Proceedings of the Westminster Medical Society. Nos. 1-3 (session 1848-1849).

  • Westminster Medical Society (London, England)
Date:
[1848-1849]
Catalogue details

Licence: Public Domain Mark

Credit: Proceedings of the Westminster Medical Society. Nos. 1-3 (session 1848-1849). 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.

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    found on the heart, and on the pneiirao-gastric and sympathetic nerves. Dark viscid blood filled the cavities on the right side of the heart; in one or two instances coagula were found. The cavities on the left side were generally nearly empty, containing only a small quantity of thick, black blood. The aorta and its large branches were also neaidy empty. The lungs and pulmonary arteries were gorged with very dark, treacly-looking blood, and spots of ecchymosis were observed, in two or three of the bodies examined, between the pleura and parenchyma of the lungs. In the abdomen there was great venous congestion. In the cava, iliac and portal veins, the blood was black and tenacious. The liver was congested, and the gall-bladder distended with green or dark yellow bile, of a ropy character. The mucous glands of the intestines stood out in bold relief; the agminated and solitary, as well as those of Brunner, being enlai'ged; and the epithelium, in many of the most severe cases, was completely stripped off the mucous membrane. The kidneys, and the whole genito-urinary mucous membrane, were vastly congested, and the bladder much diminished in size. On examining the brain, medulla spinalis, and their envelopes, in the cases which terminated fatally during the algide stage of the disease, with the exception of venous congestion, there was found no particular morbid appearances; whereas, when death had occurred subsequent to the establishment of reaction, great vascular tur- gescence was observed, and in two cases in which coma had existed for some time prior to death, serum was found effused into the ventricles. From the appearances observed after death, from the mode of development of the disease, and from the peculiar character of the symptoms in its successive stages, the author concluded that the organic nervous centres are, if not primarily, at least consentaneously affected with the blood, and that all remedies should be prescribed with reference to this view of the pathology of the disease. He considered it unphilosophical and irrational to apply our remedial agents with a view to check one or other of the isolated symptoms which manifest themselves in the progress of the disease. In speaking of the treatment, the author reviewed the various remedies which have been proposed, and stated his conviction that no known therapeutical measures have any specific poioer of coun- teracting the peculiar agency of the poison. In order to attain even a moderate amount of success in the treatment, he considered it essential that a comprehensive view should be taken of the whole disease, and that special attention should not be directed to any one particular symptom which may show itself during life, or to one particular lesion which may be discovered after death. The dis- ease should not be located in any particular organ, when all are affected; but the leading symi)toms during life, and the prominent morbid lesions most frequently observed after death, should be care- fully noted, and the effects of medicines in modifying the severity of the symptoms watched most attentively.