Elements of surgical pathology / by Augustus J. Pepper.

  • Pepper, Augustus J. (Augustus Joseph)
Date:
1890
Catalogue details

Licence: Public Domain Mark

Credit: Elements of surgical pathology / by Augustus J. Pepper. Source: Wellcome Collection.

    72/576 (page 56)
    the blood is suddenly charged with infective matter the natural tonic contraction of the muscles is replaced by a succession of rapidly repeated contractions, over which the patient has little or no control. There are four degrees of this : 1. Fibrillar tremor.—This can be better felt than seen; like the subsultus teudinum, it indicates extreme nervous exhaustion. 2. Rigor.—Here the contraction is more pro- nounced and more general. It is accompanied by a sensation of cold which is subjective, for before the rigor sets in the temperature'has generally risen several degrees. It is the relative coldness of the atmosphere to the heat of the patient's body, which in his febrile state is a highly sensitive thermometer. The mind remains clear, firstly because the disturbance is mainly confined to the motor centres, and secondly because the contractions are not sufficiently vigorous and sustained to fix the chest walls, and so cause cerebral congestion from asphyxia. There may be only an initial rigor; or a succession of rigors. They vary in degree from chattering of the teeth to shaking of the whole body. They are usually followed by profuse perspiration, not alone as a consequence of the rigors, but as a later link in the chain of toxic effects. 3. Edam-ptic convulsions.—These in children take the place of rigors in the adult, for in them there is greater excitability of the nerve centres. Not that adults are exempt from convulsions as the result of high fever. Primary convulsions usually usher in some acute fever, pneumonia; e.g., wlieii they occur later som« grave lesion should be suspected—cerebral embolism, tlirombosis, etc. The contractions are more violent than in rigors. There is loss of consciousness and more or less asphyxia. There are many causes of convulsions, but liere we are only considering those dependent upon tlie pyrexia! state.