Observations, pathological and therapeutic, on the epidemic cholera as it has prevailed in Edinburgh and its vicinity / by David Craigie.

Date:
[1833?]
Catalogue details

Licence: Public Domain Mark

Credit: Observations, pathological and therapeutic, on the epidemic cholera as it has prevailed in Edinburgh and its vicinity / by David Craigie. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    characters of typhous fever. I have on a former occasion mentioned, that my observation of the first cases of choleric re- action which I witnessed led me to doubt the accuracy of this view ; and my subsequent experience has only tended to confirm this opinion, and to enable me to recognize a wide difference between the state of the system in typhous fever and during the reaction from the collapse of an attack of cholera. Choleric reaction consists in a congestive state of all the larger vessels of the head, chest, and belly ;—the vessels of the brain and its membranes; those of the lungs and the heart; those of the sple'en, stomach, and intestines; and those of the liver and kidneys especially. This congestion is not con- fined to the brain alone, or to the lungs alone, but extends to every part of the sanguiferous system. It approaches in gene- ral by slight redness of the cheeks and a little warmth of the face, while the eyes continued still suuk in the orbits, and sur- rounded by a leaden-coloured areola. At the same time the breathing, which had before been slow and languid, becomes slightly freer, but is performed by an extremely labouring and heaving motion of the chest, without, however, seeming to fill the lungs perfectly. At this period there is often hiccup, or even occasional retching or vomiting; and the congestion of the kidneys is indicated by no urine being as yet secreted. In the course of eighteen or twenty hours, if this state did not amelio- rate, a degree of drowsy lethargy and sleep came on, from which the patient could be raised, speaking not always very coherent- ly, and often showing hallucinations and other errors of sense; the respiration either became more frequent, with short and in- complete inspirations, or, remaining the same in point of fre- quency, was slow, languid,and feeble; mucous rattling was heard in the bronchial tubes; the pulse continued heavy and oppres- sed ; and the beat of the ventricles was dull and labouring; the surface at the same time exhaled a urinous odour, and no urine was voided. At the end of twelve or twenty hours more, this state was followed either by complete lethargy and coma, or violent and uncontrollable delirium ; the respiration became slow and feeble, or rapid, and with incessant tracheo-bronchial rattling; the surface became cold; the action of the heart still more labouring and oppressed, and without any urine being dis- charged, yet bilious and feculent stools escaping either involun- tarily, or by the use of medicines; the patient, after gasping long in a half-dying state, breathed his last. Nothing can be more anomalous than the whole of this state of reaction, which embraces, as it were, the symptoms of seve- ral different diseases at once; and which, though possessing several common characters, was scarcely in any two patients in all respects the same. These variations occurred not merely