is

innocent. But whicheve supposition eadopt, it lead us to conclude that thematter of syphilis and gonorrhoea re esse sentiali different. The hirtand last se of arguments arethos drawn frona the methodis cure. Itis certain that the remedies by whicli theone is overcome, are essentiali different froni hos curing the other. Formeri itwas, indeed, the practice in ever instance

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α84 MEDICA L CASES

perhaps, here there is ea n to apprehend that a syphilitiestaint has been communicated a the fame time illi gonor- rhoea, this is the mos prudent course. Butricis beyon dispute certain that fortite cur of gonorrhoea alone, mercur isno necessary and it is even tole doubtedi iti usefui. The cur is more readilyeffecte by more simple medicines. There an e no doubi, o the oneliand that the treatinent servinito remove gonorrhoea, is by no means illed for thecure of the yphilis and on the other hand that the reaiment uite for thecure of fyphilis, is no calculated for the remova of gonorrhoea. of this there is undoubte evidence rom attendinito thecases of thos who areinfortunate noughto labour unde both diseases a the same time. Where this happens, recourse is usuali ha to the means os curing the syphilis, a being the assection rom,hicli thegreatest immediate ange is to hesdread-ed, and rom the continuance of whichthe

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AN OBSERVATION S. 28s

the greatest viis are to e apprehended. Under his reaiment, indeed the OnOrrhoea will ver generali be diminished butthis dimunition ahes place in no greater degre than would happen froin the samelength of time alone, conjoined with the antiphlogisti regimen And the cure of the onorrhoea si no means in proportion to the influence hicli mercur has in healinichancres, discussinibuboes, o removing the syphiliti symptoriis. Be fides, in ver violent instances of the onor- rhoea, it is observed tole uninterrupted init coui se, or even increasing in severityduring the use of mercur tora great X-tentu hile, at the sanie time, his mei cur Proves essectuat in removin the sympionis of syphilis. Thus, heia, hereis no oom totoubi that with respeet tolli method of cur a least the w dis ea- se by no means agree. And this it mustbe allowed is no inconsiderable videlice that the aris fro infectious matteris a nature essentialty different. From at these circumstances ahen togetheri

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ther, I cannot hel thinhing that thi, opinion, hiches have no endeavouredio suppori, is a least in ome degre pro-

Pam far, however, Dom imagining that what Uliave no thrown out illi any means afford conviction. Posse the present observations atheros the subjecto future reflection, hancis a round for present decision and Linali e glad, is these remarks mali lead yo to examine facts with attention ford apprehend thaticis by this means alone that the presentcontrovers cante finali determined. must, however, conclude, a Phaveaiready observed that fro every vieinwhiches have been able to alae of this matter Pam inclinest conside the disiae asses a essentiali disserent. Anyon this Opinion, the practice in the instance be reus proceeded. of this, then, it nexi fol-lows that, mould osse a se observa tions and as e stati no probabi againsee much of this patient, me ma no offer such remark as are suggested

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AN OBSERVATION S. 8

In his case besere the patient came unde ou care the diseasse ad been nearly of a forinight' standing. y this there re Was reclude fro the tria o fuch practices a mightie supposie to operate, ei theri dissolving the mucus, o,hichthe infectious matter adherer ori disia charginiit, froni increasing the secretion. A the time,lien his patient came underou care the inflammator stage of thediseas might be confideresas nearly bout

the height. I thought there re, haesit ought a first tot the principat object tomitigat this. The symptoms, Owever, weremo in suci a state as to require, Withthis intention, an great evacuations And, apprehend that the more evacuant medicines cani avoide during the inflammator stage of the diseasse the les dangerthere is of the continuance of a running for an great tength of time. It was on his account, that atri si Phadnei ther recourse tollee lingior purgatives.

But bessides et oining the antiphlogistic regimen, I directed meret a medicines,

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thei se of diluent an refrigeranis Withthe last intention I employed powder of niti e withium Arabies; illi the sirst, the infusionis lintseed fron thesea oped, in sonae degree, to diministi the generalimpetus os circulation concluded however, that the would stili have more effectas countera 'ing the ea os urines and by this means ould obviat the osturgent symptoria, the strangury foro concluded that his a solet the effectos the stimulus of the urine on part8, thesensibilit of which was augmented and thises expected o diminis hirom sileathingilie acrimon of the urine by the demulcent qualit of the gum Arabic and lint- seed Buid expected stili more benesi fromincreas in the proportion of the water tosaline paris, by the introductio os diluent into the system, and by the diuretici owers of the nitre. From these practices, however, I id notreas ali the good effect whicli I expected and the state of the inflammatio at neXt repori a such that Prechone it necesse

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