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.

catio a themispensar after he was dissemisse l. And when inquiry was made a te him a the cnd of severa monilis afterile was disinissed fro the Dispensary, hestili continued free frona an return of his forme complaint, and in ther respecta

in perfectaealth. XXIII. An si inale culaneous Uection of the leprous

fifth ear of her age of a moderate ly culi habit and id die stature, has ondisserent paris of the rura of her Ody, an eruption appearing unde the fori of try litte- coloured scales, risin a litile above the sui face of the si in Her legsand arm are also oversi read illi an eruptionis the fame kind; ut se appear onhra face. These dry scab areis different

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aso MEDICA L CASES

degre and in a mort time the are again gradually covered by the whit scabs of

the same nature.

Shecis neve Dee rom his affection foran par of the earn ut the eruption is usuali observed tote mos extensive durinis priniann autumn Besides the eruption me complain also Ofieinifrequently affected illi eadacti, attende initiissem degre o vertigo, hicli principallyattach her in the morning an is for themon pari easter toward night Her appetite is good her beat naturat an herpulse beat about eight strokes in the minute me bell and menses are regular.

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AN OBSERVATION S. st

teen ear ago, and was theniearly to asgreat an extent asint present. During the periodis it continuance, it has a differ ent times telded to medicines directedior the remova os t. ut me has neve been long ree from t. hedoes notino what the medicines were. ut abola sive ears ago, hen me was in the Roya Infirmaryfor his complaint, here ste remainedfor the pace of bout si xteen weeks, hereceived ver considerable relies rom theus o pilis, hicli ad the effecti renderinther ieeth loose. Sh ascribes his complain to her ha- vin ea much salmon, and afterwardsdruntas resti milla as, oon after me haddone so the present affectioniegan None

of her parent oriea relations have everheen subjecte to any such complaint. Andae diei, a wellis her mode of Iiving, in other respeens, has been in nota ticular different froin that of the peopleo her own rank. Mercurii corrosivi sublimati grana quatuor aquae fontanae uncias septem a solutio, et solutioni adde spiritus lavendulae compositae unciam

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itam imam. M. Capiat semunciam omni noctς hora fomm. May 3. he has ahen the solution regulari ; and it has neve produced anys weat during the night hiat the sir si doses gripedier a litile, and occarioned somedoose stool in the moria ing. Now, o ever, itneither produces gripes nor loosenes, butiue does no observe an obviolas change in the eruptioni in the state of herither

complaintS. Continuetur medicamentum ut antea.

May 16. Her symptonas continue a be- fore, and he has o uneasines froin thesolution. Con in uetur medicamen lum. Ma 23. The eruption is sonacwhat diminis hed o the trunk of heriody, buton her armcit continues much in the samestate a formet ly. In ther res pedis, however, in no thiniis that me ei oysiciter health than at the time hen heleganher medicines. Cont Druetur solutio. Ma 3 o. The eruption on her arm is nothing

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nothin diminimed and that on thetrunk of heriod is rather increasse sincelast report. The solution has of late occasionesmuch ichnes a stomach, and se- Vere gripes, with om loosenesis; ut ithas neve had an effect in producingmoistur on the hin during the night. Intermittatur solutio mercurii corro, hblimati, eth, Acidi uitriolic drachmam, mi Aquae fontana fescunciam. S rupi simplicis semunciam M.

Capiat drachmam unam ex aquae Fatho

June I . The mixture illi the vitriolicacid occasion sichnes a stomach, ut without vomiting. She nil complain ofgripes and is particularly Uected illi them in the afternoon, hen the are in generat attended illi sonte degree of loosenes s. The eruption on herlarnis, and also on the trunk of her Ody, is much dimi nished vice inelegan his medicine. Continuetur mylura vitriolica Sed capiatdr 'chmlim unam mane et vespere nec non capiat,

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piat, bis in festimona, salis Luberi festiniariam ex aquae ferventis unciis octo pro cathar-

June 17. The w doses of Glauber'ssalis operate rathe severely hut themixture,ith the vitriolic acid sit easit onlier stomach. And the eruption is no almos entiret gone rom ver par of the furface of heriody, exceptinia litile out the wrist and ankles. Continuetur mixtura vitriolica ut antea et repetatur a GDuberi bis in septimana, sed capiat unciam unam solummodo. OBsΕRvATION delivere Iune 4. The affection under hichiliis patient labours, at least the far reater part offit, is an obvious one. I afford us an evident ex- ample os a culaneous diseasse, and that too, noctes extensive than distincti marhed in iis appearance. Some paris, indeed, of thes ursace of theiody are more affected withi than othersci and this is particulari thecas e

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cas with respexto the superior extremittes ut bessi de these the inferior ex tremities also, and the trunk of heriody,

when me came unde ou care, ere Inman place covere With the fame eruption But, exclusive of the discas obvi ousi appearing there,ere also mark indicatin here a genera affectio of the system for o fuch an affection the hea lachand vertigo, to hicli me is frequently subjected afford undoubted eviden ce These, however, are noto b consideredos by an means constitutinia separate diseasse, o giving what couldie viewed as a complicated affection. . They are meret to beconsidere a symptom Aoui the utane-ous affection, and that probabi depend-inion the dis charge by the furface. Notwithst aniling the extent of the dis easse, however, it ould appea that herhealth, in severat respects is ver litti affected. Her pulse and heat are at the natura standard while, at the fame time, the dis charges by tool urine, and ther excretions are in a healthful condition, and

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and her appetite is unimpatre l. I could, therefore, conside hercis eira subjectento no other dis eas but the obvious utaneous affection.

O the distinction os culaneous Tections and of the genera causes o,hichthe are tot attributed when speahingons me other cases, I have ali eady had occasion to make s me remarks. Accordingi the distinction hicha then attemptestio establim, there cante no doubi in referring the present case to the head of the

almost ali the character of the lepra, as defined by the greater number of nos logists. True, indeed, it is here aid that there is nei ther an itch noriainsul sensation rom the eruption Andrit is to beobserved that the forme of these theitch sensation is introduced in to the definition os lepra by most nos logi sis. Butit cannot I imagine, e considere as an essentiat par of the diseas . Aud not-with standing the account i vera by urpatient, it is, I hink, extremel doubifula hether

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whether his sensation has been entii ely

O at the species described by r Sau-

vages, the present most early resembles his Lepra Graecorum, or ascit is calle Mordinari ly the Lepra Andricis here toleobserved that the paris affecte are, ithout patia, and in sonae meas ure insensi ble. Thus, a faris an itch sensation oes occur it is hien confine i to the paris sui rounding the scabs. This affection, e ma observe, ahes place, no incleast bucraret in this coun- tryo aniles may say thates neve beforesa an instanc occurring precisset in thesiam formis the present. The eruptionis more dry and caly, and at the fame time these scales malle in si Ze, and X- tendinis arther ver theiody than is generali the casse. From ever circum lance, I was dispos edto conclude that we ould find this amec

tion ver obstinate. The dis eas , in thes area re described is generali remarhedio be o. ut it a b conssidered a still farther

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farther iantavolarabie in the instance bes reus, that the affection is by no means in arecent state. me fore this patient came underisu care, iri ad ali ead subsisted fourreen ear and during that period a great variet os medicines ad been trie invalia. o ome, indeed, e re old thati seemed for a litile time o ield; ut itfoon again returne xt it forme condition. heia, heres ore there is thias far evidence of iis being rooted in the constitution me Canno reas nabl expect an expeditious cui en and there is even reason to apprehend that in the nil, shalli asmucti follectos ther pracstitioners have been es may however assert, that he attempis to cure hich e have ali ea lymade, have o been altogethe without effect andri an no without opes that we mali e able to dismis this patient considerably elieved, and that he wil atteas continue o for ome time. I have formet ly observed that, illi respect to the principies on whicli the practice in such a cas ought to proceed, om

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