A manual of the practice of medicine / by Frederick Taylor.

  • Taylor, Frederick, Sir.
Date:
1891
Catalogue details

Licence: Public Domain Mark

Credit: A manual of the practice of medicine / by Frederick Taylor. Source: Wellcome Collection.

    131/966 (page 111)
    shivering, soon followed by febrile reaction. Sometimes in this stage of invasion the patient is in a peculiar absent condition, with staggering gait and tremulous speech; or he is seized with indefinable fear and restlessness ; or there may be nausea, vomit- ing, or diarrhoea. The fever is generally high, the temi^erature from 102° to 104°, or in the w^orst cases over 107°, the pulse from 100 to 130. The tongue, at first moist and white, becomes dry and brown, and a tyx^hoid condition may supervene with delirium or coma, sordes on the lips and teeth, failing pulse and cold extremities. In the Volga ei^idemics, the urine was scanty or suppressed. After one, two, or three days' fever the local signs show themselves in the formation of glandular swellings in the groins, axillse, or neck. Mostly only one group is swelled, and generally it is the inguinal glands that are affected. The swelling may be as large as a hen's egg, is attended with severe pain, and if the i^atient survives may suppurate about the seventh day. About this time also boils or carbuncles may apj^ear, but they are not very frequent; they occur on the lower extremities, the buttocks, or the back of the neck. In the severest cases petechise, or larger subcutaneous hsemorrhages, appear shortly before death, either distributed generally over the body, or more marked in the neighbourhood of the enlarged glands. Death takes place mostly before the sixth day. In cases that recover convalescence begins from the sixth to the tenth day, but may be much protracted by suppuration of the glands. Sequelae.—Furuncles, imeumonia, dropsies, partial paralyses, and mental disturbances are mentioned as sequelae. Varieties.—Netten Radcliffe described a larval or abortive form in which the buboes appear without any feverishness, but either suppurate or more often subside in about fourteen days; and a very severe, ov fulminant form, in which patients are struck down and die in a few hours. Some such cases, occurring on the banks of the Euphrates in 1873-74, were characterized by intense fever and vomiting of blood. The mortality has always been very great, reaching 40, 50, or even 80 per cent. In the early period of an epidemic nearly every case is fatal. Morbid Anatomy.—The enlarged lymphatic glands are found to be inflamed, and generally red or violet in colour, and soft or jelly-like in consistence. The internal glands in the same neigh- bourhood are involved; thus the pelvic glands with inguinal l)u])oes, or the mediastinal glands with buboes of the neck. Tlicre is often hsemorrhage in the connective tissue around the glands. The spleen is large, soft, and dark, and there are ecchymoses of the mucous or serous membranes, and swelling of the kidneys with extravasation into their substances and into the sur- rounding cellular tissue. Treatment.—This may, as in the case of other epidemic diseases, be divided into iwophylactic and curative. The former