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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sar to obtain a depletion of the system bycathartics With his vlew, Phad reco ui scio one of the refrigerant hind the operationis hicli I rechon most certain the sal Glauberi. From this, illi the continuance of the forme course the symptotos of inflammation oon dis appea red: And whenthere remaine n sympioni os an consequencei ut the running I considerei thestate of the esset to e the reat objecto attention With the vie of restoringto thei forme vigour the secretinior-gans in the urethra the powers of the system them selves are osten fuit sussicient. And untes e the where the discli arge sexcessive in potiatis quantity, or here truns On to a very great tength, i is necesse

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29 MEDICA L CASES.

more frequently employed with safety, thatis, Peruvian bark and whicli, under properadministration is no without ver considerable Tects the extent, indeed, in whicli it was here iven I could no expect ver great benefit from it But when

exhibite early in the dis easse, ali that is requisue is that it Inouldie iuen in a paring mannem for unquestionably, it has 1bme teti lene to remove a disposition to inflammation an in ome particular constitutions the runniniis eventa sud-

e ver my intention, is circumstances mouid require or permit it, afterWard to increasse the quantity. cannot illi rea confiden cerissirm, that he Peruvian bar had here an re-

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it the diminution of the running hichsoon asterward happened Andri ammo incline to thinh, that unles froni imprudent management on the par of ur ratient imself, his complainis it in nolonitime have a favourabie termination.

It wasio found necessarycio increasse the quantityis Peruvian bar given to this patient. An as his symptom dis appeared his attendance at themispensarywas oon discontinued.

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XIX. An 'drocephalus of the Cranium. - - admitted the Lith fApri 1777, ea three years of age,

is assected illi a considerable enlargementos the cranium, hici has a monstrous appearance. The ea meas ures in cimcumference, ahen a litile bove the eyes, about twenty- eight inches and Do earto ear, long the ourse of the sagittat suture, it measures ear xleen inches.

The wholeippe par of the head is ostand elastic, an nothiniresemblinibone cani fel forta pace of severa inches in diameter. The fames et is also discoverable in the cours of mos of the futures, particulari in the bac par of the head , about the angi of the lamboid future. Her mollier hinks that in is also af sected with tota blindnesis The pupiis

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AN OBSERVATION S. 93

of her 3 es are very much dilated, and Cannot e contracted by the action oflight whil a the sanie time there occursan almost constant strahismus. Sheris unable t wal oriand net ther has siue eve been able to articulate; ut at times h ulter uncommon stirielis.

Sh has frequently been observe to pichlier nos and to grin hercieeth. Her pulse beat above an hundredstrolies in the minutes; ut the eat ofher kin is early natural her apppetite is voraciotas, and me di inlis much. More that two years ago me a sei redwith a sever attended illi convulsions, ina ery severe manner Froni that timehe head has been observet graduali toenlarge, and ali the other symptom have supervene l. A the time of her birththere,as nothiniuncommon in the appearance of he head. me mollier is inclinet to attribute her dis eas to the severiand me nows no the cause o,hicli itcante assigne l.

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tried, illi a vie to the remova of hercomplaint; ut ithout produc in any diminution of the fige of heraead, o any mitigation os an of her other sympionis. Applicetur empla rum vesicatorium hi ter

capidas, et pytia sat fonticulus ope unguenti epi polici nec non

Tincturae alappaesemunciam. S rupi implicis uncias duas. M. Capiat cochleare parυulum omni semihora donec supervenerit cathar s.

Et repetatur talis dosis bis in septi- April 9. There as a very copious disia charge of water froin the blister; ut not-withstanding the applicationis the 1 ue Oiniment, it is no perfecti healed Themixture purged herariskly, and her bellystili continues Pen. Applicetur iterum emplastrum vescatorium inter scapulas, ut antea ; sed intermittatur Uisura.

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AND OBSERVATION S. 9s

OBsERVATION delivere Iune . This patient for sonae time past has notbeen brought to the Dispensary, probab lyfrona the place of her residencessieiniat thedistance of sonae miles rom Edinburgh. Had sh continued regula in attendanCC, she would ather have affordedis an opportunit os mari in the progress of thedisease, han of the cure Respecting the nature of the assection to hicli his patient is subjected there is no room for any doubt Froni the fir st vie of her head , the dis proportion hic licitiore to the restos heriody couldio fati to strike themostinattentive observer: hil a the fame time, in his eniat gement the face, unies sin a far ascit is formed by the bones of the cranium, had evidently no mare. That par of the head however, whicli in a natural state is occupied only by the brain, was here augmented to a very great de

Such an affection, thoughio every ay

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t be et illi, et pon the whole care hardi be rectioned an Unfrequent occurrerice illi insanis, inso much that hereare also two ther subjecte to the fame distemper a present unde ou care a Dis pensar patients. Such enlargements areoniversalty found on dissection, to arise,no from any morbid increasse of the natural content of the cranium, but rom adropsica affectionci And that the case be- fore, af rd a strii in inflance of the hydrocephalus, an admit of no doubt. Under his genera term however, ery different affections are comprehended. Anil perhaps, there is no Section in whicli the symptonas are more Varied, froin the seat of the water. Practitioners in genera divide his affection into Hydrocephalus externus and internus Bythe last the understand thos instances where the water is deposited illiin the ventricies of the brain. y the first, allthos cases here the water is exterior totheirain iis etf. f, examine the nos logica systems, howevor, we,ill find that the

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AN OBSERVATION S. 29

the definition in ali of them, excepi thato M Sagar, appi oni to the externat: And his definition is a very vagiae ne fori is no more than that he hydrocephalusis a rops of the head . At the definition into hicli the en-

largement of the head enter a a charac

terising symptoto of the disease, illi nomeans appl to the hydrocephalus internus, in the sense in hicli,e would adoptthe term : And this symptom of enlarge ment of the head enter the definition ofal the other nos logists B hydrocephalus internus, e ould understand that diseas whichris si accurately described by Dryhyte, that se pracstitioners h have read his ork with attention ill e at alos to distinguisti it after it has made acertain progress Although, indeed, init earlier stages, it is a dis eas of a most insidious naturen and tilliser lately, ema perhaps a that it a no under-stood. his I the ather mention a theternis hydrocephalus interior and exteriorare employed by auvages in a sense dis T a ferent

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α98 MEDICA L CASES

ferent froni that in hicli the are commoni understood B hydrocephalus interior, he means hos cases here thewater collected illiin the cranium di sten is and opens the sutures, as in the instanceie resus B the exterior he means thos cases in hicli a mere anasarco u affection occur partiali to the integuments

of the head. Froin these disserent senses of the samo terna, dissiculties may ome times arisse. apprehend it ould nolint be the meansos auoi ling confusion, but would even far ther serve sonae good ui pose, at leas in the prognosis, is the assection ere divi dedint three species These, indeed, propei lyspeahing, are perhaps tot considere ra-ther a distin O genera than species ; atteast is, as in ther paris of theiody, e suppos genera to e constitute by thecavit in hicli the water is effuse l.

Theseci ould distinguisti by the following term :I. Hydrocephalus of the ventricles, when

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