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. 339

much at a lassi These are in a great mea- fure tot accommodated to the particular cause rom,hicli the affection more immediatet arises and whil suci causesare in thei nature very different, theycannot tways, illi an degre o certain ty be determine l. In the casu bes reis, there are se circumstances throwin much light on the particula cause Which have operate i. In this may there is no conclusion to edrawn froni the remote causes. The patient ei fel ascribet her assiection to eat- in sim illi illa. For his conjecture, however, lam disposset to thin there isno foundation. Not ni patient them-selves indeed, ut pracstitioners also, reled i conside the iis of fisti as a powerfui cause of culaneous dis eas es andri dono mean o deri that it a b the casse. But when his happens, it is no the Tecto a single meat, but of the long- continia edus os niti, and of thes a then constitu-ting the greates par of the aliment. Here, however, the dis eas is ascriben

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36 MEDICA L CASES

the se of sim at on mia only and thento the imprudent mixture of them illi milli, hich he ook at the fame meat. Though suci a mixture is ver generalty fori, id I am inclinet to conside it sineret a popularii ejudice. And at ny

tion, we might conclude, haesit ould hemeret os a transitor nature suci ascis frequently observe J to proceed, in omeliab iis, rom the se of hell-fissi and in-deed, in particula constitutions froni theaestion o different articles of die on the

From the obstinacy and extent of the a section, illi his patient, I was inclined toconsside the dis eas as in a reat meas ure depending on the genera state of the fluids Hences imagine, that a cure aschi est tot expected rom an alterationo the mas of lood Andri is no improbabie, that a radica recovery, is it beobta ined, illi more the effect os diei than os medicines It is on the dea no mentioned however, thates have thoughis Of

373쪽

AN OBSERVATION S. 361

C attempting the cur rathe by internalthani externat meas ares: Though I mustat the fame time confessi, that the remedies whicli I have ali eady mployed re used rathe on an empirica than on a rationalfooting. Pliave ali eady suid that Plookipon thegi eater par of culaneous affections a tobe curediatheri externa than by internalmeans Andri imagine that even the lat-ter omelimes have influencei topical ac tion on the affected part after entei in by

circulation.

How a the medicines hicli, havehere sed may have acted ora these principies, I halliso pretend o say. ut Iam inclinet to thinli, that his is particulari the case illi respect to the sirs medicine hicli, employed the mercurialsolution Ilam persuaded that here is nota more powerfui medicine than mercury, where a change is requiret in the generalmas of the fluids A the fame timeo suppos it to aet also as a stimulant, and asMi evacuant by different excretortes rom

a the

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36 MEDICA L CASES

thelody It exeris these essect more speciali on the excretori' at the sui face, when it is thrown into the system in anacri or saline state. And of ali the acrid mercuria preparations I conside the corrosive sublimate mei cur to e the ost

Lwas heresere in hopes that in the present instance, it might have been productive of good essects It is osten, Owever, inconvenient oscit occasion gripes, an lother assections of the alimentar canal, especiali when it is continued foris con-ssiderable tengiliis time without intermisiason. With the present patient, after omeweeks continuance, it produce these effect and as, during that time, the progress of cure mas, at the ulmost, ut verysio w, I substituted in iis place a different

medicine.

The medicine I then ordemst as, in-deed, ne hicli, in such complainis, hasbeen very litile used Andri chi est employed i in the present case, a I imagine liliat, is it succee led in an affection o obstinatet

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AN OBSERVATION S. 63

stinate, it ould assori me the strongest confirmation o iis emcncy. his medicine a the vitrioli acid, ahen internalty It was i st, I belleve, introducedin his anne against culaneous assectionin the armi es of his russian Majesty, as cure so the ich. Since that time it hasbeen much used in the continent of er- many particulari a Goettingeri, by rBal linger, ne of the most eminent professor there, as a cure both for the Scabies Sicca and Humida. The successe hicli ithas had in his hand is sussicient Pthink, to lead to future triai and with the pre sent patient, the appea rances arent least son fialtering he had not sed i formany ays, hen the eruption, even where it a bes ore the worsi, was ver much di- minimed. In this siluation, however, I rec-koned it prudent to have recourse to the useo repented purgatives No that I drea lectan thin frona ha is generali callest the repulsion of the eruption, ut hecause I concluded that it must occasion a change in the circulation, frona hicli there as

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36 MEDICA L CASES

sbine inconvenien eoo e apprehended. And suci, inconvenieno in practice, thinh, I have ali eady ad occasion to ex perience. In ne instance in hicli I used the vitrioli acid against an eruption fili herpeti hin i, very oon after it was begula, the progress to cure appeare tolever rapid. ut the remova of the eruption a succee led by a dropsica assection hicli I was incline to attribute tolli cur of the utaneous diseasse, and whicli, Pthought might have been avoid-ed by assor lin another utiet. It was with the intentionis affordinisuch that Phere employed the saline purgative. twas used however, only with the vie of obviat in consequeraces and in his case, it is, intention to try, at leas for sonae time, ha canae essected by the internaluse of the vitrioli ac id alone. Is his dono succeed, I have thought os applyingit externalty united with hog's-lard. In suci, an union it fornis an Oinimenti nomeans inelegant, hiches an incline tothin wil posses severa advantages Ver

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AN OBSERVATION S. 6s

The eruption, hicli ad versi reade ver par of this patient' body, was in the pace of a se weelis almos enti relygone. In his ituation it was thought un- necessar to continue the vitrioli acid tolli sanie extentos efore. It was here- fore ordere estote iven in malle doses and les frequently repeated hantefore. But no long after his hange had been made, o me resti pol appeared on herarnas and thes couldieitherie adesto γield to the internat se of the vitriolicac id, o to the externa applicationis itin

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366 MEDICA L CASES

in the oriri os intinent. inster these medicinest ad been tricii or What a thought due tength of time, recourse was' ad to second tria of the corrossive sublimate mercury solutior of this a both taken internalty, and applied diruardlyto the affected paris in the orna of oultice. these practices his loca assection, at east, telded; for no eruptionreturned in the trunk of heriody or onthe inferior extremittes And, bout theend of October, he was dismissed romthemispensary, ree romine complainis. But abolit the eginning of April herforme affection returned and me hecame again a patient a themispensary, here a

temporary remova of the disease Was oncemore obtaine l.

XXIV.

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D OBSERVATION S. 36

present attended mitti the expectoration of visci xyellow- coloured alter. in different times heias expectoraled ery considerable quantities of florid red lood nearly in the sanae state ascis it ad beendis charged frona a vein About two weehsago, he hinks that he also dis charged a considerable quantity of loodi vomit ing and he frequently discoversis litile in the alter hicli helat present expectorates. ut the matter dis charged has eitheran fetid mellisor dis agreeable aste He

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368 MEDICA L CASES

lily, ins much that he an alii oni in the mos infirm manner. His habit is, toaPPearance, Ver much exhausted heingremat habi th in and spare; hicli, hesays, was no formerly the casse. Whenthere is a considerable discliarge of blood, it cases both the ough and dissiculi ofhreathin for a mort time. ut these symptotos soon again return, and hesthinks that his complaints are increasing in vio-ience Hesseeps it in the night his appetite is much impatred his pulse beat; about inely- si strohes in the minute; and his bellyris in genera regular. He has been assected illi his presentcomplainis, particularly illi the loodyexpectoration, at times, o ome degree, for these severat ear past. An the debilit whicli the have induced has beenso great, that for these last three ears, he has been linos totali incapable fworking. He attributes these complaint to colit,to hicha was exposed before the commencement of them, and whicli, at that timea

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