On the treatment of rheumatic fever in its acute stage, exclusively by free blistering / by Herbert Davies.

  • Davies, Herbert, 1818-1885.
Date:
1864
Catalogue details

Licence: Public Domain Mark

Credit: On the treatment of rheumatic fever in its acute stage, exclusively by free blistering / by Herbert Davies. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    18/48 (page 26)
    of Empt. Lyttae around each limb, and above the inflamed joints, and as the urine had already become alkaline, the medicine was discon- tinued. June IWi.—There is a free discharge established from the four blistered surfaces. The patient states 'that she feels quite com- fortable j that the pain of the blisters while they were applied was great, but that they had cured the pain, and that she would rather endure them over again than have it back/ I did not remark the exact number of the pulse, but was struck with the sudden abatement of all the febrile symptoms. I gave her no medicine, the urine was still neutral. June 2>Qth.—Has passed a good night, and feels very much better. July 1st.—The left wrist is rather painful, and I have ordered another blister to be applied above it. Prom this date the patient rapidly recovered, without any other treatment beyond a little chalybeate medicine. There was no heart complication from first to last. It is evident from the details of this case that the chemical pro- duction of alkaline urine by the internal administration of alkalies is no proof that the acid materies is fully neutralized and eliminated. The alkaline condition of the urine only proves that the alkali absorbed into the circulation has passed off in such quantities by the kidneys as to be able to neutralize and overpower any normal or abnormal acid making its exit in that direction from the body. The tendency of alkalies to run off by the urine is easy of demon- stration. Mr. Brande states that two drachms of carbonate of soda rendered healthy urine alkaline in six minutes, occasioning the precipitation of triple phosphate in a quarter of an hour, and re- storing the blue colour to reddened litmus paper. * It is probable that a portion of the acid virus of rheumatic fever lingers at the joints, being detained iu the tissues by some powerful force of affinity, and while inducing acute inflammatory action, eludes the antagonizing effect of the alkaline remedies introduced into the stomach. Another portion free and uncombined with the tissues, very probably becomes neutralized by the alkali, and eliminated by means of the kidneys. * Pereira's Mat, Med., vol. i. p. 177.